scholarly journals Recent developments in borderline personality disorder

2000 ◽  
Vol 6 (3) ◽  
pp. 211-217 ◽  
Author(s):  
Anthony P. Winston
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
World Health ◽  
Recent Developments ◽  
Icd 10 ◽  
Negative Effect ◽  
Health Organization ◽  
Personality Disturbance ◽  
Emotionally Unstable Personality Disorder

Patients with borderline personality disorder (BPD; known in ICD–10 (World Health Organization, 1992) as emotionally unstable personality disorder) pose some of the most difficult management problems facing the clinical psychiatrist. They frequently present in crisis, but are often difficult to engage in any form of treatment. Their behaviour causes considerable anxiety but their ambivalence about treatment often leaves professionals feeling frustrated and resentful. These feelings can all too easily be transformed into therapeutic nihilism. As well as being a significant problem in its own right, comorbid personality disturbance complicates the management of other psychiatric disorders and has a negative effect on their prognosis (Reich & Vasile, 1993).

All-Cause Mortality of Hospital-Treated Borderline Personality Disorder: A Nationwide Cohort Study

2020 ◽  
Vol 34 (6) ◽  
pp. 723-735 ◽  
Author(s):  
Jesper N⊘rgaard Kjær ◽  
Robert Biskin ◽  
Claus Vestergaard ◽  
Povl Munk-J⊘rgensen
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mortality Rate ◽  
Borderline Personality ◽  
High Rate ◽  
Standardized Mortality Ratio ◽  
Central Research ◽  
Emergency Rooms ◽  
Icd 10 ◽  
Mortality Ratio

Patients with borderline personality disorder (BPD) are known to present frequently in emergency rooms, and they have a high rate of suicide. The mortality rate of patients with BPD is still unclear. The Danish Psychiatric Central Research Register and The Danish Register for Causes of Death were used to identify patients with a first-ever diagnosis of BPD (ICD-10: F60.31) from 1995 through 2011 together with time and cause of death. A total of 10,545 patients with a BPD diagnosis were followed for a mean time of 7.98 years. A total of 547 deaths were registered. The standardized mortality ratio of patients with BPD compared to the general population was 8.3 (95% CI [7.6, 9.1]). More than three inpatient admissions per year or a comorbid diagnosis of substance use disorder correlated with a higher mortality rate. The increased mortality rate in patients with BPD treated in secondary care emphasizes that it is a severe mental disorder.

scholarly journals The Cognitive, Ecological, and Developmental Origins of Self-Disturbance in Borderline Personality Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Axel Baptista ◽  
David Cohen ◽  
Pierre Olivier Jacquet ◽  
Valérian Chambon
Keyword(s):  
Developmental Biology ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavioral Ecology ◽  
Life History Theory ◽  
Evolutionary Developmental Biology ◽  
Borderline Personality ◽  
Sufficient Evidence ◽  
Early Life Adversity ◽  
Recent Developments

Self-disturbance is recognized as a key symptom of Borderline Personality Disorder (BPD). Although it is the source of significant distress and significant costs to society, it is still poorly specified. In addition, current research and models on the etiology of BPD do not provide sufficient evidence or predictions about who is at risk of developing BPD and self-disturbance, and why. The aim of this review is to lay the foundations of a new model inspired by recent developments at the intersection of social cognition, behavioral ecology, and developmental biology. We argue that the sense of agency is an important dimension to consider when characterizing self-disturbances in BPD. Second, we address the poorly characterized relation between self-disturbances and adverse life conditions encountered early in life. We highlight the potential relevance of Life-History Theory—a major framework in evolutionary developmental biology—to make sense of this association. We put forward the idea that the effect of early life adversity on BPD symptomatology depends on the way individuals trade their limited resources between competing biological functions during development.

Personality problems and disorders

2017 ◽  
Author(s):  
Tom Burns ◽  
Mike Firn
Keyword(s):  
Mental Illness ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Team Work ◽  
Dimensional Approach ◽  
Outreach Workers ◽  
Dsm V ◽  
Icd 10

This chapter deals with the controversial issue of personality disorder, whether these are meaningful diagnoses and, if so, how they affect management. The classification is entirely pragmatic: the definitions and classification in both ICD-10 and DSM-V are outlined along with proposals to abandon categories in favour of a dimensional approach. The issue of treatability is explored, but we conclude that ignoring personality and personality disorders is not a viable alternative for outreach workers. Most of the chapter deals with the management of dissocial personality disorder (usually in men) and borderline personality disorder (usually in women). Specific psychotherapies are not dealt with here; the focus is on how to use team work to manage individuals with severe mental illness and disorders of personality.

scholarly journals The Ecological Origins of Self-disturbance in Borderline Personality Disorder

2020 ◽  
Author(s):  
Axel Baptista ◽  
David Cohen ◽  
Pierre O. Jacquet ◽  
Valerian Chambon
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Evolutionary Biology ◽  
Borderline Personality ◽  
Limited Resources ◽  
Sufficient Evidence ◽  
Behavioural Ecology ◽  
Biological Functions ◽  
Early Life Adversity ◽  
Recent Developments

Self-disturbance is recognized as a key symptom of Borderline Personality disorder (BPD). Although it is the source of significant distress and significant costs to society, it is still poorly specified. In addition, current research and models on the aetiology of BPD do not provide sufficient evidence or predictions about who is at risk of developing BPD and self-disturbance, and why. The aim of this review is to lay the foundations of a new model inspired by recent developments at the intersection of social cognition and behavioural ecology. We argue that the sense of agency is an important dimension to consider when characterizing self-disturbances in BPD. Second, we address the poorly characterized relation between self-disturbances and adverse social conditions encountered early in life. We highlight the potential relevance of the phenotypic plasticity framework in evolutionary biology to make sense of this association. We suggest that the effect of early life adversity on BPD symptomatology depends on the way individuals trade their limited resources between competing biological functions along the life cycle.

scholarly journals Eclectic Therapeutic Relationship with BPD Clients: Examining the Eclectic Therapeutic Relationship with Clients with Borderline Personality Disorder

2014 ◽  
Vol 13 (1) ◽  
pp. 53
Author(s):  
Preethi Anne Ninan ◽  
Sudeshna Biswas
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Therapeutic Relationship ◽  
Borderline Personality ◽  
Comprehensive Therapy ◽  
Eclectic Approach ◽  
Rapport Building ◽  
Self Harm ◽  
Integrated Or ◽  
Emotionally Unstable Personality Disorder

Borderline Personality Disorder (BPD) or Emotionally Unstable Personality Disorder (EUPD) clients are characterised by behavioural symptoms of acts of deliberate self-harm, difficulty controlling anger, and instability in relationships, besides others. While specific therapies address specific problem behaviours, an integrated or eclectic approach enables clinicians to adopt a comprehensive therapy plan (Livesley, 2008). Since the therapeutic relationship with BPD clients is characterised by frequent ruptures and fluctuations, it is necessary to understand how the eclectic stance approaches the therapeutic relationship with BPD clients. This study explores these questions through in-depth interviews with seven self-identified eclectic therapists who have worked with BPD clients. Using Thematic Network Analysis, it was found from the interviews that eclectic therapists choose the stance because of the flexibility it offers them, and because of definite client and setting factors. This stance, they suggested, helps in mutual decision-making and leads the therapist to make constant adjustments to the client‘s level. The process of rapport-building was seen to be an on-going process, where the therapist acts as a facilitator, and often works against resisting traits of the clients. Therapists also talked about ruptures in the relationship due to certain factors and identified means through which these can be repaired. Finally, they identified their reactions to BPD clients as consisting of both positive reactions, and negative and unconscious reactions, which require monitoring. The results of this study yield an understanding about the reasons behind the decision to take an eclectic stance, and how it affects the therapeutic relationship. Keywords: Borderline personality disorder, Eclectic therapy, Therapeutic alliance.

Reasons for Acute Psychiatric Admissions and Psychological Interventions for Patients with Borderline Personality Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S71-S71
Author(s):  
N.P. Lekka ◽  
G. Carr ◽  
T. Gilpin ◽  
B. Eyo
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Significant Risk ◽  
Borderline Personality ◽  
Psychological Interventions ◽  
Nice Guidance ◽  
Icd 10 ◽  
Psychosocial Difficulties ◽  
Relationship Breakdown ◽  
Competing Interest

IntroductionNICE guidelines advise to consider admission for patients with borderline personality disorder (BPD) for the management of crises involving significant risk to self or others. Furthermore, to consider structured psychological interventions of greater than three months’ duration and twice-weekly sessions according to patients’ needs and wishes.ObjectivesWe aimed to assess reasons for admission and access to psychological interventions in an acute inpatient BPD population.MethodsCase notes of patients with a diagnosis of BPD (ICD-10 F60.3 and F60.31), discharged from four acute general adult wards in Sheffield during a period of twelve months were studied retrospectively, using a structured questionnaire based on BPD NICE guidance.ResultsOf the 83 identified BPD patients, seventy-eight percent were female and 82% between 16–45 years old. Eleven patients had four or more admissions. Eighty percent reported suicidal ideation at admission, with 50% having acted on it (70% by overdose, 50% cutting, 10% hanging). Of this cohort, 58% reported they intended to die. Psychosocial factors at admission were identified in 59 cases, including relationship breakdown (47.5%), alcohol/drug use (30.5%) and accommodation issues (17%). Disturbed/aggressive behaviour was documented in 27.1% of these cases. Sixty-eight percent of patients had psychology input in the 5 years preadmission: 38% (21 patients) received structured therapy, whilst 62% received only one assessment or advise to teams.ConclusionsPatients were mainly admitted for risk management. A high proportion received unstructured psychological interventions. Services offering structured psychological interventions should be supported, as hospitalisations only temporarily address BPD patients’ suicidality and psychosocial difficulties.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Impact of clinical severity on outcomes of mentalisation-based treatment for borderline personality disorder

2013 ◽  
Vol 203 (3) ◽  
pp. 221-227 ◽  
Author(s):  
Anthony Bateman ◽  
Peter Fonagy
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Controlled Trial ◽  
Symptom Distress ◽  
Borderline Personality ◽  
Clinical Severity ◽  
Axis Ii ◽  
Randomised Controlled ◽  
Personality Disturbance ◽  
The Impact

BackgroundEvidence of remission from borderline personality disorder (BPD) without specialised treatment is accumulating.AimsTo establish whether specialised treatments are indicated for patients with clinically severe disorder.MethodThe impact of clinical severity on outcomes of a randomised controlled trial of mentalisation-based treatment (MBT) was contrasted with structured clinical management (SCM). Severity indicators were defined as severity of comorbid psychiatric syndromes, severity of BPD, severity of personality disturbance and severity of symptom distress. Logistic regressions were used to predict the likelihood of recovery at 18 months, and mixed-effects regression analysis was applied to examine the association of severity and rates of improvement across time in the two treatment groups.ResultsNone of the severity criteria predicted outcome at the end of treatment on logistic regression. However, testing the significance of distribution of cases of recovery v. non-recovery suggested that multiple Axis II diagnoses and symptom distress influenced outcomes.ConclusionsBorderline personality disorder with significant Axis II comorbidity is a possible but uncertain indicator for specialist treatment. Patients whose only personality disorder diagnosis is BPD do equally well with SCM. Prospective studies are needed.

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