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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Narcissistic personality disorder is rarely the primary reason for people seeking mental health treatment. When people with NPD enter treatment, it is typically prompted by life difficulties or to seek relief from another disorder, such as major depressive disorder, substance use disorders, bipolar disorder, or eating disorders, or at the insistence of relatives and friends. This is partly because individuals with NPD generally have poor insight and fail to recognize their perception and behavior as inappropriate and problematic due to their very positive self-image.
Treatment for NPD is centered around psychotherapy. In the 1960s, Heinz Kohut and Otto Kernberg challenged the conventional wisdom of the time by outlining clinical strategies for using psychoanalytic psychotherapy with clients with NPD that they claimed were effective in treating the disorder. Contemporary treatment modalities commonly involve transference-focused, metacognitive, and schema-focused therapies. Some improvement might be observed through the treatment of symptoms related to comorbid disorders with psychopharmaceuticals, but , according to Elsa Ronningstam, psychologist at Harvard Medical School, "Alliance building and engaging the patient's sense of agency and reflective ability are essential for change in pathological narcissism."
Pattern change strategies performed over a long period of time are used to increase the ability of those with NPD to become more empathic in everyday relationships. To help modify their sense of entitlement and self-centeredness schema, the strategy is to help them identify how to utilize their unique talents and to help others for reasons other than their own personal gain. This is not so much to change their self-perception of their "entitlement" feeling but more to help them empathize with others. Another type of treatment would be temperament change. Psychoanalytic psychotherapy may be effective in treating NPD, but therapists must recognize the patient's traits and use caution in tearing down narcissistic defenses too quickly. Anger, rage, impulsivity, and impatience can be worked on with skill training. Therapy may not be effective because patients may receive feedback poorly and defensively. Anxiety disorders and somatoform dysfunctions are prevalent but the most common would be depression.
Group treatment has its benefits as the effectiveness of receiving peer feedback rather than the clinician's may be more accepted, but group therapy can also contradict itself as the patient may show "demandingness, egocentrism, social isolation and withdrawal, and socially deviant behavior". Researchers originally thought group therapy among patients with NPD would fail because it was believed that group therapy required empathy that NPD patients lack. However, studies show group therapy does hold value for patients with NPD because it lets them explore boundaries, develop trust, increase self-awareness, and accept feedback. Relationship therapy stresses the importance of learning and applying four basic interpersonal skills: "...effective expression, empathy, discussion and problem solving/conflict resolution". Marital/relationship therapy is most beneficial when both partners participate.
No medications are indicated for treating NPD, but may be used to treat co-occurring mental conditions or symptoms that may be associated with it such as depression, anxiety, and impulsiveness if present.
The effectiveness of psychotherapeutic and pharmacological interventions in the treatment of narcissistic personality disorder has yet to be systematically and empirically investigated. Clinical practice guidelines for the disorder have not yet been created, and current treatment recommendations are largely based on theoretical psychodynamic models of NPD and the experiences of clinicians with afflicted individuals in clinical settings.
The presence of NPD in patients undergoing psychotherapy for the treatment of other mental disorders is associated with slower treatment progress and higher dropout rates.
As it has already been mentioned, patients with organic personality disorder show a wide variety of sudden behavioural changes and dysfunctions. There are not a lot of information about the treatment of this mental health disorder. The pharmacological approach is the most common therapy among patients with organic personality disorder. However, the choice of drug therapy relies on the seriousness of patient's situation and what symptoms are shown. The choice and administration of specific drugs contribute to the reduction of symptoms of organic personality disorder. For this reason, it is crucial for patients' treatment to be assessed by clinical psychologists and psychiatrists before the administration of drug.
Additionally, the dysfunctions in expression of behaviour of patients with organic personality disorder and the development of symptom of irritability, which are caused by aggressive and self-injurious behaviours, can be dealt with the administration of carbamazepine. Moreover, the symptoms of this disorder can be decreased by the administration of valproic acid. Also, emotional irritability and signs of depression can be dealt with the use of nortriptyline and low-dose thioridazine. Except from the symptom of irritability, patients express aggressive behaviours. At the onset of drug therapy for effective treatment of anger and aggression, the drug of carbamazepine, phenobarbital, benztropine and haloperidol can be administrated in order to reduce the symptoms of patients with organic personality disorder. In addition, the use of propranolol may decrease the frequent behaviours of rage attacks.
Finally, it is important for patients to take part in psychotherapy sessions during the period of drug therapy. In this way, there is prevention and patients can be protected by negative effects of drugs on their organism and their behaviour. Furthermore, the clinicians can provide useful and helpful support to patients during these psychotherapy sessions. Thus, the combination of drug therapy with psychotherapy can lead to the reduction of symptoms of this disorder and the improvement of patients' situation.
A fixed fantasy — also known as a "dysfunctional schema" — is a belief or system of beliefs held by a single individual to be genuine, but that cannot be verified in reality. The term is typically applied to individuals suffering from some type of psychiatric dysregulation, most often a personality disorder.
The term is also used in the different context of psychoanalysis to distinguish between 'a normal transitory one and a fixed fantasy' with respect to the phantasised 'fulfilment in conscious or unconscious thought of the sexualised wish'.
The FDA has approved one medication for the treatment of disorders of female libido, flibanserin.
Otherkin largely identify as mythical creatures, with others identifying as creatures from fantasy or popular culture. Examples include: angels, demons, dragons, goats, elves, fairies, sprites, aliens, and cartoon characters. Many otherkin believe in the existence of a multitude of parallel universes, and their belief in the existence of supernatural or sapient non-human beings is grounded in that idea.
With regards to their online communities, otherkin largely function without formal authority structures, and mostly focus on support and information gathering, often dividing into more specific groups based on kintype. There are occasional offline gatherings, but the otherkin network is mostly an online phenomenon.
Some otherkin (such as elvenkin) state they are allergic to iron (and products of modern technology), while others (such as dragonkin) state that having no allergies is a sign of otherkin condition. Some otherkin also claim to be especially empathic and attuned to nature. Some state to be able to shapeshift mentally or astrally, meaning that they experience the sense of being in their particular form while not actually changing physically.
The therian and vampire subcultures are related to the otherkin community, and are considered part of it by most otherkin, but are culturally and historically distinct movements of their own, despite some overlap in membership.
Otherkin are a subculture who socially and spiritually identify as partially or entirely non-human. Some of them surmise that they are, either spiritually or genetically, not human; however, this claim is unsubstantiated. This is explained by some members of the otherkin community as possible through reincarnation, having a non-human soul, ancestry, or symbolic metaphor. Some scholars categorize this identity claim as "religious", because it is largely based on supernatural beliefs. Adherents more typically deny the religiosity of otherkinism, referring to it instead as simply a congenital condition, or a metaphysical state of being.
Studies of borderline children often uncovered at the base of their self-destructive behaviour patterns ' a "fixed fantasy"...a rigid, nonreflective scenario of self-induced pain'. As part of a psychic defence mechanism, 'the omnipotence betrayed by the "fixed fantasy" underlying self-victimization or other forms of self-defeating behaviour...creates the illusory sense that they are actively producing the abandonment [&] pain', rather than merely suffering it passively - 'arranging deceits..arrang[ing] for blows to fall'. Unfortunately 'in the course of development, these patterns acquire multiple adaptive functions...and serve as a key organizer of their sense of self'.
'In producing movement away from fixed fantasy systems, commonplace statements are often necessary because the more fixed and extensive the fantasy system, the fewer the transitional opportunities offered; there is little conflicting material to ride. Banalities may be the only resource', as anything more complex may be used to feed back into the fantasy system itself.
Money disorders are the maladaptive patterns of financial beliefs and behaviors that lead to clinically significant distress, impairment in social or occupational functioning, due to financial strain or an inability to appropriately enjoy one’s financial resources. With the exception of pathological gambling and compulsive buying, psychology and the mental health fields have largely neglected dysfunctional money disorders. The term is contentious among mental health professionals and as of 2017, money disorder is not a clinical diagnosis in either the DSM or ICD medical classifications of diseases and medical disorders.
Types of behaviors, or “scripts”, related to money disorders include money avoidance, money worship, money status and money vigilance. Some mental health practitioners say that those afflicted with money disorders or who have problematic money beliefs can seek financial therapy. With financial therapy, financial planners and relationship therapists work together to provide comprehensive treatment to clients experiencing financial distress.
Codependency is a type of dysfunctional helping relationship where one person supports or enables another person's drug addiction, alcoholism, gambling addiction, poor mental health, immaturity, irresponsibility, or under-achievement. Among the core characteristics of codependency, the most common theme is an excessive reliance on other people for approval and a sense of identity.
Given its grassroots origin, the precise definition of codependency varies based on the source but can be generally characterized as a subclinical and situational or episodic behavior similar to that of dependent personality disorder. In its broadest definition, a codependent is someone who cannot function from their innate self and whose thinking and behavior is instead organized around another person, or even a process, or substance. In this context, people who are addicted to a substance, like drugs, or a process, like gambling or sex, can also be considered codependent. In its most narrow definition, it requires one person to be physically or psychologically addicted, such as to heroin, and the second person to be psychologically dependent on that behavior. Some users of the codependency concept use the word as an alternative to using the concept of dysfunctional families, without statements that classify it as a disease.
Treatment by a physician involves assessing parental competence, and whether the parents set limits correctly and consistently. Physicians should rule out dysfunction in the family, referring dysfunctional families for family therapy and dysfunctional parents for parenting skills training, and counsel parents in methods for modifying their child's behavior.
Some scholars believe that codependency is not a negative trait, and does not need to be treated, as it is more likely a healthy personality trait taken to excess. Codependency in nonclinical populations has some links with favourable characteristics of family functioning.
Stan Katz states that codependence is over-diagnosed, and that many people who could be helped with shorter-term treatments instead become dependent on long-term self-help programs. The language of, symptoms of, and treatment for codependence derive from the medical model suggesting a disease process underlies the behavior. However, there is no evidence that codependence is caused by a disease process.
In their book, “Attached.”, Dr. Amir Levine and Rachel S. F. Heller, address what they call the “codependency myth” by asserting that attachment theory is a more scientific and helpful model for understanding and dealing with attachment in adults.
Low frustration tolerance (LFT), or "short-term hedonism" is a concept utilized to describe the inability to tolerate unpleasant feelings or stressful situations. It stems from the feeling that reality should be as wished, and that any frustration should be resolved quickly and easily. People with low frustration tolerance experience emotional disturbance when frustrations are not quickly resolved. Behaviors are then directed towards avoiding frustrating events which, paradoxically, leads to increased frustration and even greater mental stress.
In REBT the opposite construct is "high frustration tolerance".
In early infancy, a baby seeks food, contact, and comfort by crying. This behavior should be viewed as a distress signal indicating that some biological need is not being met. Although parents sometimes worry about spoiling their children by giving them too much attention, specialists in child development maintain that babies cannot be spoiled in the first six months of life. During the first year, children are developing a sense of basic trust and attachment. In general, the more attention and care they receive from their parents, the better.
There are several subtypes of female sexual arousal disorders. They may indicate onset: lifelong (since birth) or acquired. They may be based on context: they may occur in all situations (generalized) or be situation-specific (situational). For example, the disorder may occur with a spouse but not with a different partner.
The length of time the disorder has existed and the extent to which it is partner- or situation-specific, as opposed to occurring in all situations, may be the result of different causative factors and may influence the treatment for the disorder. It may be due to psychological factors or a combination of factors.
Organic personality disorder (OPD) is not included in the wide variety of group of personality disorders. For this reason, the symptoms and diagnostic criteria of the organic personality disorder are different from those of the mental health disorders, which are included in this various group of personality disorders. According to the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems ICD-10, it defines the organic personality disorder as the personality change, which can be caused by traumatic brain injury (TBI) that means there are specific brain areas of patients, which have been injured after a very strong accident. Moreover, according to the ICD-10, the organic personality disorder is associated with a "significant alteration of the habitual patterns of premorbid behaviour". Furthermore, organic personality disorder is associated with "personality change due to general medical condition". There are crucial influences on emotions, impulses and personal needs because of this disorder. Thus, all these definitions about the organic personality disorder support that this type of disorder is associated with changes in personality and behaviour.
As autotopagnosia arises from neurological and irreversible damage, options regarding symptom reversal or control are limited. As of April 2010, there are no known specific treatments for autotopagnosia.
No medications or pharmaceutical remedies have been approved by the U.S. Food and Drug Administration to treat or cure autotopagnosia. There have been cases in which extensive rehabilitation has been beneficial following restitution, repetitive training to correct the impaired function, and compensation of other skills to make up for the deficit. Rehabilitation is not a definitive treatment and only shows signs of slight improvement in a small percentage of autotopagnosia patients. The condition of the disease can be monitored with continued neurological examination and using a CT scan to note the progression of the parietal lesion.
The frustration discomfort scale (FDS), a multidimensional measure for LFT, was developed using REBT theories.
These dimensions were labelled in four categories:
1. Emotional intolerance, involving intolerance of emotional distress.
2. Entitlement, involving intolerance of unfairness and frustrated gratification.
3. Discomfort intolerance, involving intolerance of difficulties and hassles.
4. Achievement, involving intolerance of frustrated achievement goals.
Indifference to illness may have an adverse impact on a patient's engagement in neurological rehabilitation, cognitive rehabilitation and physical rehabilitation. Patients are not likely to implement rehabilitation for a condition about which they are indifferent. Although anosognosia often resolves in days to weeks after stroke, anosodiaphoria often persists. Therefore, the therapist has to be creative in their rehabilitation approach in order to maintain the interest of the patient.
Since the underlying cause of the disorder is damage to the brain, at present ideational apraxia is not reversible. However, Occupational or Physical Therapy may be able to slow the progression and help patients regain some functional control, with the treatment approach being the same as that of ideomotor apraxia. Some recovery may occur in younger patients after stroke, because brain plasticity may allow the functions of these damaged regions to be remapped. As patients develop new behaviors to cope with their apraxia, their brain's functioning neurons may take on some of the functions of the dead or damaged regions.
In the context of dementia, apraxia is a major cause of morbidity, and progresses with the underlying disease sometimes to the extent that patients may be unable to feed themselves or use simple utensils. Patients often become highly dependent or require nursing home placement because of their inability to properly use objects.
Brain imaging techniques such as fMRI, EEG, and PET scans may help in understanding the neuroanatomical and computational basis of ideational apraxia. Understanding these mechanisms is likely to be crucial in developing new modes of therapy to help patients cope with their disorder.
The current diagnostic criteria for MCDD are a matter of debate due to it not being in the DSM-IV or ICD-10. Various websites contain various diagnostic criteria. At least three of the following categories should be present. Co-occurring clusters of symptoms must also not be better explained by being symptoms of another disorder such as experiencing mood swings due to autism, cognitive difficulties due to schizophrenia, and so on. The exact diagnostic criteria for MCDD remain unclear but may be a useful diagnosis for people who do not fall into any specific category. It could also be argued that MCDD is a vague and unhelpful term for these patients.
Multiple complex developmental disorder (MCDD) is a research category, proposed to involve several neurological and psychological symptoms where at least some symptoms are first noticed during early childhood and persist throughout life. It was originally suggested to be a subtype of autistic spectrum disorders (PDD) with co-morbid schizophrenia or another psychotic disorder; however, there is some controversy that not everyone with MCDD meets criteria for both PDD and psychosis. The term "multiplex developmental disorder" was coined by Donald J. Cohen in 1986.
As autotopagnosia is not a life-threatening condition it is not on the forefront of medical research. Rather, more research is conducted regarding treatments and therapies to alleviate the lesions and traumas that can cause autotopagnosia. Of all the agnosias, visual agnosia is the most common subject of investigation because it is easiest to assess and has the most promise for potential treatments. Most autotopagnosia studies are centered on a few test subjects as part of a group of unaffected or “controlled” participants, or a simple case study. Case studies surrounding a single patient are most common due to the vague nature of the disease.
Tactile hallucination is the false perception of tactile sensory input that creates a hallucinatory sensation of physical contact with an imaginary object. It is caused by the faulty integration of the tactile sensory neural signals generated in the spinal cord and the thalamus and sent to the primary somatosensory cortex (SI) and secondary somatosensory cortex (SII). Tactile hallucinations are recurrent symptoms of neurological diseases such as schizophrenia, Parkinson's disease, Ekbom's syndrome and delerium tremens. Patients who experience phantom limb pains also experience a type of tactile hallucination. Tactile hallucinations are also caused by drugs such as cocaine and alcohol.
Given the complexity of the medical problems facing ideomotor apraxia patients, as they are usually suffering from a multitude of other problems, it is difficult to ascertain the impact that it has on their ability to function independently. Deficits due to Parkinson's or Alzheimer's disease could very well be sufficient to mask or make irrelevant difficulties arising from the apraxia. Some studies have shown ideomotor apraxia to independently diminish the patient's ability to function on their own. The general consensus seems to be that ideomotor apraxia does have a negative impact on independence in that it can reduce an individual's ability to manipulate objects, as well as diminishing the capacity for mechanical problem solving, owing to the inability to access information about how familiar parts of the unfamiliar system function. A small subset of patients has been known to spontaneously recover from apraxia; this is rare, however. One possible hope is the phenomenon of hemispheric shift, where functions normally performed by one hemisphere can shift to the other in the event that the first is damaged. This seems to necessitate, however, that some portion of the function is associated with the other hemisphere to begin with. There is dispute over whether the right hemisphere of the cortex is involved at all in the praxis system, as some evidence from patients with severed corpus callosums indicates it may not be.
Although there is little that can be done to substantially reverse the effects of ideomotor apraxia, Occupational Therapy can be effective in helping patients regain some functional control. Sharing the same approach in treating ideational apraxia, this is achieved by breaking a daily task (e.g. combing hair) into separate components and teaching each distinct component individually. With ample repetition, proficiency in these movements can be acquired and should eventually be combined to create a single pattern of movement.