Borderline Personality Disorder (BPD):Diagnosis and Management

Borderline Personality Disorder (BPD):Diagnosis and Management

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Borderline Personality Disorder (BPD):Diagnosis and Management

@powderhownd14924 days ago

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https://psychscenehub.com/psychinsights/bpd-diagnosis-management-strategies/
harsh@psychs…

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Borderline Personality Disorder – Deconstructing the Diagnosis from a Neurobiological
and Psychody…

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This outcry highlights the impact that diagnostic labels can have on those who receive
them, often…

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Advocates for this perspective argue that adopting and rehabilitating the term “severe
personality…

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Jeyasingam argues that maintaining this biological perspective is crucial, as it increases
the cha…

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interventions – and that it will pass with as little destruction on its path as possible. Like
aff…

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APPROACH TO THE DIAGNOSIS OF BPD
Patients with Borderline Personality Disorder (BPD) often seek tr…

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Do your feelings toward other people quickly change into opposite extremes (e.g.,
from love and ad…

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Awareness of these dynamics is essential, as they can influence the clinician’s judgment
and the t…

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Clinicians should remain aware of the potential for positive change, incorporating this
understand…

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7. Distinguishing BPD from Bipolar Disorder
A key clinical challenge lies in differentiating BPD f…

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Bayes et al. (2019) critically examined recent studies to clarify the clinical distinctions
betwee…

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and interpersonal relationships-empirical evidence suggests that these conditions can be
distinctl…

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CPTSD is characterised by symptoms where impulsivity and suicidal/self-injurious
behaviours may oc…

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Childhood Interview for DSM-IV Borderline Personality Disorder (CI-BPD) –
BPD only, designed speci…

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Self-report instruments to assess impairment in personality functioning:
Severity Indices of Perso…

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perceive clinicians as “good” or “bad.”
Consistency is particularly important in preventing splitt…

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Unrealistic expectations can lead to disappointment, which may damage the therapeutic
relationship…

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emotional and interpersonal regulation, which can provoke strong reactions from
clinicians, such a…

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Psychotherapy aims to foster long-term changes, while pharmacological treatments
should be minimis…

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The use of short-term medications may be considered to stabilise the patient during acute
crises, …

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BPD is often accompanied by comorbid psychiatric conditions, which can complicate the
clinical pre…

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1. Dialectical Behavioural Therapy (DBT)
2. Mentalization-Based Treatment (MBT)
3. Schema-Focused…

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Specialised psychotherapies, including DBT, MBT, and schema therapy, consistently
outperform more …

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It involves four components: [Leichsenring et al., 2024]
1. Individual Therapy:
Exploration of pa…

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Patients are taught to focus on one task at a time with a non-judgmental attitude,
promoting full …

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Dialectical Behaviour Therapy (DBT) and other interventions that focus on improving
affect regulat…

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A critical goal of MBT is to foster epistemic trust, enabling patients to trust and apply the
know…

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Transference-Focused Psychotherapy (TFP) is based on psychoanalytic object relations
theory, focus…

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SCHEMA THERAPY (ST):
Schema Therapy (ST) integrates cognitive-behavioural, psychodynamic, attachme…

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therapist assists the patient in recognising and distancing themselves from this
punitive inner vo…

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The therapist establishes a safe, nurturing relationship that counters the abusive or
punitive dyn…

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focus should remain on BPD-specific psychotherapy.
The National Institute for Health and Care Exce…

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treatment of BPD. The efficacy of existing psychotropic medications in treating core BPD
symptoms …

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In acute crises, sedative antihistamines (e.g., promethazine) or low-potency
antipsychotics (e.g.,…

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Click to enlarge. Downloadable with a Hub Pro subscription.
Mood Stabilisers:
Mood stabilisers li…

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Benzodiazepines, however, should be avoided due to their addictive potential and risk of
increasin…

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The Neuroscience of Addiction – Application to Clinical Practice
Alcohol Use Disorder – Evidence-B…

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Click to enlarge. Downloadable with a Hub Pro subscription.
Among people with attention-deficit/hy…

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Current treatment for comorbid ADHD and BPD relies on expert opinion rather than
systematic eviden…

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This dual diagnosis is associated with greater symptom severity, higher rates of additional
mental…

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1. Trauma-related memory fragments
2. Anomalous experiences which may not be directly linked to tr…

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daily stressors eliciting pronounced psychotic responses, including paranoia and
hallucinations. […

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Click to enlarge. Downloadable with a Hub Pro subscription.
SELF-HARM IN BPD:
Repetitive self-har…

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Furthermore, corticotropin-releasing factor (CRF) antagonists, such as antalarmin, are
currently b…

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Ketamine has been shown to significantly reduce symptoms of depression, borderline
personality dis…

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emotionally.
Recognising and managing these countertransference reactions is critical to maintaini…

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6. Feeling mistreated or abused by the patient.
7. Feeling frightened by the patient.
8. Feeling …

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“It’s like their presence suffocates me, and I have to fight off this overwhelming
irritation.”
“…

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3. Balancing confrontation with empathy:
A successful therapeutic approach involves balancing the …

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Treatment can’t be standardized. Much ingenuity is required, not only to adapt treatment
to the in…

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While various psychotherapeutic approaches, such as Dialectical Behavior Therapy
(DBT), Mentalizat…

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Gunderson, J. G., Herpertz, S. C., Skodol, A. E., Torgersen, S., & Zanarini, M. C. (2018).
Borderl…

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Gartlehner, G., Crotty, K., Kennedy, S., Edlund, M. J., Ali, R., Siddiqui, M., Fortman, R.,
Wines,…

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individuals at clinical high risk for psychosis: results from an event-related fMRI
Study. Schizop…

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September 29, 2024
5:29 pm
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Achieve clinical excellence in Adult ADHD
Join Academy b…

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with studies indicating that while some symptoms may remain stable, others do not.
However, the pe…

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Have you been extremely moody?
Have you ever deliberately hurt yourself (e.g., cut or burned yours…

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confirming the presence of a pervasive personality pathology. 3. Developmental Onset
and Progressi…

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observed in BPD should be classified as an "ultra-rapid cycling" subtype of bipolar
disorder, rais…

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The importance of accurately differentiating these conditions lies in their distinct treatment
app…

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BPD is characterised by ego-syntonic affect regulation issues, which are more
persistent and perva…

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content Semi-structured clinical interviews or clinician-rated instruments:
Structured Clinical In…

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Schedule for Nonadaptive and Adaptive Personality-II (SNAP-II) – All personality
disorders and tra…

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the focus should be on learning self-care and that pharmacological treatments are largely
adjuncti…

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Collaboration and Consistency Among Clinicians In cases where multiple clinicians
are involved in …

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conditions, and administered with caution. Psychotherapy aims to foster long-term
changes, while p…

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patient to develop more nuanced and integrated views of themselves and others can
mitigate the ext…

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interventions have been developed and rigorously evaluated. Core Therapies: 4
psychological interv…

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psychotherapy for BPD remains less conclusive. [Storebø et al., 2020] A recent systematic
review a…

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(e.g., by exposure techniques), and reducing polarisation or supporting a dialectical
view of the …

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Distress tolerance skills:
Includes self-soothing and distraction techniques.
Aims to transform i…

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Based Therapy (MBT) aims to enhance patients' capacity for mentalizing, particularly in
the contex…

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Transference-Focused Psychotherapy (TFP) is based on psychoanalytic object relations
theory, focus…

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abandoned/abused child, the angry/impulsive child, the detached protector, and the
punitive parent…

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Involves imagery work, dialogues, and unsent letter writing.
Therapists model the healthy adult ro…

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3. Autonomy development:
In the final phase, the focus shifts from reparenting within therapy to f…

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co-occurring symptoms in BPD, highlighting the need for caution given the low certainty of
evidenc…

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content COMORBID MAJOR DEPRESSIVE DISORDER (MDD) IN BPD: Up to 80% of
BPD patients experience at l…

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Mood Stabilisers: Mood stabilisers like valproate and lamotrigine have been explored as
adjunctive…

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Behaviour Therapy adapted for SUD (DBT-SUD) and Dynamic Deconstructive
Psychotherapy are effective…

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3. ADHD and BPD might be distinct nosological categories, yet they could share
overlapping aetiolo…

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efficacy of these interventions for patients with BPD-PTSD. Post Traumatic Stress
Disorder (PTSD) …

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usually intact. The relationship between childhood trauma, dissociation, and psychotic
symptoms in…

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behaviours are employed to alleviate psychological pain or distress. [Blasco-Fontecilla et
al., 20…

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empirical research exploring the link between suicidal behaviours and
emptiness. Cholinergic and s…

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Clinicians must be attuned to these dynamics and maintain a steady therapeutic
stance.
2. Managin…

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perceptions. By interpreting shifts between roles, such as victim and victimizer, therapists
help …

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Join Academy by Psych Scene to access over 40 hours of in-depth, high-quality
psychiatry courses t…

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treatment of adults with a (sub) clinical borderline personality disorder? A systematic
review and…

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Prada, P., Nicastro, R., Zimmermann, J., Hasler, R., Aubry, J. M., & Perroud, N. (2015).
Addition …

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Online, 4(4), 21-32.
Dewall, C. N., Macdonald, G., Webster, G. D., Masten, C. L., Baumeister, R. F…

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MBBS, MRCPsych, FRANZCP
Dr. Sanil Rege is a Consultant Psychiatrist and founder of Psych Scene and…

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As a Pro user you can download this article in a PDF format.
After clicking, please wait for your …

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Borderline Personality Disorder (BPD):Diagnosis and Management

@powderhownd1492

This presentation explores the complexities of diagnosing and managing Borderline Personality Disorder (BPD). It highlights the importance of accurate diagnosis, evidence-based treatment strategies, and understanding the interplay of neurobiological and psychodynamic factors. Clinicians will gain insights to improve patient outcomes and navigate the ongoing debates surrounding BPD's validity as a distinct disorder.

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