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Psyc337 - Psychopathology > BPD > Flashcards

BPD Flashcards

1
Q

What is most controversial about BPD

A

The term “border” gives us no real information so its name is the most controversial

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2
Q

How did Stern conceptualized BPD in the 30s

A

Inordinately hypersensitive
Problems with reality testing
Experienced negative reactions in therapy (symptoms got worse in therapy)

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3
Q

BPD is said to be between the _____ and _____

A

Psychoses; neuroses

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4
Q

How did BPD continue to go on until the DSM-3

A

Pseudo-neurotic schizophrenia
Referred to patients who were extremely challenging to treat - namely interpersonal problems

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5
Q

What specific criteria developed for BPD in the DSM-3

A

Intense affect
Impulsivity
Relationship problems
Brief psychotic experiences

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6
Q

True or false: the term “border” serves more purpose to us today than it used to and provides us with more information about the disorder

A

False: the term remains confusing, provides with no insight on the disorder

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7
Q

BPD is strongly linked to which school of thought

A

Psychoanalysis

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8
Q

What term does the ICD-10 use to classify BPD

A

Emotionally unstable disorder

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9
Q

Which classification manual is closer at describing BPD in its nomenclature

A

ICD, not DSM

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10
Q

How many out of 9 symptoms does an individual need to show to get a diagnosis of BPD

A

5/9

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11
Q

How does the DSM conceptualize BPD

A

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts as indicated by 5 or more symptoms

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12
Q

What are the 9 symptoms that someone with BPD may exhibit

A
  1. Frantic efforts to avoid real or imagined abandonment
  2. A pattern of unstable and intense interpersonal relationships
  3. Identity disturbance
  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 to mood
  7. Chronic feelings of emptiness
  8. Inappropriate, intense anger, or difficulty controlling anger
  9. Transient, stress-related paranoid ideation or severe dissociative symptoms
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13
Q

What is the issue with not having an A criterion

A

Many different diagnostic profiles exist

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14
Q

What may be a potential A criterion for BPD

A

Affective instability

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15
Q

What can be said about emotions in BPD

A

They are unstable, they change rapidly and repeatedly
They are intense and unpredictable
They are intensely felt and difficult to control

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16
Q

True or false: Within a single day, someone with BPD will likely experience a roller coaster of deep emotions

A

True

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17
Q

What is the most common type of emotion outburst in the clinical picture of BPD

A

Angry outbursts

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18
Q

What will family members of those with BPD often report in terms of the emotional instability

A

It feels like they are walking on eggshells

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19
Q

What is a common method to test emotional reactivity in BPD

A

Backward masking paradigm

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20
Q

What are the findings of the study by Baskin-Sommers et al. (2015) regarding BPD and emotional reactivity

A

Those with BPD showed more activation in the amygdala for happy and fearful faces
Those without BPD showed more activation int the amygdala for angry faces

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21
Q

What are the neurotransmitters that can be at play in BPD

A

Serotonin and dopamine

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22
Q

What has the evidence shown for the levels of serotonin in BPD

A

Low levels of serotonin (5-HT) activity in BPD patients

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23
Q

In what area of functioning do individuals with BPD show improvement if they are treated with SSRIs

A

Aggressive impulsivity

24
Q

Why has some evidence pointed to the idea that there is dopamine dysfunction in people with BPD

A

Antipsychotic meds are moderately effective in treating BPD
Inferred through behaviours like impulsivity, sensation-seeking, emotion dysregulation

25
True or false: Aside from showing instability in their emotions, individuals with BPD show instability in their relationships
True
26
What is emotional instability usually triggered by in BPD in the context of relationship instability
Perceived or experienced loss, rejection, disappointment
27
How can we characterize one’s unstable representation of others in the context of relationship instability in BPD
Quickly switching from idealizing the person to intense anger and wanting to punish them (usually after 1 minor disappointment)
28
The fear of _____ is coupled with the fear of _____ in the context of relationship instability in BPD. What does this then lead to?
Rejection; becoming too attached Leads to “testing” the significant other
29
Don Dutton at UBC looked at men who engage in spousal abuse and found that 40% of those men were high on BPD characteristics and met criteria. What are the reasons that he gives for these men to be susceptible to BPD
Set unreasonably high standards Blame the partner when things go wrong Poor impulse control
30
How is BDP characterized by HiTOP
Externalizing and internalizing
31
What is the pattern of spousal abuse with women
Evidence is unclear and less reported because it’s more common for men to act abusively
32
What are 2 ways in which we would be able to get people into a study regarding spousal abuse
The person wants to stop the abuse and needs tools to help them do so They are put in therapy by the justice system
33
True or false: someone who suffers from BPD has a very stable sense of self which is usually very positive
False: their self-concept is very fragile and very negative
34
People with BPD have a persistent sense of ____. Which makes it hard for them to tolerate being alone
Emptiness
35
What would happen if someone with BPD would get a threat to their relationship
They would also interpret it as a threat to their sense of self since relationship are a high priority for these individuals
36
What are some common impulsive, self-damaging behaviours that we would expect to see in someone with BPD
High rates of alcohol and substance abuse Spending sprees Risky sexual behaviour Gambling Eating binges suicide & NSSI
37
How would a non-BPD person interpret the behaviour of someone with BPD
They would think the person is fun to be around
38
What is a common reason for an individual with BPD to engage in NSSI
Interpersonal loss or rejection
39
True or false: suicidal ideation, attempts and deaths are very common in individuals with BPD
True
40
True or false: when attempting suicide, individuals with BPD increase the lethality and severity of their methods, which eventually leads to death
True
41
What are some reasons that individuals with BPD will attempt suicide
To get away/escape To punish themselves Revenge To make others better off
42
True or false: it is common for clinicians to have lack of empathy for people with BPD
True
43
True or false: episodes of dissociation and/or paranoid ideas are extremely uncommon in individuals with BPD
False: it’s extremely common
44
Stiglmayr and colleagues (2008) did a study with BPD patients, clinical controls and controls asking them to provide hourly ratings of stress, dissociation for 48 hours. What did they find?
BPD patients had higher stress then the clinical controls and the controls BPD patients had more dissociative experiences in frequency and intensity Dissociation was linked to stress for all the groups Dissociation was present in BPD even under relatively low levels of stress
45
True or false regarding the prevalence of BPD: in the general population the prevalence is low (around 1-2%) but in clinical settings prevalence in much higher (around 10-15%)
True
46
What is the etiology of BPD regarding the family
There is an additive genetic component - it runs in families There is a non-specific familial coaggregation - common to also find high rates of SUD, APD, externalizing and MDD
47
A study by Bandelow et al. (2005) looked at how trauma, abuse and neglect play a role in the etiology of BPD. What did they find in the BPD patients compared to the controls
The controls reported less history of childhood trauma than the BPD patients
48
True or false: a history of childhood trauma as an etiological factor is unique to the onset of BPD
False
49
Seeing that comorbidity is the norm in BPD, what are the common disorders that are comorbid with BPD in order from most to least comorbid
MDD, PTSD, bipolar, eating disorders
50
What is the course of BPD
Chronic
51
Although BPD has a chronic course, what is a positive outcome
A large majority of people can be successfully treated and this is sustained.
52
True or false: BPD is often most severe in younger populations
True
53
If someone with BPD gets treatment, what are some improvements we can expect to see
Suicidal and impulsive behaviours decrease Mood reactivity persists but patients are better able to cope with it DBT (Dialectical Behaviour Therapy)
54
What did Marsha Linehan put forward
The Biosocial Theory
55
Describe the Biosocial Theory
Biological predispositions towards difficulty regulating emotions: emotions are more intense, more sensitive to variations in environmental stimuli and take longer to return to baseline Invalidating family environment Inability to regulate strong emotional responses

Psyc337 - Psychopathology (18 decks)

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