Personality Disorders in Older Adults: Emerging Issues in Diagnosis and Treatment

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  • Edition: 1st
  • Format: Hardcover
  • Copyright: 1999-06-01
  • Publisher: Routledge

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As the average age of the population rises, mental health professionals have become increasingly aware of the critical importance of personality in mediating successful adaptation in later life. Personality disorders were once thought to "age out," and accordingly to have an inconsequential impact on the lives of the elderly. But recent clinical experience and studies underscore not only the prevalence of personality disorders in older people, but the pivotal roles they play in the onset, course, and treatment outcomes of other emotional and cognitive problems and physical problems as well. Clearly, mental health professionals must further develop research methods, assessment techniques, and intervention strategies targeting these disorders; and they must more effectively integrate what is being learned from advances in research and theory into clinical practice. Inspired by these needs, the editors have brought together a distinguished group of behavioral scientists and clinicians dedicated to understanding the interaction of personality and aging. Offering a rich array of theoretical perspectives (intrapsychic, interpersonal, neuropsychological, and systems), they summarize the empirical literature, present phenomenological case reports, and review psychodynamic, cognitive-behavioral, and pharmacological treatment approaches. This comprehensive state-of-the-art guide will be welcomed by all those who must confront the complexity and the challenge of working with this population.

Table of Contents

Contributorsp. ix
Prefacep. xi
Acknowledgmentsp. xii
Conceptual Backgroundp. 1
Conceptual Overview of Personality Disorders In the Elderlyp. 3
Referencesp. 13
Personality and Aging: A Psychotherapist Reflects Late in His Own Lifep. 17
Referencesp. 28
Research and Assessment: Overview and Outcome Measuresp. 29
Personality Disorders in Adults: A Reviewp. 31
Referencesp. 49
Personality Disorders After Age 50: a Meta-Analytic Review of the Literaturep. 55
Acknowledgmentp. 65
Referencesp. 66
Personality Disorders and Treatment Outcomep. 69
Refeencesp. 91
Dimensional Measures and The Five-Factor Model: Clinical Implications and Research Directionsp. 95
Referencesp. 112
Acknowledgmentsp. 112
Determining Personality Disorders in Older Adults Through Self-Identification and Clinician Assessmentp. 119
Referencesp. 132
Conceptual and Methodological Issues in the Assessment of Personality Disorders in Older Adultsp. 135
Acknowledgmentsp. 148
Referencesp. 149
Clinical Issues: Diagnosis and Treatmentp. 151
The Patient-Therapist Relationship and the Psychotherapy of the Older Adult with Personality Disorderp. 153
Referencesp. 171
The Influence of Personality On Reactions of Older Adults To Physical Illnessp. 175
Referencesp. 186
Neuropsychological Contributions to Differential Diagnosis of Personality Disorder in Old Agep. 189
Referencesp. 202
Personality Disorders in Older Adults: Some Issues in Psychodynamic Treatmentp. 205
Referencesp. 214
Cognitive-Behavioral Therapy, Personality Disorders, and The Elderly: Clinical and Theoretical Considerationsp. 215
Referencesp. 225
Pharmacologic Treatment of Personality Disorders in Late Lifep. 229
Referencesp. 251
Systems and Social Issuesp. 255
Personality Disorders and The Difficult Nursing Home Residentp. 257
Referencesp. 272
Ethical Issues in the Clinical Management of Older Adults with Personality Disorderp. 275
Acknowledgmentsp. 286
Referencesp. 287
Afterword: Personality Disorders in Late Life and Public Policy: Implications of the Contextual, Cohort-Based, Maturity, Specific Challenge Modelp. 289
Rfferfncesp. 293
Author Indexp. 295
Subject Indexp. 309
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