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Borderline personality disorder review of the literature
Borderline personality disorder review of the literature
Borderline personality disorder case study
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After reading Alessandra’s vignette, it is apparent that she has borderline personality disorder (BPD) (APA, 2013; Roberts & Louie, 2015). The symptoms that Alessandra presents are frequent tearful fits, yelling, chronic issues with her mood, frequent interpersonal problems with her husband, difficulty getting out of bed, “drama” with coworkers, inappropriate communication with customers, references of responding to others comments with suicide, and attention seeking with faking pain. To meet full criteria for BPD, Alessandra must first meet criteria A to F for a personality disorder, followed by criteria A for BPD. Criteria A requires that Alessandra has a long-lasting pattern of behavior or inner experience that deviates from cultural expectation …show more content…
(APA, 2013). This must be noted in two or more areas coming from cognition, affectivity, interpersonal functioning and/or impulse control. Alessandra meets criteria A by displaying enduring dysfunctional patterns in four of the four possible areas. In regards to (1) impulse control, it is made apparent that Alessandra struggles with controlling her impulses, which is made evident by her yelling and crying abruptly in response to seemingly unprovocative statements made by her husband. In regards to (2) interpersonal functioning, it is made apparent that Alessandra struggles to function properly in social situations, with is made evident by a history of counseling for family issues, multiple separations from her husband, and being fired from work for inappropriately entertaining costumers. In regards to (3) affectivity, Alessandra tends to be eccentric and emotionally unstable. Her eccentricity and emotional instability is made evident by Alessandra faking pains, responding to her husband’s unprovocative statement with a desire to commit suicide, and her frequent and spontaneous fits of tears. Lastly, in regards to her (4) cognition, Alessandra struggles to rationally perceive her situations with her husband in therapy and tends to interpret his seemingly innocuous statements as threatening. Criteria B requires that these long-lasting patterns are pervasive in Alessandra’s life as well as inflexible (APA, 2013).
It is apparent that Alessandra meets criteria B from her long history of psychotherapy to treat her mood issues and her dysfunction with her family. Criteria C requires that such long-lasting behaviors or inner experiences cause significant distress in important areas of functioning. Alessandra meets criteria C by the distress that her symptoms have caused her in her relationships with family, her relationship with her husband, and by her being fired from her job. Furthermore, this is made evident by her parents referring to her as a drama queen because her frequent relationship troubles and separations with her husband, and by her neglecting to attend work and inadequately preforming at work. Criteria D requires that the dysfunction can be traced back to adolescence or early adult life. The vignette does not provide much information regarding her past, therefore, it is difficult to determine if her symptoms were present in early stages of her life. With that being said, the vignette does note that she had been in therapy for years to address mood and family problems, which could be vaguely indicating that she has had a long history of problems; additional information is needed to confidently state that Alessandra meets criteria D. Criteria E requires that the dysfunction is not better explained by another psychological disorder. Alessandra meets criteria E by all differential diagnoses being ruled out; further analysis of the differential diagnoses and justification for her meeting criteria E is presented in the subsequent section. Criteria F requires that the behaviors or inner experiences are not better explained by the use of substances. It is difficult to rule out criteria F due to the vignette not stating nor denying a history of drug use. With that being said, and assuming that the vignette is only stating pertinent concerns, it is
possible to conditionally claim that she meets criteria F. Further investigation in to her possible drug use is needed. For Alessandra to meet the criteria or BPD, she must meet criteria A of BPD. Criteria A of BPD requires that Alessandra displays five or more of nine listed symptoms (APA, 2013). Of these nine, the vignette shows that Alessandra experiences five symptoms. It can be seen that Alessandra displays symptom 2 of BPD, which focuses on unstable interpersonal relationships. This is made evident by her frequent and seemingly unresolvable interpersonal problems with her husband. Her relationship with her husband has a degree of idealization, given that she married him with obvious fits of devaluation, as she presents with her comments about him not listening to her. It can be seen that Alessandra displays symptom 3, which focuses on unstable image of self. This is made evident by her presenting herself as a well put together person, who dresses well, while frequently reporting to want to kill herself and being tearful and unable to get out of bed. It can be seen that Alessandra displays symptom 5, which focuses on self-injurious thoughts or gestures. This is made evident by the report that the husband’s comments frequently cause her to feel as though she wants to “slit her wrists”. It can be seen that Alessandra displays symptom 6, which focuses on affective instability and mood. This is made evident by her long history of chronic mood problems, which she has sought out therapy for. Her instability is also evident by her impulsive crying and yelling in therapy with her husband. It can be seen that Alessandra displays symptom 4, which focuses on impulsivity. This is made evident by her engaging in reckless spending on expensive clothes that she reportedly only wears once, and by her inability to reframe from engaging in inappropriate entertaining of customers at her past job. Her lack of conscientiousness, as made evident by her inability to focus on her job, is another indication of the presence of BPD (Millon, 2012). Her impulsivity can also be seen in her responsive yelling in therapy with her husband. When making a diagnosis, it is always important to consider differential diagnoses. The diagnostic and statistical manual of mental disorders (APA, 2013) proposes five differential diagnoses to consider when considering BPD as a diagnosis. First, a diagnosis of depressive and bipolar disorders can be ruled out by depression not being a prominent symptom of Alessandra and by her not reporting episode of symptoms, but rather consistent and pervasive symptoms. In light of this, she reported not getting out of bed for work at times and trouble with mood. Although this is a classic trait of BPD, further investigation should be pursued before depressive or bipolar disorders are confidently ruled out (Roberts & Louie, 2015). Other personality disorders should also be ruled out. Histrionic personality disorder can be ruled out by the fact that Alessandra disrupting close relationships, such as with her husband—which is the primary problem presented in therapy—and with her family and past coworkers. Paranoid personality disorder can be ruled out by her not expressing suspicion, and dependent personality disorder can be ruled out by her fears of abandonment being coupled with rage instead of submissiveness. As for a diagnosis of personality change due to another medical condition can be conditionally ruled out by there being no mention of any medical disorders in her past. Despite this, Alessandra should see her physician so that this can be confidently ruled out. In regards to substance use disorder, there was no mention of substance use in the vignette, which raises concern because of the prevalence of co-occurring substance use with BPD (Roberts & Louie, 2015). Substance use disorder can be conditionally ruled out until further evaluation of her unmentioned substance use history confirms such. Identity problems can be ruled out because such problems are related to developmental phases and Alessandra is 37 years of age. It is always important to consider the culture of the patient when making a diagnosis. Because Alessandra is a Puerto Rican women, it is important to consider cultural differences that could distort the clinician’s conceptualization of her case. For example, it is possible that when she was spending too much time entertaining customers at her past job that she was acting in accordance with what was culturally expectable in Puerto Rico, but not America. Therefore, it is important to distinguish between if her behaviors with the customers should be pathologized or if they are just culturally different. Also, the way she dresses should be determined if she is acting in accordance with her culture, or if she is overcompensating.
Susanna was admitted into Claymoore Hospital and was diagnosed with a borderline personality disorder. I believe that Susanna met the criteria for a diagnosis of borderline personality disorder. A person that has been diagnosed with BPD are
Denise Gilmartin, a 26 year old female, exhibits behaviors which meet criteria for Borderline Personality Disorder. Denise exhibits unstable intense interpersonal relationships characterized by idealization and devaluation (Criterion 2). She has a history of brief tumultuous relationships and friendships. They start of with quick intense attachments and are described by Denise as “wonderful” and “incredibly special” (idealization); however, these feelings quickly devolve into “contempt” and “loathing” (devaluation). Additionally, Denise displays an unstable sense of self (Criterion 3). Her unsteady employment history is partially explained by dramatic shifts in interests. She switched from marketing to legal work to waitressing. It is also important to note that interpersonal issues underly most of her
She acquired borderline personality disorder because her husband, Tommy passed away. In the DSM-5, borderline personality is described as “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five of the following” (Butcher, Hooley, & Minek, 2014, 342). Tiffany showed at least five symptoms of borderline personality
Mary has suffered with her illness for over 10 years. She has previously been diagnosis with a Cluster B type Personality Disorder. Mary comes across as narcissistic, self-engrossed and can be very demanding at times. Mary suffers from anxiety and is prone to panic attacks in relation to her PD diagnosis. At times Mary has been known to make ...
Diana Miller, 25 was diagnosed with major depressive disorder and borderline personality disorder after being rushed to the hospital following another suicide attempt . Her symptoms and background are outlined in her vignette and will be examined in detail throughout the paper. The purpose of this essay will be to explore the possible additional diagnoses for Diana’s behaviour as well as look deeper into the feasible explanations of how and why her behaviour turned abnormal. Therefore through analyzing the diagnostic features, influence of culture, gender, and environment, in addition to outlining paradigm explanations and possible treatment methods, one can better understand Diana Miller’s diagnoses.
Disco Di have shown these symptoms during her time when she ran away from her parents because they would not pay attention to her. She got into drugs use, had many promiscuous relationships with boys. Her relations with these boys were full off passion and chaotic with many violent arguments. She would seek out excitements such as getting drunk and go dancing where she would leave with strange men then have intercourse. After being admitted to a hospital, she would always expect and demanded that people would always have to pay attention to her. Also, I believe this because in the journal “Histrionic Personality Disorder” it stated “Histrionic PD is indicated when people exaggerate their emotions and go to excessive lengths to seek attention” (Crawford et al, 2007) and this is indicated when Disco Di ran away from home because she believed her parent did not pay enough attention to her. Next, the diagnostic feature of her other disorder, borderline personality disorder, is that mark of instability of mood, unstable relationships, chronic feeling of emptiness and recurrent threats of
Other background information that must be cleared up concerns history of traumas, domestic violence, housing status, primary usage of drugs, mental health problem in family, cases of hospitalization, treatment, previous usage of medication. All these items can influence current client's condition. Despite, as Meredith’s sister Sarah also has some personal problems, it is necessary to find out the origin of it; Sarah might have personal disorder that is inherited, so Meredith is under the risk to have it.
The psychiatrist recommended that she be admitted to a mental hospital for women, where she can rest and recover. Another sign of the Borderline Personality Disorder is c...
This paper looks at a person that exhibits the symptoms of Borderline Personality Disorder (BPD). In the paper, examples are given of symptoms that the person exhibits. These symptoms are then evaluated using the DSM-V criteria for BPD. The six-different psychological theoretical models are discussed, and it is shown how these models have been used to explain the symptoms of BPD. Assessment of
In order for someone to be diagnosed with Borderline Personality Disorder, they must experience at least five of the following symptoms: 1) fear of abandonment, 2) a history of intense and unstable relationships with family, friends, and loved ones, which often go back and forth between idealization (which includes love and extreme closeness) to devaluation (which includes extreme hatred or anger), 3) a disto...
Borderline Personality Disorder (BPD) affects about 4% of the general population, and at least 20% of the clinical psychiatric population. (Kernberg and Michels, 2009) In the clinical psychiatric population, about 75% of those with the disorder are women. BPD is also significantly heritable, with 42-68% of the variance associated with genetic factors, similar to that of hypertension. BPD can also develop due to environmental factors such as childhood neglect and/or trauma, insecure attachment, and exposure to marital, family, and psychiatric issues. (Gunderson, 2011)
Borderline Personality Disorder (BPD) hinders people’s security, makes interpersonal and interpersonal relationships difficult, worsens the person suffering from the disorder’s life and those around them, effects their affect and self-image, and generally makes a person even more unstable (Davidon et al., 2007). This disorder is a personality disorder which effects the people’s emotions, personality, and daily living including relationships with other and job stability. People with BPD may experience a variation of symptoms including but not limited to: intense contradictory emotions involving sadness, anger, and anxiety, feelings of emptiness, loneliness, and isolations (Biskin & Paris, 2012). This disorder makes it hard for the person with the disorder to maintain relationships since they have tendentious believe that people are either strictly good or bad. Also, they are sensitive to other people’s actions and words and are all over the place with their emotions so those in their life never know which side to expect. (Biskin & Paris, 2012)
The history of BPD can be traced back to 1938 when Adolph Stern first described the symptoms of the disorder as neither being psychotic nor psychoneurotic; hence, the term ‘borderline’ was introduced (National Collaborating Centre for Mental Health, 2009, p. 15). Then in 1960, Otto Kernberg coined the term ‘borderline personality organization’ to describe persistent patterns of behavior and functioning consisting of instability, and distressed psychological self-organization (National Collaborating Centre for Mental Health, 2009, p. 15).
In Medea, Medea shows copious traits of an unstable individual, which I believe to be characterized by borderline personality disorder. “Borderline personality disorder is a mental health disorder that impacts the way you think and feel about yourself and others, causing problems functioning in everyday life. It includes a pattern of unstable intense relationships, distorted self-image, extreme emotions and impulsiveness” (Mayo Clinic Staff, 2015, p. 1). Throughout the various actions and emotions displayed by Medea, sorceress and wife of Jason, you can see the relevancy of borderline personality disorder on herself.
Self-destructive behaviors are also very common in individuals with Borderline personality disorder. Susanna validates this trait by her lack of motivation, conversations about suicide, and her suicide For example; Lisa, the diagnosed sociopath, displays very little empathy for those around her. This is made clear when she sees Daisy’s post suicide body and is not saddened whatsoever. Another accurate portrayal is the patient with anorexia nervosa Janet. Janet refuses to eat, is in denial about her condition, is emotionally labile, and is always exercising.