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Bpd 7 Notes

Psychology Notes > Abnormal Psychology (2nd year) Notes

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BPD
PERSONALITY DISORDERS
Personality = collection of charac or traits that we have developed growing up and something which makes each of us an individual
Including the ways we think, feel and behave
Different kinds of personality disorders  research suggests 3 groups:

1. Cluster A: Odd or Eccentric

2. Cluster B: Dramatic, Emotional, or Erratic

3. Cluster C: Anxious and Fearful

BORDERLINE PERSONALITY DISORDER
BPD = emotional instability, fears of abandonment, impulsivity, self-mutilating behaviours, unstable sense of self  intense and stormy personal relationships
Long term
Frequent change in emotions
Marked impulsivity
Associated with a wide variety of disorders

Epidemiology
Leichsenring et al., 2011:
USA population sample: 0.5-5.9%
In clinical sample: 10% all psychiatric outpatients; 15-25% inpatients
Non clinical: 5.9% (many individuals fail to seek appropriate treatment)

DIAGNOSIS: DSM-V CRITERIA
The essential features of a PD are impairments in personality functioning and the presence of pathological personality traits
To diagnose BDP, the following criteria must be met:
A Sig impairments in personality Impairments in self functioning (a or b)
a: identity functioning manifest by:
b: self-direction
Impairments in interpersonal functioning a: empathy
(a or b)
b: intimacy
B Pathological personality traits Negative Affectivity, characterised by:
a: emotional liability in the following domains:
b: anxiousness c: separation insecurity d: depressive
Disinhibition, characteristied by:
a: impulsivity b: risk taking
Antagonism, characterised by:
a: hostility
High prevalence of aggression 
Newhill et al., 2009: 73% of BP patients have engaged in aggressive behaviour over 1 year BPD
LIFE COURSE AND COMORBIDITY
Co-morbidity
Unipolar/bipolar mood, anxiety disorders, substance-use, eating disorders
Paris, 2007: 50% those with BPD also qualified for a mood disorder
Co-morbid with other PDs especially histrionic, dependent, antisocial and schizotypal
Tomko et al., 2014:
Results suggest that 2.7% of adults in the USA meet diagnostic criteria for BPD
High rates of the disorder in F, people in lower income brackets, people younger than 30, and individuals who are separated/divorced

BPD individuals were likely to have co-occurring lifetime mood disorders, anxiety disorders, substance use disorders, and other personality disorders

84.8% of individuals with BPD also had a lifetime anxiety disorder, 82.7% had a lifetime mood disorder/episode, and 78.2% were diagnosed with a lifetime substance use disorder
Karsten et al., 2016:
BPD women (compared to psychiatric patient none-BPD F):
 More likely to have been abused as children
 More likely to have a history of outpatient treatment
 Less likely to be convicted for homicide
 More likely to be comvited for arson
 More likely to have comorbid substance abuse
 Incidents towards others and themselves were more violent
Several risk factors for BPD F:
 Poor behavioural control
 Impulsivity
 Irresponsibility
 F diagnosed with BPD are a subgroup within the F psychiatric population

Lieb et al., 2004: NEUROBEHAVIORAL MODEL OF BPD
Genetics factors
Adverse childhood experience
Emotional dysreg/impulsivity
Dysfunctional behaviour
 All interlink and worsen each other

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