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By John G. Gunderson

Protecting the variety of scientific shows, remedies, and degrees of care, Borderline character sickness: A scientific Guide, moment version, offers a finished consultant to the prognosis and therapy of borderline character illness (BPD). the second one version comprises new learn approximately BPD s courting to different issues and up to date descriptions of empirically demonstrated remedies, together with cognitive-behavioral and psychodynamic techniques. Compelling new learn additionally shows a far better diagnosis for BPD than formerly identified.

A pioneer within the box, writer John Gunderson, M.D., director of the Borderline character sickness heart at McLean clinic, attracts from approximately forty years of his personal learn and adventure. This history is now complemented by means of the extra scientific and study event of Paul hyperlinks, M.D. The advisor starts with a transparent and particular definition of BPD and gives an in-depth description of a number of modalities of therapy, together with pharmacotherapy, kinfolk remedy, and cognitive-behavioral remedies. Gunderson outlines healing ways for a number of settings, corresponding to hospitalization, partial hospitalization courses, and outpatient care. Complementing the well-organized therapy consultant are a chain of informative sidebars, recommending particular do s and don ts for disclosing the prognosis, discussing medicinal drugs, assembly with households, and dealing with suicidality.

A synthesis of concept and useful examples, Borderline character disease: A medical Guide, moment variation, offers an intensive and useful handbook for any clinician operating with BPD sufferers

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Additional resources for Borderline Personality Disorder: A Clinical Guide

Sample text

Because the diagnostic system has traditionally set apart psychoses as major mental illnesses, there were reservations about introducing criteria suggesting transient lapses. If such lapses were present, they seemed when DSM-III was written to fit better with preconceptions that a reality-testing criterion was more consistent with the schizotypal personality disorder construct than with BPD. The accumulated data from many studies (Table 1–3) were needed to document the presence of such phenomena in samples of patients with BPD.

According to Stone et al. (1987), BPD patients with self-injurious behaviors are at increased risk for suicide attempts—especially when they are associated with higher levels of depression, hopelessness, and impulsivity. Stanley et al. (2001) reported that a history of self-injurious behavior, regardless of the intention, actually doubles the likelihood of suicide. Borderline patients with self-injurious behavior can misperceive and underestimate the lethality of their acts. Often, the patient will relate his or her self-injurious behaviors to multiple intentions, including a wish to die (Santa Mina et al.

8. Identity disturbance. This criterion is derived from Kernberg’s description of borderline personality organization (see earlier in this chapter, section “Shifts in the Borderline Construct”). Since DSM-III, this criterion has undergone modifications intended to differentiate it from the generic identity issues that are normal parts of development, most notably adolescence. The identity disturbance criterion is meant to encompass the body image distortions seen in persons with anorexia or body dysmorphic disorder; more important, it is meant to recognize the pathological disorders of self that are more specific to borderline patients—that is, adults whose values, habits, and attitudes are dominated by whomever they are with to the extent that they feel they have no identity.

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