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Analytical psychology, personality disorders, borderline

Aidan G C Wright, Michael N Hallquist, Stephanie D Stepp, Lori N Scott, Joseph E Beeney, Sophie A Lazarus, Paul A Pilkonis
Borderline personality disorder (BPD) is a diagnosis defined by impairments in several dynamic processes (e.g., interpersonal relating, affect regulation, behavioral control). Theories of BPD emphasize that these impairments appear in specific contexts, and emerging results confirm this view. At the same time, BPD is a complex construct that encompasses individuals with heterogeneous pathology. These features-dynamic processes, situational specificity, and individual heterogeneity-pose significant assessment challenges...
August 2016: Assessment
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January 2016: Psychological Assessment
Mark Zimmerman, Kristy Dalrymple, Diane Young, Iwona Chelminski, Jennifer Martinez
Gunderson (2010) recently offered a sharp criticism of the draft proposal for diagnosing personality disorders in DSM-5. Based on a review of phenomenological, factor analytic, social psychology, family, neurobiological, and treatment studies of borderline personality disorder (BPD), he proposed an alternative revision of the BPD criteria. One of the suggested changes was a modification of the DSM-IV diagnostic algorithm. Gunderson did not, however, provide any data on the impact this new diagnostic algorithm would have on the prevalence of BPD, or the validity of this alternative approach compared to the DSM-IV algorithm...
December 2012: Journal of Personality Disorders
Mark Zimmerman, Kristy Dalrymple, Diane Young, Iwona Chelminski, Jennifer Martinez
Gunderson (2010) recently offered a sharp criticism of the draft proposal for diagnosing personality disorders in DSM-5. Based on a review of phenomenological, factor analytic, social psychology, family, neurobiological, and treatment studies of borderline personality disorder (BPD), he proposed an alternative revision of the BPD criteria. One of the suggested changes was a modification of the DSM-IV diagnostic algorithm. Gunderson did not, however, provide any data on the impact this new diagnostic algorithm would have on the prevalence of BPD, or the validity of this alternative approach compared to the DSM-IV algorithm...
September 17, 2012: Journal of Personality Disorders
Jutta M Stoffers, Birgit A Völlm, Gerta Rücker, Antje Timmer, Nick Huband, Klaus Lieb
BACKGROUND: Psychotherapy is regarded as the first-line treatment for people with borderline personality disorder. In recent years, several disorder-specific interventions have been developed. This is an update of a review published in the Cochrane Database of Systematic Reviews in 2006. OBJECTIVES: To assess the effects of psychological interventions for borderline personality disorder (BPD). SEARCH METHODS: We searched the following databases: CENTRAL 2010(3), MEDLINE (1950 to October 2010), EMBASE (1980 to 2010, week 39), ASSIA (1987 to November 2010), BIOSIS (1985 to October 2010), CINAHL (1982 to October 2010), Dissertation Abstracts International (31 January 2011), National Criminal Justice Reference Service Abstracts (15 October 2010), PsycINFO (1872 to October Week 1 2010), Science Citation Index (1970 to 10 October 2010), Social Science Citation Index (1970 to 10 October 2010), Sociological Abstracts (1963 to October 2010), ZETOC (15 October 2010) and the metaRegister of Controlled Trials (15 October 2010)...
August 15, 2012: Cochrane Database of Systematic Reviews
Michael N Hallquist, Paul A Pilkonis
Borderline personality disorder (BPD) is a heterogeneous disorder, and previous analyses have parsed its phenotype in terms of subtypes or underlying traits. We refined the BPD construct by testing a range of latent variable models to ascertain whether BPD is composed of traits, latent classes, or both. We also tested whether subtypes of BPD could be distinguished by anger, aggressiveness, antisocial behavior, and mis-trustfulness, additional putative indicators drawn from Kernberg's (1967, 1975) theory of BPD...
July 2012: Personality Disorders
C Versaevel
OBJECTIVES: This article is a review of psychotherapies for patients suffering from dependent personality and interpersonal dependency. METHOD: We synthesized articles making reference to this question, notably those written by Bornstein, author who refers to the dependent personality. We highlighted the psychotherapies that have been the object of an evaluation. The research on the subject is sparse: only eight studies permitting assessment of psychotherapies in this indication in 2005...
April 2012: L'Encéphale
Carla Sharp, Carolyn Ha, Jared Michonski, Amanda Venta, Crystal Carbone
Empirical evidence is increasing in support of the validity of the construct of borderline personality disorder (BPD) in adolescence. There is growing consensus that the early identification and treatment of emerging borderline traits may be an important focus. However, few diagnostic (questionnaire- or interview-based) measures specifically developed or adapted for adolescents and children exist. The Childhood Interview for DSM-IV Borderline Personality Disorder (CI-BPD) [Zanarini, 2003] is a promising interview-based measure of adolescent BPD...
August 2012: Comprehensive Psychiatry
Martin Schmidt
In this paper, I apply the concept of psychic skin to analytic work with people suffering from personality disorders and psychoses. When psychoses emerge, the defensive skin which protects the ego is breached and violent unconscious forces rip through the personality. Some of the patients diagnosed as schizophrenic with whom I work have identified with archetypal characters such as Christ, Satan, John Lennon and the Queen. I attempt to show how the adoption of these inflated personas can serve as secondary psychic skins...
February 2012: Journal of Analytical Psychology
Stephen Kellett, Dawn Bennett, Tony Ryle, Anna Thake
This study sought to examine the competency of cognitive analytic therapy (CAT) delivered under routine care conditions and to identify the effectiveness of CAT for patients with borderline personality disorder (BPD). Ten cognitive analytic therapists in six National Health Service Trust sites treated 19 patients with BPD using the standard CAT BPD contract of 24 sessions plus four follow-ups. The methodology was small N repeated measures deign, with patients interviewed at the third follow-up session using the Change Interview...
May 2013: Clinical Psychology & Psychotherapy
Elizabeth A Reilly
This paper explores the dynamic complexities that are triggered when a group member becomes pregnant. Through clinical illustrations taken from a weekly analytical group, the developmental processes and resonances found in such groups are discussed, alongside the technical challenges they pose on the leader. The scant literature on this topic and how it impacts on the therapeutic space is reviewed from individual and group analytic literature. This paper then extends the figuration of groups as types of metaphorical maternal container (Foulkes, 1964)...
2010: International Journal of Group Psychotherapy
Moshe Halevi Spero
The concepts of the primeval skin ego, psychic envelope, and related pre-ego containing and wrapping functions elaborated respectively by Esther Bick, Didier Anzieu, and Francis Tustin occupy an important position in contemporary psychoanalytic theory and clinical practice. The psychic envelope begins as a virtual mental protostructure ("proto" because it is not yet based on fully symbolized representations) that holds the budding mind together pending further developments. With maturity, the enveloping functions adopt symbolized, metaphoric form (for example, the aesthetic use of cloth, the analytic framework), but can regress to more concrete and pathological forms...
2009: Psychoanalytic Study of the Child
Anne-Marie Daly, Susan Llewelyn, Emma McDougall, Andrew M Chanen
BACKGROUND: Ruptures are potential change events in therapy that might result in positive or negative consequences for the therapeutic alliance and outcome. Alliance ruptures and premature drop-out are common with clients diagnosed with borderline personality disorder, limiting treatment effectiveness. OBJECTIVE: To test a nine stage model of rupture resolution in cognitive analytic therapy (CAT) with adolescents. METHOD: The validation phase of task analysis was employed to test the rupture resolution model and to relate handling of ruptures to outcome using quantitative and qualitative analysis of transcripts...
September 2010: Psychology and Psychotherapy
Peggilee Wupperman, Craig S Neumann, Jeannie B Whitman, Seth R Axelrod
This study investigated whether deficits in mindfulness (attention, awareness, and acceptance of the present moment) underlie variability in borderline personality disorder (BPD) features and related impairments in interpersonal functioning, impulsivity, and emotion regulation. A path analytic approach was used to examine the relationships of trait mindfulness with BPD features, interpersonal effectiveness, impulsive and passive emotion-regulation, and neuroticism in a psychiatric sample of adults (N = 70)...
October 2009: Journal of Nervous and Mental Disease
Erika Krejci
In order to treat patients with a narcissistic structure showing a rigid shell of defence together with a lack of inner differentiation - insufficient subject/object constitution - one has to deal with a split kind of transference. Their compelling need for distance corresponds to their fragile self-esteem. They feel threatened by the analysis and the analytic relationship. Because the seeming normality of these patients' thinking and language is deceptive, a variation of psychoanalytic technique to facilitate the work with them is described and explained in detail...
August 2009: International Journal of Psycho-analysis
Charles A Sanislow, Todd D Little, Emily B Ansell, Carlos M Grilo, Maria Daversa, John C Markowitz, Anthony Pinto, M Tracie Shea, Shirley Yen, Andrew E Skodol, Leslie C Morey, John G Gunderson, Mary C Zanarini, Thomas H McGlashan
Evaluation of the validity of personality disorder (PD) diagnostic constructs is important for the impending revision of the Diagnostic and Statistical Manual of Mental Disorders. Prior factor analytic studies have tested these constructs in cross-sectional studies, and models have been replicated longitudinally, but no study has tested a constrained longitudinal model. The authors examined 4 PDs in the Collaborative Longitudinal Personality Disorders study (schizotypal, borderline, avoidant, and obsessive-compulsive) over 7 time points (baseline, 6 months, 1 year, 2 years, 4 years, 6 years, and 10 years)...
August 2009: Journal of Abnormal Psychology
S H Aggen, M C Neale, E Røysamb, T Reichborn-Kjennerud, K S Kendler
BACKGROUND: Despite its importance as a paradigmatic personality disorder, little is known about the measurement invariance of the DSM-IV borderline personality disorder (BPD) criteria; that is, whether the criteria assess the disorder equivalently across different groups. METHOD: BPD criteria were evaluated at interview in 2794 young adult Norwegian twins. Analyses, based on item-response modeling, were conducted to test for differential age and sex moderation of the individual BPD criteria characteristics given factor-level covariate effects...
December 2009: Psychological Medicine
Erling Hansen, Lars-Gunnar Lundh, Anders Homman, Margit Wångby-Lundh
The present article describes data from pilot studies with the Swedish versions of the Mindful Attention Awareness Scale (MAAS) and the Kentucky Inventory of Mindfulness Skills (KIMS). The MAAS and two of the KIMS scales, Act with Awareness and Accept without Judgment, were found to correlate in the predicted direction with measures of well-being and emotional distress. The KIMS scales Observe and Describe showed more ambiguous results, possibly because these two scales measure a mixture of two opposite kinds of processes: healthy self-observation ("experiential self-focus") and unhealthy rumination ("analytical self-focus")...
2009: Cognitive Behaviour Therapy
Timothy J Trull, Marika B Solhan, Sarah L Tragesser, Seungmin Jahng, Phillip K Wood, Thomas M Piasecki, David Watson
Ecological momentary assessment (EMA; Stone & Shiffman, 1994) was used to characterize and quantify a dynamic process--affective instability in borderline personality disorder (BPD). Sixty outpatients (34 with BPD and affective instability; 26 with current depressive disorder but not with BPD or affective instability) carried electronic diaries for approximately 1 month and were randomly prompted to rate their mood state up to 6 times a day. Results indicated that BPD patients (a) did not report significantly different mean levels of positive or negative affect; (b) displayed significantly more variability over time in their positive and negative affect scores; (c) demonstrated significantly more instability on successive scores (i...
August 2008: Journal of Abnormal Psychology
Mark F Lenzenweger, John F Clarkin, Frank E Yeomans, Otto F Kernberg, Kenneth N Levy
Borderline personality disorder (BPD) is characterized by considerable heterogeneity. Prior approaches to resolving heterogeneity in BPD pathology have used factor and cluster analytic as well as latent class analysis strategies. These prior studies have been atheoretical in nature, but provide an initial empirical corpus for further sub-typing efforts in BPD. A model-based taxonomy for BPD that is supported by evidence from an advanced statistical methodology would enhance investigations of BPD etiology, pathophysiology, and treatment...
August 2008: Journal of Personality Disorders
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