Personality Disorders: Part II

Question 1

Borderline Personality Disorder

Answer 1

• love and loathing: I love you/I hate you, hero or devil

- self-injurious behavior: chronic suicidality, cutting, self-destructive behavior

Question 2

DSM-V Criteria: Borderline Personality Disorder

Answer 2

indicated by 5 of the following:

• frantic efforts to avoid real or imagined abandonment
• unstable and intense interpersonal relationships
• unstable self-image
• impulsivity: sex, spending, eating
• suicidal behavior
• affective instability
• chronic feeling of emptiness
• inability to control anger
• paranoid thoughts

Question 3

Potential Causal Factors in Borderline Personality Disorder

Answer 3

• possible genetic factors: emotional lability, impulsivity
• biological factors: low serotonin, poor regulation of norepinephrine
• environmental factors: abuse, trauma, parental loss, parental psychopathology

Question 4

Borderline Personality Disorder: Psychodynamic Views

Answer 4

• distorted perception of reality
• extreme, maladaptive defenses against negative emotion
• nonspecific ego awareness: poor impulse control, low anxiety tolerance

Question 5

Borderline Personality Disorder: Object Relation Theory

Answer 5

• Mateson 1972: dysfunction in internalization of primary object relations
• mental representation of others: withdraw and attack in response to expression of needs and affect
• deficit in evocative object constancy: inability to self-soothe or tolerate negative affect due to failure to remember how others soothed them

Question 6

The Broken Ego: BPD

Answer 6

• ego dysfunction: inferiority, poor ego control, low ego resiliency
• ego identity: erikson: failure to achieve trust, competence, identity

Question 7

The Broken Self: BPD

Answer 7

• disrupted self development: unmet narcissistic needs lead to immature way of relating to others
• disrupted attachment: failure to form healthy attachment bond leads to lack of trust, failure to develop self-worth, fear of abandonment (ambivalent or disorganized attachment)

Question 8

Social Learning Theory: BPD

Answer 8

• inadequate learning experiences and modeling of unstable emotion and behavior
• failure to learn adequate coping skills, tolerance of negative affect
• failure to learn appropriate emotional expression

Question 9

Cognitive Theory: BPD

Answer 9

• distorted cognition: intense emotional arousal and poor impulse control overwhelm cognitive functioning
• little insight/awareness of distorted thinking, feeling and behavior

Question 10

Cognitive-Behavioral Theory: BPD

Answer 10

intense emotional arousal and poor impulse regulation + distorted cognition + deficient learning experiences = erratic emotions and behavior, distorted view of self and others

Question 11

Treatment of BPD

Answer 11

• pharmacotherapy for mood and impulsivity
• psychodynamic therapies: strengthen weak ego, reduce black and white thinking
• dialectical behavior therapy: increase ability to tolerate negative affect