Borderline Personality Disorder Flashcards
What are the four primary areas that the nine symptoms can be divided into?
- Mood instability
- Impulsivity and uncontrolled behaviours
- Interpersonal psychopathology
- Distortions of thought and perception
What are the primary features of BPD?
Impulsivity
Instability in relationships
Instability in self-image
Instability in mood
Which symptoms from the DSM-IV-TR come under the subdivision of
Mood instability?
- Frantic efforts to avoid real or imagined abandonment
- Affective(mood) instability and marked reactivity to environmental situations
- Chronic feelings of emptiness
- Inappropriate, intense anger or difficulty controlling anger
Which symptoms from the DSM-IV-TR come under the subdivision of Impulsivity and uncontrolled behaviour?
- Impulsivity in at least two areas that are potentially self-damaging (eg spending, sex, substance abuse, reckless driving, binge eating)
- Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
Which symptoms from the DSM-IV-TR come under the subdivision of Interpersonal Psychopathology?
- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
- Identity disturbance: Markedly and persistently unstable self-image or sense of self
Which symptoms from the DSM-IV-TR come under the subheading of Distortions of thought and perception?
- Transient, stress-related paranoia or severe dissociative symptoms (feelings of unreality)
To receive a diagnosis of BPD, how many of the nine symptoms must the person exhibit?
At least five
What are the most important factors in risk for suicide?
Mood changes and impulsivity
What are the three categories that the defining criteria were grouped into by a collaborative, longitudinal study by researchers for classification purposes?
- Disturbed relationships
- Uncontrolled behaviour
- Mood irregularity
Summarise the category ‘disturbed relationships’
Problems relating to oneself, as well as to others. Identity disturbance will naturally proceed into relationship difficulties. When identity insecurity persists, there often develop feelings of emptiness and meaningless. When the sense of self disappears altogether, dissociation from reality occurs.
Summarise the category ‘Uncontrolled behaviour’
Destructive impulsivity and self-destructive behaviour.
Summarise the category ‘Mood irregularity’
Encompasses all of the remaining criteria. Mood instability often leads to frustration and the expression of inappropriate anger. These intense emotions alienate others, leaving the individual alone and abandoned.
What is a difficulty with the DSM’s conceptualisation of BPD?
It embraces all nine criteria as being equally contributory and allows for the seeming paradox that someone with the supposedly enduring diagnosis of BPD could suddenly be “cured” of the illness by overcoming even one defining criterion.
What would be a positive statement about the DSM’s conceptualisation of BPD?
It allows for objective, measurable determinants.
What have some authors argued about defining personality disorders?
That enduring traits of personality disorders should be defined in a dimensional way. Rather than concluding whether a person is borderline or not, these authors argue that the disorder should be organized along a spectrum by the intensity of exhibited symptoms and by weighting certain criteria and background info proportionately.
What is a proposal for the future DSM-V?
To include considerations of redefining personality (Axis II) disorders utilising dimensional models.
What is the most common co morbid disorder to BPD?
Depression. More than 95% of BPD patients also satisfy criteria for this disorder.
What is the difficulty in BPD diagnosis?
BPD rarely stands alone. Some of the defining symptoms are identical to criteria for other illnesses. For example, ADHD symptoms include impatience, impulsivity, quickness to anger, poor self-esteem and fractured relationships. ASPD includes symptoms of impulsivity and outbursts of anger.
Which disorders do almost 90% of borderlines meet the criteria for?
Anxiety illnesses, PTSD, panic disorder, and social anxiety disorder.
Substance abuse and sociopathy are seen significantly more often in which gendered borderlines?
Males
Eating disorders and PTSD are correlated more often in which gendered borderlines?
Females
Why must a clinician address the most disabling symptom first?
Because borderlines usually present with several afflictions. The clinician must juggle the effects that treatment may have on accompanying problems.
Why would stimulant medication such as Ritalin not always be appropriate for patients with BPD?
As borderline symptoms such as rage and mood swings may be exacerbated.
How often are Primary care physicians able to accurately recognise and treat BPD?
Less than half of the time
