Personality and Personality Disorder

2020 ◽  
pp. 119-130
Author(s):  
Joel Paris
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Traits ◽  
Mood Disorders ◽  
Suicidal Behavior ◽  
Borderline Personality ◽  
Clear Cut ◽  
Normal People ◽  
Affective Instability

Personality traits differ among normal people, and one should only diagnose a personality disorder (PD) in the presence of a clear-cut impairment of functioning. Most of these disorders lie on a spectrum with traits, but those that cause prominent symptoms present more often in psychiatry The most clinically important category of PD is borderline personality disorder (BPD), but this condition is widely underdiagnosed. Since these patients often present with depression and/or affective instability, clinicians often see them as suffering from mood disorders, and treat them unsuccessfully with antidepressants. However, this population, which shows repetitive suicidal behavior, needs to be correctly diagnosed to be referred for specialized psychotherapy.

Borderline Personality Disorder and Mood Disorders

2017 ◽  
Author(s):  
Eric A. Fertuck ◽  
Megan S. Chesin ◽  
Brian Johnston
Keyword(s):  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Borderline Personality Disorder ◽  
Major Depression ◽  
Personality Disorder ◽  
Mood Disorders ◽  
Suicide Risk ◽  
Borderline Personality ◽  
Mood Symptoms ◽  
Affective Instability

Borderline personality disorder (BPD) and mood disorder (MD) can be difficult to differentiate from each other due to several overlapping clinical features. Among BPD symptoms, chronic dysphoria can be mistaken for major depression, while affective instability may be confused with the depressed and elevated mood episodes of bipolar disorder (BD). Conversely, in those with BPD, co-occurring MDs can be difficult to rigorously assess and treat. Even though there is moderate to high co-occurrence between these conditions, BPD and MDs have distinct facets of impulsivity, affective instability, and mood symptoms. Furthermore, BPD, MD, and their co-occurrence predict courses of illness, prognosis, treatment outcomes, and suicide risk. Consequently, thorough assessment and differential diagnosis of these conditions should inform treatment planning and clinical management in both BPD and MD.

Screening for depression with the Edinburgh Postnatal Depression Scale and finding borderline personality disorder

2018 ◽  
Vol 53 (5) ◽  
pp. 424-432 ◽  
Author(s):  
Fiona Judd ◽  
Stephanie Lorimer ◽  
Richard H Thomson ◽  
Angela Hay
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Traits ◽  
Pregnant Women ◽  
Postnatal Depression ◽  
Edinburgh Postnatal Depression Scale ◽  
Past History ◽  
Depression Scale ◽  
Borderline Personality ◽  
Borderline Personality Traits

Objective: The aim of the study was to explore the range of psychiatric diagnoses seen in pregnant women who score above the ‘cut-off’ on the Edinburgh Postnatal Depression Scale when this is used as a routine screening instrument in the antenatal period. Method: Subjects were all pregnant women referred to and seen by the Perinatal Consultation-Liaison Psychiatry Team of a tertiary public hospital over a 14-month period. Edinburgh Postnatal Depression Scale score at maternity ‘booking-in’ visit, demographic and clinical data were recorded and diagnoses were made according to Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria following clinical interview(s) and review of documented past history. Data were analysed using descriptive statistics. Results: A total of 200 patients who had completed the Edinburgh Postnatal Depression Scale were seen for assessment; 86 (43%) scored ⩾13 on Edinburgh Postnatal Depression Scale. Of those scoring 13 or more on Edinburgh Postnatal Depression Scale, 22 (25.6%) had a depressive disorder. In total, 12 patients (14%) had an anxiety disorder, 14 (16.3%) had borderline personality disorder and 13 (15.1%) had a substance use disorder. An additional 23 women (26.7%) had two or more borderline personality traits. Conclusion: Psychiatric assessment of women who scored 13 or more on the Edinburgh Postnatal Depression Scale at routine antenatal screening identified a significant number with borderline personality disorder or borderline personality traits rather than depressive or anxiety disorders. Clinical Practice Guidelines note the importance of further assessment for all women who score 13 or more on the Edinburgh Postnatal Depression Scale. The findings here suggest that this assessment should be made by a clinician able to identify personality pathology and organise appropriate and timely interventions.

scholarly journals Self-esteem instability and affective instability in everyday life after remission from borderline personality disorder

2020 ◽  
Author(s):  
Philip Samuel Santangelo ◽  
Tobias D. Kokler ◽  
Marie-Luise Zeitler ◽  
Rebekka Knies ◽  
Nikolaus Kleindienst ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Self Esteem ◽  
Borderline Personality ◽  
Specific Symptom ◽  
Affective Dysregulation ◽  
Daily Life Activities ◽  
Diary Studies ◽  
Affective Instability

Abstract Background: Borderline personality disorder (BPD) is defined by a pervasive pattern of instability. According to prior findings and clinical theories, self-esteem instability and affective instability are key features of BPD. Previous e-diary studies showed that instability in self-esteem is heightened and that it is highly intertwined with affective instability in BPD in comparison to healthy controls (HC). The present study sought to extend these findings by adding symptomatologically remitted BPD patients (BPD-REM), i.e. former patients with BPD who met four or fewer BPD criteria within the past year, as a comparison group.Methods: To examine differences regarding self-esteem instability and affective instability, we used e-diaries for repeatedly collecting data on self-esteem, valence, and tense arousal 12 times a day for four consecutive days while participants underwent their daily life activities. Determining three different state-of-the-art instability indices and applying multilevel analyses, we compared 35 BPD-REM participants with previously reported 60 acute BPD patients (BPD-ACU) and 60 HC.Results: Our results revealed that self-esteem instability was significantly lower in the BPD-REM compared to the BPD-ACU group, irrespective of the instability index. In contrast, there were no significant differences regarding affective instability between the BPD-REM participants and those in the BPD-ACU group. The comparison between the BPD-REM with the HC indicated both a significantly higher instability in self-esteem as well as significantly heightened affective instability in the BPD-REM participants. Moreover, even though the associations were not significant, we found tentative support for the assumption that affective changes that are accompanied by changes in self-esteem are experienced as more burdensome and negatively impact the quality of life of remitted BPD participants.Conclusions: This study builds on growing evidence for the importance of self-esteem instability in BPD. Whereas affective instability has been reported in various psychiatric disorders and might indeed constitute a transdiagnostic marker of affective dysregulation, our results indicate that self-esteem instability might be a specific symptom that construes the unique pathology in BPD.

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