Science topic

Borderline Personality Disorder - Science topic

Borderline personality disorder (BPD) (called emotionally unstable personality disorder, borderline type in the ICD-10) is a personality disorder characterized by unusual variability and depth of moods. These moods may secondarily affect cognition and interpersonal relationships.
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science fiction, fantacy, animation series and movies are watched by children and a specific group of adults. does it signify any relationship with the personality type/ personality of the adult watching it?
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In my opinion, this is too far-reaching thesis. Science fiction novels, short stories, movies and series have a lot of fans. Are there studies that confirm that fans of science fiction novels, short stories, movies and series have significantly more people than the general population who exhibit personality disorders or other mental health conditions? I have not encountered the results of scientific research that could confirm the occurrence of this type of correlation.
Regards,
Dariusz Prokopowicz
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The manual of the inventory that is available from Google search and is provided by Fredrick Coolidge on his website, doesn't mention the item numbers of Narcissism scale. One of the earlier versions of the manual indicates that the scale has 26 items. Can anybody please tell me the item numbers of Narcissism scale in CATI ?
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Have a look on Coolidgetests.com
All the Coolidge tests are available to researchers free of charge for university related research. You should get the test and scoring.
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Currently preparing a study on the relationship between Substance Abuse relapses and personality disorders , I want theories about the relapses and cognition for people relapsing, 
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I think the answer you're looking for is neuroinflammation.
There is neuroinflammation in Borderline Personality Disorder as well as several conditions often diagnosed in Borderlines (ADHD, Autism and PTSD) and multiple studies have shown a correlation between levels of cytokines and inflammatory endotoxins from leaky gut and alcohol/drug abuse, suggesting that activation of innate immune signaling increases alcohol craving/consumption and contributes to alcohol dependence and relapse.  Recent studies provided further evidence that neuroimmune activation and inflammation contribute to alcohol dependence when targeted disruption of TLR4 in the central amygdala reduced alcohol consumption (but one single injection of LPS from leaky gut increases it).
"Repeated cycles of alcohol and stress cause a progressive, persistent induction of HMGB1, miRNA and TLR receptors in brain that appear to underlie the progressive and persistent loss of behavioral control, increased impulsivity and anxiety, coupled with increasing ventral striatal responses that promote reward seeking behavior. "
Dopaminergic cell death is TLR4-dependent and Borderlines have reduced dopamine because of genetics.
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I've found research that creates poems from data sets, but little research that seems to use poetry written by participants as data. I am looking at poetry by those with lived experience of carrying a label of "borderline personality disorder" and the effects said labelling has on them. I need help figuring out which methodological analysis to use. Does anyone have citations of work carried out in this way?
thanks
Louisa
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I had misunderstood the question - but only in part. I think it is essential that, whatever work you attempt to analyse, the psychoanalytical component in it should be so unambiguously and demonstrably present that the work itself so to speak "cries out" for a discussion of it. If that is not so, and you start making assumptions that cannot easily be demonstrated to be "right", you run a serious risk that you will not succeed in persuading others that your interpretation is arbitrary and too personal. But that is just at the moment my own personal impression, and only the outcome of what you yourself produce will in some way determine your result in the eyes of others. So I feel you should probably very much carve out your own path. Be clear, however, as to just precisely what you mean by psychoanalysis, as otherwise you will not take your readers with you. All best wishes! - Joost
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I was thinking on using the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) but the self-report version has only 9 items (with dimensions being addressed with only 2 or 3 items) which is probably not methodologically appropriate. Any suggestions?
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Not sure if this is helpful, but here's an overview of all the different BPD inventories that are available. I'm not advocating one over the other, but just like no two people are exactly the same, their personality disorders are likely unique unto themselves as well. One assessment may be better suited for the many variants that may present.
Hope you find this useful.
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I am looking for research on Borderline Personality Disorder. Something within the last 5 years as this disorder comes with a lot of different points. Does anyone have suggestions where to look for research on this certain topic? I find this disorder quite fascinating.
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Hello Rebecca,
I'm currently doing my thesis on Borderline personality disorder and I can send you some of my citations that relate your question. Just message me.
Dallas
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Hello everyone,
I'm studying the link between psychopathy and self-aggression/suicide. All variables are numeric.
IV is psychopathy: 4 levels.
DV is self-aggression.
I would like to test the contribution of gender, traumatic experiences and aggressiveness.
And control age and borderline personality disorder (BDP).
I'm considering these two options:
1. Multiple regression + post hoc: First I would do a multiple regression to test the 4 levels of the IV and then analyse the contribution (moderation / mediation) of gender, traumatic experiences and aggressiveness.
But using this method I can't control age and BDP, right?
2. Multiple hierarchical regression : First I would do a multiple regression to test the 4 levels of the IV. Then first model would include age and BDP, second one gender, third traumatic experiences and fourth aggressiveness. I would do 4 regressions, one for each level of the IV (psychopathy).
If the difference of R2 between model 1 and 2, 3, 4 is significant then I can report ΔR2 as the additional variance explained, hence knowing if any of the variables have an impact on self-aggression.
Thanks in advance!
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You do not need to do any post-hoc tests for multiple linear regression analysis.
From the part correlation column you see how much each IV contributes with (when you square the part correlation you get the %). The IV percentages do not add up to the R2 because the only tell how much each IV uniquely and significantly contribute to the total variance in your DV.
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Specifically short style vignettes with a story line which portray the controversial/ misunderstood features of an individual living with BPD.
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Magdalena, I'm not sure if a video would help, but strongly recommend watching the film "Back from the edge": https://www.youtube.com/watch?v=967Ckat7f98
Rachel.
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Dear investigators:
¿What is your opinion about to work with the new alternative proposal of DSM-5 for obtain a screening validated instrument for borderline personality disorder using the criteria A and B or only one group A or B?
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To assess daily functioning, the weaknesses of WHODAS 2.0 are that it targets only a few activities, which do not cover the specific characteristics of BPD, and it has not been validated with this population. Moreover, the WHODAS 2.0 covers only part of the entire range of the concept of functioning in daily life; it does not take into account other aspects that this complex concept might include, such as the amount of assistance required and how activities are executed.
A recent analysis of the concept of functioning (Desrosiers et al., 2019] sheds light on the attributes of daily functioning. According to this concept analysis, a functioning assessment should document how daily activities are done and how they can contribute to health and well-being [23]. In addition to identifying observable behaviors, it is recommended to look at how people perceive the difficulties they encounter in daily life [37].
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I can find psychoanalytic literature on 'BPD' of course, and I can find some feminist writings, but I'm looking for any feminist psychoanalytic literature on the phenomenon of BPD.
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Thank you. I have Becker’s book but wasnt aware of the second - that’s helpful!
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Novel therapeutic strategies for patients with borderline personality disorders have emerged since the last quarter of the 20th century. However, it is difficult to find evidence of the long-term outcome of the various approaches, among them schematherapy (J.Young).
Who can help me to find systematic research on evidence in this field?
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You might want to reach out to Andrea Ivanoff in the School of Social Work at Columbia University. She is an expert on a specific evidence supported intervention (DBT).
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I am currently in early stages of qualitative research design in the areas of perceptions and exploration of older adults . I am looking at investigating older adults with personality disorders and their experiences with Schema therapies to learn how as therapists we may then correlate it to younger patients in the life span and in addition enhance older patients quality of life
I am look to incorporate Delphi technique, qualitative questionnaire , focus groups and discussion
your thoughts in an area that is not well developed are valuable to a proof of concept or initial paper on the area of enhancing therapy for older patients and of course applying it to younger patients .
regards
Gary Darbyshire
MMgmt , MstratMktng, GradDip-CouPsych
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2018 free paper:
Adolesc Health Med Ther. 2018; 9: 199–210.
Borderline personality disorder in adolescents: prevalence, diagnosis, and treatment strategies
Jean Marc Guilé,1,2,3 Laure Boissel,1,2 Stéphanie Alaux-Cantin,1,2 and Sébastien Garny de La Rivière1
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Does anyone have any experience om working with complex trauma by NET (Narrativ exposure therapy) with a patient who also has paranoid personality disorder and borderline personality disorder? I’m looking for advice, some literature or research that could be helpful?
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Thank you Michael Uebel.
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Currently completing a project as part of studies in Mental health of older patients at the Australian College of Applied Psychology in Sydney Australia
I am currently designing a research proposal and require to quickly secure my document for approval
Urgently looking for a minimum of 6 to 8 qualified therapists who have dealt with older patients diagnosed with borderline personality disorder for a qualitative interview and questionaiire
I need to move quickly so if you have had experience in as a therapist I would very interested in talking to you you I have a deadline to secure participants so if you are able to assist please reply as soon as possible
Your assistance in this research will benefit future therapy in the area of treating older patients who have this disorder.
And referrals welcome
My details
Ph 61 434028920
Kind Regards
Gary Darbyshire
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My Proposal date of submission 17th March so I need to confirm opportunity to access and discuss in interview mode before that date.
This will form my major research project for a required component.
Again Thank you.
Gary Darbyshire MMgmt MStratMktng Grad Dip Cou.
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What subtypes are present in Borderline Personality Disorder and how might they differentially impact treatment response?
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As a psychotherapist, I am not really interested in subtypes of BPD, it does not make much difference having a subtype title in terms of therapy. However, Smits et al offers 3 subtypes, here is the link
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Just some context - Ive read many research reports to try and determine an appropriate set of questions for my interviews but to no avail. Each set i have made however keeps getting knocked back from my supervisor. I would just like to know how i can go about finding public perception of Borderline personality disorder in a qualatative manner I.E I know what i want to ask its just finding the correct wording. Thankyou
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Since most members of the general public probably do not have any perception of borderline personality disorder, you need to begin the interview by familiarizing them with your topic. One way to do that would be to present "vignettes" in the form of descriptions of people who have this condition, and get their reactions.
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The symptoms described by Freud were : episodic episodes of "psychosomatic" dyspnea, cough, afonia (without a medical explanation and then " conversion" symptoms ) but also : depression, " hysterical "
social withdrawal, and "taedium vitae" ( i.e. for the modern " emptiness" ? )
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No - in that the history of Borderline/Borderland (WA White 1912) shows it to be a " diagnostic waste bucket" for persons unaware of E Minkowski's work on structure (1924). Conversion points to hysteria - no more but no less.
David F Allen
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Dutch psychiatrist Henricus Cornelius Rumke defined a term "Praecox Gefuhl" meaning Praecox Feeling to indicate the phenomenological experience by the clinician in first few minutes of encounter with a schizophrenic patient, in order to reach a diagnosis. Though the topic is less considered in mainstream psychiatry currently, but many proponents of phenomenological approach favor the existence of such a feeling.
From the similar perspective, are there any other feelings that clinicians experience in encounters with other kinds of patients like personality disorders, or OCD or depression, or anxiety disorders? And for that matter, even childhood disorders too like autism or ADHD. I am looking for some relevant literature as well as personal experiences of clinicians, since I believe that such phenomena have not been reported often. Please share your own experiences too.
P.S. This question arose from a personal experience of a feeling of "being possessed" during the first few minutes of interviewing with a patient diagnosed with Narcissistic Personality Disorder having other Cluster B traits. I labeled this feeling, similar to Rumke's as "Gefuhl Besitz", which means "feeling possessed". I have experienced similar respective feelings with depressed/manic/OCD/Borderline personality and other patients too. There have been many repeated experiences of these feelings, quite often, which follow a pattern corresponding to similar diagnoses. That's why I am curious!!
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This answer reflects my experiences in 15 years of actual nearly full-time clinical practice. I believe these are the sorts of answer you were pursuing?
1) There are times that walking into the hospital room of a patient who is severely depressed feels as if there is a palpable gust of "sad" that "comes off" the patient (this is not literal of course). I have described this experience over the years to students and trainees as similar to the actual gust of heat one feels when opening the door of an oven that has been at 400 F for a while.
2) I think we can all universally agree there are some persons with Autism you meet and it's completely clear immediately - by this I mean the sort of classic, profound Autism characterized by a person being non-verbal, lacking joint attention, and engaging in repetitive, self-stimulatory behaviors. When people say they "just know" someone has Autism without doing a complete diagnostic short of those sorts of presentations, frankly I get concerned.
3) As for ADHD, many times you will see behaviors from a child that could have you immediately conclude that the child must have it, until you take a history that includes significant trauma. So that immediate feeling is not trustworthy at all, and because it can be strong, has to be actively fought against.
I'm sure there are other similar phenomena if you were to ask people who do a lot of clinical work. I believe that all of this is what is intended to be captured under the concept of transference. But that does not mean it isn't possibly worthy of more careful description and understanding than lumping into one big pot.
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In therapy of personality disorder , How far down in the super ego can we go to re initiate change in client therapy .What is the new divide in experiential therapy.
Please enlighten us ..
Please enlighten us .
Cheers
Gary Darbyshire MMgmt MstratMktng
Masters Student in Psychotherapy.
University of Southern Queensland ( USQ )
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What a fabulous question Gary. Sorry I don't know the answer.
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Key themes and identifiable areas of BPD That are unique to adults diagnosed as symptomatic of the disorder..
What is the missing link.
What more do we need to learn
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Peripheral personality disorder is a type of personality disorder of group B, one of the most prominent symptoms of which is characterized by a characteristic impulse and an imbalance in the expression of emotions, relationships with people, and self-image. This disease is classified as a diagnostic and statistical guide to mental disorders. Other symptoms of this disorder are fear of abandonment, and severe episodes of anger. In addition, they may harm themselves or commit suicide.
Best Regards @ Gary Darbyshire
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I am interested to find subtle differences in presentation and other symptoms of older people with borderline personality disorder ( bpd )
As I continue my research and build my knowledge in this area I find it curious that not more work has been done in this area which would greatly assist the therapist whether they be a psychologist or counsellor in the areas of understanding the mind of an older person and therapies to assist the client more holistically in therapy
I am curious to understand if there is possible new presentations of BPD in older age , as was the case in myself as a patient the possibility symptoms that otherwise would not appear earlier .
Or are we to assume that older people have had BPD from a younger age ?
Interested in your thoughts in this area as I increase my knowledge my masters in Counselling ( Mental Health practices) at the University of Southern Queensland
Kind regards
Gary Darbyshire MMgmt MStratMktng ACA ( Australian Counselling Association) student member.
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I have to admit that I have not undestood everything claimed by you in your question. The problem of the presentation of BPD symptoms in older patient is interesting and I would like to give you some hints:
- I dont think that you can find BPD symptoms in a patient that never showed signifiants psychiatric symptoms, someway suggesting a Personality Disorder. A personality disorder has a longtime history.
- there is a consensus that BPD sympotms can become milder in old age.
- It can happen in my opinion that a personality disorder like BPD can adapt himself very well under certains conditions of his life and show a severe maladjustment symptomatology in other circumstances.
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If there is any trial to more brief and treatment with reasonable cost,
I would like to get it's information. Because patients and their family are severely suffering with not so many proper specialists especially with proper cost to my knowledge.
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Thank you very much Renzo. Purpose of my project is provide remission to Borderline Personality
Disorder(BPD). What I mean remission in case of BPD is, stably work in school or in place of work,
able to enough motivated to her/his aim in their life. I find often originality or creativity in BPD person.
For example, a person given by a psychiatrist's sessions to became professional entertainer after that
in fact.
I wonder their personality should be evaluated rather than antisocially estimated. I mean some BPD person has "young age crisis'" as they should be somebody rather than now they are. If that is the case, our duty is to awake their possibility and they can take their proper course thereafter. That is why what should be done by us is, somewhat less than generally thought giving them to confidence.
Thank you, again
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I've been really taken with Michelle Schoenleber and Howard Berenbaum's paper on "Shame Regulation in Personality Pathology", and I'm developing a bit of a bias toward their 'solution'. But I am curious what other researchers make of the idea that dysfunctional shame processing in particular is a central or core problem for this population. What do you think (and why do you think it?)
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I suspect in those cases where neglect and abuse occurred in childhood that the damage was complex. And I further suspect that the young mind struggled to make sense of the treatment they endured. I would think that the 'core problem' would relate more to the manners in which the person would try to cope and function over the coming years. What further and deeper damage occurs when the individual uses unhealthy ways to exist and avoid more pain?
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I would like to examine the role of emotions regulation strategies for the context of stigma through subjective disease repressions and quality of life in patients with narcolepsy and cataplexy. For this purpose, I would like to use the questionnaire inventories to collect the subjectively perceived stigma caused by the disease narcolepsy and cataplexy.
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Turismo y Ocio.
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I am interested in the hypotheses around the probable causes of bipolar for a personal reason
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I'm working on a thesis about Borderline Personality Disorder and comoribidity with Drug Use Disorder. One purpose is to compare diagnosis made by SCID-II, SWAP-200 and PID-5. On literature I can't find how to scoring PID-5, or better, which result I have to consider pathological. For example, is it corret to consider 1-2 moderately pathological and 2-3 severely pathological? Or is the cut-off only 1.5?
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Sorry for this delayed response.
In the alternative DSM-5 model for personality disorders, criterion A (Level of Personality Functioning) is used to detect or diagnose the presence and severity of personality disorder, whereas criterion B (PID-5 traits) is used to describe the style/type of the personality disorder / or personality difficulties. In other words, a cut-off is not really relevant for the PID-5. 
For clinical purporses, I recommend to use a computerized version of the PID-5 and an excel scoring sheet for rapidly creating graphical profiles. 
In our clinical setting, we use this procedure, and we also use T-scores instead of raw-scores based on a normal population sample, which allows us to see where the patient is above the avarage and below the average - and we can also use one standard deviation (15) below or above 50 as indicator of a clinical significant score. 
Hopefully an officially available practitioner's guide will soon be published along with easy-to-use administration and scoring software.
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We have found within our community specialist PD team there are a small number of service users who present with exceptionally high risk clinical problems, complexity and comorbidity that they cannot be safely contained and supported in community settings. Their needs are complex, and often require more intensive and in-depth assessment, reformulation and stabilisation work which cannot be safely done within a community setting or whilst on an acute inpatient ward. Such service users, when in the stage of severe chaos, self-harm or suicidality may find an acute ward too stressful and over stimulating for them, which can lead to their attempts at coping to get worse, rather than better. The tendency to regress and lose skills and abilities whilst in an acute hospital setting has been well known clinically (e.g. Paris, 2004; Bateman and Krawitz, 2013).
Current research evidence and guidance on the use of hospital admission is mostly based on expert opinion and a little empirical research. Expert opinion and guidance suggest that admissions should be avoided as far as possible, but where needed, they should be used for acute crisis management rather than chronic risks and be as brief as possible (NICE, 2009; Paris, 2004; Krawitz and Watson, 2008; Fagin, 2004). There is some evidence that brief planned admissions are no more harmful than standard treatments (Van Kessel et al, 2002). 
We are considering the development of a specialist unit where these focussed admissions may occur safely in order to stabilise service users so they are more abel to engage in evidence-based treatments in community settings.
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Hi Stuart,
Maybe you are allready familiar with this paper but at least it shows some preliminary results suggesting that DBT might provide an effective treatment in Institutional settings.
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I am looking for any empirical studies that have looked at the rate of change or symptom improvement in people with Borderline Personality Disorder, treated with Dialectical Behaviour Therapy. I am hoping there is something out there that suggests that treatment with DBT results in a faster pace of improvement in psychological symptoms, when compared to other psychotherapy or group program. TIA.
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Dear Alicia
Most older trials evaluating the efficacy of DBT compared this specialised treatment to very poorly designed TAU conditions; sometimes therapists in the TAU arm were not even familiar with PD patients in general, let alone BPD patients. More recently, well-conducted RCTs have indicated that DBT is not superior to other specialized treatments, according to some studies not even to general psychiatric management (e.g. Clarkin et al 2007; Am J Psychiatry 164:922-928; McMain et al 2012; Am J Psychiatry 169:650-661).
Best,
Michael
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I am conducting in-depth interviews during the qualitative stage of a mixed methods scale development study. I have incorporated several elements of descriptive phenomenology; however, I am not sure which elements of context should be varied when utilizing imaginative variation, particularly when generating spontaneous probes during interviews. For instance, should I ask participants how their experiences of emptiness vary when people are present versus when participants are alone? What are the rules of thumb when choosing which elements to vary and how?
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Please also see below information, where the elaboration by giving examples, and illustration in terms of case studies, should be helpful to your topic. 
  • Anosike, P., Ehrich, L. C. and Ahmed, P. (2012) Phenomenology as a method for exploring management practice, International Journal of Management Practice, 5, 3, pp. 205-224.
  • Bevan, M. T. (2014) A Method of Phenomenological Interviewing, Qualitative Health Research, 24, 1, pp. 136-144.
  • De Castro, A. (2003) Introduction to Giorgi's existential phenomenological research method, Psicologia Desde el Caribe. Universidad del Norte, 11, 3, pp. 45-56.
  • Dowling, M. (2007) From Husserl to van Manen. A review of different phenomenological approaches, International Journal of Nursing Studies, 44, 1, pp. 131-142.
  • Giorgi, A. (1999) A phenomenological perspective on some phenomenographic results on learning, Journal of Phenomenological Psychology, 30, 2, pp. 68-93.
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The effects of emotional invalidation & childhood abuse on BPD (leads to more primitive defense styles & endorsement of depressed mood).
I want to run a correlation between perceived history of abuse during childhood with the Defense Styles Questionnaire (DSQ) and a mood measurement (not sure which one yet) and another correlation between emotional invalidation and the DSQ and mood measurement. I want to conduct an experiment for the emotional invalidation variable. I was thinking of having participants read statements and telling them to think of their partner or someone they had strong feelings for in the past, and to imagine the statements were coming from them (if anyone has a better idea for what to tell participants please let me know). There would be 4 groups: (1) more negative "invalidating" comments than positive, (2), more positive than negative, (3) neutral comments, and (4) even distribution of positive and negative. My hypothesis is that the more emotional invalidation the participants (who will ideally be a clinical population with a diagnosis of BPD) are exposed to, their DSQ will reflect higher levels of primitive defenses and their mood assessment will reflect higher levels of negative affect than the other groups. And my second hypothesis is that higher levels of reported perceived childhood abuse will be associated with even higher levels of primitive defenses and negative affect than the participants who reported less childhood abuse. Does anyone have any opinions, thoughts, ideas?
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A suicide threat has been defined as "a verbal statement or behavioral act that may indicate serious intent to kill oneself" (see link to Wedig et al., 2013). In the case of borderline personality disorder suicide threats may also be made without any intent to take one's life (see J. Paris, Half in Love with Death, 2006). Suicide threats may be contingent ("If I'm not admitted I will...") or non-contingent ("I'm going to shoot myself!") (See Lambert, M., Seven-Year Outcome of Patients Evaluated for Suicidality, Psychiatric Services, 2002, 55,1, 92-94). Threats may or may not reference a plan. Suicide threats, of any type, would seem to be the second most common forms of suicidal behavior after suicidal ideation. The overwhelming majority of threats heard daily by emergency responders, crisis centers, hot lines, rehabs, and ERs, are conditional with more intent of personal gain or manipulation than personal demise. Nonetheless, many excellent discussions of "suicidal behavior" do not address suicide threats (e.g., Nock et al., Suicide and Suicidal Behavior, Epidemiology Rev., 30,1, 133-154). There appears to be relatively little research explicitly focusing on threats as suicidal behavior
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Hi Keith and others...
The definition of suicidal:
"deeply unhappy or depressed and likely to commit suicide.
relating to or likely to lead to suicide."
What does likely to commit suicide imply?
90%?    50%?      10%    .04% ?
The most at risk are bipolar men who have self harmed (Nordentoft et al 2011). They had a risk of about .04% per month.
Therefore no matter what a patient says or does they are unlikely to commit suicide. We need better terminology for patients who feel "suicidal" or self harm.
We need to assess the problems patients present with and regard all patients as at risk as most patients who commit suicide were assessed as not high risk. If we focus on hige risk we are ignoring most of those who will kill themselves.
What do you think?
For a fuller account of my delusions about suicide risk  see: http://bjpo.rcpsych.org/content/2/1/e1
Declan
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There are several treatments that are most often used to manage BPD.
Borderline personality disorder (BPD) is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed BPD as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses.
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Dear Abdelfattah,
Every 'mental' disorder (BPD)  patients need to be addressed with dire sensitivities. It is made easier if it is listed as a diagnosable DSM illness.
BPD being a 'serious' mental illness, talking with a highly dedicated and genuinely caring professionals create great trust to the patient.
To the patient, it makes it very worthwhile at one instant to know that someone sympathizes, care and most willing to 'treat' him/her. That's when the talking session, even done once would be very effective.
When this fails, there are several approaches you could apply using -
1. Dialectical Behaviour Therapy (DBT)
- treatments include individual therapy, group skills training and phone coaching
2. Cognitive Behaviour Therapy (CBT)
- treatments include recognizing and changing the patient's belief system
3. Mentalization-based Therapy (MBT)
- treatments include talking out the patient's feeling and addresing it accordingly
4. Transference-focused Therapy (TFP)
- treatment includes situational based scenarios brought upon by the therapist for the patient to apply elsewhere
5. Medications
- not useful but not detriment to include supplement like Omega 3 (not vetted) yet could relieve BPD symptoms nonetheless
6. Self-Care
- educating the patient on the importance of caring for one self  at all time
In order to minimise remissions, always refrain verbally from labeling BPD as a PSY patient to or among other healthcare team. 
This is  because such patient (knowing the gravity of this illness) will either walk away for good or die a brutal death because the doctor-patient trust and privacy have been broken totally.
Best regards - Mariam
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Looking to do some research on this; any papers would be greatly appreciated. Would be preferable if they had a healthy comparison control group.
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I'm looking for some articles on the level of insight individuals with personality disorders have.
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I would suggest the work of Rudi Vermote (KU Leuven), a psychoanalytic approach to personality disorders and insight/mentalisation. He did his PhD on this topic and published several articles on this subject.
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Borderline Personality Disorder is very difficult to treat;working on reducing its predisposing factor may help preventing its occurrence.Since,childhood trauma has been associated with multiple psychiatric conditions, including anti-social personality disorder, my research question would be to find its association with Borderline Personality Disorder.
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 Herman, van der Kolk, and Perry found a high degree of abuse in persons with bipolar disorder.
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I have found very little research examining chronic emptiness and I have not found any information about effective treatments for alleviating it. 
If you know of any papers, specifically examining this symptom, please let me know. 
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The most useful conceptual framework I've found for "emptiness" is object relations theory, which posits that as children mature with a reliable caregiver, they develop an implicit memory of that caregiver that is always with them. (Hence, "transitional objects" such as binkies and stuffed animals around the time that children start school, which provide comfort by representing the warmth of the caregiver as they transition from the early childhood sense of feeling like the caregiver is gone forever when they are separated, to knowing they are still connected and will see them again after school). I think this feeling of emptiness arises when the person never internalizes an omni-present originally god-like sense of other, against which they define themselves, and from which comes the sense that "everything is going to be OK." 
This then would lead to looking for treatments related to object relations or self psychology. And obviously, DBT. If you look at the core tasks and guidelines in DBT, even if they don't talk about it, they are working on ameliorating that lack, through the non-traditional 24/7 availability of the therapist (reliable caregiver who is predictable, and warm but has strong boundaries), through teaching mindfulness (where one starts to develop self-awareness), and so on.
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I am looking for US graduate programs and I beginning my search by finding potential research mentors. My research interests specifically encompass identity and interpersonal problems associated with borderline personality disorder.  
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I would suggest you look into the Personality Disorders Institute & it's associated psychology training programs at Weill Cornell Medical College and the psychology programs at the University of Washington.  The former is lead by O. Kernberg and the latter has M. Linehan on its faculty.
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Are there only ten items in The Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD)? If not, can someone tell me where I can find the full version, or send it to me? I would like to use it for my future research projects. Thank you!
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Thank you! However, it says there are only nine items, which is even less than the one I found. Maybe I did have the full version?(http://depts.washington.edu/brtc/files/BSL23.pdf)
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I'm searching for a brief questionnaire that assesses for BPD traits or even BPD.  I'm not so interested in a dialogue about the philosophical or clinical merits of this diagnosis, however. 
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I'm writing a paper on the role of the fronto-limbic network in Borderline Personality Disorder (BPD).  In line with my stereotyped notion of BPD behavior, most of the literature seems to correlate BPD with an overactive amygdala-- during various cognitive and emotional tasks, as well as in resting states.  The physiology involved is also closely linked with unprocessed trauma.
A compelling 2013 study observed fronto-limbic activity during an emotional processing task in BPD, Bipolar, and healthy control groups.  Neuro-images captured the BPD and Bipolar groups diverging from healthy controls as they got more dysregulated: they both used less of the left dl-PFC and more of the right vl-PFC.
In the Bipolar set, this activated the dm-PFC, whose limbic connections soothed the amygdala. Behaviorally, I think this means they became aware of feeling dysregulated; they consciously attended, self-soothed, and gained perspective.  In the BPD group, this didn't happen.  This makes sense, since structures along the dm-PFC pathway are implicated in the "sense of self" known to be lacking in BPD.  What they did find was that somehow, for BPD, activity in the amygdala was already diminished... suggesting a disordered bottom-up process.
I can't seem to understand this; I'm unsure of the timeline, whether there's a causal relationship between the lower left-brain activity and higher right-brain activity; and I don't understand it in the context of the vast majority of BPD/limbic literature, which seems contrasting.  However, I am curious whether perhaps even BPD amygdala activity is highly circumstantial.  Details such as where in the amygdala, which hemisphere, and what type of activity/connection, are not included here, neither are they usually specified in the literature.  I believe there may be a subtype of BPD who shows reduced amygdala function not due to co-morbidity with another PD or psychopathy, but in response to pain, and that this could be linked to developing NSSI as a coping skill.  Can anyone tell me more about this, or correct me?  Is it related to dissociation? Is it related to this article?  :)
I would really appreciate any explanations or information available about this!  Most people would probably just leave that article out of the paper, :) but somehow I feel like without it, I'm missing a crucial piece.  I've attached it for anyone willing to read-- it's very brief.  Thank you SO MUCH!
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Corrina, this is not exactly my field as I am involved with a clinical population that includes both BP and BPD, however I have noted that there is evidence in the literature for differential functioning of the left and right amygdala, for example in the area surrounding the right amydala there is decreased gray matter associated with depression, dissociation and pornography addiction, while in the left amydala projection zone there is decreased gray matter in defiant aggressive females.
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People with borderline personality disorder suffer from problems to regulate emotions and thoughts, have unstable relationships with others etc.
My question is: is it possible that a person who has a self-destructive behavior, such as substance abuse, have a depression of any range due to an emotional abandonment?
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The link between PTSD (abuse and neglect) and BPD has been found over and over again
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Can anyone point me to the paper or papers that demonstrated that patients diagnosed with borderline personality disorder also score highly on self-report rating scales for depression and psychosis.
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Thank you all for input - I would like to clarify my question
I don't want to confront metaphysical/ontological questions of the existence or otherwise of certain entities that might be called mental illnesses or disorders etc. I am also not asking about the so-called "co-morbidity" question.
My question is more addressed to the rate of false-positive depression/psychosis diagnoses yielded by self-report questionnaire when compared to a comprehensive psychiatric assessment by a specialist psychiatrist.
I remember reading somewhere that patients who are diagnosed with BPD by a psychiatrist, when completing a self-report symptoms-based questionnaire, will actually appear to have more severe symptoms of depression and/or psychosis than a patient who would be diagnosed with depression or schizophrenia in a psychiatric assessment. That is BPD is associated with over-reporting of symptoms when compared to the so-called Axis 1 disorders.
The context: The NIMH RDoC matrix includes a column called "self-report" and I would like to argue that this column is not actually equivalent to a phenomenologically oriented psychiatric interview.
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A commonly noted factor causing BPD is reported to be environmental stress.  How much of a contributor is stress from the patient's immediate family in initially triggering the onset of the disease,  Until diagnosed and treated, would immediate family conflicts and tensions from reactions to the emerging behaviour symptoms further aggravate the patient's conditions ? Finally, can the patient's immediate family positively contribute to the diagnosis, treatment, recovery and rehabilitation phases.
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One area that CBT is focussed in the last2 decades is Bipolar  Disorder
Please check David Miklowitz papers for Family Focussed Treatments for Bipolar Disorder. I believe you will find them very useful.He is the expert on this topic and you can contact him directly. Please do not hesitate to give my name if you contact him directly
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I have two alternative hypotheses. (1) The client improves when exposed to current events, because he or she faces the reality of those events.  For example, the newspaper mentions the President of the United States. It would refute that the client suffering a delusion of grandeur would realize that they were not the President of the United States. (2) The client improves when exposed to current events, because the cleitn feels that he or she is connected to the larger world aroung him or her versus being stuck in the isolative nature.
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It would probably be a good idea to check out with the client what exposure to such facts would mean to them. I have worked with a lot of clients who when exposed to challenges on their delusional belief systems end up building these facts into said belief systems, hence not actually altering the delusion itself. So it is always helpful to check out how they would interpret this information.
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Most therapists, mental health agencies, consider BPD untreatable.  I choose to believe that all things are possible.  Can anyone lead me to research in this area?
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Hi Terry,
I noticed that the previous comments have mentioned several different treatment options, including DBT.  Interesting, Marsha Linehan, who developed DBT, was herself diagnosed with Borderline Personality Disorder.  She is a powerful example that BPD is treatable.
Many people who have been diagnosed with BPD have learnt to live with their condition and recover (although recovery means a lot of different things to different people).  I am one of them - I'm currently studying for a Masters in developing effective services for people with personality disorder. One of the modules includes an overview of psychologically informed therapeutic interventions, including Schema Focussed Therapy, Dialectical Behavioural Therapy, Therapeutic Communities, Co-Produced/Service User Led Initiatives, Mentalization Based Treatment, Psychologically Informed Environments.
Each has a different focus and underpinning model, and the requirements on where a person is in their recovery journey will depend on whether or not they are considered suitable for each treatment.
This are not an exhaustive list of potential treatments, and what works for one person will not suit another.  The main message I wanted to give you is that people with BPD can and do recover.  I am one, I work with colleagues who have a lived experience of the condition, and several of my lecturers fit into this category.  I am part of a national team in the UK that delivers personality disorder awareness training to staff who work in the health sector, prison/probation and third sector organisations.  Part of the delivery protocols include having a service user consultant to co-facilitate the training.  If recovery weren't possible, this couldn't happen.  
For further information, there is a huge amount written about therapeutic interventions for personality disorder.  I'm not sure where to tell you to start, but Rex Haigh is a UK Consultant Psychiatrist who has done a lot of work in Therapeutic Communities and has also been part of developing the national training for working with personality disorder.  Jeffrey Young developed Schema Therapy, and I have already mentioned Marsha Linehan.
Try accessing the Emergence website: www.emergenceplus.org.uk. Emergence is a service user led third sector organisation that is run by people who have a lived experience of personality disorder.  I work with them delivering consultancy, as well as with the NHS. We work to dispel the stigma associated with personality disorder and work alongside people who are impacted by it - staff, family, friends, service users.  There are various strands to what we do - education, research, consultancy, service design, creative networks.
Another useful website is www.personalitydisorder.org.uk, which outlines 11 of the major UK pilot projects funded to work with personality disorder. Some of them include places mentioned in the above comments (The Haven, etc)
If you have any other questions about specific interventions or recovery, I may not know, but have access to a good network of people who will normally point me in the right direction.
I hope this helps.
Tamar.
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I am interested in knowing more about the endurance of anhedonia in BPD patients after they have suffered a depression. I can't find relevant literature on this topic, so perhaps someone here can help me out?
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Consider iatrogenic etiologies secondary to either dopamine antagonists or SSRIs.
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I work in acute mental health services and would like to do some research surrounding personality disorder and domestic violence. 
Patient type: Females aged 16+
Diagnosis: Borderline Personality Disorder preferred however all personality disorders are of interest. Suspected personality disorder are also of interest. 
Patients must have experienced some form of domestic violence (physical, sexual, financial or emotional) past or current. 
Thank you in advance, your help is greatly appreciated. 
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Hello Isla
There are several points I will try to summarise in regard to your questions before suggesting any studies.
There is indeed a vast majority of empirical evidence showing  adverse mental health outcomes (not necessarily "illness") linked to domestic violence/partner abuse victimisation/perpetration. One of the most common reasons some activists, mental health professionals and researchers do not link disorders found in the DSM is because of the fear of "pathologising" partner abuse and how this could take away accountability for perpetrators, particularly in legal settings (e.g. courts of law). Whilst some research (gendered perspective) focuses on control and structural gender inequality differentials (and to a lesser extent other factors) to explain partner abuse aetiology, other research pioneered by family violence researcher shows a constellation of factors  (amongst them individual factors such as personality features, psychopathology) within an ecological model impacting victims and perpetrators (NOTE here I say mental health indicators have been tested as VARIABLES. This is important to clarify because a great deal of (if not all) studies will test certain mental health CORRELATES  (not causality, e.g. PTSD, depression, anti-social or borderline behaviour, etc.) and partner abuse.
Another point to clarify is that most intimate partner violence is not often only targeted at one person (at least not in countries such as the US, Canada, the UK). You review the studies of Murray Straus and collaborators, John Archer's meta-analyses, etc.
Certainly, history of violence in the family of origin is one of the strongest factors linked to adulthood experiences of partner abuse victimisation/perpetration. You can check the Dunedin longitudinal study by Terri Moffit and colleagues. Researchers such as Murray Straus, Denisse Hines, Michael Johnson have conducted studies investigating  adverse mental health  conditions focusing on women and men by victimisation type. Typological research (focusing also on perpetrators-e.g Holtzworth-Munroe & Stuart, John Gottman, etc) will also shed light on these matters.
 Hopes this helps 
Esteban
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I’m currently involved with an experimental drug protocol for treatment-resistant depression that excludes participants that have borderline personality disorder.  I was inquiring if there is a short assessment tool that helps objectively diagnose a patient with BPD? I understand that diagnosing BPD is a difficult and long process. However, for a research protocol that is time sensitive especially for screening a potential participant, does a valid test exist for BPD?
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Hello,
At our DBT clinic we use the SCID-II interview for diagnosis (First, MB., Gibbon M, Spitzer RL, Williams, JBW, Benjamin LS.: Structured Clinical Interview for DSM-IV Axis II Personality Disorders, (SCID-II). Washington, D.C.: American Psychiatric Press, Inc., 1997), as well as some questionnaire measures to gain a more complete picture of the individuals BPD symptom severity. We use the Borderline Symptom Inventory, and the Difficulties in Emotion Regulation questionnaire, among others. 
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Looking for research results or clinical experiences regarding the intensive day hospital treatment of BPD patients.
My main interest would be towards psychotherapeutic approaches.
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Here's a link to a link to a matched-control study:
All the best,
Matt.
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Borderline Personality Disorder (BPD) is a disorder which causes emotional instability, such as frequent anger etc.
I once got a friend who suffers BPD and shows abrupt of anger many times without sufficient reason. After reading some materials, I found that there is possible link between BPD and lack of sleep, that is the function of brain in BPD looks similar with people which have lack of sleep. I hypothesize that perhaps the serotonin level in BPD is also affected by lack of sleep.
And recently I found a paper in J. Clin. Sleep Med. 2008 which seems to support the connection between BPD and lack of quality sleep, see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2576314/.
Does it mean that BPD can be associated with lack of sleep? Does it mean that a person who suffers BPD should increase their sleep time and also get sleep medication? Your comments are welcome.
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I was of the understanding that poor sleep was more of a symptom of BPD rather than a causal factor.  In my limited experience, BPD sufferers at the peak of the symptoms don't feel like they deserve a good night sleep, consequently don't get them.  That is from anecdotal and limited experience though
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Borderline Personality Disorder is not a diagnostic label usually used by primary care physicians in Spain. I'm not sure if this is a shortcoming or appropriate. Will more knowledge and use of the label BPD lead to better clinical management of BPD patients in primary care?
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I think Jose Nunes makes very good point.
I find it hard to believe that doctors/psychiatrists make this diagnosis (of course with care) to insult the patient (as some colleagues have suggested) and cause them harm)
I can share with colleagues the relief numerous patients of mine have expressed when this diagnostic possibility is carefully and sensitively discussed (making sure the patient does not feel guilty and having positive approach).
Indeed, we need to have some understanding of what we are communicating about (the patient and the doctor) and using a diagnostic label usually helps.
As for the prejudice and stigma, to conquer this, we need to work on our own minds and on the minds of fellow members of society.
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Paranoid schizophrenia is often misdiagnosed. Many times it is confused with nonspecific recurrent psychotic episodes occurring in patients with borderline or antisocial personality. This mistake involves important damage for patients diagnosed like that.
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I thank very much your bibliographic information.
From my point of view, the persistence of this uncertain concept entails important problems for people diagnosed in that way:
1. Treatment with antypsychotic drugs, oftenly during all life.
2. These drugs usually reinforce negative syptoms.
3. Strong stigma with isolation and social rejection.
4. There is a broad hotchpotch betwwen diagnoses of Paranoid Schizophrenia and diagnoses of Unespecified Psychotic Disorder. This high comorbidity is deeply harmful for both groups of patients.
5. Finally, there are scientific data, especially in genetic investigations and in neurocognitive researches, that point to a different nature of positive and negative syndromes of schizophrenia.
For these reasons, I think this diagnosis must disappear or at least it must be preserved to patients with a clear negative syndrome before the begining of antipsychotic treatment.
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Difficulties in emotional dysregulation or relationship difficulties in BPD could diminish the capacity for the client to get involved in his (her) treatment for AD. But anxiety on the other hand could fuel distress. It is often difficult to choose priorities for treatment : AD first, then BPD (ex: DBT), or combined treatment. Any insights on that matter?
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Both research studies and clinical experience suggests that BPD should be the primary target of intervention, rather than co-occurring anxiety disorders. In randomized controlled trials of manual-based psychotherapies for BPD, measures of anxiety have been shown to markedly improve as symptoms of BPD improve (Bateman & Fonagy, 1999). Moreover, in longitudinal studies remission of Axis I disorders is dependent on remission of BPD and not vice versa (Zanarini, 2004). In my own clinical experience, I have witnessed marked improvement in anxiety disorders, including PTSD, OCD, GAD, and panic do, with treatment targeting BPD. From a neurobiological perspective, anxiety symptoms with BPD could be seen as stemming in part from reactivity of the amygdala in response to emotional stimuli (see review by New et al., 2012). Targeted psychotherapies provide a means to remediate the neural pathways involved in adaptive emotion processing.
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This is not an area of expertise for me, so any suggestions would be helpful.
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I recommend the Borderline Personality Inventory developed by Leichsenring (1999). I use the Polish adaptation of it and it works really well. Maybe you should contact with the author?
Leichsenring, F. (1999). Development and first results of the Borderline Personality Inventory: a self – report instrument for assessing Borderline Personality Organization. Journal of Personality Assessment, 73, 1, 45-63.
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I will use SCID II interview for borderline disorder (just borderline section), however, I need to have one or two questionnaires to give me an account of the comorbid axis I and II disorders as well.
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You already posted this question in oktober, are you still in need of suggestions? I agree with Aliza Krieger who suggested the SCID I. You will only use a specific section of the SCID II, why not use the whole interview? Another option for axis I disorders is the MINI (see below for reference) which should take less time compared to other options like the SCID.
good luck!
Sheehan, D.V., Lecrubier, Y., Sheehan, K.H., e.a. (1997). The validity of
the Mini International Neuropsychiatric Interview (M.I.N.I.)
according to the scid-p and its reliability. European Psychiatry,
12, 232-241.
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The best data would be older data for easier IRB. I want to research in this area. I have some help but definitely need data connection. Mental hospital statistics?
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Perhaps the following papers or their authors could be of some help:
# Boysen GA, VanBergen A. A review of published research on adult dissociative
identity disorder: 2000-2010. J Nerv Ment Dis. 2013 Jan;201(1):5-11. doi:
10.1097/NMD.0b013e31827aaf81. Review.
# Boysen GA. The scientific status of childhood dissociative identity disorder:
a review of published research. Psychother Psychosom. 2011;80(6):329-34. doi:
10.1159/000323403. Epub 2011 Aug 5. Review.
# Rodewald F, Wilhelm-Göling C, Emrich HM, Reddemann L, Gast U. Axis-I
comorbidity in female patients with dissociative identity disorder and
dissociative identity disorder not otherwise specified. J Nerv Ment Dis. 2011
Feb;199(2):122-31. doi: 10.1097/NMD.0b013e318208314e.
# Dale KY, Berg R, Elden A, Ødegård A, Holte A. Testing the diagnosis of
dissociative identity disorder through measures of dissociation, absorption,
hypnotizability and PTSD: a Norwegian pilot study. J Trauma Dissociation.
2009;10(1):102-12. doi: 10.1080/15299730802488478.
# Sar V, Unal SN, Ozturk E. Frontal and occipital perfusion changes in
dissociative identity disorder. Psychiatry Res. 2007 Dec 15;156(3):217-23. Epub
2007 Oct 24.
# Sar V, Akyüz G, Doğan O. Prevalence of dissociative disorders among women in
the general population. Psychiatry Res. 2007 Jan 15;149(1-3):169-76. Epub 2006
Dec 8.
# Vermetten E, Schmahl C, Lindner S, Loewenstein RJ, Bremner JD. Hippocampal and
amygdalar volumes in dissociative identity disorder. Am J Psychiatry. 2006
Apr;163(4):630-6.
# Brand BL, Armstrong JG, Loewenstein RJ. Psychological assessment of patients
with dissociative identity disorder. Psychiatr Clin North Am. 2006
Mar;29(1):145-68, x. Review.
# Dorahy MJ, Lewis CA. Dissociative identity disorder in Northern Ireland: a
survey of attitudes and experience among clinical psychologists and
psychiatrists. J Nerv Ment Dis. 2002 Oct;190(10):707-10.
# Gleaves DH, May MC, Cardeña E. An examination of the diagnostic validity of
dissociative identity disorder. Clin Psychol Rev. 2001 Jun;21(4):577-608. Review.
# Sno HN, Schalken HF. Dissociative identity disorder: diagnosis and treatment
in the Netherlands. Eur Psychiatry. 1999 Sep;14(5):270-7.
# Middleton W, Butler J. Dissociative identity disorder: an Australian series.
Aust N Z J Psychiatry. 1998 Dec;32(6):794-804.
# Akyüz G, Doğan O, Sar V, Yargiç LI, Tutkun H. Frequency of dissociative
identity disorder in the general population in Turkey. Compr Psychiatry. 1999
Mar-Apr;40(2):151-9.
# Coons PM. The dissociative disorders. Rarely considered and underdiagnosed.
Psychiatr Clin North Am. 1998 Sep;21(3):637-48. Review.
# Rifkin A, Ghisalbert D, Dimatou S, Jin C, Sethi M. Dissociative identity
disorder in psychiatric inpatients. Am J Psychiatry. 1998 Jun;155(6):844-5.
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Because I am not a clinician, I want to know the real case. They have a fact to often cause a problem action, in society. And they can not keep good relationship with others. For these patients, I think that person centered approach, PCA,(counseling) is effective. Also treatment is difficult in my country, and almost they depends to medication prescription.
I want to hear the real case and the the good idea of the treatment for your BPD patient.
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Person-centred working is important with people with Borderline Personality Disorder. Therapists need to be genuine, consistent and accepting within clear boundaries. However, some of the behaviours exhibited by people with BPD can be problematic for patient and for others, and some other kinds of therapy, including problem management/CBT for self-harm, for example, will probably need to be integrated into a person-centred framework, to establish the safety, stabilization and security necessary to address the underlying trauma. Definitely not a project for the trainee counsellor!