The Blending of Evidenced-Based Protocols in the Treatment of Borderline Personality Disorder

2016 ◽  
Vol 15 (5) ◽  
pp. 392-408
Author(s):  
James P. Loveless ◽  
Matthew C. Whited ◽  
Ashley C. Rhodes ◽  
Tony Cellucci

Until recently, borderline personality disorder (BPD) has been the stepchild of psychiatric disorders. Many researchers even questioned its existence. Clinicians have been reluctant to reveal the diagnosis to patients because of the stigma attached to it. But individuals with BPD suffer terribly and a significant proportion die by suicide and engage in nonsuicidal self-injury. The aim of this primer on BPD is to fill this void and provide clinicians with an accessible, easy-to-use, clinically oriented, evidenced-based guide for early-stage BPD. We present the most up to date data about BPD by leading experts in the field in a format accessible to trainees and professionals working with individuals with BPD and their family members. The volume is comprehensive and covers the etiology of BPD, its clinical presentation and comorbid disorders, genetics and neurobiology of BPD, effective treatment approaches to BPD, the role of advocacy, and the treatment of special subpopulations (e.g., forensic) in the clinical management of BPD.


2014 ◽  
Vol 32 (4) ◽  
pp. 318-324 ◽  
Author(s):  
Elizabeth B Stuyt

Objectives Retention of individuals with co-occurring borderline personality disorder (BPD) and substance use disorders in treatment is known to be difficult. An outcome study of a tobacco-free 90-day inpatient dual-diagnosis treatment programme that uses several evidenced-based treatments in addition to ear acupuncture (acudetox) was undertaken to determine overall treatment effectiveness. Methods Between January 2009 and December 2011, 231 patients were treated in the programme, 88% with nicotine dependence and 79% with personality disorder diagnoses. All patients completing the programme were invited to enrol in a 1-year follow-up study in which they responded to monthly questionnaires to assess outcomes. Results 185 patients (80%) successfully completed the programme. There was no correlation between successful programme completion and gender, race, age, primary drug dependence diagnosis or primary psychiatric diagnosis. The use of acudetox was positively correlated with successful completion (p=0.006). Of the 78 patients with BPD, 100% of men and 83% of women successfully completed the programme. Their use of acudetox was positively correlated with successful completion (p=0.026). At the end of the year, 140 questionnaires were returned: 51 patients with BPD reported outcomes similar to the group as a whole, with 55% sober and doing well. Conclusions The use of acudetox was positively correlated with both successful completion of the programme for those with BPD as well as successful tobacco cessation, which ultimately improves the ability to maintain sobriety.


Author(s):  
Heidi L. Heard ◽  
Marsha M. Linehan

This chapter elaborates on the multiple integrative aspects of dialectical behavior therapy (DBT), an evidenced-based treatment for individuals who meet criteria for borderline personality disorder (BPD). It discusses how behavioral theory, Zen, and dialectics provide the primary principles and describes how the dialectical principles perform various integrating roles throughout the therapy. It also clarifies the construct of traumatic invalidation, a component of the treatment’s biosocial theory. The section on methods describes key therapeutic strategies, including problem-solving and validation. A case example illustrates the dialectical and integrative nature of the treatment. The chapter also reviews the results of randomized controlled trials examining the efficacy of DBT for BPD and identifies the settings, ages, and other clinical disorders for which the treatment also has empirical support.


Crisis ◽  
2020 ◽  
pp. 1-7
Author(s):  
Jacqueline M. Frei ◽  
Vladimir Sazhin ◽  
Melissa Fick ◽  
Keong Yap

Abstract. Psychiatric hospitalization can cause significant distress for patients. Research has shown that to cope with the stress, patients sometimes resort to self-harm. Given the paucity of research on self-harm among psychiatric inpatients, a better understanding of transdiagnostic processes as predictors of self-harm during psychiatric hospitalization is needed. The current study examined whether coping styles predicted self-harm after controlling for commonly associated factors, such as age, gender, and borderline personality disorder. Participants were 72 patients (mean age = 39.32 years, SD = 12.29, 64% male) admitted for inpatient treatment at a public psychiatric hospital in Sydney, Australia. Participants completed self-report measures of coping styles and ward-specific coping behaviors, including self-harm, in relation to coping with the stress of acute hospitalization. Results showed that younger age, diagnosis of borderline personality disorder, and higher emotion-oriented coping were associated with self-harm. After controlling for age and borderline personality disorder, higher levels of emotion-oriented coping were found to be a significant predictor of self-harm. Findings were partially consistent with hypotheses; emotion-oriented but not avoidance-oriented coping significantly predicted self-harm. This finding may help to identify and provide psychiatric inpatients who are at risk of self-harm with appropriate therapeutic interventions.


2017 ◽  
Vol 33 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Anne van Alebeek ◽  
Paul T. van der Heijden ◽  
Christel Hessels ◽  
Melissa S.Y. Thong ◽  
Marcel van Aken

Abstract. One of the most common personality disorders among adolescents and young adults is the Borderline Personality Disorder (BPD). The objective of current study was to assess three questionnaires that can reliably screen for BPD in adolescents and young adults (N = 53): the McLean Screening Instrument for BPD (MSI-BPD; Zanarini et al., 2003 ), the Personality Diagnostic Questionnaire 4th edition – BPD scale (PDQ-4 BPD; Hyler, 1994 ), and the SCID-II Patient Questionnaire – BPD scale (SCID-II-PQ BPD). The nine criteria of BPD according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV; APA, 1994 ) were measured with the Structural Clinical Interview for DSM-IV Axis II disorders – BPD scale (SCID-II; First, Spitzer, Gibbon, Williams, & Benjamin, 1995 ). Correlations between the questionnaires and the SCID-II were calculated. In addition, the sensitivity and specificity of the questionnaires were tested. All instruments predicted the BPD diagnosis equally well.


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