STEPPS for Over-Controlled and Under-Controlled Emotional Dysregulation in Older Adults with Personality Disorders: A Case Study.

OBJECTIVES

This paper aims to present a clinical illustration of under-controlled and over-controlled emotional dysregulation behaviors in older adults with personality disorders (PD). Furthermore, another aim is to explore how Systems Training for Emotional Predictability and Problem Solving for Older Adults (STEPPS-OA) can be useful for both types of emotional dysregulation.

METHODS

A 65-year-old woman with emotional under-control and a 67-year-old woman with emotional over-control participated in STEPPS-OA. STEPPS-OA is a treatment program consisting of 21 weekly group sessions, individual sessions and support group meetings.

RESULTS

The participant with under-control struggled with impulsivity and destructive behaviors. She learned to use techniques to recognize the buildup of tension and manage emotions. The participant with over-control struggled with difficulties in differentiating and expressing emotions. She learned to use techniques to recognize suppressed feelings and began practicing assertive behaviors.

CONCLUSIONS

Emotional dysregulation can occur from either over-controlled or under-controlled behaviors in older adults with PD. STEPPS-OA seems to be a promising treatment option for both types of behavior because the interventions seem to fit both cases.

CLINICAL IMPLICATIONS: STEPPS-OA is a promising treatment option for older adults with PD and emotional over-controlled and under-controlled behaviors.