Personality Disorders and AgingLive webinar held April 24, 2014
Attendees were required to have a computer with access to high speed internet (to view the slide presentation) and computer speakers OR access to a telephone. Additional information was provided through the registration form.
Lindsey Slaughter, PsyD
Lindsey Slaughter, PsyD,is a licensed clinical psychologist and Psychology Director at Piedmont Geriatric Hospital in Burkeville, VA. Before assuming the director-ship, she served as a team psychologist on the admissions unit of this state psychiatric hospital solely servicing those 65 and older with severe mental illness and/or dementia. Areas of passion include healthy and successful aging, assessment (such as decision-making, cognitive, personality), and cultural competency. She also enjoys facilitating trainings on various topics such as older adults and behavioral management and working with older adults diagnosed with personality disorders, and supervising graduate level trainees.
She completed her Doctorate of Psychology at Wright State University’s School of Professional Psychology and her internship at Howard University’s Counseling Center. Dr. Slaughter’s other clinical experiences included working in university counseling centers, in outpatient practice, and other inpatient psychiatric hospitals with civil and forensic patients.
E. Ayn Welleford, PhD
E. Ayn Welleford, PhD,received her BA in Management/Psychology from Averett College, M.S. in Gerontology and PhD in Developmental Psychology from Virginia Commonwealth University. She has taught extensively in the areas of Lifespan Development, and Adult Development and Aging, Geropsychology, and Aging & Human Values. As an educator, researcher, and previously as a practitioner she has worked with a broad spectrum of individuals across the caregiving and long term care continuum.
As Associate Professor and Chair of VCU’s Department of Gerontology, she currently works to “Improve Elder Care through Education” through her Teaching, Scholarship, and Community Engagement. Outside of the classroom, Dr. Welleford provides community education and serves on several boards and committees.
Dr. Welleford is former Chair of the Governor’s Commonwealth of Virginia Alzheimer’s and Related Disorders Commission, as well as a recipient of the AGHE Distinguished Teacher Award. In 2011, Dr. Welleford was honored by the Alzheimer’s Association at their annual Recognition Reception for her statewide advocacy. Dr. Welleford is the author of numerous publications and presentations given at national, state and local conferences, community engagement and continuing education forums. In 2012, Dr. Welleford was appointed to the Advisory Board for VCU’s West Grace Village project. She is also the recipient of the 2012 Mary Creath Payne Leadership Award from Senior Connections, the Capital Area Agency on Aging.
The webinar was recorded.
QUESTIONS POSED AND UNANSWERED DURING THE EVENT
We thank Dr. Slaughter for the additional time taken to respond to these audience-posed questions.
Q: What are you considering "Older Adults" here?
Q: What approach would you take with OA that is depressed, combative, dependent on spouse but shows none of these signs when seeing physician?
Q: What are the best current successful practices with schizophrenia?
Q: We need a sequel to this training.
Q: I would love to see a webinar on PD, Aging and determining capacity.
Q: Should PRN psychoactive medication be prescribed for older adults?
Q: Reference data was dated 15 years ago. Any research that is more current?
Q: Is medication effective for Dysthymia?
Q: How would you suggest differentiating OA paranoia in a personality disorder from psychotic paranoia? Generational knowledge gaps such as fear of technology and others? But i could be lack of knowledge or miss information. "Cell phones will melt your brain if you use them."
Q: How can you motivate a client who is borderline, narcissistic, a pathological liar, medically unstable and unsafe at home and speaks although she speaks eloquently, is resistant to follow through and self care?
Q: How can one relate to an OA who has cycles of behaviors unlike their usual self.
Q: How can CBT work for persons with dementia?
Q: Could it be possible the beginning research in the Webinar may be a bit different for the general population vs. the population some of us serve, APS, including more persons with Mental Health diagnosis, etc? Thanks.
Q: Any other thoughts when persons refuse all efforts to offer Mental Health Services, may need Mental Health vs APS.
Q: Can you speak to reporting requiring. When should APS be called?
Q: tx team and family reinforcement of modeling positive behvaiors and validation of emotional responses seems to be very important in managaing the OA with PD
Q: Can one fit into more than one Cluster?
Q: At what point do you assign a diagnosis?
Q: What was the possible diagnosis for cluster A case vignette?
Q: are people with PD more likely to develop combative behaviors and other issues of impaired impulse control with the onset of dementia?
Q: Are most older adults with personality disorde never formally diagnosed?
BIBLIOGRAPHY and RESOURCES for the FUTURE
Jarrett, C. (2006). Understanding personality disorder. The Psychologist, 19, 7, 402-404.
Widiger, T. and Trull, T. (2007). Plate tectonics in the classification of personality disorder: Shifting to a dimensional model. American Psychologist, 62, 2, 71-83.
WHERE DO THEY COME FROM?
Bradley, R., Heim, A., and Westen, D. (2005). Personality constellations in patients with a history of childhood sexual abuse. Journal of Traumatic Stress, 18,6, 769-780.
Mitchell, S. & Black, M. (1995). Freud and beyond: A history of modern psychoanalytic thought. New York: Basic Books.
HOW CAN WE BEST ASSESS PATIENTS WITH PDs?
Van Alphen, S., Engelen, G., Kuin, Y., Hojtink, A., and J., Derksen (2006). A preliminary study of the diagnostic accuracy of the Gerontological Personality Disorders Scale (GPS). International Journal of Geriatric Psychiatry, 21, 862-868.
HOW CAN WE BEST TREAT PATIENTS WITH PDs?
McCann, R. & Ball, E. (2001). Borderline personality disorder. In A.M. and J.L. Jacobson (Eds.) Psychiatric Secrets, Hanley and Belfus, Inc. Philadelphia, PA.
McCann, R. & Ball, E. (2001). Antisocial personality disorder. In A.M. and J.L. Jacobson (Eds.) Psychiatric Secrets, Hanley and Belfus, Inc. Philadelphia, PA.
Abrams, R.C. & Bromberg, C.E. (2007). Personality disorders in the elderly. Psychiatric Annals, 37, 2, 123-127.
Balsis, S., Segal, D. L., Donahue, C. (2009). Revising the personality disorder diagnostic criteria for the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V): consider the later life context. American Journal of Orthopsychiatry, 79, 4, 452-460.
Greve, K., Curtis, K., Bianchini, K, and Collins, B. (2004). Personality disorder masquerading as dementia: a case of apparent Diogenes syndrome. International Journal of Geriatric Psychiatry, 19, 701-705.
Marley, J. & Fung, R. (2013). Debate: are we overlooking personality disorder in older people? Old Age Psychiatrist, 55, 1-8.
Mordekar, A. & Spence, S.A. (2008). Personality disorder in older people: how common is it and what can be done? Advances in Psychiatric Treatment, 14, 71-77.
O’Leary, D., Jyringi, D., and Sedler, M. (2005). Childhood conduct problems, stages of Alzheimer’s disease, and physical aggression against caretakers. International Journal of Geriatric Psychiatry, 20, 401-405.
Oltmanns, T. F. & Balsis, S. (2011). Personality disorders in later life: questions about the measurement, course, and impact of disorders. Annual Review Clinical Psychology, 27, 7, 1-29.
Segal, D., Coolidge, F., and Rosowsky, E. (2006). Personality Disorders and Older Adults: Diagnosis, Assessment, and Treatment. Hoboken, New Jersey: John Wiley & Sons, Inc.
Van Alphen, et al. (2006). The relevance of a geriatric sub-classification of personality disorders in the DSM-V. International Journal of Geriatric Psychiatry, 21, 205-209.