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Borderline Personality Disorder (borderline + personality_disorder)
Selected AbstractsPossible selves and borderline personality disorderJOURNAL OF CLINICAL PSYCHOLOGY, Issue 3 2006Irene Belle Janis Although clinical theories suggest that people with Borderline Personality Disorder (BPD) experience a confused sense of self, little empirical research has directly examined the self in BPD (Heard & Linehan, 1993; Westen & Cohen, 1993). In this study, 43 female participants, 15 with BPD and 28 without BPD, completed the closed-ended version of Markus and Wurf's (1987) Possible Selves Questionnaire (PSQ). Participants with BPD were less likely than controls to endorse positive possible selves as current, but more likely to endorse negative possible selves as current, probable, desired, and important. Participants with BPD linked negative and positive selves to their desired selves, which is consistent with the unstable sense of self characteristic of BPD. © 2005 Wiley Periodicals, Inc. J Clin Psychol 62: 387,394, 2006. [source] The States Description Procedure: the use of guided self-reflection in the case formulation of patients with Borderline Personality DisorderCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 1 2005Dawn Bennett Patients with Borderline Personality Disorder are prone to switch between contrasting states in ways that are confusing to themselves and others. The Multiple Self States Model provides an explanation of this. Based on this model, a method of guided patient self-reflection is described, which can contribute to the recognition and characterization of the individual patient's array of contrasting states and provide a guide to treatment and management. A case example is provided, illustrating the understandings derived from the procedure.,Copyright © 2004 John Wiley & Sons, Ltd. [source] Individual differences in psychophysiological reactivity in adults with childhood abuseCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 4 2002Christian G. Schmahl Little is known about the neurobiological correlates of stress-related disorders. In particular almost nothing is known about biological correlates of specific personality disorders that have been linked to stress. We measured heart rate and blood pressure reactivity in response to personalized traumatic scripts together with subjective psychological ratings in four women with a history of childhood abuse with no disorder, Posttraumatic Stress Disorder, Borderline Personality Disorder, and Histrionic Personality Disorder. Psychophysiology as well as subjective ratings differed markedly between the four women, with elevated reactions found in PTSD and histrionic personality, and extreme decline in physiological reactivity associated with a dissociative response in the borderline patient. It is concluded that reactivity to traumatic reminders can be correlated with the existence of different stress-related diagnoses. Personality characteristics seem to have an influence on psychophysiological reactivity in patients with stress-related psychiatric disorders. Copyright © 2002 John Wiley & Sons, Ltd. [source] Reevaluating the distinction between Axis I and Axis II disorders: The case of borderline personality disorderJOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2005Anthony C. Ruocco The division between Axis I clinical syndromes and Axis II personality disorders is a long-standing distinction based primarily on three guiding principles: phenomenology, cause, and course. Clinical syndromes were generally thought to be characterized by transient symptoms with biological causes and an unstable course; personality disorders were supposed by many to be characterized by long-standing personality traits, whose roots were primarily psychological, and a stable and unremitting course. Borderline personality disorder (BPD), however, is a condition characterized by distinct clinical symptoms, varied causes, and a relatively unstable course. Past theorizing about the distinction between Axis I and Axis II disorders is presented in light of recent empirical evidence refuting the rationalization for the separation of personality disorders and clinical syndromes using BPD as a means for comparison. © 2005 Wiley Periodicals, Inc. J Clin Psychol 61: 1509,1523, 2005. [source] Why borderline personality disorder is neither borderline nor a personality disorderPERSONALITY AND MENTAL HEALTH, Issue 2 2009Peter Tyrer Objectives,Borderline personality disorder is the most well-studied personality disorder in psychiatry. Despite its great influence in the study of these conditions, it has not been properly recognized that borderline personality disorder is atypical. Design,A critical analysis of the differences between borderline and other personality disorders is made. Method,A comparison is made between borderline personality disorder and other personality disorders with respect to diagnostic criteria, relationship to normal personality variation and treatment options. Results,Analysis of the operational criteria for borderline and schizotypal personality disorders shows that these are the only personality disorders that are dominated by discrete symptoms rather than traits. Cluster analysis of a data set of personality traits obtained between 1976 and 1978 (before borderline personality disorder became fashionable in the UK) could find no profile that supports the existence of a borderline personality disorder grouping, and the study of published papers on treatment in personality disorder shows a 3,:,1 ratio for borderline personality disorder compared with all other personality disorders combined, approaching 9,:,1 when unspecified (probably mainly borderline) conditions are taken into account. Conclusions,Borderline personality disorder is incorrectly classified as a personality disorder and does an injustice to those who suffer from it. It is better classified as a condition of recurrent unstable mood and behaviour, or fluxithymia, which is better placed with the mood disorders than in odd isolation as a personality disorder. Copyright © 2009 John Wiley & Sons, Ltd. [source] Borderline personality disorder and sensory processing impairmentPROGRESS IN NEUROLOGY AND PSYCHIATRY, Issue 4 2009Stephen Brown FRCPsych Sensory processing disorder (SPD) is a term advocated by some occupational therapists to describe a range of problems that might be amenable to particular treatment strategies, and has mainly been applied within the fields of paediatrics and learning disability. In this article,the authors investigate whether there could be a common ground between borderline personality disorder (BPD) and SPD and describe an extension of the treatment strategies for SPD to those with BPD in their acute inpatient unit. Copyright © 2009 Wiley Interface Ltd [source] Diagnostic profiles of offenders in substance abuse treatment programsBEHAVIORAL SCIENCES & THE LAW, Issue 4 2008Christine E. Grella Ph.D. This study examined the association of Axis I and Axis II disorders among offenders who were in prison-based substance abuse treatment in a national multi-site study. Participants (N,=,280) received a psychosocial assessment and a structured diagnostic interview in two separate sessions. Logistic regression models examined the association between lifetime mood and anxiety disorders with two personality disorders, and the relationship of Axis I and Axis II disorders (alone and in combination) to pre-treatment psychosocial functioning. Over two-thirds of the sample met criteria for at least one mental disorder. Borderline personality disorder was strongly associated with having a lifetime mood disorder (odds ratio,=,7.5) or lifetime anxiety disorder (odds ratio,=,8.7). Individuals with only an Axis II disorder, or who had both Axis I and Axis II disorders, had more severe problems in psychosocial functioning than those without any disorder. Clinical treatment approaches need to address this heterogeneity in diagnostic profiles, symptom severity, and psychosocial functioning. Copyright © 2008 John Wiley & Sons, Ltd. [source] Gender differences in jail inmates' symptoms of mental illness, treatment history and treatment seeking,CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2009Amy L. Drapalski Background,Rates of mental illness among prisoners are substantial, but little is known about the unique mental health needs of women in jail, those under pre-trial custodial remand or serving short sentences. Aims,To compare male and female jail inmates along a wide range of symptoms of mental illness using identical assessment methods, and to examine gender differences in treatment seeking before and during incarceration. Methods,Soon after incarceration in a county jail, 360 male and 154 female pre-trial and post-trial inmates completed the Personality Assessment Inventory, a wide-ranging measure of psychiatric symptoms. Treatment seeking information was taken from official jail records. Results,Women were more likely to report clinically significant symptoms of anxiety, borderline personality features, somatic concerns and trauma-related symptoms; however, trauma-related symptoms and borderline features were also common among male inmates. Although both men and women reported high rates of drug-related problems, alcohol-related problems were twice as prevalent among male inmates. Female inmates were more likely to seek and be enrolled in jail-based treatment; there were no differences in reported help seeking prior to incarceration. Conclusions,Female jail inmates are especially in need of mental health services. Effective interventions for post-traumatic stress disorder and borderline personality disorder are needed in jail settings for both male and female inmates during incarceration and upon release. Copyright © 2009 John Wiley & Sons, Ltd. [source] The 10-year course of psychosocial functioning among patients with borderline personality disorder and axis II comparison subjectsACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2010M. C. Zanarini Zanarini MC, Frankenburg FR, Bradford Reich D, Fitzmaurice G. The 10-year course of psychosocial functioning among patients with borderline personality disorder and axis II comparison subjects. Objective:, The purpose of this study was to determine the 10-year course of the psychosocial functioning of patients with borderline personality disorder (BPD). Method:, The social and vocational functioning of 290 inpatients meeting both the Revised Diagnostic Interview for Borderlines (DIB-R) and DSM-III-R criteria for BPD and 72 axis II comparison subjects were carefully assessed during their index admission. Psychosocial functioning was reassessed using similar methods at five contiguous 2-year time periods. Results:, Borderline patients without good psychosocial functioning at baseline reported difficulty attaining it for the first time. Those who had such functioning at baseline reported difficulty retaining and then regaining it. In addition, over 90% of their poor psychosocial functioning was due to poor vocational but not social performance. Conclusion:, Good psychosocial functioning that involves both social and vocational competence is difficult for borderline patients to achieve and maintain over time. In addition, their vocational functioning is substantially more compromised than their social functioning. [source] The catechol o-methyltransferase (COMT) val158met polymorphism modulates the association of serious life events (SLE) and impulsive aggression in female patients with borderline personality disorder (BPD)ACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2010S. Wagner Wagner S, Baskaya Ö, Anicker NJ, Dahmen N, Lieb K, Tadi, A. The catechol o-methyltransferase (COMT) val158met polymorphism modulates the association of serious life events (SLE) and impulsive aggression in female patients with borderline personality disorder (BPD). Objective:, We analyzed i) the effects of serious life events (SLE) on impulsive aggression, and ii) modulating effects of the COMT Val158Met polymorphism on the association between SLEs and impulsive aggression in borderline personality disorder (BPD). Method:, One hundred and twelve female BPD patients from Germany were included in this study. Impulsive aggression was assessed by the Buss-Durkee-Hostility Inventory (BDHI). Results:, Childhood sexual abuse was associated with lower BDHI sum score (P = 0.003). In COMT Val158Val carriers, but not in Val/Met and Met/Met carriers, childhood sexual abuse and the cumulative number of SLEs were associated with lower BDHI sum scores (P < 0.05). Conclusion:, This study analyzing a specific gene × environment interaction in female BPD patients suggests an association between SLEs and impulsive aggression, as well as a modulating effect of the COMT Val158Val genotype on the relation between SLEs and impulsive aggression. [source] Impulsive aggression in adults with attention-deficit/hyperactivity disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2010J. H. Dowson Dowson JH, Blackwell AD. Impulsive aggression in adults with attention-deficit/hyperactivity disorder. Objective:, DSM-IV criteria for attention-deficit/hyperactivity disorder (ADHD) include examples of ,impulsivity'. This term can refer to various dysfunctional behaviours, including some examples of aggressive behaviour. However, impulsive aggression is not included in the DSM-IV criteria for ADHD. The associations of impulsive aggression with ADHD were investigated. Method:, Seventy-three male adults with DSM-IV ADHD, and their informants, completed questionnaires. Impulsive aggression was assessed by ratings of two criteria for borderline personality disorder (BPD), involving hot temper and/or self-harm. Results:, Logistic regression indicated that features of DSM-IV ADHD were predictors of comorbid impulsive aggression. However, compared with ADHD features, verbal IQ and comorbid psychopathology were more strongly associated with impulsive aggression. Conclusion:, The findings support the inclusion of features of impulsive aggression, such as hot temper/short fuse, in the ADHD syndrome in adults. These overlap with features of BPD. The findings inform the selection of research samples. [source] Psychotic reactivity in borderline personality disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2010J.-P. Glaser Glaser J-P, Van Os J, Thewissen V, Myin-Germeys I. Psychotic reactivity in borderline personality disorder. Objective:, To investigate the stress relatedness and paranoia specificity of psychosis in borderline personality disorder (BPD). Method:, Fifty-six borderline patients, 38 patients with cluster C personality disorder, 81 patients with psychotic disorder and 49 healthy controls were studied with the experience sampling method (a structured diary technique) to assess: i) appraised subjective stress and ii) intensity of psychotic experiences. Results:, All patient groups experienced significantly more increases in psychotic experiences in relation to daily life stress than healthy controls, borderline patients displaying the strongest reactivity. Borderline patients, moreover, reported significantly more hallucinatory reactivity than healthy controls and subjects with cluster C personality disorder. Paranoid reactivity to daily life stress did not differ between the patient groups. Conclusion:, These results are the first to ecologically validate stress-related psychosis in BPD. However, psychotic reactivity was not limited to expression of paranoia but involved a broader range of psychotic experiences including hallucinations. [source] Script-driven imagery of self-injurious behavior in patients with borderline personality disorder: a pilot FMRI studyACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010A. Kraus Objective:, Self-injurious behavior (SIB) is one of the most distinctive features of borderline personality disorder (BPD) and related to impulsivity and emotional dysregulation. Method:, Female patients with BPD (n = 11) and healthy controls (n = 10) underwent functional magnetic resonance imaging while listening to a standardized script describing an act of self-injury. Experimental sections of the script were contrasted to the neutral baseline section and group-specific brain activities were compared. Results:, While imagining the reactions to a situation triggering SIB, patients with BPD showed significantly less activation in the orbitofrontal cortex compared with controls. Furthermore, only patients with BPD showed increased activity in the dorsolateral prefrontal cortex during this section and a decrease in the mid-cingulate while imagining the self-injurious act itself. Conclusion:, This pattern of activation preliminary suggests an association with diminished emotion regulation, impulse control as well as with response selection and reappraisal during the imagination of SIB. [source] Psychotherapy of borderline personality disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009M. C. ZanariniArticle first published online: 6 OCT 200 Objective:, Psychotherapy is considered the primary treatment for borderline personality disorder (BPD). Currently, there are four comprehensive psychosocial treatments for BPD. Two of these treatments are considered psychodynamic in nature: mentalization-based treatment and transference-focused psychotherapy. The other two are considered to be cognitive-behavioral in nature: dialectical behavioral therapy and schema-focused therapy. Method:, A review of the relevant literature was conducted. Results:, Each of these lengthy and complex psychotherapies significantly reduces the severity of borderline psychopathology or at least some aspects of it, particularly physically self-destructive acts. Conclusion:, Comprehensive, long-term psychotherapy can be a useful form of treatment for those with BPD. However, less intensive and less costly forms of treatment need to be developed. [source] Pathological dissociation and neuropsychological functioning in borderline personality disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009V. Ø. Haaland Objective:, Transient, stress-related severe dissociative symptoms or paranoid ideation is one of the criteria defining the borderline personality disorder (BPD). Examinations of the neuropsychological correlates of BPD reveal various findings. The purpose of this study was to investigate the association between dissociation and neuropsychological functioning in patients with BPD. Method:, The performance on an extensive neuropsychological battery of patients with BPD with (n = 10) and without (n = 20) pathological dissociation was compared with that of healthy controls (n = 30). Results:, Patients with pathological dissociation were found to have reduced functioning on every neuropsychological domain when compared with healthy controls. Patients without pathological dissociation were found to have reduced executive functioning, but no other differences were found. Conclusion:, Pathological dissociation is a clinical variable that differentiates patients with BPD with regard to cognitive functioning. [source] Improvement in borderline personality disorder in relationship to ageACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2009M. Tracie Shea Objective:, It is commonly believed that some features of borderline personality disorder (BPD) improve as individuals reach their late 30s and 40s. This study examined age-related change in borderline criteria and functional impairment, testing the hypothesis that older age would be associated with relatively more improvement than younger age. Method:, A total of 216 male and female participants with BPD were followed prospectively with yearly assessments over 6 years. Results:, Participants showed similar rates of improvement in borderline features regardless of age. A significant age by study year interaction showed functioning in older subjects to reverse direction and begin to decline in the latter part of the follow-up, in contrast to younger subjects who maintained or continued improvement over the 6 years. Despite the decline, functioning for the older subjects was comparable with or slightly better at year 6 than at year 1. Conclusion:, Improvement in borderline features is not specific to the late 30s and 40s. There may be a reversal of improvement in functioning in some borderline patients in this older-age range. [source] Management of borderline personality disorder: emerging, new pharmacological and non-pharmacological strategiesACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009Shailendra Kapoor MD No abstract is available for this article. [source] The characteristics of heroin users entering treatment: findings from the Australian Treatment Outcome Study (ATOS)DRUG AND ALCOHOL REVIEW, Issue 5 2005JOANNE ROSS Abstract The current study aimed to describe the characteristics (demographics, drug use, mental and physical health) of entrants to treatment for heroin dependence in three treatment modalities; and to compare these characteristics with heroin users not in or seeking treatment. Participants were 825 current heroin users recruited from Sydney, Adelaide and Melbourne: 277 entering methadone/buprenorphine maintenance treatment (MT), 288 entering detoxification (DTX), 180 entering drug-free residential rehabilitation (RR) and 80 not in treatment (NT). Treatment entrants were generally long-term heroin users with previous treatment experience. The majority of the sample (55%) were criminally active in the month preceding interview. Injection-related health problems (74%) and a history of heroin overdose (58%) were commonly reported. There were high degrees of psychiatric co-morbidity, with 49% reporting severe psychological distress, 28% having current major depression, 37% having attempted suicide and 42% having a lifetime history of post-traumatic stress disorder. Personality disorders were also prevalent, with 72% meeting criteria for antisocial personality disorder and 47% screening positive for borderline personality disorder. Striking similarities were noted between the non-treatment and treatment groups in length of heroin use career, drug use and treatment histories. [source] New onsets of substance use disorders in borderline personality disorder over 7 years of follow-ups: findings from the Collaborative Longitudinal Personality Disorders StudyADDICTION, Issue 1 2009Marc Walter ABSTRACT Aims The purpose of this study was to examine whether patients with borderline personality disorder (BPD) have a higher rate of new onsets of substance use disorders (SUD) than do patients with other personality disorders (OPD). Design This study uses data from the Collaborative Longitudinal Personality Disorder Study (CLPS), a prospective naturalistic study with reliable repeated measures over 7 years of follow-up. Setting Multiple clinical sites in four northeastern US cities. Participants A total of 175 patients with BPD and 396 patients with OPD (mean age 32.5 years) were assessed at baseline and at 6, 12, 24, 36, 48, 60, 72 and 84 months. Measurements The Structured Clinical Interview for DSM-IV Axis I Disorders and the Diagnostic Interview for DSM-IV Personality Disorders were used at baseline, the Follow-Along version of the DIPD-IV and the Longitudinal Interval Follow-up Evaluation at the follow-up evaluations. Kaplan,Meier analyses were calculated to generate the time to new onsets. Findings BPD patients showed a shorter time to new onsets of SUD. Thirteen per cent of BPD patients developed a new alcohol use disorder and 11% developed a new drug use disorder, compared to rates of 6% and 4%, respectively, for OPD. Non-remitted BPD and remitted BPD patients did not differ significantly in rates of new onsets of SUD. Conclusions BPD patients have a high vulnerability for new onsets of SUDs even when their psychopathology improves. These findings indicate some shared etiological factors between BPD and SUD and underscore the clinical significance of treating SUD when it co-occurs in BPD patients. [source] Clinical Features and Prognosis of Nonepileptic Seizures in a Developing CountryEPILEPSIA, Issue 3 2001W. Silva Summary: ,Purpose: To determine the predictive value of clinical features and medical history in patients with nonepileptic seizures (NESs). Methods: One hundred sixty-one consecutive ictal video-EEGs were reviewed, and 17 patients with 41 NESs identified. NES diagnosis was defined as paroxysmal behavioral changes suggestive of epileptic seizures recorded during video-EEG without any electrographic ictal activity. Clinical features, age, sex, coexisting epilepsy, associated psychiatric disorder, social and economic factors, delay in reaching the diagnosis of NES, previous treatment, and correlation with outcome on follow-up were examined. Results: The study population included 70% female patients with a mean age of 33 years. Mean duration of NESs before diagnosis was 9 years. Forty-one percent had coexisting epilepsy. The most frequent NES clinical features were tonic,clonic mimicking movements and fear/anxiety/hyperventilation. The most common psychiatric diagnosis was conversion disorder and dependent and borderline personality disorder. Seventy-three percent of patients with pure NESs received antiepileptic drugs (AEDs), and 63.5% of this group received new AEDs. Fifty-nine percent of the patients received psychological/psychiatric therapy. At follow-up, 23.5% were free of NESs. Conclusions: All seizure-free patients had two good prognostic factors: having an independent lifestyle and the acceptance of the nonepileptic nature of the episodes. Video-EEG monitoring continues to be the diagnostic method to ensure accurate seizure classification. Establishing adequate health care programs to facilitate access to new technology in public hospitals as well as the implementation of continuous education programs for general practitioners and neurologists could eventually improve the diagnosis and treatment of patients with NESs. [source] Personality disorders in 545 patients with eating disordersEUROPEAN EATING DISORDERS REVIEW, Issue 2 2008*Article first published online: 5 DEC 200, Kristine Godt Abstract Objective Previous research on the prevalence of personality disorders in patients with eating disorders varies greatly in findings, but a general understanding seem to exist that personality disorders are rather common among eating-disordered patients. The present investigation is aimed at establishing the prevalence of DSM III-R or DSM IV personality disorders in a large population seeking treatment for eating disorders. Method Five hundred and forty-five patients with DSM IV- eating disorders have been evaluated using the structured clinical interview for DSM III-R or IV-Axis II and the eating disorder examination. Results The 29.5% of the population have one or more personality disorders according to DSM III-R or DSM IV criteria. Personality disorders, and specifically borderline personality disorder, are significantly more common in patients with bulimia nervosa. Discussion The proportion of eating-disordered patients with co-morbid personality disorder may not be as large as often found in studies. This challenges the understanding of a strong overall connection between the two groups of disorder; however, the connection seems to exist in subsets of eating disorder samples. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Validation of the UPPS impulsive behaviour scale: a four-factor model of impulsivityEUROPEAN JOURNAL OF PERSONALITY, Issue 7 2005Stephen P. Whiteside The current study attempts to clarify the multi-faceted nature of impulsivity through the use of the four-factor UPPS Impulsive Behaviour scale. In order to build the nomological network surrounding this scale, the UPPS was administered to individuals with borderline personality disorder (BPD), pathological gamblers (PG), alcohol abusers (divided into two groups based on the presence of antisocial features), and a control group. Several of the UPPS scales (e.g. Urgency, lack of Premeditation, and Sensation Seeking) differentiated the BPD, PG, and alcohol abusers with antisocial features from a group of non-antisocial alcohol abusers and a control group. Overall, the UPPS scales accounted for between 7% (pathological gambling) and 64% (borderline personality disorder features) of the overall variance in the psychopathology measures. Individual UPPS scales also made unique contributions to several of these disorders, which may provide insight into which of these personality traits may predispose individuals to behave in maladaptive or problematic ways. The results provide support for the differentiation of impulsivity-related constructs into the current four-factor model. Copyright © 2005 John Wiley & Sons, Ltd. [source] The Epigenesis of the Family System as a Context for Individual DevelopmentFAMILY PROCESS, Issue 3 2002Herta A. Guttman M.D. In this article, the concept introduced by Lyman Wynne, that the individual develops epigenetically within the family system, is discussed and validated with data from a study of the characteristics and relationships of 27 women with borderline personality disorder and their parents. Each stage of the epigenetic process is impaired in one way or another, adversely affecting subsequent stages. Early impairment of attachment-care-giving processes is at least partly attributable to a lack of empathic parenting; effective communication is marred by family members' inability to experience or express feelings (alexithymia); this, in turn, makes it difficult to engage in joint family problem solving. Mutuality between family members does not occur in such a context, and there is an absence of intimacy between family members. These are often abusive family systems, with multiple abuse and intrafamilial sexual abuse more specifically directed at the daughter with BPD. The symptoms of the daughter can be understood systemically, as representing both predispositional characteristics and reactions to the family system. It is suggested that the epigenetic paradigm could be used to characterize the specific failure of developmental processes in many different disorders. [source] The transitional object in dementia: clinical implicationsINTERNATIONAL JOURNAL OF APPLIED PSYCHOANALYTIC STUDIES, Issue 2 2007Sheila LoboPrabhu Abstract The concept of the transitional object in human development was first proposed by Winnicott, and it has been extensively discussed in the child psychoanalytic literature. However, there are very few empirical studies on the transitional object in adult development. The transitional object has been discussed in relation to medical illness, medication, aggression, dreams, spirituality and religion, borderline personality disorder, anxiety disorder, fetishes, medication, and body image. There is very little literature on the transitional object in dementia. Dementia is a process of transition from a healthy, active state to a dependent state with progressive loss of memory, functional skills, and independence. Patients and families experience grief, loss, fear, anxiety, guilt, and anger. In this article, we address the role of the transitional object in dementia. We discuss the concepts of the transitional object and precursor object, and their possible role in interventions with patients and caregivers. We discuss various aspects of the therapeutic process and treatment setting, which may serve as transitional objects in various stages of dementia. The therapeutic relationship serves as the "holding environment" in which various transitions may be safely accomplished. Copyright © 2007 John Wiley & Sons, Ltd. [source] Art psychotherapy in a consumer diagnosed with borderline personality disorder: A case studyINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2009Scott Lamont ABSTRACT This case study reviews 11 sessions of art psychotherapy with a consumer diagnosed with having borderline personality disorder. A consumer who reported difficulty in communicating her lived trauma verbally and engaged in self-harming behaviour was offered individual art therapy sessions following a consultation between an art therapy student and clinical nurse consultant in an attempt to understand her experiences and to collaboratively engage her. Notes were taken after each session by the art therapy student, reflecting conversations with this consumer while they were engaged in art making, which were subsequently explored within formal clinical supervision sessions with a mental health nurse consultant. An art portfolio is reproduced. It illustrates the expressive power of image creation. The key features of the images were that of lived trauma, the externalization of thoughts and feelings, and intense emotional expression. The results of this chronological art portfolio case study indicated therapeutic benefits from the intervention for this consumer. Further investigations of this type of intervention are warranted within the mental health setting. [source] Cluster A personality disorders: Considering the ,odd-eccentric' in psychiatric nursingINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2007Brent A. Hayward ABSTRACT:, Psychiatric nurses are familiar with the concept of personality disorder because of their contact with persons with the most common personality disorder in clinical settings , borderline type, who frequently engage mental health services. Perhaps it is this familiarity that has focused research and clinical attention on borderline personality disorder compared with the other personality disorders. The significance of cluster A personality disorders for nursing is multifaceted because of their severity, prevalence, inaccurate diagnosis, poor response to treatment, and similarities to axis I diagnoses. Despite this, literature reviews have established that relatively few studies have focused on the treatment of the cluster A personality disorders , paranoid, schizotypal, and schizoid , resulting in a dearth of evidence-based interventions for this group of clients. A discussion of these disorders in the context of personality disorder and their individual characteristics demonstrates the distinctive and challenging engagement techniques required by psychiatric nurses to provide effective treatment and care. It is also strongly indicated that the discipline of psychiatric nursing has not yet begun to address the care of persons with cluster A personality disorders. [source] Borderline pathology in children and adolescentsINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2004Charles Meekings ABSTRACT:,,Mental health nurses have historically been pessimistic about and often unsympathetic towards clients diagnosed with borderline personality disorder. By the time these clients reach adult mental health services their behaviours are often difficult to manage and they often suffer significant re-victimization by health services. Questions need to be raised about how best to avert the consolidation of the problems associated with the disorder. This paper explores the concept of ,borderline pathology' in children and adolescents and examines the best available evidence for utilizing an early identification and intervention model for children and adolescents who exhibit this constellation of symptoms. [source] Emotional intelligence and mental disorderJOURNAL OF CLINICAL PSYCHOLOGY, Issue 9 2009Janine Hertel Abstract Emotional abilities were measured with a performance test of emotional intelligence (The Mayer-Salovey-Caruso Emotional Intelligence Test; Mayer, Salovey, & Caruso, 2002) in patients diagnosed with major depressive disorder, substance abuse disorder, or borderline personality disorder (BPD), and a nonclinical control group. Findings showed that all clinical groups differed from controls with respect to their overall emotional intelligence score, which dovetails with previous findings from self-report measures. Specifically, we found that the ability to understand emotional information and the ability to regulate emotions best distinguished the groups. Findings showed that patients with substance abuse disorder and BPD patients were most impaired. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1,13, 2009. [source] Dialectical behavior therapy for comorbid personality disordersJOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2008Thomas R. Lynch Abstract Dialectical behavior therapy (DBT) was originally designed as a treatment of emotionally dysregulated, impulsive, and dramatic disorders (e.g., borderline personality disorder) and populations (e.g., parasuicidal women). However, a number of complex disorders represent the dialectical opposite of BPD and related disorders; these disorders are characterized by being overcontrolled, emotionally constricted, perfectionistic, and highly risk-averse. In this article, the authors introduce a recent adaptation of DBT that targets cognitive,behavioral rigidity and emotional constriction and illustrates its application through the case of a man suffering from both paranoid personality disorder and obsessive,compulsive personality disorder. © 2008 Wiley Periodicals, Inc. J Clin Psychol. In Session 64: 1,14, 2008. [source] Structure of borderline personality disorder symptoms in a nonclinical sampleJOURNAL OF CLINICAL PSYCHOLOGY, Issue 9 2007Jeanette Taylor Relations among symptoms of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) borderline personality disorder (BPD) assessed using semistructured clinical interviews were examined using exploratory principal components analysis in a sample of 82 college men and women who were symptomatic for BPD (30.4% of whom met criteria for a BPD diagnosis at threshold or subthreshold certainty level). A three-component solution was found and, as expected, the first component was characterized by interpersonal instability and included unstable relationships, identity disturbance, and chronic emptiness. The second component reflected affective instability and low impulsivity. The third component reflected stress-related paranoia and low anger. Results highlight similarities in the structure of BPD criteria in clinical and nonclinical samples, and could inform future research on dimensional models of BPD. © 2007 Wiley Periodicals, Inc. J Clin Psychol 63: 805,816, 2007. [source] | ||||||||||||||||||||||||||||||||||