scholarly journals Borderline personality disorder diagnosis in a new key

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Abby L. Mulay ◽  
Mark H. Waugh ◽  
J. Parks Fillauer ◽  
Donna S. Bender ◽  
Anthony Bram ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Theory And Practice ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Whole Person ◽  
Highly Correlated ◽  
The Individual

Abstract Background Conceptualizations of personality disorders (PD) are increasingly moving towards dimensional approaches. The definition and assessment of borderline personality disorder (BPD) in regard to changes in nosology are of great importance to theory and practice as well as consumers. We studied empirical connections between the traditional DSM-5 diagnostic criteria for BPD and Criteria A and B of the Alternative Model for Personality Disorders (AMPD). Method Raters of varied professional backgrounds possessing substantial knowledge of PDs (N = 20) characterized BPD criteria with the four domains of the Level of Personality Functioning Scale (LPFS) and 25 pathological personality trait facets. Mean AMPD values of each BPD criterion were used to support a nosological cross-walk of the individual BPD criteria and study various combinations of BPD criteria in their AMPD translation. The grand mean AMPD profile generated from the experts was compared to published BPD prototypes that used AMPD trait ratings and the DSM-5-III hybrid categorical-dimensional algorithm for BPD. Divergent comparisons with DSM-5-III algorithms for other PDs and other published PD prototypes were also examined. Results Inter-rater reliability analyses showed generally robust agreement. The AMPD profile for BPD criteria rated by individual BPD criteria was not isomorphic with whole-person ratings of BPD, although they were highly correlated. Various AMPD profiles for BPD were generated from theoretically relevant but differing configurations of BPD criteria. These AMPD profiles were highly correlated and showed meaningful divergence from non-BPD DSM-5-III algorithms and other PD prototypes. Conclusions Results show that traditional DSM BPD diagnosis reflects a common core of PD severity, largely composed of LPFS and the pathological traits of anxiousness, depressively, emotional lability, and impulsivity. Results confirm the traditional DSM criterion-based BPD diagnosis can be reliably cross-walked with the full AMPD scheme, and both approaches share substantial construct overlap. This relative equivalence suggests the vast clinical and research literatures associated with BPD may be brought forward with DSM-5-III diagnosis of BPD.

Application of the DSM-5 Level of Personality Functioning Scale by Lay Raters

2018 ◽  
Vol 32 (5) ◽  
pp. 709-720 ◽  
Author(s):  
Leslie C. Morey
Keyword(s):  
College Students ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Clinical Experience ◽  
Alternative Model ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Undergraduate College Students ◽  
The Individual ◽  
Considerable Experience

One concern that has been expressed with the Alternative Model for Personality Disorders (AMPD) presented in DSM-5 is that the description of characteristic impairments in personality function uses concepts requiring considerable experience and clinical inference to apply. To examine this question, the individual indicators included in the AMPD's Level of Personality Functioning Scale (LPFS) that describes these core impairments were abstracted as individual items, and then rated on a target acquaintance by 194 undergraduate college students with minimal training in personality disorder and no training in the AMPD. Results indicated that the LPFS indicators were highly internally consistent as rated in this sample, and that the degree of discrimination between groups corresponded very well with the putative level of severity represented for each indicator in the LPFS. These findings support the contention that using the LPFS might not require any particular clinical experience or training.

scholarly journals The PID -5 Inventory: the dimensional profile of DSM5 to guide diagnosis and therapeutic needs in personality disorders.

2018 ◽  
Vol 35 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Juan-F. Torres-Soto ◽  
Francisco-J. Moya-Faz ◽  
Cesar-A. Giner-Alegría ◽  
Maria-A. Oliveras-Valenzuela
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
American Psychiatric Association ◽  
Negative Affectivity ◽  
Borderline Personality ◽  
Day Hospital ◽  
Dsm 5 ◽  
Clinical Disorders ◽  
Therapeutic Needs

The PID-5 Inventory of the American Psychiatric Association evaluates personality and related disorders based on the dimensional trait model (DSM-5 Section III), which guides individual diagnosis and therapeutic needs. We analysed its usefulness as it was applied to patients that had been referred to a Day Hospital for Personality Disorders. In the sample of 85 subjects, 51 % had Borderline Personality Disorder (BPD), and 47 % had Personality Disorder NOS or Mixed (PD-NOS/MP), 65 % presenting comorbid clinical disorders. Among the BPD group, 89 % were women, 53 % were under 30 years old; they presented a PID-5 profile of greater severity, the Negative Affect and Disinhibition Domains stood out, as well as the facets of depression, impulsivity, anhedonia and distraction. Their borderline symptoms (BEST scale) were of greater intensity, they used fewer symptom coping strategies and more avoidance strategies (COPE-28 inventory). Among the PD-NOS/MP group, 58 % are women, 80 % were aged over 30 years, and negative affectivity, especially anxiety, stood out in their PID-5 profile. Both groups show borderline and avoidant features in the IPDE screening. The PID-5 was useful for confirming specific diagnoses (BPD), for describing the trait profile as well as proposing the specific therapeutic needs of both BPD and PD-NOS/MP patients.

scholarly journals Proportion of Psychiatry Outpatients with Borderline Personality and Associated Clinical Syndromes using the Millon Clinical Multiaxial Inventory-III: A Retrospective Study

2021 ◽  
Author(s):  
Shaunak Ajit Ajinkya ◽  
Pranita Shantanu Sharma ◽  
Aparna Ramakrishnan
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Mental Health Professionals ◽  
Borderline Personality ◽  
Personality Types ◽  
Care Hospital ◽  
Millon Clinical Multiaxial Inventory ◽  
Clinical Syndromes ◽  
Thought Disorders

Introduction: Personality disorders are a group of behavioural patterns associated with significant personal and socio-occupational disturbances. Numerous studies have demonstrated borderline personality to be one of the most common personality disorders. It’s less often diagnosed with just a clinical assessment. Aim: To examine the proportion of patients with Borderline Personality Disorder (BPD), and its associated personality types and clinical syndromes, using the Millon Clinical Multiaxial Inventory version-III (MCMI-III). Materials and Methods: A retrospective observational study was carried out on 450 adult patients who attended the psychiatry outpatient department of an urban tertiary care hospital. They had been administered the MCMI-III, a self-rating questionnaire commonly used to provide information on personality types and associated clinical syndromes. Statistical Package for the Social Sciences (IBM SPSS, Windows) version 20.0 was used for statistical analyses. Data was expressed in terms of actual number, mean and percentages. Chi-Square or Fisher’s-exact test, as appropriate, was used for categorical data to test for associations. Odds ratio was estimated to measure strength of the association. Results: Borderline was the most common personality type comprising nearly half (46.63%) of the study population. 25.5% had borderline traits while 21.1% had Borderline Personality Disorder (BPD). BPD was significantly higher in females (p<0.001), younger age group below the age of 40 years (p<0.001) and unmarried persons (p<0.001). It was comorbid most with Anxiety (90.91%; OR=4.05; p<0.001), Major Depression (85.23%; OR=18.39; p<0.001), Post Traumatic Stress Disorder (PTSD) (46.59%; OR=6.30; p<0.001) and Thought disorders (56.82%; OR=18.15; p<0.001). Alcohol (22.73%; OR=3.54; p<0.001) and Drug dependence (13.64%; OR=11.52; p<0.001) were also seen significantly higher in patients with BPD. Personality types significantly comorbid with BPD were Sadistic, Depressive, Masochistic, Negativistic, Schizotypal, Avoidant, Dependent, Antisocial and Paranoid types, with odds being most for Sadistic personality (OR=9.44). Conclusion: It is recommended that mental health professionals and clinicians should start to look for underlying symptoms of BPD in patients of anxiety and mood syndromes. If found these patients should be directed for psychotherapy as early as possible. The MCMI psychological test would be an important contribution to this area, given the need for systematic, quick, and objective testing methods that facilitate the diagnosis.

scholarly journals The person behind the label: co-production as a tool in teaching about borderline personality disorder

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S122-S122
Author(s):  
Nyakomi Adwok ◽  
Sharon Nightingale
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Mental Health Professionals ◽  
Service User ◽  
Borderline Personality ◽  
Junior Doctors ◽  
Service Users ◽  
Teaching Session ◽  
Negative Attitudes

AimsThe overarching aim of the session was to address and reduce stigma around Borderline Personality Disorder among doctors. The three main objectives were:To increase empathy and understanding around Borderline Personality Disorder by exposing junior doctors to service user perspectives outside a clinical setting;To address knowledge gaps identified by junior doctors in a self-reported questionnaire disseminated prior to the teaching session;To offer junior doctors a basic psychological framework to base their assessment and formulation of service users with personality disorders.Background‘Borderline Personality Disorder: The Person Behind the Label’ was the title of the first co-produced teaching session in the Leeds and York Partnership Foundation Trust (LYPFT). Prior to the teaching session, an online questionnaire was sent out to trainees. The results highlighted three key issues:Negative attitudes towards service users with personality disorders;Poor subjective knowledge of the psychological models of personality disorders;Perception among trainees that they do not receive adequate training to deal with the challenges service users with personality disorders present.MethodA teaching session was co-produced by a team of two service users, a principal clinical psychologist within the Leeds Personality Disorder Network (PDN) and a core Psychiatry trainee. It was delivered in a 75 minute session to 40 attendees consisting of both trainee doctors and consultants.ResultFeedback was collected immediately after the session through the use of anonymous feedback forms. The response to the training was overwhelmingly positive with all 28 respondents rating the session as 4/5 or 5/5 on a satisfaction scale ranging from 1 (poor) to excellent (5). Key themes from the feedback included appreciation for the service user perspective and teaching on psychological theory. The fourth question in the questionnaire: “How will this teaching impact your work?” produced the highest number of responses (25/28) and provided evidence that the above listed objectives of the session were met.ConclusionCo-produced teaching has great potential to address negative attitudes around highly stigmatised conditions by bridging the gap that often exists between service users and mental health professionals.

Personality Disorders

2014 ◽  
Author(s):  
Yosefa A. Ehrlich ◽  
Amir Garakani ◽  
Stephanie R Pavlos ◽  
Larry Siever
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Traits ◽  
Personality Disorders ◽  
Diagnostic Criteria ◽  
Early Adulthood ◽  
Borderline Personality ◽  
Clinical Population ◽  
Organizational System ◽  
Medical Disorders

Personality can be defined as an organizational system of self that shapes the manner in which a person interacts with his or her environment. Personality traits develop in adolescence or early adulthood and are thought to be shaped by early childhood experiences and enduring throughout a lifetime. Personality traits that prevent an individual from being able to function in society or that cause significant distress are diagnosed as personality disorders. A thorough history is needed to rule out other psychiatric and medical disorders. This chapter reviews the diagnostic criteria, differential diagnosis, comorbidity, prevalence, etiology (including genetics and neurobiology), prognosis, and treatment of paranoid, schizoid, schizotypal, borderline, antisocial, narcissistic, histrionic, avoidant, obsessive-compulsive, and dependent personality disorders. A discussion of the relevance of personality disorders to primary care practices and approaches to managing such patients is also included. Tables describe the diagnostic criteria of each personality disorder. Figures illustrate the prevalence of personality disorders in the general and psychiatric populations; schizotypal personality disorder in the community, general population, and clinical population; childhood trauma in individuals with personality disorder; and comorbid disorders in individuals with borderline personality disorder. A model of brain processing in borderline personality disorder is also featured. This chapter contains 5 highly rendered figures, 10 tables, 230 references, and 5 MCQs.

Diagnostic accuracy of DSM-5 borderline personality disorder criteria: Toward an optimized criteria set

2021 ◽  
Vol 279 ◽  
pp. 203-207
Author(s):  
J. Christopher Fowler ◽  
Marianne Carlson ◽  
William H. Orme ◽  
Jon G. Allen ◽  
John M. Oldham ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Diagnostic Accuracy ◽  
Borderline Personality ◽  
Dsm 5

Change of Emotional Experience in Major Depression and Borderline Personality Disorder During Psychotherapy: Associations With Depression Severity and Personality Functioning

2019 ◽  
pp. 1-20 ◽  
Author(s):  
Ulrike Dinger ◽  
Magdalena Fuchs ◽  
Johanna Köhling ◽  
Henning Schauenburg ◽  
Johannes C. Ehrenthal
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Positive Emotions ◽  
Emotional Experience ◽  
Negative Emotions ◽  
Borderline Personality ◽  
Depression Severity ◽  
Personality Functioning ◽  
Before And After ◽  
Patient Groups

This study examines emotional experience in major depressive disorder (MDD) with and without comorbid borderline personality disorder (BPD). It investigates if depression severity or personality functioning mediates group differences and which aspects of emotional experience change during psychotherapy. The emotional experience of MDD-BPD patients (n = 44) was compared to MDD-only patients (n = 35) before and after multimodal short-term psychotherapy. Emotions were classified based on valence and an active/passive polarity. MDD-BPD patients exhibited more active-negative emotions. This group difference was mediated by the level of personality functioning, but not by depression severity. Although passive-negative emotions decreased and positive emotions increased during therapy, there was no significant change in active-negative emotions. The two patient groups did not significantly differ in the change of emotional experience. Lower levels of personality functioning in depressed patients with BPD are associated with a broader spectrum of negative emotions, specifically more active-negative emotions.

scholarly journals Threading a pathway through the forest of mood and personality disorders

2019 ◽  
Vol 26 (1) ◽  
pp. 58-60
Author(s):  
Peter Tyrer
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
The Will

SUMMARYThe classification of mood and personality disorders has become unnecessarily complicated. It has become bogged down by well-meaning but unhelpful subcategories that puzzle the will of clinicians to make useful judgements. The answer is to think of bipolar, depressive and personality disorders as each constituting a spectrum of severity and not to be too preoccupied with individual labels. It would also be useful to avoid the diagnostic chimera of borderline personality disorder, a condition that defies proper classification.

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