Borderline+Personality+Disorder



**BORDERLINE PERSONALITY DISORDER (BPD) **


 * Diagnositic Features**

BPD is a personality disorder defined in DSM-IV and described as a prolonged disturbance of personality function in a person (generally over the age of eighteen years, although it is also found in adolescents), characterized by depth and variability of moods. The disorder typically involves unusual levels of instability in mood; black and white thinking or splitting; chaotic and unstable interpersonal relationships, self-image, identity and behavior; as well as a disturbance in the sense of self.

In extreme cases, this disturbance in the sense of self can lead to periods of dissociation. (Wikipedia Encyclopedia)

**Causes** The cause of BPD is unknown. People with BPD are impulsive in areas that have a potential for self-harm, such as drug abuse, drinking and other risk-taking behaviors.

**Risk factors for BPD include:** - Abandonment in childhood or adolescence - Disrupted family life - Poor communication in the family - Sexual abuse

This personality disorder tends to occur more in women and among hospitalized psychiatric patients. (Medline Plus Medical Encyclopedia)

A great web site for support for people with Borderline Personality Disorder is: __[]__

**__DSM-IV-TR__**

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, as indicated by five (or more) of the following:
 * 1) frantic efforts to avoid real or imagined abandonment. **Note:** Do not include suicidal or self-mutilating behavior covered in Criterion 5.
 * 2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
 * 3) identity disturbance: markedly and persistently unstable self-image or sense of self
 * 4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). **Note:** Do not include suicidal or self-mutilating behavior covered in Criterion 5.
 * 5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
 * 6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
 * 7) chronic feelings of emptiness
 * 8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
 * 9) transient, stress-related paranoid ideation or severe dissociative symptoms


 * TREATMENT**

Research on psychological treatment is growing. One of the most thoroughly researched treatments was developed by Linehan (1987, 1993). This approach, which she calls dialectical behaviour therapy (DBT), involves helping people cope with the stressors that seem to trigger suicidal behaviour. (Essentials of Abnormal Psychology, First Canadian Edition 2008)


 * Dialectical Behavioural Therapy**

DBT consists on two parts: 1. Once-weekly psychotherapy sessions in which a particular, problematic behaviour or event from the past week is explored in detail, beginning with the chain of events that lead up to it, going through alternative solutions that might have been used and examining what kept the client from using more adaptive solutions to the problem. 2. Weekly group therapy sessions in which interpersonal effectiveness, distress/reality acceptance skills, emotion regulation and mindfulness skills are taught. The group setting is designed to provide an accepting environment where they learn effective strategies for coping with situations and practice these skills using situations they have experienced personally. These skills are further reinforced during individual therapy.Individual therapy also provides the avenue for working with issues specific to each group member's needs so that the group session does not lose its focus.
 * DBT** is a cognitive-behavioural approach. As people with this disorder lack interpersonal skills and have an impaired self-image, the dialectical strategy aims to help the patients accept the way they are while simultaneously helping them to change.

DBT targets behaviours in a descending hierarchy: 1. Descending high-risk suicidal behaviours. 2. Descending responses or behaviours that interfere with therapy. 3. Decreasing behaviours that interfere with/reduce quality of life. 4. Decreasing and dealing with past- traumatic stress responses. 5. Enhancing respect for self. 6. Acquisition of the behavioural skills taught in group. 7. Additional goals set by patient. DBT addresses these following skills: 1. Accepting reality. 2. Letting go of emotional suffering 3. Distraction 4. Improve the moment 5. Evaluating the pros and cons of tolerating distress 6. Self-soothing 7. Reducing vulnerability to negative emotion 8. Interpersonal effectiveness (made by Caz Farmer Youtube.com)

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