When Your Loved One Has Borderline Personality Disorder

Escape Plan From a Borderline Woman

Escape from Damaged Woman book is an eye-opener to all men in the modern society who go through domestic abuse and struggles in a relationship all because they fear to get out of the relationship. The book provides ways through which an abused man can apply and get away from the damaged woman in confidence. Reading the book will help a man recognize and decide that he needs to get away from the damaged woman. He will also know how to prepare and take the real action. Ivan Throne has even gone an extra mile of discussing how to handle fragile days after the escape plan is executed and also ways of making sure that the escape plan is permanent. After conducting a test on Escape Plan from the Damaged Woman, results prove that the book contains contents which are solid and compelling which add value to men and society at large. Continue reading...

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What are the symptomsdiagnostic criteria of borderline personality disorder

What are the most prevalent symptoms of borderline personality disorder What developmental characteristics are often present in patients with borderline personality disorder What drug class should be avoided in Benzodiazepines, because of addictive patients with borderline personality potential and with overdose disorder

Borderline personality

The second of the more extreme personality disorders and one that has received considerable attention recently is the borderline personality. It is not very aptly named because it suggests that someone has a personality that is only acceptable in a borderline way. However, the borderline is between neurotic traits (extreme anxiety, emotional instability) and psychotic tendencies (as in schizophrenia). At even more extreme moments, persons with the borderline personality disorder may engage in self-mutilation (usually cutting themselves). They also occasionally suffer psychotic withdrawals from reality in which they lose all sense of time and place. Because of the extremes to which 'borderline' cases swing, they also tend to be diagnosed with other disorders such as depression, generalised anxiety, agoraphobia, and so on. Whereas the anti-social personality disorder is more common in men, the borderline disorder is more common in women. Borderline personality disorder is not well...

Table 193 Characteristics of Borderline Personality Disorder

Typical Thoughts or Beliefs Associated with the Borderline Personality difficulty with relationships, they may form stable relationships if given enoug structure and support. If they find someone who is accepting and stable, who is diplo matic, who meets their expectations for commitment, and who is caring and can diffuse trouble as it occurs, then the borderline personality may experience a satisfying relationship.

Borderline Personality Disorder

There is a great deal of confusion in clinical psychiatry today concerning the boundaries between bipolar II disorder, cyclothymic disorder and borderline personality disorder. Such individuals also often use various substances, which further complicates their diagnostic status. Although much has been written from either personality disorder 220 or mood disorder perspectives 221 , definitive studies to convince the opposite groups are lacking or what has been published is conflicting. In the present author's clinical judgement, conceptualizing borderline conditions as belonging to the bipolar spectrum has the advantage that it opens therapeutic opportunities for them. The diagnosis of borderline personality disorder is usually applied to teenage and young adult females with labile emotionality of particularly hostile nature. Indeed the DSM-IV diagnostic criteria for the disorder indicate a liberal m lange of low-grade affective symptoms and behaviour. The overlap between borderline...

Description Of The Group And Client Popula Tion

This kind of intervention is effective with both time-limited and ongoing process groups. The group leader pay attention to the phenomenon of counterresistance in all types of group psychotherapy. Nevertheless, in groups with regressed, aggressive, narcissistic, borderline patients, as well as patients with serious problems relating to others, then one should be doubly attentive. Greater difficulties can surface and one's careful interventions require more skill on the part of the therapist.

Conclusion And Contraindication

There are some contraindications to conducting this intervention. It may be very challenging for people who were not allowed to say no as children. People with borderline personality disorder or those with other severe interpersonal deficits may have a great deal of difficulty

Contraindications

These interventions are contraindicated for highly narcissistic and borderline patients who will not be able to tolerate and metabolize the intense feelings evoked. Also, leaders who have difficulties in addressing money matters freely and containing negative feelings may not be successful in using the fee as a clinical tool.

Michael J Devlin Stephen A Wonderlich B Timothy Walsh and James E Mitchell

Body checking 78, 79, 81, 82, 84, 85, 87 body dissatisfaction and body image disturbance 78 and childhood trauma 59 in children and adolescents 45, 82, 223 compared in BED, obesity without BED, and bulimia nervosa 79-80 and depression 79, 82 and the dual pathway model of binge eating 47 and low self-esteem 82 in obesity 79 as a risk factor for BED 221 body dysmorphic disorder (BDD) 79 body image, definition 78 body image disturbance in anorexia nervosa 79 cognitive model of 81, 81-2 definition 78-9 development in children and adolescents 82 as a maintaining factor of BED 83, 83-4 as a risk factor for BED 82 three components of 79-81 treatments for 84-6, 129, 197 body image in racial and ethnic groups 19 body mass index (BMI) and body dissatisfaction 79 in Caucasians 18, 21 and childhood trauma 58, 59 in children and adolescents 171 considered acceptable in places of employment and colleges 243 and eating breakfast 94 in intuitive eaters 207 in obesity 68-9 as a predictor of later body...

Causes of Personality Disorders

The material covered in this chapter so far has been mainly descriptive, drawing from and expanding on the diagnostic criteria in the DSM-IV. Abnormal psychology is a strongly descriptive science, and ef forts are mainly to develop classifica tion systems and taxonomies of disorders. This does not mean, however, that there are no attempts to understand how personality disorders develop or what causes one person to have a particular disorder . Researchers generally examine both biological and environmental factors that contribute to the development of personality disorders (Nigg & Goldsmith, 1994). For example, it is clear that persons who suffer with borderline personality disorder experienced poor attachment relationships in childhood (Kernber g, 1975, 1984 Nigg et al., 1994), and that many borderline persons were the tar get of sexual abuse in childhood (W esten et al., 1990). There is abundant evidence that most people with borderline personality disorder grew up in chaotic...

Kay E Segal Sarah E Altman Jessica A Weissman Debra L Safer and Eunice Y Chen

Dialectical Behavior Therapy (DBT) represents an example of one of the new-wave behavior therapies that integrate mindfulness practice into the treatment of Binge Eating Disorder (BED), e.g. acceptance commitment therapy (Lillis et al. 2011) and mindfulness-based cognitive therapy (Kristeller and Wolever 2010). DBT is an outpatient cognitive-behavioral therapy originally developed by Linehan (1993a, 1993b) for women with extreme emotion dysregulation and recurrent suicidal behavior i.e., borderline personality disorder (BPD). A comprehensive skills-based treatment, DBT integrates change-based behavioral strategies (e.g. problem-solving and contingency management) and crisis intervention with strategies derived from acceptance-based practices such as Zen and contemplation practice (e.g. mindfulness and validation). These strategies are integrated within a dialectical framework, emphasizing wholeness, interrelatedness, and process, and utilizing persuasive dialogue and the therapeutic...

Marney A White and Loren M Gianini

On average, adults with BED report higher depression, lower quality of life, and lower self-esteem than NBO adults (de Zwaan et al. 2002 Isnard et al. 2003). Much like Jamie, they may feel depressed about their eating, shape, and repeated failed attempts to lose weight. In general, patients with BED tend to be more concerned with rejection and feeling unworthy as compared to NBO (Nauta et al. 2000). Additionally, binge eating obese adults have higher rates of Axis I comorbid psychopathology than NBO (Fontenelle et al. 2003). In particular, they are more likely to suffer from major depression, and, to a lesser extent, anxiety disorders (Fowler and Bulik 1997). In terms of Axis II diagnoses, some evidence suggests that people with BED have significantly higher rates of all personality disorder diagnoses, particularly borderline personality disorder and avoidant personality disorder (Telch and Stice 1998 Yanovski et al. 1993).

Dimensional Model of Personality Disorders

Widiger (1997) ar gues that disorders simply are maladaptive variants and combinations of normal-range personality traits. The personality traits most studied as sources of disorders are the five traits of the five-factor model, which we reviewed in Cha ter 3. Costa and Widiger (1994) edited an influential book supporting the idea tha the Big Five traits provide a useful framework for understanding disorders. Widiger (1997) presents data ar guing that, for example, borderline personality disorder is extreme narcissism, and schizoid disorder is extreme introversion accompanied by low neuroticism (emotional stability). Extreme introversion accompanied by extremely high neuroticism, on the other hand, results in avoidant personality disorder . Histrionic disorder is characterized as extreme extraversion. Obsessive-compulsive disorder is a maladaptive form of extreme conscientiousness. Schizotypal personality disorder is a complex combination of introversion, high neuroticism, low...

Bipolar Unipolar Dichotomy

Based on epidemiological and family studies and clinical intuition, Akiskal estimated that 4-5 of the general population belongs to a broad bipolar spectrum with predominantly depressive phenomenology and muted bipolar features. These figures contrast the classical figure of 1-1.6 for bipolar disorder. This widening of bipolarity to the detriment of unipolar forms was corroborated by Angst 1 , who demonstrated through epidemiological data that more than 5 of the general population might be affected by bipolar spectrum conditions. Akiskal proposes a number of syndromes as candidates for inclusion in a broadly conceived bipolar spectrum mania, recurrent depressions with hypomania (irrespective of duration), pharmacologically induced hypomania, as well as depressions in association with cyclothymic and hyperthymic temperaments, and recurrent (pseudo-unipolar) depressions with bipolar family history or cyclic depressions responsive to lithium. He also argues that a substantial proportion...

Substance Abuse And Family Life

Disrupted family dynamics can occur irrespective of socioeconomic status and ethnic group membership. Research involving a large cross-sectional sample found that offspring of substance abusers were more likely to experience marital instability and psychiatric symptoms, especially if they had experienced physical and sexual abuse (Greenfield etal., 1993), and it has also been found that alcohol abuse often co-occurs with domestic violence (Fagan, Barnett, & Patton, 1988 Dinwiddie, 1992). Construction of family trees,'' or genograms, are now in common use as clinical tools to depict the degree to which abuse of various substances has had effects on several generations in a family, the extent that support is available from family members, and the emotional valence of kinship relationships (Lex, 1990). Background factors significant for women include childhood violence experiences, violence from a cohabiting partner, and presence of concurrent antisocial and or borderline personality...

Conclusion On Group Therapy

Individual experiential psychotherapy must be handled and utilized cautiously. The clients must be high functioning, have good ego strengths, and willing to receive feedback from the other members. It is important to be careful about who is chosen as a member. Certainly anyone with borderline personality features or disorders, antisocial or narcissistic personality disorders would not be a candidate. Severely depressed clients with poor ego boundaries, active substance users or anyone with marginal intellectual functioning would not be appropriate. In addition, no one should be forced to participate if they are not willing to do so. However, when choosing members for this type of group experience, that is already a consideration.

Trisha M Karr Heather Simonich and Stephen A Wonderlich

In general, numerous studies have shown that comorbid psychiatric disorders are common among individuals with BED, and have indicated that between 33-83 per cent of research participants have at least one additional diagnosis (Hudson et al. 2007 Peterson et al. 2005 Schulz and Laessle 2010 Specker et al. 1994 Telch and Stice 1998 Wilfley et al. 2000 Yanovksi et al. 1993). Similar to Gina, the most frequent diagnoses for participants with BED appear to be mood disorders, anxiety disorders, and substance use disorders. In regard to personality disorders, some studies have reported that personality disorders are more common among individuals with BED than obese controls (Specker et al. 1994 Telch and Stice 1998 Yanovski et al. 1993), whereas others have noted high rates of personality diagnoses, but no differences between obese samples with and without BED (Becker et al. 2010 Wilfley et al. 2000). Across studies, impulsive personality disorders, including borderline personality disorder...

Borderline intellectual functioning An IQ

Between 70 and 85 in the absence of functional or adaptive problems, sometimes considered in the slow learner educational category. Earlier classifications referred to this IQ range as borderline mental retardation. Neither term is linked to borderline personality disorder. borderline personality disorder A pervasive pattern of instability in interpersonal relationships and self-image, with marked impulsivity, beginning by early adulthood. Borderline personality disorder (BPD) affects one in 50 children in the United States. The name borderline personality disorder was given because experts once thought the condition fell somewhere between neurosis and psychosis on the mental illness continuum. Professionals who are educated about the BPD all agree that the name should be changed as it does in no way describe the disorder. Recent research has shown that medications can significantly relieve the suffering of borderline patients when used in combination with psychotherapy. Treatment may...

Caveats in Interpreting Electrophysiologic Data in Substance Abuse Research

Similarly, even though the reductions in P300 amplitude observed during withdrawal from either heroin, cocaine or ethanol (Poijesz et al., 1987 Kouri et al., 1996 Bauer, 1997 Noldy and Carlen, 1997) are very similar to those observed in a number of psychiatric disorders including dementia (Pfefferbaum et al., 1984) schizophrenia (Roth et al., 1980), depression (Diner et al., 1985) and borderline personality disorder (Kutcher et al., 1987), this lack of diagnostic specificity of the P300 has provided important information on the similarities between acute withdrawal from drugs of abuse and these other psychiatric disorders.

When things go wrong in life

Eventually, even though the nurses who had to deal with Emily became sick of her, they managed to track down some medical records for her. They found that she had had a long history of appearing at various hospitals, seeking admission and treatment for a very wide range of problems. Although all of the patient notes were written in a relatively guarded way, it was obvious that Emily always treated people in this unpredictable way. Her history also showed a similar pattern with her family members and friends. Emily was suffering with a borderline personality disorder and so leading all of those who tried to help her to despair. In the end, she was very difficult to help or even to feel any sympathy for.

Length of Treatment

Psychodynamic treatment of depression can be employed either as a brief psychotherapy (approximately 3-6 months) aimed at relief of depressive symptoms or as a longer-term treatment (approximately 6 months to 2 years) aimed at reduction of characterological and intrapsychic vulnerabilities to recurrence of depression. Some patients with recurrent depression, chronic dysthymia, and entrenched character pathology (e.g., borderline personality disorder), however, may require more than 2 years of treatment. Although a short-term treatment can aid in developing some understanding of the conflicts that trigger depressive symptoms, therapists and patients often recognize that a more lengthy treatment may be needed to comprehend more fully those personality problems, internal conflicts, and problematic relationships that can increase the patient's vulnerability to depression. In addition, because conflicts are frequently unconscious, a longer-term treatment can provide an opportunity to...

Case Example

N was a graphic artist in her late 20s who presented with concurrent diagnoses of borderline personality disorder and severe depression. This patient had a history of alcohol abuse and a prior suicide attempt, and her interpersonal relationships were quite stormy. Ms. N would feel upset and victimized if friends or coworkers seemed uncaring and would confront them with tearful, angry recriminations. She paid such attention to the subtle details of her interactions that one former boyfriend chided her that being in a relationship with you is like reading a book and having to study every footnote.

Case Illustration

S, a 34-year-old, single African American female with a 10th-grade education, overdosed on her antidepressant medication with a moderate degree of suicide intent and lethality following occupational stressors that led to her job termination. The patient attributed her depressive symptoms to her recurrent poor job evaluations during the past year. In addition, Ms. S had been experiencing significant symptoms of posttraumatic stress disorder (PTSD) due to her history of chronic sexual abuse at the age of 14, and witnessing at the age of 28 the killing of her boyfriend by gang members. Her first and only other reported suicide attempt was at the age of 15, when she confided in her mother about the sexual molestation by the mother's live-in boyfriend. However, her mother reportedly did not believe her daughter's account of the abuse and allowed the perpetrator to remain in the household. The patient had a history of alcohol, marijuana, and cocaine abuse prior to her boyfriend's death...

Psychotherapy

Gabbard et al 67 , in a meta-analysis of 10 published studies involving randomized assignment to psychotherapy or clinical management in conjunction with standard pharmacotherapy, found significant overall cost savings attributable to psychotherapy for individuals with bipolar disorder as well as schizophrenia and borderline personality disorder. Much of the economic impact of psychotherapy was linked with reduced inpatient treatment and decreased work impairment, suggesting a benefit both for direct and indirect illness-related expenses.

Future Directions

Shulman et al, in their review of age and gender issues on phenomenology and management of bipolar disorder, have given the reader a most comprehensive view of the literature. The recurrent themes of discussion and debate about child and adolescent bipolar disorder include Does bipolar disorder really onset in this age group How common is it How can one recognize bipolar disorder before there is threshold level mania What are the overlaps and interfaces with attention deficit hyperactivity disorder (ADHD) and conduct disorder, alcohol and substance abuse, and borderline personality functioning Are the clinical manifestations different from the classical adult onset variety of the disorder Is there cognitive dysfunction and functional deficit in juvenile onset bipolar disorder What are the effective treatments in this age group Although clinicians often use dichotomous diagnostic thinking to come to a decision if an adolescent is suffering from a bipolar disorder or borderline...

Good vs Evil

Paul Soloff and colleagues from the University of Pittsburgh have found prefrontal hypoperfusion and decreased glucose uptake in the prefrontal cortex (PFC) in violent criminal offenders, murderers and aggressive psychiatric patients. FDG-PET studies were also performed after a fenfluramine challenge. In healthy volunteers, fenfluramine led to increases in glucose utilization in the left prefrontal and left temperoparietal cortex. Studies were performed in persons with borderline personality disorder (BPD), a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. In these persons, fenfluramine produced bilateral frontal cortex activation and decreased activity of the temporal cortex and thalamus.

What is abnormal

To describe someone as abnormal depends on the circumstances. What is abnormal in one culture or at one time might not be abnormal in the next culture or a few years later. One way of looking at abnormality is statistically. This equates the abnormal with the rare. At first sight this might seem reasonable. In Western culture, the two types of reaction described at the start of this chapter are relatively rare. Fortunately, either for themselves or for those around them, not many people suffer from paranoia or from borderline personality disorder. But, there again, even fewer people win a Nobel Prize or run a 4-minute mile. This is even more abnormal, but such achievements do not have anything negative about them.

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