The unified protocol for anxiety and depression with comorbid borderline personality disorder: a single case design clinical series

2019 ◽  
Vol 12 ◽  
Author(s):  
Michelle E. Lopez ◽  
Steven R. Thorp ◽  
Matthew Dekker ◽  
Andrew Noorollah ◽  
Giovanna Zerbi ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotional Disorders ◽  
Single Case ◽  
Borderline Personality ◽  
Anxiety And Depression ◽  
Individual Treatment ◽  
List Type ◽  
Unified Protocol ◽  
Clinical Series

AbstractThis study used a single case experimental design to investigate the use of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) among a sample of individuals with depression and anxiety who also presented with borderline personality disorder (BPD). Eight women received individual treatment with the UP over the course of 14–16 treatment sessions, and were assessed for anxiety and depression severity on a weekly basis over a 2–6 week baseline period and throughout treatment. Three of the eight participants demonstrated reliable pre- to post-treatment clinical improvements on depression and stress scales, and one participant demonstrated a reliable reduction on an anxiety scale. Two participants demonstrated a reliable improvement in overall anxiety. The results indicate that the UP applied to individuals diagnosed with primary BPD may lead to clinical improvement in depression, stress and anxiety for some individuals. However, the majority of individuals with BPD in our sample did not show strong improvement, and this suggests the need for additional sessions of UP or an intervention that focuses on the symptoms of BPD specifically for some women.Key learning aims (1)To describe the applicability of the Unified Protocol in the treatment of individuals with borderline personality and co-occurring anxiety or depression.(2)To understand the value of utilizing a transdiagnostic approach as an alternative to diagnosis-specific approaches to treatment.(3)To identify the four core modules of the Unified Protocol and describe the general format for individual treatment.

The Unified Protocol for Borderline Personality Disorder

2017 ◽  
pp. 200-214
Author(s):  
Shannon Sauer-Zavala ◽  
Kate H. Bentley ◽  
Julianne G. Wilner
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotional Disorders ◽  
Borderline Personality ◽  
Diagnostic Group ◽  
Emotional Disorder ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Maintenance Factors ◽  
Case Presentations

Borderline personality disorder (BPD) is a severe, difficult-to-treat psychiatric condition that represents a large proportion of treatment-seeking individuals. This disorder is characterized by high rates of co-occurrence with depressive and anxiety disorders, and recent explanations for this comorbidity suggest that these disorders share biological vulnerabilities and functional maintenance factors. Given the commonalities among BPD and other emotional disorders, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was clinically applied to five individuals who met criteria for BPD and at least one comorbid emotional disorder. This chapter will highlight the theoretical rationale for considering BPD an emotional disorder, underscoring the use of the UP with this population. In addition, detailed case presentations of two individuals with BPD treated with the UP will be presented to illustrate the ways in which UP skills can be flexibly applied within this diagnostic group.

scholarly journals Metacognitive Interpersonal Therapy for Borderline Personality Disorder: A Single Case Study

2020 ◽  
Vol 20 (1) ◽  
pp. 56-74
Author(s):  
Giampaolo Salvatore ◽  
Lorena Bianchi ◽  
Luisa Buonocore ◽  
Nadia Disturco ◽  
Angus Macbeth ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotion Dysregulation ◽  
Single Case ◽  
Sense Of Self ◽  
Severe Disease ◽  
Borderline Personality ◽  
Interpersonal Therapy ◽  
Metacognitive Interpersonal Therapy

Borderline personality disorder (BPD) is a severe disease, characterized by severe instabilities in identity, affect and relationships. Clinical improvement of BPD can be facilitated by psychotherapy aimed at tackling multiple specific cross-modality impairments and their patterns of interaction: impaired sense of self, maladaptive interpersonal schemas, impaired metacognition, emotion dysregulation and impulsivity. Herein, we describe the steps in the treatment of a young woman meeting the criteria for with BPD with paranoid traits, successfully treated with Metacognitive Interpersonal Therapy, a treatment based on comprehensive assessment of domains. In the initial phase, treatment focused on promoting emotion regulation, integrating opposing patient representations of the therapist, enhancing metacognition, and increasing focus on the maladaptive schema that elicited dysregulated behaviors. Later in therapy, treatment focused on supporting the patient to realize her ideas about self and others were schema-driven; and improving metacognitive capacity to understand others’ minds. General implications for psychotherapy of BPD are discussed.

Staff attitudes towards patients with borderline personality disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 1010-1010
Author(s):  
E. Bodner ◽  
S. Cohen-Fridel ◽  
I. Ianco
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Professionals ◽  
Negative Emotions ◽  
Borderline Personality ◽  
List Type ◽  
Staff Attitudes ◽  
Community Settings ◽  
Common Diagnosis ◽  
Level Of Agreement

IntroductionBDP is a common diagnosis in hospitals and community settings, estimated at 20% and 11%, respectively. Nevertheless, the attitudes and skills of all mental health professionals regarding the treatment of these patients had hardly been studied.ObjectivesDevelop tools and use them to understand staff attitudes towards BDP patients.Aims(1)To develop two inventories for the measurement of cognitive and emotional attitudes towards borderline personality disorder (BPD) patients and their treatment;(2)To use these tools to understand and compare attitudes of psychiatrists, psychologists and nurses toward BPD patients.MethodTwo lists of items referring to cognitive and emotional attitudes towards BPD patients were formulated. Nurses, psychologists and psychiatrist (n = 57), working in public psychiatric institutions rated their level of agreement with each item. Both lists of attitudes yielded three factors (cognitive: required treatment, suicidal tendencies, and antagonistic judgment, and emotional: negative emotions, experienced difficulties in treatment, and empathy, respectively).ResultsPsychologists scored lower than psychiatrists and nurses on antagonistic judgments. Nurses scored lower than psychiatrists and psychologists on empathy. Regression stepwise analyses on the three emotional attitudes separately showed that suicidal tendencies of BPD patients mainly explained negative emotions and difficulties in treating these patients. All groups were interested in learning more about the treatment of these patients.ConclusionsSuicidal tendencies of BPD patients provoke antagonistic judgments among the three professions. Psychiatrists, psychologists and nurses hold distinctive cognitive and emotional attitudes towards these patients. Staff training programs regarding BDP patients should consider these differences and concerns.

scholarly journals Eating disorders among patients with borderline personality disorder: understanding the prevalence and psychopathology

2020 ◽  
Author(s):  
Mohsen Khosravi
Keyword(s):  
Eating Disorders ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Eating Attitudes ◽  
Borderline Personality ◽  
Anxiety And Depression ◽  
Dsm 5 ◽  
Feeding And Eating Disorders ◽  
Eat 26 ◽  
Tas 20

Abstract Background: Treatment protocols can be bolstered and etiological and maintenance factors can be recognized more easily by a superior understanding of emotions and emotion regulation in the comorbidity of borderline personality disorder (BPD) and feeding and eating disorders (FEDs). Therefore, the present study aimed at investigating the prevalence and psychopathology of FEDs in patients with BPD.Methods: In this cross-sectional study, 220 participants were examined in three groups, namely BPD (n = 38), BPD+FEDs (n = 72), and the healthy control (n = 110), from August 2018 to November 2019. The participants were selected by systematic random sampling among the patients who referred to Baharan psychiatric hospital in Zahedan, Iran, with the sampling interval of 3. The subjects were evaluated by borderline personality inventory (BPI), structured clinical interview for DSM-5 personality disorders (SCID-5-PD), structured clinical interviews for DSM-5: research version (SCID-5-RV), the 26-item eating attitudes test (EAT-26), 20-item Toronto alexithymia scale (TAS-20), Beck anxiety disorder (BAI), and Beck depression inventory-II (BDI-II). Results: The results showed a 65.4% (n = 72) prevalence of FEDs in patients with BPD. Also, the highest and lowest prevalence rates were reported for “other specified feeding and eating disorders” (51.3%) and “bulimia nervosa” (6.9%), respectively. Although the highest mean score of TAS-20 was related to anorexia nervosa, there was no significant difference between the scores of various types of FEDs. The mediation analysis showed that anxiety and depression would play a mediating role in the relationship between alexithymia and eating-disordered behaviors. Conclusions: The results have suggested that alexithymia, anxiety, and depression should receive clinical attention as potential therapeutic targets in the comorbidity of BPD and FEDs. The clinical implications of the research have been conducted to date, and directions for future research have been discussed.

scholarly journals Metacognition, Borderline Pathology and Psychotherapeutic Change: A Single-Case Study

2014 ◽  
Vol 16 (2) ◽  
pp. 102-108
Author(s):  
Raffaella Perrella ◽  
Antonio Semerari ◽  
Francesca Scafuto ◽  
Giorgio Caviglia
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Current Literature ◽  
Cognitive Functions ◽  
Single Case ◽  
Borderline Personality ◽  
Assessment Scale ◽  
Single Case Study ◽  
Psychotherapeutic Change

The aim of this study is to analyze whether: (a) a specific type of metacognitive deficit is present in a patient with Borderline Personality Disorder; (b) a metacognitive improvement can be detected during the psychotherapy treatment; (c) if this improvement can be indicative of the effectiveness of psychotherapy itself. A single case study has been conducted; metacognitive deficits have been measured with the Metacognition Assessment Scale (MAS). In line with the hypothesis, the results show a global and progressive improvement of meta-cognitive functions. We conclude in agreement with the current literature, the existence of a major deficit in Differentiation and Integration subfunctions (belonging to Self-reflexivity), compared to Characterization and Relation between variables subfunctions (belonging to Metacognitive monitoring).

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