scholarly journals Mentalization-based treatment for patients with borderline personality disorder: an overview

2009 ◽  
Vol 31 (1) ◽  
pp. 72-75 ◽  
Author(s):  
Mariana Eizirik ◽  
Peter Fonagy
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Professionals ◽  
Therapeutic Process ◽  
Psychological Trauma ◽  
Borderline Personality ◽  
Randomized Controlled ◽  
Effective Interventions ◽  
Psychodynamically Oriented ◽  
The Individual

OBJECTIVE: To describe the concept of mentalization, and its application in understanding the development of psychopathology in patients with borderline personality disorder; to give an account of the main features of mentalization-based treatment; to summarise the evidence supporting its effectiveness. DISCUSSION: Mentalization is a predominantly preconscious mental activity that enables the individual to understand him/herself and others in terms of subjective states and mental processes. Psychological trauma in childhood is associated with deficits in mentalization and with the development of borderline personality disorder. Mentalization-based treatment is a psychodynamically-oriented manualized psychotherapy for borderline personality disorder that aims to develop a therapeutic process in which the patient's capacity for mentalization becomes the focus of treatment. Randomized controlled trials have demonstrated the effectiveness of this treatment for patients with borderline personality disorder. CONCLUSIONS: The development of a psychodynamically-oriented therapeutic intervention that specifically targets the deficits involved in the psychopathology of borderline personality disorder is a crucial step in increasing the effectiveness of treatment. Mental health professionals should be adequately prepared to deliver effective interventions to their patients, such as mentalization-based treatment.

scholarly journals Individual Factors Underlying Suicidal Behaviors in Patients with Borderline Personality Disorder: A Qualitative Study

2022 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Marjan Hajfiroozabadi ◽  
Jamileh Mohtashami ◽  
Foroozan Atashzadeh-Shoorideh
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Professionals ◽  
Suicide Attempts ◽  
Psychiatric Inpatient ◽  
Borderline Personality ◽  
Individual Factors ◽  
Suicidal Behaviors ◽  
Limited Information ◽  
The Individual

Background: Borderline personality disorder (BPD) is associated with a high risk of suicide. Limited information is available on the individual factors underlying suicidal behaviors, especially suicide attempts (SAs), in Iranian patients with BPD. Objectives: This study aimed to analyze the individual factors underlying suicidal behaviors in patients with BPD. Methods: This was a qualitative descriptive study that was conducted from May 2020 to February 2021 in Tehran and Karaj, Iran, on 23 participants, including 14 patients with BPD and seven mental health professionals, as well as two members of their families. The research environment included psychiatric inpatient wards, psychiatric emergencies, and psychiatric clinics. Participants were selected through purposive sampling. Data were collected using semi-structured interviews and were analyzed using conventional content analysis. Results: Data analysis revealed five main themes and 15 sub-themes related to the individual factors underlying the identification and prediction of the risk for suicidal behaviors and SAs. The extracted themes included “psychological pain and loneliness”, “defects in the distinction and integration of emotions”, “unconventional behavior and emotion”, “pervasive incompatibility”, and “breakdown of the self-integrity”. Conclusions: The BPD is a complex and challenging disorder in which patients with BPD usually tend to engage in suicidal behaviors, and with the emergence of individual factors underlying the occurrence of such behaviors, appropriate preventive measures and interventions can be taken to reduce suicide-related behaviors such as suicidal thoughts and planning, as well as SAs.

Mentalization-Based Treatment of Borderline Personality Disorder

2012 ◽  
pp. 766-784 ◽  
Author(s):  
Anthony W. Bateman ◽  
Peter Fonagy
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Professionals ◽  
Psychological Trauma ◽  
Mental States ◽  
Borderline Personality ◽  
Interpersonal Interaction ◽  
The Face ◽  
Disorder Treatment ◽  
Core Problem

An outline of the developmental origins of mentalizing and its relevance to borderline personality disorder is provided. Mentalizing, a capacity to understand intentions of oneself and others in terms of mental states, develops in the context of attachment relationships. Disruption of the attachment relationship due to psychological trauma leads to a vulnerability in adulthood to a loss of mentalizing in the context of interpersonal interaction, which is a core problem for people with borderline personality disorder. Treatment requires a focus on mentalizing, and mentalization-based treatment has been developed with the aim of helping patients improve their ability to maintain mentalizing in the face of emotional stimulation in the context of close relationships. The treatment has been subjected to research trials and shown to be effective in reducing many of the symptoms of borderline personality disorder when implemented by generic mental health professionals with limited specialist training.

scholarly journals Deficits of Affect Mentalization in Patients with Drug Addiction: Theoretical and Clinical Aspects

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Svetoslav Savov ◽  
Nikola Atanassov
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Drug Addiction ◽  
Self Regulation ◽  
Complex Form ◽  
Borderline Personality ◽  
Clinical Aspects ◽  
Empirical Testing ◽  
Affective States ◽  
Psychodynamically Oriented

Traditionally treated with wariness, drug addictions have provoked a serious interest in psychodynamically oriented clinicians in recent decades. This paper discusses the development of contemporary psychodynamic conceptualizations of addictions, focusing specifically on mentalization-based theories. The concept of mentalization refers to a complex form of self-regulation which includes attribution of psychological meaning to one’s own behavior and affective states, as well as those of the others. We hypothesize that drug-addicted patients have severe impairments in mentalizing, associated with developmental deficits, characteristic for the borderline personality disorder and psychosomatic conditions. Psychodynamic models of mentalization and their corresponding research operationalizations are reviewed, and implications for a contemporary understanding of drug addictions and psychotherapy are drawn. The authors propose that mentalization-oriented theories provide an adequate conceptualization, which is open to empirical testing and has clear and pragmatic guidelines for treatment.

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 Engagement Complications of Adolescents with Borderline Personality Disorder: Navigating Through a Zone of Turbulence

2020 ◽  
Author(s):  
Lyne Desrosiers ◽  
Micheline St-Jean ◽  
Lise Laporte ◽  
Marie-Michèle Lord
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychosocial Functioning ◽  
Health Care Services ◽  
Subjective Experience ◽  
Therapeutic Process ◽  
Borderline Personality ◽  
Warning Signs ◽  
Constructivist Grounded Theory ◽  
Grounded Theory Method

Abstract Objective: Premature treatment discontinuation is a widespread phenomenon in child and adolescent mental health services that impacts treatment benefits and costs of care. Adolescents with borderline personality disorder (BPD) are heavy users of health care services and notoriously difficult to engage in treatment. However, there is hardly any data regarding this phenomenon with these youths. Considering that BPD treatment is associated with intense and chaotic therapeutic processes, exploring barriers emerging in the course of treatment could be relevant. Thus, conceptualizing treatment dropout as a process evolving from engagement to progressive disengagement, and ultimately to dropout, could highlight the mechanisms involved. The aim of this study was to describe the process of treatment disengagement and identify warning signs that foreshadow dropouts of adolescents with BPD. Method: A constructivist grounded theory method was used. This method has been favoured based on the assumption that the behaviours and decisions leading to disengagement may be better informed by the subjective experience of treatment. Thirty-three interviews were conducted to document 11 treatment trajectories with 3 groups of informants (9 adolescents with BPD 13-17 of age, 11 parents, and 13 clinicians). Results: Well before dropout occurs, different phenomena identified as “engagement complications” characterize the disengagement process. These unfold according to a three-step sequence starting with negative emotions associated with the appropriateness of treatment, the therapeutic relationship or the vicissitudes of treatment. These emotions will then generate treatment interfering attitudes that eventually evolve into openly disengaged behaviours. These complications, which may sometimes go unnoticed, punctuate the progression from treatment engagement to disengagement leading the way towards the development of a “zone of turbulence” which creates a vulnerable and unstable therapeutic process presenting risk for late dropout. Conclusion: Engagement of adolescents with BPD is neither static nor certain, but on the contrary, subject to their fluctuating perceptions. Therefore, it can never be taken for granted. Clinicians must constantly pay attention to emergent signs of engagement complications. Maintaining the engagement of adolescents with BPD should be a therapeutic objective akin to reducing symptomatology or improving psychosocial functioning, and should therefore be given the same attention.

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