Transcript Understanding Borderline Personality Disorder

Morabeto Mind Legacy Associates
Janice R. Morabeto, M.Ed. L.S.W. NLP Practitioner,
C.H.T.
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To briefly identify the differences between an Axis
I and Axis II disorder.( I.E. Between the symptoms
that one suffers from compared to who the
individual has become developmentally.)
To identify the signs and symptoms of Borderline
Personality Disorder
To identify the prevalence and course of this
disorder
To identify common Axis I disorders associated
with BPD
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Personality disorders are commonly referred
to as disorders of the “self” or
characterological disorders.
They differ from Axis I disorders because
they seem to:
Develop over time
 Affect the individual’s belief systems
about
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 The world
 The self
 Other people
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Be pervasive, difficult, if not
impossible to treat
◦ Axis I disorders are commonly referred to as having
a set of psychiatric symptoms.
 Ex.
 Major Depressive Disorder
 Eating impairments
 Sleeping impairments
 A lack of desire to be involved in previously enjoyable
behaviors or activities
 Lack of concentration
 Etc.
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Include the common diagnostics such as:
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ADHD
Major Depressive Disorder
Oppositional Defiant Disorder
Bipolar Disorders
Autism
Substance Related Disorders
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Include only:
◦ 10 Personality Disorders
◦ Mental Retardation, Developmental Delay (MRDD)
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Most research regarding Personality
Disorders suggest an:
◦ Over-developed or hypervigilance in some
personality characteristics common in most, if not
all people. For example:
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Paranoia
Fear of Rejection
Dependency
Low self esteem
Etc.
A.
An enduring pattern of inner experience and behavior
that deviates markedly from the expectations of the
individual’s culture. This pattern is manifested in two
(or more) of the following areas:
1. Cognition: ways of perceiving and interpreting self,
other people, and events
2. Affectivity: range, intensity, lability, and
appropriateness of emotional responses
3. Interpersonal functioning
4. Impulse control
B. The enduring pattern is inflexible and
pervasive across a broad range of
personal and social situations.
C. The enduring pattern leads to clinically
significant distress or impairment in
social occupational, or other important
areas of functioning.
Diagnostic Criteria
DSM IV (1994) DSM IV-TR (2000)APA
 Patterns
of Instability
 Patterns
of Impulsivity
 Beginning
(at least and often
sooner) by early adulthood
 Consistent
across a wide variety
of contexts: (family, work,
friendships, academic)
A
Pervasive Pattern of
Instability in:
Instability
Interpersonal
Relationships
Affect
Self-Image
Marked impulsivity beginning by
early adulthood
Present in a variety of
contexts, as indicated by at
least
5 of the following:
Frantic efforts to avoid real or imagined
abandonment.
A pattern of unstable and intense interpersonal
relationships characterized by alternating between
extremes of idealization and devaluation
Identity disturbance: markedly and persistently
unstable self-image or sense of self
Spending
Binge
eating
Sex
4. Impulsivity
in at least two
areas that are
potentially selfdamaging:
Reckless
driving
Substance
Abuse
5. Affective instability due to
A Marked Reactivity of
Mood
Intense Episodic Dysphoria
Irritability, or anxiety (usually lasting a
few hours and only rarely more than a
few days.)
 Recurrent
suicidal behavior,
gestures, or threats, or selfmutilating behavior
7. Chronic
feelings of
emptiness
Frequent
displays of
temper
Constant
anger
Recurrent
physical
fights
Transient, stress-related
paranoid ideation or severe
dissociative symptoms
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75% of this PD is diagnosed in women.
Comprises 2% of the general population
10% of clients seen in out-patient mental
health centers
20% of inpatient psychiatric patients
◦ Indicates:
 Need for help
 Their ability to ask for it
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Has been diagnosed in all regions of the
world
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Quite variable
Usually worse in the young-adult years
Gradually decreases with age.
During their 30’s and 40’s the majority of
individuals with this disorder attain greater
stability in their relationships and vocational
functioning.
After about 10 years, about half of the
individuals with this disorder no longer meet
the full criteria for Borderline Personality
Disorder.
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Mood Disorders
◦ Unipolar/Bi-Polar
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PTSD
Substance Related
Disorders
Eating Disorders
(Mostly Bulimia)
Antisocial
Personality Disorder
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Anxiety Disorders,
Generalized Panic
Attacks
Somatoform
Disorders
Brief Reactive
Psychosis
Psychogenic Fugue
States
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American Psychological Association, 1997, 2000
Gunderson J. G. Borderline Personality Disorder: A Clinical Guide American Psychiatric Publishing,
Inc.;( 2001)
Heller L .M. (1999) Life at the Border Understanding and Recovering from Borderline Personality
Disorder Okeechobee Fla. Dyslimbia Press Inc.
Kriesman J. J. and Strauss H: (1991 ) I Hate you -don’t leave me :Understanding the Borderline
Personality New Your NY Avon Books
Linehan M. M. (1993) Cognitive Behavioral Treatment of Borderline Personality Disorder New York
Guilford Press
Linehan M. M. (1993) Skills training manual for treating Borderline Personality Disorder New York
Guilford Press
Mason P.T. and Kreiger R. Stop Walking on Eggshells: Taking back your life when someone you care
about has Borderline Personality Disorder. Oakland CA. New Harbinger Publications
Santoro J. and Cohen R. (1997) The Angry Heart: Overcoming Borderline and Addictive Behaviors, an
Interactive and Self Help Guide. Oakland CA. New Harbinger Publications
The American Psychiatric Publishing Textbook of Personality Disorders (2005)
by John M. Oldham (Editor), Andrew E. Skodol (Editor), Donna S. Bender (Editor) American Psychiatric
Publishing, Inc.; 1 edition