When Your Loved One Has Borderline Personality Disorder

Escape Plan From a Borderline Woman

Escape from Damaged Woman book is an eye-opener to all men in the modern society who go through domestic abuse and struggles in a relationship all because they fear to get out of the relationship. The book provides ways through which an abused man can apply and get away from the damaged woman in confidence. Reading the book will help a man recognize and decide that he needs to get away from the damaged woman. He will also know how to prepare and take the real action. Ivan Throne has even gone an extra mile of discussing how to handle fragile days after the escape plan is executed and also ways of making sure that the escape plan is permanent. After conducting a test on Escape Plan from the Damaged Woman, results prove that the book contains contents which are solid and compelling which add value to men and society at large. Read more...

Escape Plan From a Borderline Woman Summary

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Norepinephrine transporter polymorphisms

At least 13 polymorphisms of NET have been identified,20 the functional significance of which is unknown. Alterations in the concentration of NE in the CNS have been hypothesized to cause, or contribute to, the development of psychiatric illnesses such as major depression and BPAD. Many studies have reported altered levels of NE and its metabolites NMN and dihydroxyphenylglycol (DHPG) in the CSF, plasma, and urine of depressed patients as compared with normal controls. These variances could reflect different underlying phenotypes of depressive disorders with varying effects on NE activity. The melancholic subtype of depression (with positive vegetative features, agitation, and increased hypothalamic-pituitary-adrenal (HPA) axis activity) is most often associated with increased NE. Alternatively, so-called atypical depression is associated with decreased NE and HPA axis hypoactivation. In one study, urinary NE and its metabolites were found to be significantly higher in unipolar and...

Amy W Wagner Marsha M Linehan

Dialectical behavior therapy (DBT) was initially developed for the treatment of chronically suicidal individuals who meet criteria for borderline personality disorder (BPD). Because the majority of people with BPD have histories of trauma and meet criteria for posttraumatic stress disorder (PTSD), it seems appropriate to describe DBT in a book on the treatment of trauma. There are two potential applications of DBT to individuals with histories of trauma. One main application is to achieve stabilization prior to initiating exposure-based interventions. DBT is organized into treatment stages the first stage aims to achieve behavioral control, safety, and connection to the therapist. This aim is consistent with the initial goals of other stage-oriented treatments for trauma and PTSD (e.g., Cloitre, 1998 Keane, Fisher, Krinsley, & Niles, 1994). Perhaps more than other treatments, DBT clearly specifies the manner in which stabilization can be achieved. A second potential application of...

Impulse Control Disorders Not Elsewhere Classified

As is suggested by the title of this diagnostic grouping, no one diagnostic class in DSM-IV-TR comprehensively includes all of the impulse control disorders. A number of disorders characterized by impulse control problems are classified elsewhere (e.g., conduct disorder, attention-deficit hyperactivity disorder, oppositional-defiant disorder, delirium, dementia, substance-related disorders, schizophrenia and other psychotic disorders, mood disorders, antisocial and borderline personality disorders). What ties together the disorders in this class is that they present with clinically significant impulsive behavior and that they are not better accounted for

Personality Disorders

This diagnostic class is for personality patterns that significantly deviate from the expectations of the person's culture, are pervasive, and lead to significant impairment or distress. Ten specific personality disorders are included in DSM-IV-TR paranoid personality disorder (pervasive distrust and suspiciousness of others), schizoid personality disorder (detachment from social relationships and a restricted expression of emotions), schizotypal personality disorder (acute discomfort with close relationships, perceptual distortions, and eccentricities of behavior), antisocial personality disorder (disregard for the rights of others), borderline personality disorder (instability of personal relationships, instability of self-image, and marked impulsivity), histrionic personality disorder (extensive emotionality and attention seeking), narcissistic personality disorder (grandiosity, need for admiration, and lack of empathy), avoidant personality disorder (social inhibition, feelings of...

Guidelines for Client Selection

When selecting clients for ACT who have experienced trauma or who have already been diagnosed with PTSD, there are a number of points to keep in mind. First, the client must be ready (i.e., able to commit to a number of sessions) and willing to undergo an intensive therapy in which the therapist is quite active in session. Second, if the client has problems that would be better treated by a different approach (according to the literature), this approach needs to be implemented first or integrated into the course of ACT. For example, if the client has borderline personality disorder, dialectical behavior therapy should be implemented initially, with ACT brought in during later stages. Finally, a functional analysis of the case should fit the

Caveats in Interpreting Electrophysiologic Data in Substance Abuse Research

Similarly, even though the reductions in P300 amplitude observed during withdrawal from either heroin, cocaine or ethanol (Poijesz et al., 1987 Kouri et al., 1996 Bauer, 1997 Noldy and Carlen, 1997) are very similar to those observed in a number of psychiatric disorders including dementia (Pfefferbaum et al., 1984) schizophrenia (Roth et al., 1980), depression (Diner et al., 1985) and borderline personality disorder (Kutcher et al., 1987), this lack of diagnostic specificity of the P300 has provided important information on the similarities between acute withdrawal from drugs of abuse and these other psychiatric disorders.

Persistent Avoidance of Stimuli Associated with the Trauma

The types of avoidance described above could have serious impact on the development of relationship skills involved in ordinary, day-to-day, social interactions as well as those required for intimate relationships, including therapy relationships. Healthy adult functioning involves being able to describe and identify the behavior of others as well as one's own internal reactions. Coping with trauma in a manner that involved externally focused perceptual avoidance could lead to problems such as revictimization. Perceptual avoidance that is directed inward distorts the ability to experience, identify, and describe internal states and may lead to problems of the self and personality disorders (primarily borderline personality disorder Kohlenberg & Tsai, 1991, Ch. 6 Kohlenberg & Tsai, 1993). Finally, the ability to tolerate the arousal that is required for exposure might also be affected, because the person would simply avoid the exposure experience.

The Development Of Suppression And Rediscovery Of Trauma Theory

About the prevalence of child sexual abuse by fathers and others, which has held up in current time as a factor for Dissociative Identity Disorder and Borderline Personality Disorder, may have been too much for Freud to accept. Some believe that he experienced a personal crisis and worried about the impact that publishing these findings might have on his career. He has been harshly criticized and condemned by some modern-day writers (Masson, 1984, 1990). According to Masson, the field of psychoanalysis suppressed the truth and did not take seriously patient reports of incest and abuse. Rachman (1997) writes

Psychiatric Comorbidity And Sequelae

Comorbid Axis II disorders are even more prevalent than Axis I disorders, with rates of personality disorders in cocaine abusers ranging from 30 to 75 in inpatient samples (Kleinman et al., 1990 Kranzler, Satel, & Apter, 1994 Weiss et al., 1993). Cocaine addicts with personality disorders tend to have greater psychiatric severity than those without personality disorders and are also at greater risk for both anxiety and mood disorders (Bunt, Galanter, Lifshutz, & Castaneda, 1990 Stone, 1992). Among cocaine-abusing outpatients, 48 have at least one personality disorder, whereas 18 have two or more (Barber, Frank, Weiss, & Blane, 1996). Even more compelling, 65 of those with a comorbid Axis II diagnosis have a Cluster B disorder, antisocial and borderline personality disorder (BPD) being the most frequent. Patients with BPD have higher levels of polysubstance and cocaine dependence, and also have more personality disorders such as avoidant, antisocial, and dependent personality...

Implications For Medication Adherence

Specifically, individuals high in neuroticism on the EPQ were less likely to be adherent to HAART as their level of perceived stress increased (Bottonari et al., 2005). Neuroticism is the trait that best distinguishes borderline patients from patients without this personality disorder (Morey and Zanarini, 2000). It is not surprising, therefore, that preliminary research on personality disorders and adherence suggests that BPD is associated with nonadherence to HAART. In a convenience sample of 107 triply diagnosed methadone patients (HIV positive with at least one psychiatric diagnosis and at least one substance use diagnosis), only BPD of all the Axis I and II psychiatric disorders was associated with less than 95 adherence in a 3-day recall of medications taken (Palmer et al., 2003).

Categorical Personality Disorders

The Cluster B personality disorders (antisocial, borderline, narcissistic, and histrionic), as described in DSM-IV, demonstrate elevated rates of SUDs (Mors & Sorensen, 1994). Conversely, in patients with SUDs, there is an elevated rate of Cluster B personality disorders, and multiple-substance-dependent patients are more likely to be diagnosed with Cluster B personality disorders than non-multiple-substance-dependent subjects (Skinstad & Swain, 2001). For example, in 370 patients with heterogenous SUDs, Rounsaville and colleagues (1998) found that 57 had an DSM-III-R personality disorder diagnosis, of which 45.7 were Cluster B, including 27 with antisocial personality disorder (ASPD) and 18.4 with borderline personality disorder (BPD). Borderline Personality Disorder

Personality Disorder In Hiv Atrisk And Hivpositive Individuals

The diagnosis of personality disorders in the clinic setting must be undertaken cautiously. Making a DSM-IV diagnosis according to Axis II of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR American Psychiatric Association, 2000) requires considerable time and experience, but does little to explain behavior or suggest intervention strategies. Classifying individuals along a continuum of personality traits rather than in DSM-IV Axis II discrete categories has been shown to be a better predictor of HIV risk behavior (Tourian et al., 1997). Furthermore, a diagnosis of antisocial or borderline personality disorder can be stigmatizing, particularly in a general medical clinic where care providers may have less experience managing such patients.

Functional Analytic Clinical Assessment in Trauma Treatment

Since the establishment of the diagnosis of PTSD in the DSM-III and subsequent updates (American Psychiatric Association, 1980, 1987, 1994, 2000), a considerable volume of literature has been published that describes clinical problems that may be likely to co-occur with PTSD. At the level of diagnostic labels, PTSD is noted to co-occur with depression, anxiety, phobia, and panic disorders perhaps in part because of symptom overlap in diagnostic criteria (Davidson & Foa, 1991). A variety of other diagnostic labels are also associated with PTSD, including substance abuse and Axis II cluster B disorders, such as borderline personality disorders with impulsivity (Foa, Davidson, Frances, & Anxiety Disorders Association of America, 1999).

Treatment Considerations

A., Schulz, S. C., & Grueneich, R. (1993). Impulsivi-ty, coping styles, and triggers for craving in substance abusers with borderline personality disorder. J Personal Disord, 7, 214-222. Trull, T. J., Sher, K. J., Minks-Brown, C., Durbin, J., & Burr, R. (2000). Borderline personality disorder and substance use disorders A review and integration. Clin Psychol Rev, 20, 235-253.

Table of Contents

Personality Disorder 439 Diagnosis 439 Treatment 440 Paranoid Personality Disorder 441 Diagnosis 441 Treatment 442 Schizoid Personality Disorder 443 Diagnosis 443 Treatment 444 Schizotypal Personality Disorder 444 Diagnosis 444 Treatment 445 Antisocial Personality Disorder 446 Diagnosis 446 Treatment 447 Borderline Personality Disorder 448 Diagnosis 448 Treatment 448 Histrionic Personality Disorder 450 Diagnosis 450 Treatment 451 Narcissistic Personality Disorder 452 Diagnosis 452 Treatment 453 Avoidant Personality Disorder 453 Diagnosis 453 Treatment 454

Comorbidity

Therapists need to be aware of comorbid (and often preexisting) disorders that may be exacerbated by the distress elicited by exposure. Some of the more problematic preexisting disorders include borderline personality disorder and people with psychotic histories. People with these problems can experience marked deterioration, including psychotic episodes, severe dissociative states, and self-destructive tendencies, when confronted with expo

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