Discovering
Borderline Personality Disorder
What Having this Disorder can
Mean
Borderline personality disorder (BPD) is a dangerous mental illness.
What are the signs and symptoms? How is it managed? Here, one can find an
overview of a few of the basics of BPD.
BPD is among a few personality illnesses acknowledged by the American
Psychiatric Association. Personality illnesses are mental illnesses that begin
in adolescence or early adulthood, keep going over many years, and bring about a good deal of distress.
Personality
illnesses also often intervene with an individual's ability to enjoy life or
accomplish fulfillment in personal relationships, school, or work.
Borderline Personality
Disorder Symptoms
BPD is related to specific
problems in social relationships, self-image, emotions, demeanors, and
thinking.
Patients
with BPD tend to have bad relationships caused by plenty of dispute, arguments,
and separations. BPD is also connected with strong sensitivity to neglect (abandonment), that includes intense concern of
being deserted by loved ones and efforts to avoid actual or unreal desertion.
Patients with BPD have troubles associated with the stability of their
sense of self. They describe many "ups and downs" in the way they
feel about themselves. One
minute they could feel great about themselves, but the next minute or so they
may feel they are evil or criminal when in fact they are not.
Psychological
instability is a central feature of BPD. Persons
with BPD may claim that they feel like they're on an emotional roller coaster, with
quick shifts in mood (for instance, going from feeling fine to feeling very down
or blue within several minutes). BPD is also related to feelings of extreme anger and emptiness.
BPD is linked with a tendency
to engage in hazardous and impulsive conduct, such as engaging in shopping
sprees, consuming excessive amounts of alcohol, abusing medications, partaking
in promiscuous sexual activity, or overeating. In addition, persons with BPD
are more inclined to engage in self-harming activities, like cutting
themselves, or attempting to commit suicide.
Under circumstances of extreme stress, individuals with BPD can experience
alterations in thinking, including paranoid ideologies (for instance, thoughts
that other people may be attempting to injure them), or dissociation (feeling
spaced out).
Causes of Borderline
Personality Disorder
As is the case with most psychological problems, the exact etiology (cause)
of BPD isn't known. Nevertheless,
there are studies that show that some combination of nature (biological science
or genetics) and the physical environment is responsible.
Studies have shown that many individuals diagnosed with BPD are known to
have experienced childhood abuse or negligence, or were displaced from their
caregivers at an early age. Yet, not all individuals with BPD had one of these
childhood characteristics (and, many individuals who have had these
characteristics don't have BPD).
There is furthermore evidence of genetic factors and differences in brain
power and function in patients with BPD.
Treatment of Borderline
Personality Disorder
Though formerly experts thought that BPD was unlikely to react to drug
therapy, studies
have now shown that BPD is really treatable.
An assortment of treatments are available for BPD, and these types of
therapy may be administered in outpatient (clinic) or inpatient (hospital)
settings. BPD is
generally treated with a mix of psychotherapy and drugs. Hospitalization or more intensive types of therapy
might be necessary during crisis.
More from this Author:
References
American Psychiatric Association. (2000). "Diagnostic and statistical
manual of mental disorders." (4). Washington, DC,
Kraus, G, and Reynolds, DJ. (2001). "The A-B-C's of the Cluster B's:
Identifying, Understanding, and Treating Cluster B Personality Disorders."
Clinical Psychology Review. 21: 345-373.
The copyright of the article Discovering Borderline Personality Disorder
in Chronic Illness is owned by
Naheed Ali. Permission to republish Discovering
Borderline Personality Disorder in print or online must be granted by the
author in writing.
Borderline
Personality Disorder Brain Metabolism
Neurophysiological Studies of
Borderline Personality Disorder (BPD)
A study recently appearing in the May 2007 issue of Journal of Psychiatry
and Neuroscience reviews what we know about brain physiology of BPD patients.
What Is Borderline Personality
Disorder?
According to the DSM-TR-IV (2000), psychology's diagnostic
"bible," BPD is a type of psychological personality disorder that
interferes with an individual's ability to regulate emotion.
People with this disorder are prone to unpredictable outbursts of anger,
which sometimes manifests as self-injurious behavior. Borderlines are highly
sensitive to rejection, and fear of abandonment may result in frantic efforts
to avoid being left alone, such as suicide threats and attempts.
The Brain and BPD
Primarily over the past 30 years, researchers have examined the Borderline
brain and found abnormalities in anatomy and physiological response.
In this study, Lis et al (2007) set out to examine existing research on the
neurological differences between individuals with and without BPD as well as
the genetics that may play a role in development of this disorder.
This Suite101 summary focuses on the metabolic differences that were found.
For anatomical or biological differences, see Suite101 article Anatomy of the BPD Brain.
Study Methods
Using databases of academic articles, the investigators looked for relevant
research published between 1980 and 2006 and found 49 journal articles
describing original research about the brain and/or genetics of BPD patients.
BPD Research Findings
The use of neuroimaging in the study of BPD dates back only a few years.
Overall, BPD has been linked to the amygdala and limbic systems of the brain, the centers that control
emotion and, particularly, rage, fear and impulsive automatic reactions.
BPD Metabolic Abnormalities
Reduced Brain Metabolism
Neurological studies using positron emission tomography (PET) and magnetic
resonance imaging (MRI) suggest that, in BPD patients, areas of the brain used
to regulate and control emotion are hypometabolic (have reduced
metabolic activity) and, in contrast, activation of limbic areas, when it
occurs, is excessive (hypermetabolic).
This might reflect a failure of rational thought to control emotional
thought, leading to the emotional instability that is characteristic of BPD.
NAA Concentrations
Patients with BPD also show deficiencies in N-acetyl-aspartate (NAA)
concentrations in the dorsolateral prefrontal cortex, suggesting a lower
density of neurons and disturbed neuronal metabolism.
NAA is the second most highly concentrated molecule in the brain. It’s made
in the neurons, and although scientists are not certain as to its function, NAA
is believed to be related to: fluid balance in the brain; lipid and myelin
synthesis (myelin is the “insulation” that surrounds neural axons and enables
efficient neuron-to-neuron communication); creation of
N-Acetylaspartylglutamate; and perhaps in the production of energy in neuronal
mitochondria.
Study Conclusions
Imaging technology such as PETs and MRIs have shown that brain structures
with reduced volume in BPD patients may show hypermetabolism (increased
metabolic activity).
Perhaps some of the lost volume in these structures may be due to reduced
numbers of inhibitory neurons resulting in lost inhibition and ultimately the
impulsive behavior and overly negative interpretation of others that is
associated with BPD.
Other Resources on BPD
There are numerous on-line and in print resources with additional
information on the treatment of Borderline Personality Disorder, including: Psychology
Prof Online, BPD Resource Center and the
Suite101 articles Personality Disorders: Brief
Summary of the Ten Disorders of Personality, and Borderline PD Information.
This Suite 101 article is a brief summary of a portion of one study of BPD.
The contents of this article are not meant to be used for diagnosis and are not
a substitute for professional help and counseling.
Sources
American Psychiatric Association APA (2000) Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV-TR).
Lis, E., Greenfield, B., Henry, M., Guile, J.M. and Dougherty, G. (2007) Neuroimaging
and genetics of borderline personality disorder: a review. Journal of
Psychiatry and Neuroscience, 32, 3.
The copyright of the article Borderline Personality Disorder Brain
Metabolism in Borderline
Personality is owned by Tami
Port. Permission to republish Borderline Personality Disorder Brain
Metabolism in print or online must be granted by the author in writing.
 |
|
|
|
|
Read more: http://borderline-personality.suite101.com/article.cfm/metabolism_in_the_bpd_brain#ixzz0D1vd1lYD&B
Therapy DBT
Dialectical
Behavior Therapy DBT
An Effective Treatment for
Borderline Personality Disorder BPD
DBT is a therapeutic approach, designed by Marsha M. Linehan, Ph.D.,
specifically for chronically suicidal borderline patients.
What Is Borderline Personality
Disorder?
According to the DSM-IV-TR, psychology's premier diagnostic manual, BPD is
a type of psychological personality disorder that
interferes with an individual’s ability to regulate emotion. The characteristic
emotional instability results in dramatic and sudden shifts in mood,
impulsivity, poor self-image, turbulent relationships, and often threats of and
attempts at suicide. Prevalence of Borderline Personality Disorder is
estimated at 1% to 2% of the general population.
In addition to appropriate drug therapy, psychotherapy has proven to be the
most effective means of treating BPD, and in recent years, new therapies such
as Dialectical Behavior Therapy (DBT) and Transference-Focused Psychotherapy (TFP) have
been designed specifically to treat this disorder (Clarkin 2007).
What Is Dialectical Behavior
Therapy?
DBT Theory
Marsha M. Linehan, Ph.D. created DBT for the treatment of chronically
suicidal borderline clients. The theory behind Dialectical Behavior Therapy is
based on the belief that BPD is a combined result of the patient's emotional
vulnerability, lack of skills in controlling emotions, and unsupportive
interpersonal environment. These factors cause the patient to be emotionally
“dysregulated,” at the mercy of wildly vacillating feelings and unpredictable
behaviors.
Linehan believes that the disorder is the result of an emotionally
vulnerable individual growing up in an invalidating environment. She defines ‘emotionally
vulnerable' as someone whose autonomic nervous system reacts in extreme
to relatively low levels of stress and then takes longer than would be expected
to return to normal, once the stress is removed.
The term 'invalidating environment' is considered a setting in which the
personal experiences and responses of a child are discredited or ‘invalidated’
by the significant others in her life. When the child voices her feelings,
these feelings are deemed invalid or inappropriate by those around her. In this environment, the
authority figures also tend to place a high value on characteristics of
self-control and self-reliance.
The result is an emotionally vulnerable child who may learn not to trust
her own feeling and reactions, and, therefore, never develop effective coping
mechanisms for dealing with stressful situations. Borderlines often
look to others for indications of how they should be feeling, as well as
expecting others to solve their problems (Linehan 2003).
DBT Method
DBT focuses directly on helping the patient develop new skills for
regulating emotion and reducing symptoms. The five specific components of
treatment DBT described by psychologist Cynthia Sanderson are: “1) individual therapy to address
and maintain the patient's motivation for treatment; 2) group skills training to
increase the patient's capacities; 3) brief weekly phone calls to insure
generalization of new skills; 4) therapist consultation team to provide
supervision and prevent burnout; 5) administrative function to structure the
environment so effective treatment can take place” (Borderline Personality
Disorder Resource Center).
New Research into Treatment of
Borderline Personality
A study of BPD treatments, recently
published in The American Journal of Psychiatry, examined the efficacy
of Dialectical Behavior Therapy in comparison with two other therapeutic
options used to treat BPD: Transference-Focused Psychotherapy (TFP) and Dynamic
Supportive Treatment. The results indicated that all three therapeutic
approaches were effective in fostering global improvement in the symptoms of
BPD. However, each approach was found to have specific strengths for treating
different aspects of the disorder (Clarkin 2007).
More Information on BPD
There are numerous on-line and in print resources with additional
information on the treatment of Boderline Personality Disorder, including: Psychology
Prof Online and The Borderline
Personality Disorder Resource Center
This article features a description of one type of therapy used to treat
Borderline Personality Disorder. The content is not meant to be a substitute
for professional help and counseling.
Additional BPD Resources
Personality Disorders: Brief
Summary of the Ten Disorders of Personality.
Clarkin, J.F., Levy, K.N., Lenzenweger, M.F., and Kenberg, O.F. (2007).
Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave
Study. The American Journal of Psychaiatry. Vol. 164, 6.
Linehan, M. (2003) Dialectical Behavior Therapy (DBT) for Borderline
Personality Disorder. The Journal of the NAMI California, Vol. 8, 1.
American Psychiatric Association APA (2000) Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV-TR)
The copyright of the article Dialectical Behavior Therapy DBT in Borderline
Personality is owned by Tami
Port. Permission to republish Dialectical Behavior Therapy DBT in print
or online must be granted by the author in writing.
|
|
|
|
|
|
Read more: http://borderline-personality.suite101.com/article.cfm/dialectic_behavior_therapy#ixzz0D1vvekJU&B
No hay comentarios:
Publicar un comentario