Discussion – Personality Disorders
Antisocial Personality Disorder (ASPD)
Treating individuals with ASPD and Substance Use Disorder (SUD) is particularly challenging due to their pervasive pattern of disregard for the rights of others and impulsivity. These individuals often lack motivation for treatment and may engage in manipulative or deceitful behaviors, making therapeutic alliances difficult to establish (Seid et al., 2022). For example, someone with ASPD and a heroin addiction may frequently miss appointments or attempt to manipulate the system to obtain medications. The focus should be on structured treatment settings and consistent boundaries.
Borderline Personality Disorder (BPD)
Individuals with BPD and SUD present unique challenges due to their emotional instability, fear of abandonment, and impulsive behaviors. These traits make an individual an unreliable client when it comes to adhering to treatment recommendations and stability in life (Sharan et al., 2023). For instance, a patient who has both BPD and alcohol dependence will experience mood swings and self-harm, which may necessitate urgent and vigorous treatment approaches. Dialectical Behavior Therapy can be effective in treating these dual disorders because its main goals are to manage emotions and achieve interpersonal success.
Narcissistic Personality Disorder (NPD)
Treating NPD and SUD is complicated by the individual’s grandiosity, need for admiration, and lack of empathy. These traits can lead to denial of the addiction because of becoming easily defensive and finding someone else to blame for all of their woes. For instance, an NPD client with cocaine dependency may have to decline group psychotherapy sessions because they are considered to be debasing (Weinberg & Ronningstam, 2022). Motivational Interviewing (MI) can be useful in such cases since it supports the awareness of the consequences of the behavior and promotes change from within. Further, it is effective to use individual psychotherapy focused on such aspects of narcissism and their relation to substance consumption.
References
Seid, M., Anbesaw, T., Melke, S., Beteshe, D., Mussa, H., Asmamaw, A., & Shegaw, M. (2022). Antisocial personality disorder and associated factors among incarcerated individuals in Dessie city correctional centre, Dessie, Ethiopia: A cross-sectional study. BMC Psychiatry, 22(1). https://doi.org/10.1186/s12888-022-03710-y
Sharan, P., Das, N., & Hans, G. (2023). Clinical practice guidelines for assessment and management of patients with borderline personality disorder. Indian Journal of Psychiatry, 65(2), 221–237. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_495_22
Weinberg, I., & Ronningstam, E. (2022). Narcissistic personality disorder: Progress in understanding and treatment. FOCUS, 20(4), 368–377. https://doi.org/10.1176/appi.focus.20220052
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Question 
Discussion – Personality Disorders
Personality Disorders are often also associated with dual diagnosis. Antisocial, Borderline, etc. Personality Disorders can make treatment extremely difficult. Please pick at least 3 Personality Disorders and explain your thoughts on the challenges of treating individuals dually diagnosed with a Personality Disorder and a Substance Use Disorder. Please be sure to provide examples to support your claims.