Week 10 Borderline Personality Disorder Flashcards
What is a personality disorder?
▪ Manifested in cognition, affect, interpersonal functioning &/or impulse control
▪ Long standing pervasive maladaptive patterns of behaviour & relating to others
▪ Behaviour deviates from the norm of one’s socio-cultural background
▪ Onset adolescence/early adult
List of identified disorders which fall under the classification of Personality Disorders in the DSM-V
Currently, there are 10 identified disorders which fall under the classification of Personality Disorders in the DSM-V
▪ Paranoid
▪ Schizoid
▪ Schizotypal
▪ Avoidant
▪ Narcissistic
▪ Dependent
▪ Obsessive-compulsive
▪ Histrionic
▪ Antisocial
▪ Borderline
Dimensions of personality disorders
Cluster A: Cognitive and perceptual distortions (eg., paranoid, schizoid, schizotypal)
Cluster B: Dramatic, emotional, erratic cluster (eg., antisocial, borderline, histrionic, narcissistic)
Cluster C: Fearful or anxious cluster (eg., avoidant, dependent, obsessive-compulsive
Affective features of BPD
▪ Individuals have difficulty in regulating their emotions; can have intense ‘dysphoria’ that doesn’t last very long (e.g., a few hours); can become quite angry or enraged (e.g., over reaction to a perceived interpersonal situation); and/or have difficulty controlling anger
▪ Can have quick shifts in affect; may be described as labile
▪ Can be described as “moody”
▪ Extreme stress & anxiety can induce psychotic symptoms (usually short-lived)
Cognitive features and sense of self of BPD
▪ May misinterpret experiences such as someone being late or a friend canceling a lunch as “abandonment.” This can precipitate intense feelings and behavioral reactions.
▪ Can have trouble accurately interpreting social cues (Bland article, p. 205)
▪ Experience dichotomous thinking – see individuals or experiences as all good or all bad – that is, have difficulty appreciating complexity
▪ Experience dissociation - may express as “spacing out”, express feelings of “unreality”, or forget blocks of time
▪ May not experience a clear or stable sense of self
▪ May shift in terms of self-image, goals, career interests
▪ May not be able to clearly describe self, what they like, what they want in life
▪ Chronic feelings of emptiness or boredom may reflect identity disturbance
▪ Have a lot of relationships – though they don’t last very long
Cognitive features and sense of self of BPD
May misinterpret experiences such as someone being late or a friend canceling a lunch as “abandonment.” This can precipitate intense feelings and behavioral reactions.
Can have trouble accurately interpreting social cues (Bland article, p. 205)
Experience dichotomous thinking – see individuals or experiences as all good or all bad – that is, have difficulty appreciating complexity
Experience dissociation - may express as “spacing out”, express feelings of “unreality”, or forget blocks of time
May not experience a clear or stable sense of self
May shift in terms of self-image, goals, career interests
May not be able to clearly describe self, what they like, what they want in life
Chronic feelings of emptiness or boredom may reflect identity disturbance
Have a lot of relationships – though they don’t last very long
Interpersonal relationships of BPD
▪ May have unstable relationships
▪ May have difficulty with boundaries and expectations of others
▪ Can idealize others and try to get too close too fast -
▪ Can be sensitive to any changes in their interpersonal world
Interpersonal relationships of BPD
May have unstable relationships
May have difficulty with boundaries and expectations of others
Can idealize others and try to get too close too fast -
Can be sensitive to any changes in their interpersonal world
Impulse control of BPD
▪ May act impulsively; not think through consequences and engage in behaviors that are risky, self-harming; for example, spend money, binge eat, abuse substances, engage in unsafe sex
▪ Can be in response to intense emotions
BPD is a pervasive pattern of instability in interpersonal relationships, self-image, & affects, and marked impulsivity as indicated byfive (or more)of the following: (First three)
▪ Frantic efforts to avoid real or imagined abandonment – someone being late – or needing to leave can cause intense anxiety and fear of abandonment
▪ Pattern of unstable, intense relationships characterized by extremes of idealization and devaluation - May get too close too fast – have certain expectations of relationships that can’t be met – and then when expectations aren’t met – can turn on that person and devalue them – Can’t tolerate the flaws in people or have understanding – people are either all good or all bad
▪ Identity disturbance – unstable sense of self – chronic feelings of emptiness, boredom – may not have clear career goals or know what they want in life
DSM-V Criteria for BPD (continued)
▪ Impulsivity in two or more areas that are self-damaging (eating, sex, substance abuse) – not thinking through consequences
▪ Recurrent suicidal behavior, gestures, threats, self-mutilating behaviors – for various reasons, means of coping – ways of dealing with trauma
▪ Affective instability – emotional dysregulation – can have difficulty regulating emotions, can become quite angry, enraged – labile – unstable emotions
▪ Chronic feelings of emptiness – may not have a clear sense of self
▪ Inappropriate and intense anger
▪ Transient, stress-related paranoid ideas or dissociative symptoms – dissociation is the disruption in the normally integrated functions of consciousness – feelings of unreality, spacing out
What are the primary defence mechanisms of BPD?
Splitting
Idealizing
Devaluing
Splitting
An inability to synthesis positive & negative aspects of self & others
Splitting is closely connected to behaviors, thoughts and feelings.
Idealizing
Viewing people (e.g., nurse) as perfect or better than others
Tends to occur when the individual with BPD feels their needs are being met.
Devaluing
Minimizing the merit of worth of a person (e.g., nurse).
when needs are not being met
Tends to occur when the individual with BPD feels their needs are not being met.
