Borderline personality disorder (original) (raw)
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Issues in Mental Health Nursing, 2020
There is now compelling evidence that a range of psychotherapeutic treatments are effective in the treatment of borderline personality disorder (BPD). Such treatments are often lengthy, expensive, subject to high rates of incompletion and are rarely available to people with sub-threshold symptoms. There is broad agreement that some combination of vulnerability, invalidating environment, childhood adversity, disrupted attachment in childhood or trauma play a role in the aetiology of the syndrome of BPD. These factors also contribute to problems with the capacity to mentalise, regulate emotions, tolerate distress and impact on psychosocial development with or without self-damaging and suicidal behaviour. This column takes as a given that people with BPD should receive evidence-based psychological treatments such as dialectical behaviour therapy (DBT), interpersonal therapy and cognitive behavioural therapy in a sufficient dose to be helpful. However, to avert an escalating trajectory which may lead to a diagnosis of BPD the right dose of the right therapy at the right time is necessary. Under-dosing or ineffective psychotherapy can be potentially harmful. This column reviews the evidence, such as it is, for therapeutic approaches which may contribute to more skilful negotiation of life's difficulties and which may avert deterioration in mental health and quality of life in vulnerable individuals and families.
An Overview on Borderline Personality Disorder
Journal of Pharmaceutical Research International, 2021
Borderline Personality Disorder (BPD) is a psychiatric disease marked by unstable interpersonal relationships, fear of abandonment, difficulty regulating emotions, feelings of emptiness, persistent dysphoria or sadness, impulsivity, and increased risk-taking behaviors. The prevalence of borderline personality disorder has been reported at 11 percent in the psychiatric outpatient community and as high as 20% in the psychiatric inpatient population. Patients with BPD have a high rate of morbidity, which makes medical treatment more difficult. Although the role of genetics in BPD is unclear, inheritance of BPD appears to be considerable. Life events are also found to play a role in the development of BPD. The most important risk factor for the development of BP is childhood trauma. Symptoms that have been present since adolescence or early adulthood and manifest in a variety of settings are used to make the diagnosis. There are no lab or imaging tests available to aid in the diagnosis....
Annals of Psychiatry and Treatment, 2020
Starting from the general concept of “borderline”, the present work focuses on the essential aspects of personality disorder that defi ne the clinical and diagnostic contexts, laying the foundations for a correct differential diagnosis, without neglecting the neural characteristics developed by the scientific community. A new classification model of borderline personality disorder, based on fi ve levels, is proposed. The discussion ends with the best suggested therapeutic approaches.
Etiology, Causative Factors, Diagnosis, & Treatment of Borderline Personality Disorder
2012
Background research and was conducted regarding the etiology, causative factors, diagnostic criteria, and treatment of borderline personality disorder. Proper identification by mental health professionals requires an understanding of how borderline personality is organized as a “stable form of pathological ego structure” that develops in early childhood from a lack of ego integration and the operation of primitive defensive mechanisms such as splitting, projective identification, idealization and devaluation. Because much of what a borderline personality suffers from occurs intrapsychically in the form of feelings of emptiness and depersonalization, traditionally used diagnostic instruments, such as the MMPI-II, routinely fail to diagnose the disorder. As a result, treatment strategies either do not materialize or are ineffective. This paper explores the etiology, causative factors, diagnosis, and treatment of borderline personality disorder.
An Update on Borderline Personality Disorder
Journal of Mood Disorders, 2017
The value and challenges of establishing and maintaining a successful doctor-patient relationship are thrown into sharp relief in the treatment of people with borderline personality disorder. We present an overview of this common and important condition, its epidemiology, cause, common comorbidities and neurological associations. We then propose a practical, psychologically informed framework for enhancing the therapeutic alliance for the jobbing neurologist in managing these patients.
Developments in diagnosis and treatment of people with borderline personality disorder
Current Opinion in Psychiatry, 2020
Purpose of review Borderline personality disorder (BPD) attracts significant attention from clinicians and researchers alike. Despite increased recognition and willingness to diagnose BPD, most effective treatment approaches remain inaccessible to most. We consider recent developments in the diagnosis and treatment of BPD. Recent findings A literature search of EMBASE and PsychINFO, using the search terms 'borderline personality disorder,' 'diagnosis' and 'treatment' for publications since October 2018, yielded over 300 articles and reviews. The literature highlights the increasing awareness of the diagnostic complexity of BPD as well as the emerging significance of 'common factors' and stepped care approaches for managing and treating the disorder. Summary Clinical practice is evolving to embrace more holistic diagnostic approaches, generalist treatment frameworks and stepped-care models that can be tailored to fit individual needs and service resources. The new frontiers in this field include expansion of timely treatment options, improved knowledge regarding the expression and management of BPD in men, adolescents and the elderly, and bridging cultural divides to create a worldwide population approach.
[Diagnosis and treatment of borderline personality disorder: a professionals' survey]
PubMed, 2004
Borderline personality disorder (BPD) is a frequent mental disorder whose affected present high levels of stress and suffering. Diverse diagnostic criteria exist for this disorder. Objective: The objective of our study was to establish which are the most sensitive symptoms to diagnose BPD at the present time together with the expectations and treatments of choice of mental health professionals of Buenos Aires city. Methods: A voluntary auto survey was completed by 116 mental health professionals from private and public institutes of Buenos Aires city . Results: Impulsivity, affective instability and boredom or emptiness were the symptoms referred as the most important to make the diagnosis of BPD. More than half of the people polled reported that the DSM IV was useless to establish the diagnosis of this disorder. Individual psychoanalytic psychotherapy was chosen by the majority of the surveyed as the most important treatment for these patients. Mood stabilizers are the drugs of choice for the pharmacological treatment of impulsivity. Conclusions: It is important to elaborate in our country diagnostic criteria and treatment guidelines that consider the knowledge and local experience with these patients.
Borderline Personality Disorder: A Brief Contemporary Review.
EC Psychology and Psychiatry, 2019
Borderline Personality Disorder (BPD) is a severe mental illness that is correlated with low quality of life, and inadequate psycho-social functioning, at a significantly high cost for society. Historically, BPD has been diagnosed as an unstable and pervasive pattern of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) diagnostic criteria. It is also important to note that many with this disorder are highly intuitive and perceptive. Historically, BPD has been stereotyped as a deteriorating condition. However, contemporary data affords the patient the hope, that combined with their willingness and dedicated application of evidence-based treatments, genuine healing can be theirs. Patients are encouraged to be self-accountable, to make amends to those they have hurt, shift from a learned helplessness and victim mentality, to a more confident, positive, proactive approach to their lives. Families and loved ones are encouraged to seek their own support system, and to engage in the practice of skill building, effective communication, and self-agency. This paper will discuss what is relevant and pertinent to the current diagnosis and treatment of BPD in accordance to the DSM-5. Included, will be current perspectives in diagnosis, assessment and treatment, including an integrative discussion of traditional psychological research and neuroscience.
Archives of general psychiatry, 2011
Borderline personality disorder (BPD) is traditionally considered chronic and intractable. To compare the course of BPD's psychopathology and social function with that of other personality disorders and with major depressive disorder (MDD) over 10 years. A collaborative study of treatment-seeking, 18- to 45-year-old patients followed up with standardized, reliable, and repeated measures of diagnostic remission and relapse and of both global social functioning and subtypes of social functioning. Nineteen clinical settings (hospital and outpatient) in 4 northeastern US cities. Three study groups, including 175 patients with BPD, 312 with cluster C personality disorders, and 95 with MDD but no personality disorder. The Diagnostic Interview for DSM-IV Personality Disorders and its follow-along version (the Diagnostic Interview for DSM-IV Personality Disorders-Follow-Along Version) were used to diagnose personality disorders and assess changes in them. The Structured Clinical Intervi...