Depression and Personality: Conceptual and Clinical Challenges

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Michael Rosenbluth, Sidney H. Kennedy, R. Michael Bagby
American Psychiatric Pub, 2007 M05 3 - 338 pages

Depression and Personality: Conceptual and Clinical Challenges offers an intriguing new look at where we are in understanding the relationship between personality dimensions, disorders, and mood disorder. It is both a cogent update of conceptual models and a clearly written, practical guide to the challenges faced every day by clinicians as they treat patients with depression and bipolar disorder.

Laying the groundwork for subsequent chapters, the editors emphasize the value of not only robust pharmacotherapy augmented by psychosocial interventions (with a focus on the assets rather than the liabilities of a patient's temperament), but also of a detailed review of where we are today.

An introductory overview provides valuable historical perspective on the evolution of personality from "humors" to body constitution and temperament. In 10 informative chapters, 22 contributors discuss The neurobiological dimensions of personality, focusing on affect-related traits as they review the evidence for serotonin and norepinephrine disturbance based on challenge paradigms, and the range of models to understand the interrelationship between personality and depression. The justification for depressive personality in both categorical terms, i.e., adding to the diagnostic armamentarium of DSM-V, and dimensional terms, focusing on the Five Factor Model to provide a link between several facets of neuroticism and depressive personality disorder. The impact of personality on various aspects of treatment, filling in a gap in the pharmacotherapy literature by asserting that personality pathology can affect the patient's capacity to seek, be engaged in, or be compliant with treatment. Key assessment and treatment issues, recommending a multimodal phased treatment approach that involves targeted pharmacotherapy and integrated individual psychotherapy. The role of personality disorder in the assessment and treatment of chronic depression, with a concise, practical overview of medication and psychotherapy issues regarding the role of Axis II disorders, and the complex relationship between bipolar disorder and personality factors. The complexity involved in adolescent depression with personality disorder, providing a conceptual framework for understanding what factors of personality contribute to vulnerability for depression in adolescents, and depression in later life, including particularly relevant issues such as the role of physical illness and organic factors on the clinical presentation of personality and affective disorder

Invaluable reading for clinicians and researchers alike, Depression and Personality: Conceptual and Clinical Challenges offers fascinating perspectives on the historical antecedents, neurobiological dimensions, and conceptual models regarding the relationship between personality and depression.

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Contents

THE PSYCHOBIOLOGY OF PERSONALITY DISORDERS
19
AND EMPIRICAL FINDINGS
43
THE IMPACT OF PERSONALITY ON
97
CLINICAL STRATEGIES FOR EFFICIENT
121
EVALUATING THE CONTRIBUTION OF PERSONALITY
229
THE IMPACT OF PERSONALITY DISORDERS
267
INDEX
293
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Page 246 - Disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment" (American Psychiatric Association, 1994, p.
Page 152 - Beck AT, Epstein N, Brown G, et al: An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56:893-897, 1988 Beck AT, Emery G, Greenberg RL: Anxiety Disorders and Phobias.
Page 223 - Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders.
Page 89 - Clark LA, Watson D, Mineka S: Temperament, personality, and the mood and anxiety disorders. J Abnorm Psychol 103:103-116, 1994 Clark LA, Livesley WJ, Schroeder ML, et al: Convergence of two systems for assessing personality disorder.
Page 41 - Soloff PH, Cornelius J, George A, et al: Efficacy of phenelzine and haloperidol in borderline personality disorder. Arch Gen Psychiatry 50:377-385, 1993 Stein DJ, Simeon D, Frenkel M, et al: An open label trial of valproate in borderline personality disorder.
Page 69 - A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: (1) frantic efforts to avoid real or imagined abandonment.
Page 36 - Evidence for a dysfunctional prefrontal circuit in patients with an impulsive aggressive disorder.
Page 69 - A. A pervasive pattern of depressive cognitions and behaviors beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: ( 1 ) usual mood is dominated by dejection, gloominess, cheerlessness, joylessness, unhappiness (2) self-concept centers around beliefs of inadequacy, worthlessness, and low self-esteem (3) is critical, blaming, and derogatory toward self (4) is brooding and given to worry (5) is negativistic, critical, and judgmental toward...

About the author (2007)

Michael Rosenbluth, M.D., is Assistant Professor of Psychiatry at the University of Toronto and Director of the Psychiatric Rehabilitation Treatment Program at Toronto East General Hospital in Toronto, Ontario.

Sidney H. Kennedy, M.D., is Professor of Psychiatry at the University of Toronto and Psychiatrist-in-Chief of the University Health Network in Toronto, Ontario.

R. Michael Bagby, Ph.D., is Professor of Psychiatry at the University of Toronto and Director of Clinical Research at the Centre for Addiction & Mental Health in Toronto, Ontario.

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