CBT Treatment of BPD (Linehan) Flashcards
What is the definition of parasuicide?
Kreitman’s term for 1) non-fatal, intentional, self-injurious behaviour resulting in tissue damage, illness, or risk of death; or 2) ingestion of drugs or other substances in excess of prescription with the intention of bodily harm or death; Includes both suicide attempts and self-harm with little or no intent to cause death.
Does not include successful suicide, suicide threats, or almost suicide behaviours (putting pills in mouth but not swallowing)
What is the emotional picture of parasuicidal individuals?
Chronic, aversive emotional dysregulation. Angry, hostile, irritable, and depressed.
What is the difference in baseline affective state between just BPD diagnosed, vs BPD with parasuicidal?
The DSV-IV definition indicates BPD baseline state is not particularly depressed or negative; but BPD parasuicidal baseline state is extremely negative in terms of depression.
What is the difference in anger expression between just BPD diagnosed, vs BPD with parasuicidal?
Unlike typical BPD diagnosed individuals who exhibit anger dyscontrol through intense, frequent angry acts, the latter group is overcontrolling of their anger. Overcontrolling BPD group have a marked fear of anger expression
What is splitting?
Borderline and suicidal individuals frequently vacillate between rigidly health yet contradictory points with you and are unable to move forward to a synthesis of the two positions. For example, it is not uncommon for such individuals to believe that the smallest fault makes it impossible for a person to be good inside
What are the four main differences that set DBT apart from other CBTherapies?
1) Focus on acceptance and validation of behaviour in the moment
2) Emphasis on treating therapy-interfering behaviours
3) emphasis on Therapeutic relationship as essential to treatment
4) Focus on dialectical processes
What are some (4) similarities between DBT and other Cognitive Behavioural treatment programs?
1) Emphasis on assessment
2) Data collection of behaviours
3) Precise operational definition of treatment targets
4) Mutual commitment of treatment goals
On what Eastern spiritual practice is an aspect of DBT based? Which aspect?
Emphasis on balancing acceptance and change, which originated in Zen meditation.
What is the behavioural treatment most closely associated with DBT’s emphasis on behavioural acceptance?
Haye’s contextual psychotherapy
Which aspect of DBT is similar to a psychodynamic approach, and which approach?
The focus on treament-interfering behaviours is similar to psychodynamic emphasis of ‘transference’
What is Linehan’s rationale for DBT’s emphasis on the therapeutic relationship?
It comes from her experience working with suicidal clients and her assertion that sometimes the only thing standing between them and the suicidal act is the therapeutic relationship.
What kind of therapy most resembles the dialectic approach of DBT, and how?
Gestalt therapy, which springs from a holistic systems theory and focuses on ideas like synthesis.
What is a typical feature of treatment clinical trials that is a problem for assessing DBT?
The standard of dropping from the study individuals who attempt suicide or are hospitalized for psychiatric reasons
What are the three primary characteristics of the dialectical perspective on the nature of reality and human behaviour?
1) Interrelatedness and wholeness
2) Principle of polarity
3) Thesis, Antithesis, Synthesis: the principle of continuous change
How is the dialectical principle of interrelatedness and wholeness compatible with feminist views of psychopathology?
Women, and groups without social power, are more likely to have a relational or social self as opposed to an individuated self. Western societies priviledging of the individual self may be implicated in the influence of gender on ideas of self.
