ppd 9

Question 1

which symptoms imporve after treatmant and which do not
- general severity, impulsivity, suicidality, affective instability, anger, dissociation

Answer 1

improve - general severity and affactive instability
dont improve - impulsivity, suicidality, anger, dissociation

Question 2

is BPD more common in men or women

Answer 2

in clinical settings female but in general setting equal

Question 3

what is the prevalence of NSSI and SSI

Answer 3

NSSI - 61-90%
- most commonly met diagnostic criterion

SSI - 9 - 33% of all completed suicides
- 50 x more than in the general populatiion

Question 3

what is the most effective treatment for BPD

Answer 3

schema therapy

Question 4

emotional cascade model

Answer 4

• Negative affect(anger, anxiety) and negative cognition(rumination, devaluation, low self worth) exaggerate each other
• Increased activation of amygdala and not developed pfc makes the experience of things more extreme often seen in teens and adults bpd patients
• If this emotional cascade gets rolling NSSI is often used to relieve this
• Short lived effects – (positive) decrease in neg and increase in pos affect
• Long term negative effects – decrease in pos and increase in neg affectt

Question 5

functions of NSSI

Answer 5

• relief from feeling too much - most common
• to elicit feelings bcs of not feeling enough
• to avoid social responsibilities
• manipulate

Question 6

why is signing a contract to stop engaging in NSSI a bad idea

Answer 6

• its ineffective - the person is in a different state of mind when signing then when harming
• iatrogenic effect - behaviors become more covert ( a state of ill health or adverse effect caused by medical treatment)

Question 7

what is paranoid ideation

Answer 7

feeling threatened, persecuted or conspired against, transient stress-related paranoia

Question 8

what is the difference between paranoid ideation and epistemic hypervigilance

Answer 8

paranoid ideation si about believing that others have malicious intentions distrusting the person,
epistemic hypervigilance si about the distrust of information and the sources of it rather than the intent behind it

Question 9

splitting

Answer 9

inability to hold opposing thoughts
- black or white

Question 10

what is healthy ambivalence

Answer 10

• its merging of idealisation and devaluation - healthy ambivalence
• missing in patients with BPD

Question 11

what is self other distinction and how is it conected to BPD patients

Answer 11

SOD is the ability of distinguishing ones own body, actiona and mental states from those of others, its essential to interacting with others while maintaining a stable sense of self
patients with BPD have poor SOD
- Mental State Attribution system (MSA) - underdeveloped
- frontoparieral mirror neuron system - overactive - shared representational system (SR)

Question 12

what are the differences and similarities of HPD and mania

Answer 12

simmilaritiy - grandiosity, excessive talking
difference - long term vs brief mood swings

Question 13

differences and similarities betwen HPD and BPD

Answer 13

similarities - attention seeking manipulative shifting affect
differences - BPD - self harm, anger, chronic emptines, identity issues

Question 14

differences and similarities betwen HPD and NPD

Answer 14

differences - NPD is abt reaffirming own grandiosity, tehy are willing to look weak for attention
similarities - attention seeking

Question 15

what are some characteristics of BPD

Answer 15

identity distrubance, unstable relationships, emotional instabiliy, impulsivity

Question 16

what is the most comorbid disorder of BPD

Answer 16

MDD - higher suicide risk

Question 17

what are some common countertransferences with BPD

Answer 17

1. criticised/mistreated
2. distzressing
3. overwhelmed
4. special/overinvolved
5. sexualized

Question 18

what are some common transferences in BPD

Answer 18

1. paranoid
2. narcissistic
3. erotic
4. depressive

Question 19

what are the 2 primary pitfals when diagnosing BPD with comorbid mood disorders and what are the results of it

Answer 19

1. not diagnosing BPD just mood disorders
   - leads to ineffective polypharmacy nad increased risk of suicide and hosiptalisatiin
2. not didagnsing mood disorder
   - increased risk of suicidality and hosipitalisation

BPD can and should be treated even if the patient has a mood disorder

Question 20

name some of the main HPD symptoms

Answer 20

attention seeking, shallow affect, seductivity, excessive emotionality

Question 21

what is the distinction between someone who is sociable and someone who has HPD

Answer 21

sociable ppl adjust to the social norms while HPD ppl ignore or dont recognise them bcs of intense need for attention

Question 22

what emotion drives attention seeking in HPD

Answer 22

anxiety

Question 23

Millon’s HPD Subtypes

Answer 23

• Appeasing: Attention-seeking behavior coupled with a desperate need for friendship and acceptance driven by fear and anxiety; may engage in abusive
  or predatory partnerships with codependent traits.
• Vivacious: Charming, seductive, but emotionally empty; at times, efferves-
  cent to the verge of hypomania; struggles with complex emotional attachment, so relationships’ are short-lived and shallow, with a lack of empathy consistent with narcissistic behavior.
• Tempestuous: Emotionally labile, quick to anger, will engage in conflict if it
  serves perceived attention needs. Shares several traits with borderline per-
  sonality disorder and/or bipolar 2 because of excessive mood lability and irritability.
• Disingenuous: Attention-seeking behavior is grounded in a desire to manip-
  ulate or control others for the patient’s personal amusement, particularly in
  the naïve or unsuspecting; possesses many narcissistic qualities.
• Theatrical: Self-promoting and seeks praise and adulation for superficial features such as clothing or appearance. The need for external admiration may
  exceed the need to maintain strong friendships.
• Infantile SubtypeShares features of its tempestuous counterpart, but behaviors don’t match her developmental age. Behaviors may arrange themselves in a borderline fashion; may pout and cry for attention, or present as volatile and respond inappropriately to perceived “injustices” -cancellation of plans due to work commitments,