Abstract This paper examines looks at the European and American methods of diagnosing Borderline Personality Disorder. The author covers several areas including it's definition, symptoms, history and possible reasons for its occurrence. Particular attention is paid to the knowledge that it is one of the most controversial diagnoses in psychology, and what affect this has had on anyone seeking treatment for this disorder.
From the Paper "These people have a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. They have a markedly and persistently unstable self-image; recurrent self mutilating or suicidal behavior, gestures or threats and chronic feelings of emptiness. They have difficult controlling anger, and show inappropriate, intense anger. They Transient, stress related paranoid ideation or severe disassociate symptoms. Borderline personality is usually accompanied by "symptom disorders" such as eating disorder, depression, post-traumatic stress disorder, premenstrual tension, dissociative disorder or anxiety disorder."
Abstract The basis of this study looks at the effects of a therapy derived from eastern Zen practices and western psychodynamic theory, known as Dialectical Behavioral Therapy, on the treatment of patients afflicted with Borderline Personality Disorder. DBT is a treatment paradigm created by Marsha M. Linehan of Washington University, and is the first and only treatment paradigm to be tested in clinical settings. The importance of DBT stems from the belief that BPD is the most treatment-resistant of all mental disorders outlined in the Diagnostic and Statistical Manual: Vol. IV. The study tests the hypothesis that DBT will effectively reduce targeted behaviors of BPD as compared to treatment as usual (TAU) groups, and suggests that because of the structured nature of DBT, it is the most effective of all present treatments of BPD.
From the Paper "Dialectical Behavior Therapy (DBT) is the application of a broad array of cognitive and behavior therapy strategies to the problems of Borderline Personality Disorder (BPD), including suicidal behaviors (Heard & Linehan 1994). DBT also has a number of distinctive defining characteristics. As its name suggests, its overriding characteristic is an emphasis on "dialectics" - that is, the reconciliation of opposites in a continual process of synthesis. The most fundamental dialectic is the necessity of accepting patients just as they are within a context of trying to teach them to change. This emphasis on acceptance as a balance to change flows directly from the integration of Eastern Zen practice with Western psychodynamic theory (Linehan 1993a)."
Abstract This paper looks at borderline personality disorder. It presents information as to the definition of and core clinical features associated with the disorder, followed by a discussion as to etiology of the disorder. It reviews information regarding the symptoms associated with borderline personality disorder and prevalence estimates. After this, the criteria necessary for diagnosis are reviewed, followed by a discussion of treatment issues that have been found to be associated with the disorder. It examines treatment approaches and related outcome studies and also looks at use of dialectical behavior therapy and the potential this approach offers in generating successful outcomes for individuals suffering from borderline personality disorder.
Outline
Definition and Core Clinical Features
Etiology
Symptoms and Prevalence
Diagnosis
Treatment Issues
Traditional Treatment Approaches
Dialectical Behavior Therapy
Conclusions
From the Paper "According to Barron (1998), symptoms exhibited by the person with BPD include a persistent pattern of instability regarding self-image, interpersonal relationships, and mood. The disorder results in a continual identity disturbance manifested by uncertainty regarding life issues such as self-concept, sexual orientation, long-term goals, career choices, relationships, and life values (Barron, 1998). According to the APA (2000), affective instability is common in BPD and may be evidenced by shifts in mood from baseline to depression, irritability, or anxiety. These emotional states may last a few hours or, in rare cases, several days. People with BPD often display intense and inappropriate anger expressed through outbursts of temper or physical fights."
Abstract This paper looks at the book, "Girl, Interrupted," which is the autobiographical account of Susanna Kaysen's life just after her graduation from high school in the late 1960s. The movie, is an adaptation of the book. The author reviews both works, which deal with a woman with borderline personality disorder, one of the most common, and misdiagnosed types of mental illness facing women.
From the paper:
"Another anecdote from the book that meets the DSM-IV criteria for diagnosis of borderline personality disorder is Susanna's dissociative episode. One day while simply sitting in a chair in the common room at the hospital, Susanna had the random notion that she had no bones in her hand. Susanna instantly, and for no apparent reason, became completely convinced that there were no bones in her hand. She was thus immensely disturbed and resolved to bite down on her hand until it bled in an attempt to get all the way down to the bone. Susanna felt as though she must see her bones to know that they are there and she refused to take anyone's word for it. This psychotic episode seems as though it may also be tied to a feeling of emptiness."
Abstract This paper presents the work of many researchers who have studied the connection between childhood abuse and the development of borderline personality disorder. The author believes that chronic abuse leads to dysfunction in the processes of ego and personality development, attachment and affective stability. The paper concludes that the traumatic effects of physical and sexual abuse on the development of borderline personality disorder need to be examined in light of other potential etiological factors such as genetic predisposition, neurotransmitter imbalances, and other avenues that are currently receiving attention in the BPD research community. Abstracts and excerpts from Articles.
Table of Contents
Introduction
Abuse and BPD Statistics
Physical and Sexual Abuse
Conclusions
From the Paper "Wilkins has also found that the chaotic behavior associated with borderline women is a reaction to traumatic experiences. Unable to gain security from their relationships, a dysfunction of the attachment system occurs. The symptoms associated with BPD diagnosis, therefore, can be seen as a reaction to early relationships with significant others, perceived trauma, and experiences of real abuse, which are then internalized. The adaptive behavior of the borderline adult is a direct consequence of the messages received in childhood. They frantically seek to avoid further abandonment and isolation."
Abstract This paper explains that individuals with Borderline Personality Disorder (BPD) are afflicted with a continual state of emotional conflict and chaos, often swinging from one extreme of emotion to another. Patients with BPD are traditionally known to exhibit symptoms of depression, anger and anxiety at varying times and traditionally demonstrate self injurious behavior. The paper contends that the road to treatment and recovery is often a different one, as traditional psychotherapeutic approaches often fail treating patients with BPD. The paper presents recent evidence that suggests that an integrative approach for treating BPD is best. This type of approach would combine cognitive behavioral therapy, pharmacological intervention and traditional psychotherapy techniques to find the best possible outcome for BPD patients.
Outline
Introduction
DSM-IV for Borderline Personality Disorder
Cognitive Behavioral Perspective
Conclusions
From the Paper "Because borderline personality disorder is complex in nature and difficult to label, differential diagnostic criteria and theoretical orientations have been established for assessing the disorder (Cottrell & Jones, 2000). Thus a therapist might encounter differing behavioral, symptomatic and psychodynamic formulations and findings that form the basis of diagnostic categorization of BPD (Cottrell & Jones, 2000). Differential diagnostic criteria may include: identity diffusion, contradictory aspects of self and others, splitting defenses, projective identification, idealization and omnipotence as well as denial and de-valuation of the self (Cottrell & Jones, 2000). The specificity of borderline personality disorder remains in question however because patients vary in symptomology and personality despite fitting into diagnostic criteria (Cottrell & Jones, 2000). "
Abstract People with borderline personality disorder experience instability in their
moods, their relationships with others and their organizational capacity, as well as having an unstable self image. This paper looks at the disorder in terms of causes of the condition as well as treatments which can make conditions in which an individual with borderline personality disorder more successful in situations like relationships and absolutist tendencies.
From the Paper "It is important however to clearly define borderline personality because it is a condition that many people overlook or confuse with schizophrenia or bipolar disorder, two related conditions that get more attention in textual studies and the media. People who are borderline individuals tend to have a history of personal relationships in which their perception of the other person in the relationship goes through extremes, swinging
from complete disregard to putting the person on a pedastal, but it does not go through these extremes in a way that shows shades of gradations; rather the shift is from one extreme to the other. This causes the borderline individual to have very unrealistic expectations as well as perceptions of those around them (Martin, 2000)."
Abstract This paper explores the various definitions and symptoms of borderline personality disorder. Additionally, a brief review of current literature and definitions of this psychiatric condition are examined. In particular, dialectical behavioral therapy, or DBT, is considered as a possible treatment for this disorder.
Table of Contents
Section one: Overview of Borderline personality Disorder
1 Definitions and Historical Foundations
1.2 Diagnostic and Statistical Manual of Mental Disorders (DSM
1.3. Etiology
1.3.1. DBT
1.3.2. Genetics
1.3.3. Environmental Conditions
1.3.4. Neurological Issues
2. Diagnoses and Related Issues
2.1. Comorbidity
Treatment
3.1. Treatment Overview
3.2. Psycho Pharmacological Approaches
3.3. Dialectical Behavioral Therapy
3.3.1. Empirical Support
3.3.2. Theoretical Aspects of DBT
3.3.3. The Dialectical Model
3.3.4. Etiology
3.3.5. Praxis
From the Paper "Lineham pioneered this treatment of BPD in 1991. Her ideas were based on the concept and praxis that psychological treatment was just as important in dealing with Borderline patients as was the more traditional psycho? and pharmacotherapy. Lineham also emphasized a hierarchical structure in treatment goals. This structure began with the reduction of parasuicidal and life - threatening behaviors. This was followed by a reduction of behaviors which may interfere in the therapy process. Thirdly, reducing behaviors were introduced that improved the individual's quality of life. Lineman published results of her work which attested to the practical success of her work and approach. The difference of DBT to other approaches in therapy for BPD is that is combines a dialectical perspective with cognitive- behavioral therapy. This has resulted in a particular procedure of interventions which has been shown to produce positive results in the reduction of the symptoms of BPD. "
Abstract The paper examines the mental illness from the perspectives of Karen Horney and Sigmund Freud, two of the more known psychological theorists. The paper explains that borderline personality disorder is characterized by a depressed mood, certain addictions and a dramatic or erratic antisocial personality. The paper shows how the theories of Horney and Freud present two very different views of personality disorders. The paper maintains that by combining these theories of personalities and behaviors, researchers and psychologists are better able to understand and treat borderline personality disorders on an individualized basis.
From the Paper "Personality disorders affect ten to fifteen percent of the population of the United States (Bienenfeld, 2005). As defined by the Diagnostic and Statistical Manual of the American Psychiatric Association (APA DSM-IV), personality disorders are signified by an enduring pattern of behavior that is different than that which is expected by society and that is pervasive and distressful or impairing (APA DSM-IV, 1994). Of the ten personality disorders currently recognized by the DSM-IV, borderline personality is perhaps one of the most overused in diagnosis, affecting nearly two percent of the U.S. population, with more than three times as many cases among women as in men."
Abstract This paper explores in detail the complex personality disorder known as Borderline Personality Disorder. This paper discusses the relationship dynamics involved with this disorder.
Abstract This paper will discuss the psychological illness borderline personality disorder, and seek to understand its many facets. By understanding its symptoms, the definition of this malady can be made clear in a psychological format. Also, the study of what is being done to help this illness will be sought after in the treatments available for it. In realizing all of these objectives, this paper will collect a comprehensive analysis of this illness.
Abstract This paper presents the psychological analysis of a patient suffering from Borderline Personality Disorder. The analysis looks at the background of the patient in question, analyzing what may have caused the disorder, and then looking at possible treatments and therapies. The writer also looks at how various psychologists would have studied the case, including Freud and Jung.
From the Paper "A common, Freudian interpretation of this individual manifesting a Borderline Personality Disorder might be that the individual was re-experiencing internalized trauma from the period of his or her youth. In fact, individuals with Borderline Personality Disorders often manifest symptoms of what was termed "hysteria" back in Freud's Vienna. The reenactment of abandonment becomes, for men, a symbolic fear of castration. For women (in whom the disorder is more prevalent or at least more commonly diagnosed) it becomes a reenactment of the fear of being abandoned by the father, cast off into the realm of the mother (in other words, penis envy), and guilt over sexual impulses."
Abstract The paper discusses various treatments available for the borderline personality disorder. The paper looks at transference focused therapy (TFP), selective serotonin reuptake inhibitors (SSRI) and dialectical behavioral therapy (DBT). The paper emphasizes that, as with other disorders, treatment effectiveness can vary from one patient to another. The paper relates that further research is being conducted on BPD by the National Institute of Mental Health and other researching bodies.
From the Paper "The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision [DSM-IV-TR] (American Psychiatric Association [APA], 2000) defines borderline personality disorder (BPD), an Axis II personality disorder, as "a pattern of instability in interpersonal relationships, self-image, affects, and marked impulsivity" (p. 686). To meet the DSM-IV-TR's diagnostic criteria for BPD one must present by early adulthood, with five of the eight behaviors associated with borderline, which may include, but are not limited to: a pattern of unstable relationships, irrational fear of abandonment, suicidality, self-mutilation, identity disturbance, self-damaging impulsivity, poor self-concept, and a constant feeling of emptiness."
Abstract This paper discusses the case of a teenager with borderline personality disorder. It explains the teenager's history and current problem. The writer describes the assessments done and the diagnosis and recommendations.
Outline:
Introduction
Appearance
Presenting Problem
Developmental History
Mental Status
Multi-axial Assessment
Differential Diagnosis and Recommendations
From the Paper "By her senior year, Hetty began exhibiting short bouts of anxiety and irritability, most prominently before and during examination weeks. While her outbursts became less frequent, she reported having hallucinations of Jesus hovering in front of her. This alarmed her parents and brought her in for evaluation. Hetty's symptoms meet the diagnostic criteria for borderline personality disorder. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) (American Psychiatric Association [APA], 2000), borderline personality disorder is "a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts." "
Abstract The paper reveals that borderline personality disorder (BPD) is an increasingly common diagnosis amongst American psychiatric patients. The paper covers three specific areas related to BPD; (1) a description of BPD, including its symptoms, diagnosis and treatment protocols, (2) comorbidities which can commonly occur with BPD and how they can differ from patient to patient and (3) a review of current research to demonstrate new findings in the diagnosis and treatment of BPD.
Outline:
Introduction
Causes of BPD
Comorbidities with BPD
Treatment for BPD
Newer Methods in Treating and Diagnosing BPD
Conclusion
From the Paper "BPD's definition has changed over time. The current description of BPD includes antisocial disorder, eating disorder and generalized anxiety.
A complete list of BPD's diagnostic signs includes emotional vulnerability, self-invalidation, unrelenting crises, inhibited grieving, active passivity and apparent competence. This last symptom may seem contradictory to the earlier signs, but means that the individual may present him/herself as being much more competent than they really are. Thus, as with the earlier diagnostic signs, a basis of low self-esteem and deceptive behavior is consistent with that symptom(2), BPD is often associated with affective disorder in 66% of cases, according to initial studies(3)."
