Lecture week 5 Flashcards
What are some properties of personality disorders?
- Extreme expression of personality traits
- Inflexible
- Pervasive (affects cognitive, affective, and interpersonal functioning).
- Leads to clinically significant distress or impairment in functioning.
- Stable and of long duration, onset adolescence or early adulthood.
- Often develops in childhood
- Deviates markedly from the expectations of the individual’s culture.
- Not better explained by another mental disorder, physiological effects of a substance or another medical condition
What are some symptoms of borderline personality disorder?
- Dissociation
- Self-injury
- Emotional dysregulation
- Interpersonal dysregulation
- Behavioral dysregulation impulsivity
What is the pathogenesis for BPD
Genetic, neurobiological predesposition + environmental factors (invalidating environment) –> emotion dysregulation –> dysfunctional behavior and schemata
What points to genetic, neurobiological predisposition for BPD
• Emotional hyper-senstitivity (e.g., amygdala hyper-reactivity to emotional stimuli, diminished prefrontal control)
• Prolonged emotions (diminished habituation in amygdala)
• Impulsivity (e.g., altered function in neurotransmitter systems including the
serotonin, glutamate, and GABA)
• Altered stress-reactivity (e.g., altered cortisol responses)
Define an invalidating environment
- Intolerance toward the expression of emotional experiences
• Emotional expressions are seen as unwarranted.
• Emotions are expected to be coped with (without external support). - Disorganized / chaotic attachment
• Over-protection may alternate with neglect
• Parents may be affected by mental illness or have experienced
maltreatment in their own childhood - Enmeshment
• Privacy and autonomy are often ignored
Child does not learn how to understand, label, regulate, or tolerate emotional responses
What is the prevalence of childhood abuse and neglect in people with BPD
- Emotional maltreatment (around 92%)
- Sexual abuse (around 40–76%)
- Physical abuse (around 25-73%)
What is the most frequent form of self-harm and what is the primary motive?
Self-cutting, stress reduction. It is a desperate attempt to regulate strong emotions.
Do people with BPD report an increase of impulsivity after stress compared to the resting condition and healthy controls?
Yes
What mediated the relationship between childhood maltreatment and impulsivity in BPD
Difficulties in emotion regulation
What are the three categories of symptoms of dissociation
Dissociative flashbacks, dissociative amnesia and depersonalization or derealization
Define dissociative flashbacks
Loss of continuity in subjective experience
Define dissociative amnesia
Inability to access information or control mental functions that are normally amenable to such control or access
Define depersonalization or derealization
Sense of experiential disconnectedness, including distorted perceptions about the self or the environment
What are some properties of stress related dissociation in BPD
- Positively correlated to emotional distress
- Among primary motives of self-harm in BPD
- Predicts poor treatment outcome in BPD
Why does stress-related dissociation predict poor treatment outcome?
Stress-related dissociation interferes with emotional learning, memory, and response control in individuals with BPD.
