scholarly journals Editorial Introduction to the Special Issue: Recent Advances in Transference-Focused Psychotherapy: Extending and Refining the Treatment Model

2021 ◽  
Vol 49 (2) ◽  
pp. 173-177
Author(s):  
Eve Caligor ◽  
Barry Stern
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Diagnostic System ◽  
Interpersonal Functioning ◽  
Editorial Introduction ◽  
Clinical Settings ◽  
Treatment Model ◽  
Special Issue ◽  
Recent Advances ◽  
Transference Focused Psychotherapy

The authors introduce this Special Issue of Psychodynamic Psychiatry focused on developments in the practice of Transference-Focused Psychotherapy (TFP). In the context of an evolving diagnostic system that increasingly focuses on the underlying dimensions related to self and interpersonal functioning that characterize personality disorders, the authors provide an overview of the development and nature of TFP, and preview a series of contributions that describe the refinement of TFP and is broadening application across the spectrum of personality disorder, age ranges, and clinical settings.

scholarly journals Psychodynamic psychotherapies for borderline personality disorders. Current developments and challenges ahead

2018 ◽  
Vol 15 (1) ◽  
pp. 12-14 ◽  
Author(s):  
Miguel Angel Gonzalez-Torres
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Evidence Based ◽  
Current Position ◽  
Borderline Personality Disorders ◽  
Transference Focused Psychotherapy ◽  
Psychodynamic Psychotherapies

This article summarises the current position of evidence-based psychodynamic psychotherapies aimed at the treatment of borderline personality disorder – mentalisation-based treatment and transference-focused psychotherapy – noting the main challenges they face, especially in the area of dissemination.

Part 1: Borderline Personality Disorder and Its Clinical Features

2017 ◽  
Author(s):  
Robert Biskin ◽  
Joel Paris
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Early Adulthood ◽  
Psychosocial Factor ◽  
Diagnostic System ◽  
Childhood Adversity ◽  
Borderline Personality ◽  
Clinical Settings ◽  
Self Harm ◽  
Genetic And Environmental Factors

Borderline personality disorder (BPD) is routinely encountered in all clinical settings and has been stigmatized and perceived as a difficult disorder to manage. Over the past 25 years, significant gains in our understanding of the diagnosis, treatment, and outcomes of the disorder have helped improve the lives of these patients. BPD is now understood to begin in adolescence and early adulthood, with a generally positive course and reductions in symptoms of self-harm and suicidality within several years of diagnosis. BPD is best understood as developing through an interaction between genetic and environmental factors. No clear biological features have been consistently identified yet, and similarly, no clear psychosocial factor, including childhood adversity or sexual abuse, is causative for BPD. Clearly separating BPD from other disorders, particularly bipolar disorder, is an important consideration and required to ensure proper care. Comorbid disorders, including other personality disorder, are frequent problems that partially reflect a challenge with the current diagnostic system that has not yet been resolved. Although the symptomatic outcome of patients with BPD is very good, functional outcomes, such as holding work and relationships, is more challenging for many patients, and suicide remains a risk in patients with this disorder. This review contains 2 figures, 4 tables, and 102 references. Key words: borderline personality disorder, outcome, personality disorder, self-harm, suicide

Trainee experience in diagnosis and management of personality disorders

2018 ◽  
Vol 37 (2) ◽  
pp. 136-140
Author(s):  
R. Wallace ◽  
G. Rush
Keyword(s):  
Clinical Practice ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Diagnostic System ◽  
Psychiatry Training ◽  
Linear Fashion ◽  
Diagnosis And Management ◽  
Training Structure ◽  
Trainee Experience

The diagnosis and management of personality disorders continues to evolve and develop alongside psychiatry internationally, however, not always in a linear fashion. Trainees working in a variety of clinical areas have regular exposure to personality disorder presentations. Psychiatry training bodies continue to adapt their training structure and curriculum, however, there seems to be a lack of sufficient emphasis with regards this area. We are now embarking on a new diagnostic system for personality disorders; this may impact on our clinical practice and perspective of these patients. The role of psychiatrists in diagnosing and managing personality disorders can be unclear at times and may benefit from on-going reflection and standardization.

TFP Extended: Development and Recent Advances

2021 ◽  
Vol 49 (2) ◽  
pp. 188-214
Author(s):  
John F. Clarkin ◽  
Eve Caligor ◽  
Julia Sowislo
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Full Range ◽  
Clinical Intervention ◽  
Borderline Personality ◽  
Personality Pathology ◽  
Interpersonal Functioning ◽  
The Core ◽  
Empirically Supported ◽  
Recent Advances

Recent advances in the understanding of personality pathology have contributed to an emphasis on the core of personality pathology as deficits in self-functioning and interpersonal functioning at different levels of severity that must be assessed for clinical intervention. In concert with these conceptual and empirical advances, transference-focused psychotherapy (TFP), an empirically supported psychodynamic treatment for borderline personality disorder, has been in constant development with extensive clinical use. This article describes an object relations model for conceptualizing and assessing levels of personality organization, a transdiagnostic approach to personality pathology, and related treatment modifications, thus expanding the utilization of TFP beyond borderline personality disorder to the full range of personality dysfunction. The core of this treatment approach is a sequential interpretive process between patient and therapist. This process takes place within the context of a structured treatment frame tailored to the unique individual with problems in self-functioning and interpersonal functioning in his/her particular environment.

Transference-Focused Psychotherapy for Adolescents With Personality Disorders

2021 ◽  
Vol 49 (2) ◽  
pp. 215-243
Author(s):  
Lina Normandin ◽  
Alan Weiner ◽  
Karin Ensink
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Current Evidence ◽  
Evidence Based ◽  
Object Relations Theory ◽  
Major Focus ◽  
Assessment And Treatment ◽  
Personality Disordered ◽  
Transference Focused Psychotherapy ◽  
Over Time

This article presents a conceptualization of personality disorders in adolescence and the adaptation of transference-focused psychotherapy (TFP) for personality disordered adolescents (TFP-A). The model of assessment and treatment presented is based on contemporary psychoanalytic object relations theory developed by Otto F. Kernberg and supported by findings from current evidence-based outcome research. We present a method of assessing personality disorders in adolescents that addresses the variability of personality disorder symptoms and traits among adolescents and their instability over time. We then present the goal of TFP-A and its major phases of implementation. A major focus is therapist interventions.

scholarly journals Narcissistic Personality Disorder: Are Psychodynamic Theories and the Alternative DSM-5 Model for Personality Disorders Finally Going to Meet?

2021 ◽  
Vol 12 ◽  
Author(s):  
Frans Schalkwijk ◽  
Patrick Luyten ◽  
Theo Ingenhoven ◽  
Jack Dekker
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Hierarchical Model ◽  
Interpersonal Functioning ◽  
Narcissistic Personality Disorder ◽  
Pathological Narcissism ◽  
Dsm 5 ◽  
Narcissistic Personality ◽  
Psychodynamically Oriented ◽  
Recent Developments

Narcissistic Personality Disorder is the new borderline personality disorder of our current era. There have been recent developments on narcissism that are certainly worthwhile examining. Firstly, relational and intersubjective psychoanalysts have been rethinking the underlying concepts of narcissism, focusing on the development of self and relations to others. Secondly, in the DSM-5, the Alternative DSM-5 Model for Personality Disorders (AMPD) was presented for a dimensional evaluation of the severity of personality disorder pathology. The combined dimensional and trait conceptualization of NPD opened the door to new integrated diagnostic perspectives, including both internal and interpersonal functioning. Finally, Pincus and Lukowitsky encourage clinicians to use a hierarchical model of pathological narcissism, as it opens up opportunities for shared points of interest in empirical research from different scholarly perspectives. As for most non-psychodynamic clinicians and researchers the DSM-5 clearly bears dominant weight in their work, we will take the AMPD model for NPD as our point of reference. We will discuss the narcissist's unique pattern of self-impairments in identity and self-direction, and of interpersonal disfunctioning (evaluated by assessing empathy and intimacy). Subsequently, we will examine how contemporary psychodynamic theories and the hierarchical model of Pincus and Lukowitsky additionally inform or contradict the AMPD. For us, one of the big advantages of the AMPD is the use of structured clinical evaluations of disturbances of the self and interpersonal functioning and the dimensional evaluation of severity. As psychodynamically oriented therapists, we are enthusiastic about the opportunities for inclusion of psychodynamic concepts, but we also discuss a number of sticking points.

Substance Use Disorders and Personality Disorders

2014 ◽  
Author(s):  
Timothy J. Trull ◽  
Marika B. Solhan ◽  
Whitney C. Brown ◽  
Rachel L. Tomko ◽  
Lauren Schaefer ◽  
...  
Keyword(s):  
Substance Use ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Substance Use Disorders ◽  
Recent Literature ◽  
Borderline Personality ◽  
Clinical Implications ◽  
Clinical Settings ◽  
Obsessive Compulsive ◽  
High Comorbidity

Personality disorders (PDs) and substance use disorders (SUDs) frequently co-occur both in the general population and in clinical settings. The authors review the recent literature that documents high comorbidity between these two classes of disorders, discuss possible mechanisms of comorbidity, and describe the clinical implications of this comorbidity. Although most attention on comorbidity between PDs and SUDs has focused on antisocial personality disorder (ASPD) and borderline personality disorder (BPD), it is also clear that other PDs (in particular, paranoid, avoidant, and obsessive compulsive PD) are prevalent among those suffering from SUDs. The effect of SUD on PD expression appears to be one of exacerbating PD symptomatology and, in turn, contributing to chronicity. This has important treatment implications in that clinicians must keep in mind the challenges present when planning and implementing treatment for those with both SUD and PD.

Tools & Resources: Impairment and Disability Web Sites

1999 ◽  
Vol 4 (6) ◽  
pp. 5-6
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Interpersonal Relationships ◽  
Web Sites ◽  
Outpatient Psychotherapy ◽  
Obsessive Compulsive ◽  
Not Otherwise Specified ◽  
Cluster B Personality Disorders ◽  
Clinically Significant ◽  
And Behavior

Abstract Personality disorders are enduring patterns of inner experience and behavior that deviate markedly from those expected by the individual's culture; these inflexible and pervasive patterns reflect issues with cognition, affectivity, interpersonal functioning and impulse control, and lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning. The AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, defines two specific personality disorders, in addition to an eleventh condition, Personality Disorder Not Otherwise Specified. Cluster A personality disorders include paranoid, schizoid, and schizotypal personalities; of these, Paranoid Personality Disorder probably is most common in the legal arena. Cluster B personality disorders include antisocial, borderline, histrionic, and narcissistic personality. Such people may suffer from frantic efforts to avoid perceived abandonment, patterns of unstable and intense interpersonal relationships, an identity disturbance, and impulsivity. Legal issues that involve individuals with cluster B personality disorders often involve determination of causation of the person's problems, assessment of claims of harassment, and assessment of the person's fitness for employment. Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality. Two case histories illustrate some of the complexities of assessing impairment in workers with personality disorders, including drug abuse, hospitalizations, and inpatient and outpatient psychotherapy.

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