B ORDELINE P ERSONALITY D ISORDER (BPD) Zitlaly Ortega Period 6

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?

A SSOCIATED F EATURES Need for intense emotional experiences Mood swings Boredom This causes the person to engage in impulsive behaviors.

A SSOCIATED F EATURES Might go to the extreme of self mutilation Anxiety when someone is not present. Suicidal thoughts Sexual orientation confusion

A SSOCIATE F EATURES Shifts in goals, dreams, or expectations. Identity confusion

E TIOLOGY : S OCIAL / E NVIORNMENTAL Abandonment in Childhood Parent Neglect/rejection (87%) Sexual Abuse (40-71%) Physical Abuse (25-71%)

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

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 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.

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

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

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

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

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

T REATMENT Dialectical behaviour therapy Weekly sessions Decreases: Self-harm behavior Time spent in hospital 1 year later…

T REATMENT Psychoanalytic psychotherapy (30% or more) Therapeutic communities Interpersonal therapies Cognitive–analytic therapy

L ONG -T ERM P ROGNOSIS 53 % of patients 7 years patients diagnosed with BPD after no longer meet the BPD criteria

R EFRENCES : Halgin, R.P. & Whitbourne, S.K. (2005). Abnormal psychology: clinical perspectives on psychological disorders. New York, NY: Worth Publishers. M, John.( ). Borderline personality disorder. s-of-borderline-personality-disorder/ s-of-borderline-personality-disorder/ (2011). What is borderline personality disorder?. borderline-personality-disorder/how-is- borderline-personality-disorder-treated.shtml borderline-personality-disorder/how-is- borderline-personality-disorder-treated.shtml

V IDEO : B ORDERLINE PERSONALITY DISORDER

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?