Lecture 22: Treatment

Question 1

what is stigma for PDs

Answer 1

PDs= most stigmatised disorders in DSM-5

• problematic behs–> maladaptive
• try to understand how beh. in past might have been important for person to get their emotional needs met

Question 2

maladaptive meaning

Answer 2

beh. that once served as adaptive function, but is no longer adaptive

Question 3

what are stigmatising language

Answer 3

acting out, manipulative, self-destructive

Question 4

heightened emotional arousal

Answer 4

1. sensitivity– likely to become emotional at lower threshold
2. reactivity– have stronger emotional reaction
3. slow return to baseline– takes longer to return to baseline

Question 5

trt. of PDs– explain levels

Answer 5

level 1: meta-analysis of level 2 studies– includes quantitative analysis
level 2: study of test accuracy w/: independent, blinded comparison, from people w/ clinical presentation

Question 6

evidence for level 1

Answer 6

• dialectical behaviour therapy (DBT)
• schema therapy
• psychodynamic psychotherapy

Question 7

evidence for level 2

Answer 7

• acceptance + commitment therapy (ACT)
• CBT
• Interpersonal therapy
• Psychoedu.

Question 8

what is DBT

Answer 8

• developed for borderline
• CBT based intervention for chronically suicidal behs.
• dialectic= combination of opposites
• beh. reinforcement used– use rewards to increase likelihood of beh.= use this for beh change

Question 9

central dialectics of DBT

Answer 9

acceptance + change

Question 10

goals of DBT

Answer 10

• accept yourself + current situation– while changing behs

- enhance beh, emotional, cog responses + interpersonal interactions

Question 11

DBT + evidence

Answer 11

• effective in reducing life-threatening beh
• reduces suicidal beh + self- harm
• improves emotional regulation?= no consistent benefits in improving emotional regulation

Question 12

DBT steps

Answer 12

1. mindfulness
2. distress tolerance
3. emotion regulation
4. interpersonal effectiveness

Question 13

1. mindfulness

Answer 13

• live w/ awareness in present moment– be present in your life
• no judging
• notice consequences
• no attachment to moment (pay attention to each moment, don’t ignore now, don’t cling onto past)
• wise mind

Question 14

2. distress tolerance

Answer 14

• survive crisis situations w/o making them worse
• accept reality– move forward
• don’t feel like you always have to satisfy your desires, urges, intense emotions

Question 15

3. emotion regulation

Answer 15

goals:

• understand emotions that you experience
• reduce emotional vulnerability
• decrease emotional suffering

Question 16

4. interpersonal effectiveness

Answer 16

• maintaining healthy relationships
• getting somebody to do what you want
• maintaining self-respect

Question 17

schema therapy + evidence

Answer 17

• meta-analytic findings= effective in reducing borderline PD

Question 18

schema therapy for PDs

Answer 18

• individuals all have core emotional needs
• unmet emotional needs in childhood–> schemas rise–> strengthened throughout adulthood
• early maladaptive schemas= unconditional + problematic beliefs about yourself

Question 19

conclusion for trt.

Answer 19

• most people w/ these diagnoses= have experienced sig. adversity when younger–> might have learnt problematic ways of coping w/ distress
• so= develop new ways to manage distress– in ways which allow them to get their emotional needs met
• trt.= effective

Question 20

complex trauma

Answer 20

- repeated, cumulative experiences in childhood
ongoing psychological effects include:
- anxiety + depression 
- cog distortions 
- ptsd 
- identity disturbance 
- interpersonal problems 
- substance abuse 
- binging and purging 
- unsafe sex 
- aggression 
- suicidality

Question 21

transactional model of Borderline PD

Answer 21

emotion vulnerability (sensitive, easy to react, slow return to baseline)–>
heightened emotional arousal (increased chance of emotion dysregulation)–>
inaccurate expression–>
invalidating responses from parents and others–>
prevalent history of invalidating responses–>
goes back to emotion vulnerability

Question 22

dysfunctional ways of coping

Answer 22

• surrender
• avoid– detached, avoidant– to protect yourself
• overcompensate:
• self-aggrandiser
• attention seeker
• perfectionist overcontroller
• compensate by being paranoid
• bully, attack
• conning