Cluster B (Borderline) Flashcards
What is Borderline Personality Disorder (BPD)?
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
BPD was once considered a chronic condition but has shown to be treatable with various approaches.
What are the four subgroups of borderline patients identified in the 1960’s Chicago study?
- Psychotic border (type I)
- Neurotic border (type IV)
- Predominantly negative affects (type II)
- Generalized lack of identity (type III)
These subgroups illustrate the diversity in presentations of borderline personality disorder.
What are the four key features of borderline patients identified in the 1960’s study?
- Anger as the main or only affect
- Defects in interpersonal relationships
- Absence of consistent self-identity
- Pervasive depression
These features contribute to the understanding and diagnosis of BPD.
What are the nine common features of BPD diagnostic criteria?
- Frantic efforts to avoid abandonment
- Unstable and intense interpersonal relationships
- Identity disturbance
- Impulsivity in self-damaging areas
- Recurrent suicidal behavior
- Affective instability
- Chronic feelings of emptiness
- Inappropriate, intense anger
- Transient paranoid ideation or dissociative symptoms
At least five of these features must be present for a diagnosis of BPD.
True or False: Women are diagnosed with BPD more frequently than men.
True
71% to 73% of diagnosed BPD patients are female, although male patients often present with different symptomatology.
What are some significant etiological factors for BPD?
- Neglect
- Abuse during childhood
- Early losses and separations
Childhood sexual abuse is a major contributing factor for about 60% of borderline patients.
Fill in the blank: The failure to resolve ______ appears to distinguish BPD from other personality disorders.
trauma
This unresolved trauma significantly impacts the patient’s development and relationships.
What is the Reflective Functioning Scale used for?
To measure the capacity for mentalization
It assesses how patients with BPD recognize and understand their own and others’ mental states.
What neurological findings are associated with BPD?
- Enhanced amygdala activation
- Reduced hippocampal and amygdalar volumes
- Hyperresponsive HPA axis
These findings suggest a biological basis for emotional dysregulation in BPD patients.
What are some pharmacotherapy considerations for treating BPD?
- Collaborate with the patient on target symptoms
- Taper ineffective medications
- Present medications with modest expectations
- Consider SSRIs for comorbid depression
- Use mood stabilizers like topiramate for mood issues
- Avoid benzodiazepines due to sedation risks
No medication has been found to be uniformly effective for BPD.
What types of psychotherapy have shown efficacy in treating BPD?
- Mentalization-based therapy (MBT)
- Transference-focused therapy (TFT)
- Dialectical behavior therapy (DBT)
- Schema-focused therapy
- Systems training for Emotional Predictability and Problem Solving (STEPPS)
- General psychiatric management (GPM)
- Dynamic deconstructive psychotherapy (DDP)
These therapies focus on different aspects of BPD and aim to improve emotional regulation and interpersonal relationships.
What is the importance of the therapeutic alliance in treating BPD?
Establishing and maintaining the therapeutic alliance is crucial
It involves understanding the patient’s projections and countertransference feelings to facilitate healing.
What is a significant risk factor for suicide in BPD patients?
Suicide attempters are 140 times more likely to commit suicide than non-attempters
This highlights the critical nature of monitoring and supporting patients with BPD.
True or False: Group therapy is less effective for borderline patients compared to individual therapy.
False
Borderline patients can benefit from group therapy, especially with peers who have higher-level personality disorders.
