Borderline Personality Disorder Exam Questions and Answers

Borderline Personality Disorder Exam Questions and Answers Borderline personality disorder: characterized by disruptive pattern of instability related to self-identity, interpersonal relationships, and affects, combined with marked impulsivity and destructive behavior interpersonal relationships, self-identity, affect Unstable Interpersonal Relationships: (hallmark indicator of disorder) Extreme fear of abandonment History of unstable attachments Constantly seeking reassurance and validation Idealize others and establish intense relationships that violate others' interpersonal boundaries, which leads to rejection Intense shame and self-hate follow relationship failures and often result in self-injurious behaviors "Best friends" may be healthcare workers because other relationships don't last. Personality disorder enduring pattern of inner experience and behavior deviates from expectations of culture onset in adolescents or early adulthood Inability to relate with empathy or intimacy Social and occupational impairment Occurs in about 10% of the general population Does not perceive self as having a problem BPD Appear more competent than they actually are Set unrealistically high expectations for themselves and, when not met, feel intense shame, self-hate, and self-directed anger One crisis after another Minimal coping skills Intensity of emotions often frightens them and others Others limit their contact with them because of emotional intensity Feelings of intense anger and profound abandonment are long-term problems Unstable Self-Image: Identity Diffusion No sense of their own identity or their personality is poorly developed Commonly direct their actions in accord with the wishes of other people. Ex: "I am a singer because of my mother." Look for someone else to identify with or be like Unstable Affects Affective instability: rapid and extreme shift in mood Core characteristic of BPD Friends may describe as moody, irresponsible, or intense Limited ability to regulate anger, anxiety, sadness, and disgust Cognitive dysfunctions Dichotomous thinking: "black or white" Thinking can become disorganized: bizarre notions, sometimes delusions and hallucinations Dissociation is common ■ Dissociation: thinking, feeling, or behaviors occur outside a person's awareness. Occurs to a certain extent in all people and can often be adaptive. Ex: coping strategy to avoid disturbing events. Ex: forgetting part of a trip down a familiar road because you're so used to driving it that you don't pay attention. Might be present or appear present but mentally be in different place; used as a coping skill for BPD persons. Behavioral dysfunctions ○ Impaired problem solving: soliciting help from others in a helpless manner ○ Impulsivity: act in the moment and clean up the mess afterward ■ Ex: gambling, spending money, abusing substances ■ Can be physically or verbally aggressive Self-harm behaviors: ○ Present in half of patients with BPD ○ Suicide attempts ○ Parasuicidal behaviors: any nonfatal serious, deliberate self-harm with or without suicide intent ■ Ex: wrist cutting Risk factors for BPD: ● Physical abuse ● Sexual abuse ● Parental loss and separation ● Higher proportion of women ● High rate of comorbid mood disorders in BPD Etiology of BPD: ● Brain dysfunction in the limbic system and frontal lobe ● May be an increase in dopamine that may be responsible for transient psychotic states (delusions, hallucinations) ● May not have achieved the separation-individuation developmental stage Projective identification defensive way of interacting with the world; falsely attribute to others their own unacceptable feelings, impulses, or thoughts; they project these unwanted feelings onto others. Maladaptive cognitive schemas patterns of thoughts that determine how a person interprets events; ex: misinterpretation of other people's actions as wrong or not how a normal person would see things. Emotional dysregulation the inability to control emotions in social interactions; rejection sensitivity, intense outbursts of anger where others could control themselves. Invalidating environment most severe form occurs in situations of child sexual abuse Social situation negates private emotional responses and communication: when core