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B ORDELINE P ERSONALITY D ISORDER (BPD) Zitlaly Ortega Period 6
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W HAT ID BPD? Borderline Personality Disorder: Characterized by a pervasive pattern of instability, most evident in relationships, mood, and sense of identity. What does it mean to have BPD?
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A SSOCIATED F EATURES Need for intense emotional experiences Mood swings Boredom This causes the person to engage in impulsive behaviors.
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A SSOCIATED F EATURES Might go to the extreme of self mutilation Anxiety when someone is not present. Suicidal thoughts Sexual orientation confusion
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A SSOCIATE F EATURES Shifts in goals, dreams, or expectations. Identity confusion
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E TIOLOGY : S OCIAL / E NVIORNMENTAL Abandonment in Childhood Parent Neglect/rejection (87%) Sexual Abuse (40-71%) Physical Abuse (25-71%)
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P REVALENCE 2% of the general Population 10% among individuals seen in outpatient mental health clinics 20% among psychiatric inpatients 30% to 60% among clinical populations with Personality Disorders. More prevalent in Women
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BPD: DMS IV C RITERIA 1. frantic efforts to avoid real or imagined abandonment. Note : Do not include suicidal or self- mutilating behavior covered in Criterion 5. 2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. 3. identity disturbance: markedly and persistently unstable self-image or sense of self. 4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note : Do not include suicidal or self-mutilating behavior covered in Criterion 5.
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DMS IV CONTINUED … 5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior 6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). 7. chronic feelings of emptiness 8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights) 9. transient, stress-related paranoid ideation or severe dissociative symptoms
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BPD Q UIZ 1. I nearly always feel "empty." Strongly disagree Disagree Neutral / mixed feeling Agree Strongly agree 2. I find that I often do one or more of the following: drive recklessly, engage in unsafe sex,abuse alcohol or drugs, binge eat, gamble or spend money recklessly. Strongly disagree Disagree Neutral / mixed feeling Agree Strongly agree 3. Sometimes when I'm stressed out -- especially if someone has abandoned me -- I can get very paranoid, feel myself "spacing out" or dissociate. Strongly disagree Disagree Neutral / mixed feeling Agree Strongly agreeabuse alcohol
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4. I often idealize others, especially when I first meet them, and feel comfortable in sharing the most intimate details with them. But I often feel that these same people don't care enough and aren't there enough for me. Strongly disagree Disagree Neutral / mixed feeling Agree Strongly agree 5. I'm sometimes very angry, extremely sarcastic and bitter, and feel like I have a hard time controlling this anger. Strongly disagree Disagree Neutral / mixed feeling Agree Strongly agree 6. I've engaged in self-mutilating, self-harm, or suicidal behaviors, gestures or threats. Strongly disagree Disagree Neutral / mixed feeling Agree Strongly agree
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7. I often experience a sudden shift in the way I look at myself and my life, and completely change my goals, values and career focus. Strongly disagree Disagree Neutral / mixed feeling Agree Strongly agree 8. I'm often afraid that others will abandon or leave me -- so I'll make frantic efforts to avoid this abandonment (even when it's not real). Strongly disagree Disagree Neutral / mixed feeling Agree Strongly agree 9. My mood can shift between extreme periods of anxiety, depression or irritability in just a few hours or days. Strongly disagree Disagree Neutral / mixed feeling Agree Strongly agreeanxiety
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7. I often experience a sudden shift in the way I look at myself and my life, and completely change my goals, values and career focus. Strongly disagree Disagree Neutral / mixed feeling Agree Strongly agree 8. I'm often afraid that others will abandon or leave me -- so I'll make frantic efforts to avoid this abandonment (even when it's not real). Strongly disagree Disagree Neutral / mixed feeling Agree Strongly agree 9. My mood can shift between extreme periods of anxiety, depression or irritability in just a few hours or days. Strongly disagree Disagree Neutral / mixed feeling Agree Strongly agreeanxiety
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T REATMENT Dialectical behaviour therapy Weekly sessions Decreases: Self-harm behavior Time spent in hospital 1 year later…
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T REATMENT Psychoanalytic psychotherapy (30% or more) Therapeutic communities Interpersonal therapies Cognitive–analytic therapy
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L ONG -T ERM P ROGNOSIS 53 % of patients 7 years patients diagnosed with BPD after no longer meet the BPD criteria
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R EFRENCES : Halgin, R.P. & Whitbourne, S.K. (2005). Abnormal psychology: clinical perspectives on psychological disorders. New York, NY: Worth Publishers. M, John.(1992-2012). Borderline personality disorder. http://psychcentral.com/lib/2007/symptom s-of-borderline-personality-disorder/ http://psychcentral.com/lib/2007/symptom s-of-borderline-personality-disorder/ (2011). What is borderline personality disorder?. http://www.nimh.nih.gov/health/publications/ borderline-personality-disorder/how-is- borderline-personality-disorder-treated.shtml http://www.nimh.nih.gov/health/publications/ borderline-personality-disorder/how-is- borderline-personality-disorder-treated.shtml
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V IDEO : B ORDERLINE PERSONALITY DISORDER http://www.youtube.com/watch?v=G33FIOY28zQ
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D ISCUSSION QUESTIONS : How is the term “emo” related to BPD? How does the lack of information cause society to stigmatize certain people, especially those with BPD?
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