Borderline personality disorder

Borderline personality disorder

Pervasive pattern of instability of interpersonal relationships, self image, and affects that include 5 or more symptoms

Borderline personality disorder symptoms

• Frantic efforts to avoid real or imagined abandonment

• Pattern of unstable and intense interpersonal relationships that alternate between extreme idealization and devaluation

• Identity disturbance

• Impulsively in At least two areas that are damaging

• Recurrent suicidal behaviors, gestures, or threats, or self mutilating behavior

• Affective instability due to marked reactivity of mood

• Chronic feeling of emptiness

• Inappropriate intense anger or difficulty controlling anger

• Transient stress related paranoid ideation of sever dissociation

Prevalence and comorbidity

• 5.9 adults are diagnosed with

• Most common personality disorder

• Primarily diagnosed in women

  • Ratio 3 females to 1 male

• Most common co-morbidities is affective disorders and substance use disorders

• 55% who meet diagnostic criteria have a history of suicide

• 80% experience self mutilation

• Risk of suicide is highest in 20as

• People with BPD has the greatest risk of unemployment

Onset

• Most likely a result of combination of both biological and environmental factors

• 5x more likely of first degree relative has it

• 38% genetic and 63% environmental factors

• Most at risk if there is childhood neglect or abuse and ongoing sexual abuse in childhood

Course and recovery

• Starts in Early childhood

• 1/3 in mental health settings recover after 10 years

• Those in poverty backgrounds have lower rates of success

Intervention

• In all interventions trust is crucial for the establishment and maintenance of relationships between client and therapist

• Establish a contract agreement on how relationships will proceed

• Set limits

• Help client realize they are not responsible for past trauma

• Psychotherapy is the most effective

• Firm and clear boundaries

Medication

• Help manage symptoms of depression suicide and impulse behavior

• Results vary in regards to medication

• Antipsychotic to treat impulsivity and aggression

  • Ability

  • Ypres

  • Risperdal

• Antidepressants or mood stabilizer