Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “borderline”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 613 records · Page 34Linked to original sources
PubMed1991

Treatment impressions and termination experiences with borderline patients.

This study investigates the treatment impressions and termination experiences of faculty clinicians treating individuals with borderline personality disorder. Thirty-nine clinicians (28 psychiatrists and 11 psychologists) completed the Treatment of Borderlines Survey. Results indicated that individual psychotherapy was perceived to be the most valuable treatment modality, that the majority of respondents work towards character change but do not expect "normal," the most common reported reasons for patient termination were "patient does not see the purpose of treatment" and "patient terminates through acting-out behaviors," and a slight majority reported that they had "cured" at least some of their borderline patients. The most common concerns experienced during the termination process included regression, acting-out, and self-destructive behavior. There were very few differences in the perceptions and treatment experiences between psychiatrists and psychologists. These results provide empirical support for claims made in the clinical literature on treating borderline patients.

Acting Out↗
PubMed1993

The psychotherapy of core borderline psychopathology.

A psychodynamic formulation of borderline psychopathology includes the understanding of the borderline patient's aloneness problems, need-fear dilemma issues, and difficulties with primitive guilt. The aloneness problems are at the core of the disorder, and involve an inability to maintain an evocative memory, and holding and soothing introjects of significant people when under stress of separation. The possible childhood origins of these difficulties are explored and related to the ways these issues emerge in psychotherapy. The psychodynamic formulation is crucial in the psychotherapeutic approach to the aloneness problems. It helps the therapist work with the aloneness difficulties and understand the options as the therapy continues. Since rapid therapeutic decisions are often necessary with borderline patients, the formulation provides the necessary framework, and helps the therapist process and utilize countertransference feelings. Projective identification is an important concept that helps explain the complex transference/countertransference experiences, and is used in defining the resolution of the aloneness problems of borderline patients. Finally, limit-setting and the use of transitional objects are explored, utilizing the psychodynamic framework that has been defined.

Adult↗
PubMed2001

Is couple therapy indicated for borderline personality disorder?

The healing aspects of intimate relationships are being recognized by therapists and supported by empirical findings. Little has been written regarding the indications for couple therapy for individuals with borderline personality disorder. This paper proposes a three-level hierarchy for deciding on the suitability of couple therapy for patients with borderline personality disorder. The hierarchy is based on three separate borderline behavioral clusters--impulsive, identity, and affective--that should be utilized to direct the application of couple therapy to specific patients. The three levels are illustrated by case examples. Delineation of the indications for couple therapy for borderline patients will foster further theoretical and empirical work in the area.

Adult↗
PubMed1986

Etiology and treatment of borderline personality disorder in adolescents.

The author reviews the complicated history of the concept of borderline personality disorder and associated diagnostic entities, especially as these conditions relate to adolescents. He examines current theories about etiology of borderline personality disorder, primarily those related to object relations theory and genetic vulnerability to the disorder. Because patients with borderline disorders are such a heterogeneous group and often carry other diagnoses as well, the treatments used are highly diverse. The author reviews principles of psychotherapy with borderline patients, including the difficulties of the negative transference and the intense countertransference that occur; hospital treatment; and pharmacologic treatment, usually aimed at target symptoms.

Adolescent↗
PubMed1989

How nursing staff respond to the label "borderline personality disorder".

The influence of the diagnostic labels "schizophrenia" and "borderline personality disorder" on the expressed empathy of psychiatric nursing staff was assessed by examining nurses' written responses to a series of hypothetical patient statements. Respondents were more likely to demonstrate affective involvement in response to the schizophrenic patients' statements and were more likely to offer belittling or contradicting responses to the statements of patients with borderline personality disorder. The results corroborate increasing concerns that the diagnosis of borderline personality disorder has become a pejorative label for difficult patients and suggest that staff may provide stereotypic responses and less empathic care to borderline patients than to other patients.

Adult↗
PubMed1991

Group and family treatments for borderline personality disorder.

The authors review clinical and empirical studies on the effectiveness of group treatments and family-marital treatments for borderline patients. These studies support the use of the group format in treating borderline patients, but no empirical study has examined whether group treatment combined or sequenced with individual treatment, or individual treatment alone, is better than group treatment alone. Empirical studies of family interventions with borderline patients are lacking, but further research is warranted, since many studies have shown that family pathology, especially physical and sexual abuse, is related to the development of borderline pathology.

Adolescent↗
PubMed1993

Psychotic symptoms in patients with borderline personality disorder and concurrent axis I disorder.

OBJECTIVE: Whether psychotic symptoms are part of the fundamental psychopathology of borderline personality disorder remains in dispute. The goal of the study was to examine the incidence and nature of psychotic symptoms in a sample of patients with the disorder. METHODS: The inpatient psychiatric records of 92 patients with a discharge diagnosis of borderline personality disorder, some of whom had comorbid affective disorder or substance abuse disorder, were examined to obtain data on the presence of psychotic symptoms (narrowly defined as delusions and auditory and visual hallucinations), the duration of psychotic episodes, and the clinical characteristics of the patients. RESULTS: Twenty-seven percent of the patients had psychotic episodes, typically lasting many weeks. Comorbid affective or substance abuse disorders did not predict psychotic symptoms. CONCLUSIONS: Psychotic episodes are common but not universal among patients with borderline personality disorder, regardless of whether a concurrent axis I disorder is present. Those episodes are not necessarily brief or transient, and borderline patients who experience psychotic episodes are likely to have repeated hospitalizations.

Adult↗
PubMed1994

Borderline personality disorder from the patient's perspective.

OBJECTIVES: Patients with a diagnosis of borderline personality disorder were studied to learn how they experienced the disorder and its treatment. METHODS: Life history narratives were obtained from ten patients with borderline personality disorder in a series of 90-minute interviews held over the course of a year. The interviews had minimal structure; patients were simply asked to talk about themselves. RESULTS: The narratives revealed striking similarities in the patients' experience with borderline personality disorder. Reports of their experience differed markedly from clinical descriptions of the disorder. Common themes of estrangement, inadequacy, and despair were identified, as well as common coping strategies, primarily dissociation and avoidance of self-disclosure. CONCLUSIONS: Patients' experiences with borderline personality disorder were highly consistent but differed markedly from clinical descriptions. The patient narratives provided information that could lead to more effective treatment of the disorder.

Adaptation, Psychological↗
PubMed1996

Factors associated with multiple hospitalizations of patients with borderline personality disorder.

OBJECTIVE: The study sought to identify aspects of borderline personality disorder and comorbid axis I conditions associated with multiple hospitalizations in a sample of patients with borderline personality disorder. METHODS: Data were collected as part of a larger study of treatment course of inpatients with this disorder. Predictors of multiple hospitalization from three domains were considered: demographic characteristics, criteria of borderline personality disorder, and comorbid axis I pathology. A sequential model-building strategy was used, with each domain considered separately and result combined into an overall regression model of factors related to multiple hospitalization. RESULTS: Three factors were related to frequency of hospitalization: anorexia, psychotic symptoms, and suicidality. Other variables that are often assumed to be related to hospitalization, such as depression, did not emerge as significant predictors. CONCLUSIONS: Clinicians should intervene early to address the emergence of certain axis I conditions among patients with borderline personality disorder. Increased expenditure of outpatient resources may prevent hospitalization when these conditions are present.

Adolescent↗
PubMed2003

Assessing suicidal youth with antisocial, borderline, or narcissistic personality disorder.

OBJECTIVE: This paper has 3 objectives. First, we review the epidemiologic evidence for the association between suicidal behaviour and suicide in individuals diagnosed with antisocial, borderline, or narcissistic personality disorder. Second, we examine whether any potentially modifiable risk factors are associated with these diagnoses, based on existing empirical evidence. Last, we discuss clinical approaches to assessing youth with antisocial, borderline, or narcissistic personality disorder presenting at risk for suicide. METHOD: We reviewed the English-language literature for the last 12 years (from January 1, 1991, to December 31, 2002), using as search terms the names of the 3 disorders, as well as the key words suicide, suicidal behaviour, youth, and adolescents. RESULTS: Patients with antisocial or borderline personality disorder are likely to be at increased risk for suicidal behaviour when they demonstrate such comorbid disorders as major depressive episodes or substance abuse disorders, when they experience recent negative life events, or when they have a history of childhood sexual abuse. CONCLUSIONS: For patients with antisocial personality disorder, the risk of violence has to be judged in addition to the risk of suicide or self-harm. For patients with borderline personality disorder, interventions are determined by differentiating acute-on-chronic from chronic risk of suicidal behaviour. Finally, patients with narcissistic personality disorder can be at high risk for suicide during periods when they are not suffering from clinical depression. These episodes can seem to be unpredictable.

Adolescent↗
PubMed1988

Treatment of the borderline patient, relationship management.

The author suggests that not the borderline syndrome itself but many of the worst behaviours of borderline patients are essentially iatrogenic. To do no harm should be the primary goal of any therapist encountering a patient exhibiting borderline features. Management of the patient-therapist relationship is paramount and may be in itself the most effective and safe treatment for both crisis situations and longer therapy. A conceptual model borrowing from and bridging self psychology and interpersonal theory is described. This model leads to a reframing or new interpretation of borderline symptoms and therapists' reactions. Realtionship management guidelines and specific interventions are suggested.

Borderline Personality Disorder↗
PubMed1989

Borderline traits among community alcoholics and problem-drinkers: rural-urban differences.

This study analyzed the borderline traits of a sample of community alcoholics drawn from a rural and a metropolitan area of the province of Quebec. The Diagnostic Interview Schedule and other questions from the Diagnostic Interview for Borderlines were administered. About one-third of the sample of alcoholics showed a high number of borderline traits, a proportion similar to that found in institutionalized samples elsewhere. The borderline alcoholics tended to be younger and they all came from the urban area. This result suggests that alcoholics are probably better tolerated in rural areas and are less likely to adopt a pathological behaviour.

Adult↗
PubMed1993

Stability of borderline personality disorder.

This study examines the course of illness and stability of borderline personality disorder (BPD) in a group of inpatients seen at a two-year follow-up. The diagnosis of borderline personality disorder, as established by the use of the Diagnostic Interview for Borderlines, did not change in 39 of the 65 subjects (60%) studied. Subjects who continued to show evidence of borderline psychopathology experienced more acute episodes of illness during the follow-up period and tended to be more involved in substance abuse. Impulsiveness and young age when first psychiatric care was received significantly predicted the presence of BPD features at follow-up.

Adolescent↗
PubMed1997

Childhood antecedents of self-destructiveness in borderline personality disorder.

OBJECTIVE: To assess the relationship between lifetime patterns of self-destructive behaviour and various parameters of childhood abuse and neglect in patients with borderline personality disorder (BPD) compared with other personality disorder (OPD) controls. METHOD: The subjects were 42 inpatients with the diagnosis of BPD and 17 OPD controls. Lifetime patterns of self-destructive behaviour were assessed using the Lifetime Borderline Symptom Index. Childhood experiences were assessed using a semistructured interview by raters who were blind to diagnosis. RESULTS: Chronic self-destructive behaviour discriminated patients with BPD from OPD controls. In the borderline group, parental sexual abuse was significantly related to suicidal behaviour and both parental sexual abuse and emotional neglect were significantly related to self-mutilation. CONCLUSION: Both parental sexual abuse and emotional neglect appear to play a role in the etiology of self-destructive behaviour in BPD. The results highlight the importance of considering the effects of sexual abuse within its environmental context and suggest that the etiology of borderline symptoms is likely multifactorial.

Adolescent↗
PubMed1991

Auditory evoked potentials in borderline personality disorder.

Borderline personality disorder is an increasingly recognized condition and frequent management problem in psychiatric and nonpsychiatric practice. Paroxysmal changes in affect and behavior, high incidence of soft neurologic signs and frequent EEG alterations, and evidence of clinical response to antiepileptic drugs have suggested cerebral dysfunction, particularly involving the limbic system or reticular activating system. We recorded early latency brainstem auditory evoked potentials (BAEPs) and long-latency auditory event-related potentials (ERPs) in 20 patients fulfilling DSM-III-R criteria for this disorder. BAEPs were recorded from Cz to ipsilateral and contralateral ear reference, with rarefaction clicks presented at 11.1 per second and 70 dB SL. Two thousand averages were recorded and replicated for each ear, with filter band pass of 150-3000 Hz and 10 ms analysis time. ERPs utilized binaural stimulation with 1000 and 3000 Hz tones in an 80:20 ratio, with interstimulus interval 1.1 second, analysis time 1000 ms, and filter band pass 1-100 Hz. Two hundred averages were recorded and replicated from Cz with linked ear reference. No differences were evident in I-III, III-V, and I-V interpeak latencies between borderline patients and age-matched neurologically and audiologically normal controls. N1, P2, and N2 components of the AEPs were longer in latency and lower in amplitude in borderline patients, while P3 latency was longer and amplitude was attenuated in borderline patients as compared to controls. These findings may suggest differences from normals in attention maintenance and in limbic system function.

Adult↗
PubMed2003

'Still-face' interactions between mothers with borderline personality disorder and their 2-month-old infants.

BACKGROUND: There is evidence that psychopathology in mothers may be associated with dysfunctional mother-infant interactions. AIMS: To investigate mother-infant relations when mothers have borderline personality disorder. METHOD: Eight mothers with borderline personality disorder and twelve mothers without psychiatric disorder were videotaped interacting with their 2-month-old infants in three successive phases of interaction: face-to-face play; an episode when the mother adopted a 'still face' and was unreactive; and a period when play interactions were resumed. The videotapes were rated by judges blind to the diagnostic group of the mother. RESULTS: The mothers with borderline personality disorder were more intrusively insensitive towards their infants. During the still-face period, their infants showed increased looking away and dazed looks. Following this, mother-infant interactions were less satisfying and their infants showed dazed looks and lowering of affect. CONCLUSIONS: The diagnosis of borderline personality disorder is associated with a particular pattern of mother-infant interaction. The infants' responses to the still-face challenge might suggest dysfunctional self-regulation, but the developmental significance remains to be assessed.

Affect↗
PubMed1985

MMPI characteristics of borderline psychopathology in adolescent inpatients.

This study investigated MMPI characteristics of male and female adolescent inpatients with diagnoses of borderline personality disorder (n = 28) in contrast to adolescent inpatients receiving principal diagnoses of conduct disorder (n = 21), dysthymic disorder (n = 50), other personality disorders (n = 17), and other diagnoses (n = 30). The borderline group has significantly higher elevations than comparison groups on MMPI scales F, Hs, D, Pd, Pa, Pt, Sc, and Ma. A stepwise discriminant analysis resulted in 82.1% accuracy in correctly classifying borderline patients and 78.0% accuracy in identifying nonborderline patients. Findings are discussed in terms of potential uses and limitations in identifying borderline personality disorder with the MMPI.

Adolescent↗
PubMed1986

Some Rorschach data comparing schizophrenics with borderline and schizotypal personality disorders.

The Rorschach data from 84 borderline personality disorders and 76 schizotypal personality disorders, both groups diagnosed using DSM-III criteria, were compared with each other and with two sets of Rorschach protocols collected from 80 first admission schizophrenics, one being administered shortly after admission and the second taken shortly before discharge. The data indicate that the borderline group is markedly different in both organization and functioning from both other groups; however, there are many similarities between the records of the schizotypals and schizophrenics. It is suggested that nomenclatures such as borderline schizophrenia or latent schizophrenia might be more appropriate to designate the schizotypal group and that the once used, but now discarded, nomenclature of inadequate personality offers a more fitting description of the borderlines.

Adult↗