Isabel Nino-de-Guzman
The Meadows, USA
Keynote: Clin Psychiatry
Abundant theoretical and empirical literature has demonstrated the need for specialized treatment for patients with dual disorders involving addictive conditions and mental illness. First, dual disorders can develop concurrently or independently at different times. Second, the bi-directional and complex relationship between addictive disorders and other severe clinical conditions exacerbates the severity or risk of developing the other, and symptoms of one may worsen as the direct or indirect result of the other. Third, specific clinical constellations have been identified on patients who are treated for hypersexual disorders co-occurring with other disorders. Regardless of what condition dominates the clinical picture, or at what end of the spectrum the patient is, each condition seems to affect treatment outcomes and relapse risk. Research also suggests the co-occurrence between hypersexual disorders, alcohol and substance related disorders, mental, and the need of specific paths for treatment with psychotherapy and Twelve-Step programs. In fact, dual disorders can be treated separately or sequentially, but most effective approaches are integrative and consider the dynamic presentation of the clinical conditions. Specifically, empirical evidence suggests the need for specific treatment considerations on individuals with hypersexual and addictive disorders involving compulsive constellations with negative emotionality, high dysphoria and increased depression, anxiety, and distress. Studies also indicate that treatment for those characterized by impulsive constellations involving social irresponsibility, defiance and intolerance, and highly excitatory neurobiological processes. Moreover, recent research reveals the need for conceptualizing addictive cases from a systemic dynamic approach not only considering the interaction between psychopathological factors, but the clinical constellations. Thus, personality traits that can moderate the severity of a clinical disorder co-occurring with addictive problems can be otherwise highly dysfunctional depending on the interaction among these (e.g., hypersexuality, alcohol use disorder, and dependent and antisocial personality tendencies, versus the same constellation without the dependent tendencies). The current study examines testing data on 500 patients who were seeking inpatient treatment for hypersexual disorders concurrent with alcohol and substance-related disorders. Such patients also met criteria for different clinical disorders, according to results from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Factor analysis was utilized to reduce variables into two factors representing impulsive and compulsive constellations, and to explore relationships between factors, hypersexual behaviors, and addictive syndromes. Two cases are analyzed in depth to illustrate specific treatment approaches depending on the clinical configurations that were identified in each case. Empirically-based techniques along with ecological and systemic interventions are discussed.
Isabel Nino-de-Guzman is a Clinical Psychologist from Peru, where she was involved in academia as a full Professor and Researcher at Pontificia Universidad Catolica del Peru. She is the author and co-author of several papers on reputed journals. She has worked for renowned treatment programs for addiction treatment in the United States, including Pine Grove and Hazelden Foundation. She conducted the first study utilizing latent cluster analysis to identify patterns of interaction between sexual addiction, mental health disorders, and maladaptive personality patterns. She currently works as Clinical Psychologist and Clinical Supervisor for Gentle Path at The Meadows in Arizona, the nation's premier program for treating trauma, alcohol, sex and drug addiction, and comorbid disorders. She treats patients reporting severely compulsive and addictive sexual patterns and other mental disorders. She performs highly specialized psychosexual assessments on such individuals and utilizes multi-modal individual and group techniques to help these persons to overcome mental disabilities and personal dysfunctions.
E-mail: Ideguzman@gentlepathmeadows.com
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