Boarderline Personality Disorder Flashcards
DSM-5 diagnosis for Boarderline personality disorder
A pervasive pattern of instability of personal relationships, self image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five or more of the following:
1)Frantic efforts to avoid real or imagined abandonment. (Note: do not include suicidal behaviours)
2)A pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of idealisation and devaluation (splitting)
3)Identity disturbance: markedly and persistently unstable self-image or sense of self.
4)Impulsivity in at least 2 areas that are potentially self-damaging.
5)Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour.
6)Affective instability due to a marked reactivity of mood.
7)Chronic feelings of emptiness.
8)Inappropriate, intense anger or difficulty controlling anger.
9)Transient, stress related paranoid ideation or severe dissociative symptoms.
What are some assumptions about BPD
It’s permanent
Problems with personality; ergo person is flawed
Always caused by abuse
Relatives need to take more responsibility
Medications will not help
Professionals all agree on treatment
A person has to exhibit self-harm to be diagnosed
People with BPD are manipulative
Cannot attain genuine relationships
All people with BPD’s are the same.
Crisis assessment for BPD
Determine current level of risk to self or others
Client and family need to be clear about risk management and crisis plans
Clear, concise and precise documentation
A long term perspective needs to be held
Comprehensive holistic assessment
Identification of stressors, context and protective factors
MHA can be legally used but ideally avoided
Find out what strategies and supports they have used to deal with previous crises
Ask about alcohol and other drug use
Help the person manage their anxiety and distress by focusing on the current problem
Encourage them to work with staff to identify short-term changes they can make
Process of Self-harm
For many clients the act of self-harm is often the only solution they have for releasing tension it is not an attention seeking device
Triggers
Reactions
Physical response
Thinking
Response
