Fivos E. Papamalis
The University of Sheffield, Greece
Title: The Clinical Utility of Dimensional Based Conceptualisations for disentangling and treating comorbid disorders
Biography
Biography: Fivos E. Papamalis
Abstract
Many terms are used to describe the population of individuals who have the experience of some form of mental illness along with substance use disorder. The term co-occurring disorders is increasingly being used to describe the phenomena of having multiple clinical syndromes simultaneously. Comorbidity appears to be one of the most challenging issues affecting the course and treatment as it is often associated with lack of treatment engagement, poor retention, impulsive, risky behaviours, frequent crisis, exploiting others, non-compliance with treatment, and greater risk for relapse. Literature indicates that dual diagnosis is the rule rather than the exception in substance misuse treatment. However, high prevalence, overlapping symptomatology and lack of clarity and clear distinction between personality traits and disorders induces important implications in treatment and brings into question its usefulness in treatment planning process. In this line, research evolved towards the recognition that normal and pathological personality is distributed dimensionally and suggest progressive methods of dimensional assessment for measuring personality functioning. Acknowledging individuals’ vulnerability on a trait level, it appears that dysfunction results from their phenotypic expression in the social environment. Individuals’ tendency in selecting, shaping and forming social environments is not just a by-product of their basic pre-dispositions, but rather a result from the constant interaction with the contextual environment and their self-efficacy to develop effective adaptive capacities. Identity integration and development of symbiotic interpersonal relationships are adaptive responses that an individual must develop in order to be functionally integrated in the psychosocial process. Maladjustments in this process influence personality functioning. Beyond the constitutional vulnerability, resilience and malleability of the characteristic adaptations, contextual environment and socialization agents are the naturally regulatory mechanisms that impede or facilitate the psychosocial adaptation process. Thus, contextual environment and socialization agents may play a determining role in facilitating the constructive sublimation of basic tendencies through functional characteristic adaptations