Borderline personality disorder is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed borderline personality disorder as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses.
Theories of Psychopathology
Psychoanalytic theory – Sigmund Freud
Developmental Theories
Psychosocial Stages – Erik Erikson
Cognitive Stages – Jean Piaget
Interpersonal Theories
Harry Stack Sullivan
Hildegard Peplau
Humanistic Theories
Hierarchy of Needs - Abraham Maslow
Client-centered Theory - Carl Rogers
Behavioral Theories
Classical Conditioning - Ivan Pavlov
Operant Conditioning – Burrhus F. Skinner
Borderline personality disorder is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed borderline personality disorder as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses.
Theories of Psychopathology
Psychoanalytic theory – Sigmund Freud
Developmental Theories
Psychosocial Stages – Erik Erikson
Cognitive Stages – Jean Piaget
Interpersonal Theories
Harry Stack Sullivan
Hildegard Peplau
Humanistic Theories
Hierarchy of Needs - Abraham Maslow
Client-centered Theory - Carl Rogers
Behavioral Theories
Classical Conditioning - Ivan Pavlov
Operant Conditioning – Burrhus F. Skinner
this presentioation will help individuals learn about the most popular eating disorders known around the world, and how these disorders are spreading in the arab countries.
The AssignmentRead a selection of your colleagues respon.docxtodd541
The Assignment:
Read
a selection of your colleagues' responses.
Respond
to at least
two
of your colleagues by providing one alternative therapeutic approach. Explain why you suggest this alternative and support your suggestion with evidence-based literature and/or your own experiences with clients.
Support your responses with evidence-based literature with at least two references in each colleague’s response with proper citation.
Colleagues' responses # 1
Based on the case study, the symptoms of the 15-year-old male suggestive of borderline personality disorder
Explanation of the Most Likely DSM-5 Diagnosis
The criteria for diagnosing borderline personality disorder is a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five or more of the following which are 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 such as markedly and persistently unstable self-image or sense of self, impulsivity in at least two areas that are potentially self-damaging such as spending, sex, substance abuse, reckless driving, binge eating, recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior, affective instability due to a marked reactivity of mood such as intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days, chronic feelings of emptiness, inappropriate, intense anger or difficulty controlling anger such as frequent displays of temper, constant anger, recurrent physical fights, transient, stress-related paranoid ideation or severe dissociative symptoms.
The patient presents with symptoms suggestive of the borderline personality disorder as written in DSM-5. He had suicidal ideation when he cut his leg at the school and history of multiple self-harm behaviors which started almost 10 months ago. The explanation he gives is because his boyfriend abandons him. He showed intense anger outbursts and difficulty in controlling it at home towards his mother who is taking care of him and also has problems in maintaining interpersonal relationships with his peers. His thought contents are about his broken peer relationships also, he identifies himself as pansexual and dates a male peer. His mood is depressed. He has problem with sleep onset and with low self-esteem and low energy level.
Group Therapeutic Approaches that Might be Used.
According to Allenbach et al. (2018) use of immature defense mechanisms are empirically shown in individuals with borderline personality disorder (BPD) and they used higher proportions of action, borderline, disavowal, narcissistic, and hysteric defense mechanisms than healthy matched controls. The most successful treatment for BPD.
Sample 3 bipolar on female adult populationNicole Valerio
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The AssignmentRespond to at least two of your colleag.docxtodd541
The Assignment:
Respond
to at least
two
of your colleagues by providing one alternative therapeutic approach. Explain why you suggest this alternative and support your suggestion with evidence-based literature and/or your own experiences with clients. In APA Format, Cite and Provide at least 2 references no more five year old for each responses.
Colleagues
Respond# 1
Paranoid Personality Disorder (301.0), which comes out of general personality disorder. These individuals have a constant distrust and suspicion of others around them, thinking that everyone has a motive against them. These patients start having problems from childhood and it presents in a variety of ways. Some of them are being apprehensive and doubtful of others thinking they are going to exploit, harm, or deceive them. Constantly preoccupied with unjustified doubts about the loyalty or trustworthiness of the people closest to them. Reluctant to confide with the fear that their information will be used maliciously against them. Persistently bears grudges, perceives attacks on their character when it is not so and quick to react with ager or counterattack (A.P.A., 2013).
These individuals or personality disorders are usually treated with cognitive behavioral therapy, which is a collaborative process of empirical investigation, reality testing, and problem-solving between the therapist and the patient (Wheeler, 2014). Depending on what other underlying issues or disorders they have, other therapeutic therapies can also be introduced but for the most part, CBT is the one that is used often for personality disorders. for PPD medication is usually not given and psychotherapy is the route, but depending on what other extreme symptoms the patient may have like anxiety or depression, then medications can be given for them. Unfortunately, these individuals don’t see that they have problems and usually don’t seek medical help, which makes for a poor quality of life for these individuals. It is common for them to have other comorbidities such as substance misuse disorder, major depressive disorder, agoraphobia and OCD (Vollm et al, 2011).
The essential feature here with these patients is distrust and being suspicious of others and their surroundings, therefore in order to be able to have any kind of therapeutic or therapist relationship with them one has to first get their trust completely. Make them feel that you are completely on their side by sharing with them that you respect what they believe but you don’t share it or have the same belief, that you have nothing that can harm them, that you are genuine and are there only for them (Carroll, 2018). Once that is established, which may take some time and patience on the therapist part, then little by little we can point various things out to them to help them see that what they perceived as evil is not it and from these little examples that are clarified then we can explain to them the disorder or problem they have.
Colle.
An overview of Cluster B Personality Disorder. This presentation discusses the criteria, causes, prevalence and interventions for each personality disorders.
Research-Based Interventions: Dissociative Identity Disorder 1
THIS IS AN EXAMPLE PLEASE DO NO COPY DO NOT PLAGiarism
Research-Based Interventions: Dissociative Identity Disorder
“Dissociative identity disorder is characterized by the presence of two or more identities or personality states, each with its relatively enduring pattern of perceiving, relating to, and thinking about the environment and the self” (Vermetten, Schmahl, Lindner, Loewenstein, & Bremner, 2006). There are many characteristics used that accompany Dissociative Disorder (DID). One method to understanding would be to know how the disorders are classified and defined. DID may be conceptualized effectively using the diathesis-stress model. There are many different intervention strategies for this disorder as well. Over time researchers have discovered the most effective treatments and interventions that can be used regarding DID. When one dissociates, the person may not have conscious awareness of what is happening (Vermetten, Schmahl, Lindner, Loewenstein, & Bremner, 2006).
Peer-reviewed Articles
One limitless, longitudinal, naturalistic, and prospective study investigated childhood maltreatment (CM) in adult intimate partner violence (IPV) victims among Dissociative Disorder (DD) patients with Dissociative Identity Disorder with CM rates of 80-95% and severe dissociative symptoms (Webermann, Brand, & Chasson, 2014). The methods of this study include 275 DD outpatient therapy patients who completed a self-reported measure of dissociation (Webermann, Brand, & Chasson, 2014). Analyses assessed associations between CM typologies, trait dissociation, and IPV (Webermann, Brand, & Chasson, 2014). The results of this study include emotional and physical child abuse associated with childhood witnessing of domestic violence, physical, and emotional IPV (Webermann, Brand, & Chasson, 2014) Two-tailed independent samples t -tests and z-tests were used in this study to represent data as well. “As an effect size, odds ratios (ORs) were calculated to predict the likelihood of a participant being in an abusive adult relationship if they experienced a particular type of CM” (Webermann, Brand, & Chasson, 2014, p. 5).
A double-blind study was conducted including 15 females with DID compared to 23 without psychopathology., chosen by self-disclosure results of a questionnaire along with a structured clinical interview by psychiatrists The objective was to examine the volumetric differences between amygdala and hippocampal volumes in patients with dissociative identity disorder, a disorder that has been associated with a history of severe childhood trauma (Vermetten, Schmahl, Lindner, Loewenstein, & Bremner, 2006). These researchers used MRI to measure volumes of the amygdala and hippocampus. The results included the volume of the hippocampus being 19.2 % smaller and the amygdala being 31.6% smaller in patients with DID when compared to the other subjects without psychopath ...
Larry K. Brown, M.D., Professor, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island - presenting on the topic of Adolescent Sexual Behavior: What Does Reserch Say and What Can Clinicians Do? -- at the Sheppard Pratt Health System Wednesday Grand Rounds Series for Mental Health Professionals (in Towson, MD). Presentation delivered on January 20, 2010. Contact info@sheppardpratt.org for more information on CME presentations at Sheppard Pratt.
2. Outline Description of BPD Differences in BPD Presentation Theories of Origin Treatment Options Counseling Implications Suggestions for Future Research
3. DSM IV Criteria (Axis II Cluster B) A pervasive pattern of instability of interpersonal relationships, self-image and affects Impulsivity: Five (or more) of the following: Frantic efforts to avoid abandonment Unstable and intense interpersonal relationships Unstable self-image or sense of self Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving.
4. DSM IV Criteria con’t Recurrent suicidal behavior, gestures, threats or self-injuring behavior Cutting or picking at oneself Afffectinstability due to a marked reactivity of mood (e.g., intense irritability or anxiety usually lasting a few hours and only rarely more than a few days) Chronic feelings of emptiness Inappropriate anger or difficulty controlling anger Transient, stress-related paranoid ideation, delusions or severe dissociative symptoms
6. BPD in Children and Adolescents Referring to teacher as “best” friend Reckless driving, substance abuse I hate you! Don’t leave me! Fleeting persecutory delusions Easily provoked into an argument or fight Self mutilation behavior Cross dressing, running for class president but has few friends Chronic complaints of boredom, doesn’t invest in any activities Occasional almost phobic fear of abandonment, being alone
7. BPD vs. Normal Teen Behavior BPD symptoms of affective instability, uncontrolled anger, impulsivity, and identity disturbance are common in adolescents How to differentiate? Paris (2005) “One sometimes hears that all adolescents may be ‘a little borderline.’ No one denies that moodiness and some degree of impulsive behavior are common in this age group. But most adolescents are not seriously troubled or rebellious” (p. 240). Severity of the behavior and impact on functioning can assist clinicians in differentiating
8. BPD in Girls vs. Boys Bradley, Conklin, & Westen (2005) 294 randomly selected doctoral-level clinicians described adolescent patients using Axis II rating scales and the Shedler–WestenAssessment Procedure-200 for Adolescents (SWAP-200-A) Results: BPD in adolescent girls looks more like BPD in adults BPD in the sample was clearly gendered Female patients More internalizing and emotionally dramatic Male patients More behaviorally disinhibited, externalizing, and angry
9. BPD in Children and Adolescents vs. Adults • Similarities Comorbidities Environmental risk factors Deficits in executive functioning • Differences Prevalence rates higher for juveniles Less female gender predominance
10. Controversies Distinguishing from normal adolescent behavior Origins Biological? Social? Psychological? Diagnosis prior to adulthood DSM requires 1 year of key symptoms for adolescent diagnosis Terminology emotional regulation disorder,emotional dysregulation disorder, impulse disorder, interpersonal regulatory disorder
11. What Causes BPD? Marsha Linehan: Biosocial Theory BPD is caused by the interaction of biology and environment Innate tendency to be hyper-reactive to stimuli Coupled with invalidation or abuse during childhood Dialectical Behavior Therapy
12. What Causes BPD? Brunner et al. (2010) 60 females (14–18 years), 20 with a DSM-IV diagnosis of BPD, 20 patients with a DSM-IV defined current psychiatric disorder and 20 healthy control subjects Changes in Prefrontal Cortices Adolescent with BPD had decreased gray matter volume compared with healthy subjects Changes in limbic brain volumes and white matter structures might occur over the course of the illness Biological predisposition: Other disorders related to PFC
13. Risk Factors for Early BPD Development Harsh maternal punishment Inconsistent maternal enforcement of rules Low expression of maternal affection Low maternal educational aspirations Low maternal and paternal time spend with child Maternal use of guilt to control child’s behavior Poor maternal and paternal supervision of child Poor maternal communication with child Poor paternal communication with child
15. Dialectical Behavior Therapy DBT is “the necessity of accepting patients just as they are within a context of trying to teach them to change” (Linehan, 1993, p. 19). Blends CBT w/ Eastern philosophy influences Meditation, mindfulness, etc. Non-critical stance Empathy and acceptance Can be used with family therapy 4 Stages: Orientation and Commitment Attaining Basic Capacities (minimize suicidality) Reducing Posttraumatic Stress Increasing Self-Respect and Achieving Individual Goals
16. Benefits and Limitations of DBT for Adolescents Benefits Can reduce both therapist and client anxiety through structured sessions Client-centered Focuses on keeping adolescent engaged in treatment through collaboration More likely to engage in treatment if they feel a sense of control Areas addressed are consistent with the developmental tasks of adolescence Limitations Resource intensive: group/individual/family therapy Difficulty in access to treatment Short-term treatment for adolescents (12 weeks)
18. Counseling Implications Aviram (2006): BPD, Stigma and Treatment Implicatons May affect how practitioners tolerate the actions, thoughts, and emotional reactions of these individuals The very behaviors that make it difficult to work with these individuals contribute to the stigma of BPD Minimizing symptoms and overlooking strengths Blaming the patient Less empathy Clinicians may emotionally distance themselves Exacerbate negative symptoms Clinicians' reactivity may be self-protective(distancing) Individual comes to be seen as the problem, not the behaviors Self-fulfilling prophecy and a cycle of stigmatization (both patient and therapist contribute)
19. Suggestions for Future Research More! Long term prognosis not known for adolescents diagnosed with BPD Origins Dealing with stigma Different types of treatment
20. References Al-Alem, L., & Omar, H. A. (2008). Borderline personality disorder: An overview of history, diagnosis and treatment in adolescents. International Journal of Adolescent Medicine and Health, 20(4), 395-404. Retrieved from www.csa.com Bradley, R., Conklin, C. Z., & Westen, D. (2005). The borderline personality diagnosis in adolescents: Gender differences and subtypes. Journal of Child Psychology and Psychiatry, 46(9), 1006-1019. Brunner, R., Henze, R., Parzer, P., Kramer, J., Feigl, N., Lutz, K., Essig, M., Resch, F., & Stieltjes, B. (2010). Reduced prefrontal and orbitofrontal gray matter in female adolescents with borderline personality disorder: Is it disorder specific?NeuroImage, 49(1), 114-120. Crawford, T. N., Cohen, P. R., Chen, H., Anglin, D. M., & Ehrensaft, M. (2009). Early maternal separation and the trajectory of borderline personality disorder symptoms. Development and Psychopathology, 21(3), 1013-1030. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text Revision).Washington, D.C.: Author. Aviram, R. (2006). Borderline Personality Disorder, Stigma, and Treatment. Harvard Review of Psychiatry. 14, 5, 249-256 , DOI 10.1080/10673220600975121 Guthrie, D. (2006). Adolescent Borderline Personality Disorder and Dialectical Behavior Therapy. Praxis, 6, 35-42. Hopwood, C. J., & Grilo, C. M. (2010). Internalizing and externalizing personality dimensions and clinical problems in adolescents. Child Psychiatry and Human Development, 41(4), 398-408. Kobak, R., Zajac, K., & Smith, C. (2009). Adolescent attachment and trajectories of hostile-impulsive behavior: Implications for the development of personality disorders. Development and Psychopathology, 21(3), 839-851. Linehan, M. M. (1993). Cognitive behavioral treatment of borderline personality disorder. New York: Guilford Press. Macfie, J. (2009). Development in children and adolescents whose mothers have borderline personality disorder. Child Development Perspectives, 3(1), 66-71. Takahashi, T., Chanen, A. M., Wood, S. J., Walterfang, M., Harding, I. H., Yücel, M., Nakamura, K., McGorry, P. D., Suzuki, M., Miller, A. L., Muehlenkamp, J. J., & Jacobson, C. M. (2008). Fact or fiction: Diagnosing borderline personality disorder in adolescents. Clinical Psychology Review, 28(6), 969-981. Paris, J. (2005). Diagnosing borderline personality disorder in adolescence. Adolescent Psychiatry, 29, 237–247. Rajpal, V. (2006). Impact of family risk factors and psychopathology on suicidal behavior in adolescents with borderline personality disorder. ProQuest Information & Learning). Dissertation Abstracts International: Section B: The Sciences and Engineering, 67(4-B), 2239-2239. (Electronic; Print) Santisteban, D. A., Muir, J. A., Mena, M. P., & Mitrani, V. B. (2003). Integrative borderline adolescent family therapy: Meeting the challenges of treating adolescents with borderline personality disorder. Psychotherapy: Theory, Research, Practice, Training, 40(4), 251-264. Velakoulis, D., & Pantelis, C. (2009). Midline brain structures in teenagers with first-presentation borderline personality disorder. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 33(5), 842-846. Woodberry, K. A., Roy, R., & Indik, J. (2008). Dialectical behavior therapy for adolescents with borderline features. In L. A. Greco, & S. C. Hayes (Eds.), Acceptance and mindfulness treatments for children and adolescents: A practitioner's guide. (pp. 115-138). Oakland, CA, US: New Harbinger Publications.