Borderline Personality Disorder Flashcards
Disorder
persistent pattern of mood instability, intense interpersonal relationships, impulsivity, identity disturbance, recurrent suicidal acts, and or self-mutilating behaviors, intense anger, and rage
Diagnostic Workup
- complete history and physical examination with consideration of previous neurological trauma
- Limbic System–> poorly controlled emotions
- Hypothalamus–> impulse control
BPD General Characteristics
- intense unstable relationships
- impulsive
- unpredictable
- unstable self-image
- manipulative
- polarized thinking/ splitting
General Appearance and Motor Behavior
- severe to mild dysfunction
- depends on clients present status
- severe–> disheveled and may be unable to sit still or may display labile emotions
- may seem normal
Mood
- dysphoric, unhappiness, restlessness, malaise
- intense loneliness, boredom, frustration, and feeling “empty”
- rarely experience satisfaction or “well-being”
- may become irritable, hostile or sarcastic, complain of panic anxiety
- experience intense emotions, rarely express them productively
- minor changes may precipitate a severe emotional crisis
Affect
- unstable
- erratic
Thought Processes
- adore and idealize other people even after a brief acquaintance but quickly devalue them if others do not meet their expectations in some way
- excessive and chronic fears of abandonment
- obsessive rumination about anything
- experience dissociative episodes (periods of wakefulness when they are unaware of actions–> leads to self harm)
- under extreme stress–> psychotic symptoms of hallucinations and delusions
Sensorium and Intellectual Processes
- intellectual capabilities intact
- oriented to reality (except during psychotic symptoms where reports of auditory hallucinations encourage or demanding self harm)
- symptoms abate when stress is relieved
- report flashbacks of trauma
Judgment and Insight
- behaviors consistent with impaired judgment and lack of care and concern for safety, such as gambling, shoplifting, and reckless driving
- make decisions based on emotions not fact
- difficulty accepting responsibility for meeting needs outside a relationship
- sees life problems and failures as a result of others short comings
- others always to blame; insight is limited
Self-Concept
- unstable view that shifts dramatically and suddenly
- appear needy and dependent one moment and angry and hostile the next
- sudden changes in opinion and plans about career, sexual identity, values, and types of friends
- view themselves as bad or evil or don’t exist
- suicidal threats, gestures and attempts
- self harm and mutilation
Relationships
- hate being alone
- erratic, labile, dangerous behavior often isolates them
- relationships unstable, stormy, intense
- fears of abandonment
- if another person does not immediately reciprocate their feelings, may feel rejected, become hostile and declare them as an enemy
Roles
-poor school and work performance because of constantly changing career goals and shifts in identity and aspirations
Physiological and self care considerations
- self-harm
- binge eating
- purging (self-induced vomiting)
- substance abuse
- unprotected sex
- reckless behavior
- difficulty sleeping
Thought Stopping
technique to alter the process of negative or self-critical thought patterns
- may shout “stop”
- form a visual image of a stop sign; cue to interrupt the negative thoughts
- client learns to replace recurrent negative thoughts of worthlessness with more positive thinking
Positive Self-Talk
client re-frames negative thoughts into positive ones
-Ex: “I made a mistake, but it is not the end of the world. Next time, i’ll know what to do”
