Borderline personality disorder (BPD) is characterized by patterns of intense negative affect, interpersonal difficulties, and maladaptive impulsive behaviors, and is associated with impairments in social and occupational functioning. Rumination is a maladaptive form of repetitive thought that maintains and intensifies emotional disturbance and is associated with behavioral dysregulation. This study tested several hypotheses about relationships between rumination and borderline personality features. This study included 117 college student participants, 88 female students and 29 male students, most of whom (84%) identified themselves as Caucasian. Participants completed a series of measures which included a writing sample to sample repetitive thought. Findings consistently suggested that rumination accounts for significant incremental variance in BPD features after controlling for various facets of neuroticism, which suggests that individuals with BPD features are probably engaging in high levels of multiple types of rumination. However, scores derived from the On Your Mind writing sample did not predict severity of borderline features after controlling for the NEO-neuroticism domain. Implications for these findings and limitations to this study are also discussed.

Cognitive bias and thought suppression are two maladaptive patterns of thinking that have been associated with borderline personality disorder (BPD). Negative cognitive biases related to BPD include thoughts that they are bad, powerless, or vulnerable and that the world is dangerous. Thought suppression is a maladaptive emotion regulation strategy where unwanted thoughts are intentionally pushed out of one’s consciousness. However, previous research has connected thought suppression and cognitive biases to BPD only via self-report measures. The present study examined whether a laboratory task meant to measure cognitive bias and thought suppression (Scrambled Sentences Test) would predict BPD features over and above self report measures of cognitive bias and thought suppression. A sample of 153 undergraduates completed self-report measures of BPD features, thought suppression, and negative cognitive biases, as well as the Scrambled Sentences Test (SST). Results showed that while the SST was a good predictor of cognitive biases, it did not predict thought suppression when self report measures were included. Recognizing the importance of negative cognitive bias in BPD may be useful in continued treatment development. Further research into other ways of measuring thought suppression and cognitive biases in the lab may be warranted.

Two prominent emotions in borderline personality disorder (BPD) are anger and shame. Rumination has been demonstrated to occur in response to shame and to escalate anger, and rumination, particularly anger rumination, has been shown to predict BPD symptoms. The present study examined whether one way that shame leads to the features of BPD is via increased anger and anger rumination. A sample of 823 undergraduates completed self-report measures of global and situational shame, trait- level anger, anger'rumination, and BPD features. A structural equation model was constructed using these measures. The hypothesized model of shame to anger and anger rumination to BPD features was largely supported. Bootstrapping was used to establish significant indirect effects from both forms of shame via anger rumination to BPD features, and from global shame via anger to BPD features. Recognizing this function of anger rumination may be important in developing and practicing interventions to reduce it. Further research into other ways individuals maladaptively respond to shame and functions of anger rumination is recommended.

Det övergripande syftet med studien var att undersöka hur personalen på en psykiatrisk mottagning upplevde den behandling som de ger för borderline personlighetsstörning, mentaliseringsbaserad terapi. Genom en kvalitativ metod och fokusgrupper söktes svar på frågeställningarna. Det empiriska materialet analyserades med hjälp av tematisk analys och resultatet visade att behandlingen generellt upplevdes ha förbättrat patienternas livskvalitet. De flesta av patienterna gjorde helt andra livsval efter avslutad behandling och en del uppfyllde inte längre de diagnostiska kriterierna för borderline personlighetsstörning. De som hade fullföljt behandlingen eller nästan fullföljt den var de som hade dragit mest nytta av den. De faktorer som ansågs som viktiga för förändringsprocessen rörde individvariabler, strukturella faktorer, gruppterapi, medicinering med psykofarmaka och personalvariabler. De berörde med andra ord behandlingens form snarare än de specifika interventionerna för mentaliseringsbaserad terapi. De fynd som gjorts inom ramen för denna studie skulle därmed kunna betraktas som viktiga komponenter för psykoterapeutisk behandling av borderline personlighetsstörning oavsett tillhörighet av psykoterapeutisk skolbildning. Resultatet skulle kunna indikera att de specifika behandlingsinterventionerna inte har någon nämnvärd effekt samtidigt som det skulle kunna tyda på att en behandling som ges i samma form som MBT, men med andra interventioner, skulle kunna åstadkomma ett än bättre resultat. / The overall purpose of this study was to examine how the professionals on a psychiatric clinic experienced the treatment they are using for borderline personality disorder, mentalization-based treatment. Through a qualitative approach and focus groups, answers to the questions were sought. The empirical material was analyzed by using thematic analysis and the results showed that the treatment generally had improved the patients’ quality of life, as perceived by the professionals. Most of the patients did completely different choices in life after the treatment was finished and some of them did no longer fulfill the diagnostic criteria’s for borderline personality disorder. Those who almost or fully completed the treatment where the ones who have had the most use of it. Important factors for the process of change were individual variables, structural factors, group therapy, medication with psychopharmacological drugs and personnel variables. In other words factors related to the structure of the treatment rather than the specific interventions for mentalization-based treatment. The findings within the scope of this study could hence be considered as vital components for psychotherapeutic treatment of borderline personality disorder independent of psychotherapeutic doctrine. The result could indicate that the specific treatment interventions do not have any significant effect but at the same time it could indicate that a treatment given in the same form as mentalization-based treatment, but with other interventions, could give an even better result.

No description available.

Self-harming behaviours and suicidality are a serious problem in psychiatric patients with major depressive disorder (MDD) and borderline personality disorder (BPD). Suicidal behaviours are sometimes seen as manipulative and attention-seeking in BPD patients, and are therefore not considered as dangerous as the same behaviours in MDD patients. The Suicidal Feelings and Self-Harm Questionnaire, which examines suicidal intent, was administered to all new outpatients at the Psychiatric Treatment Clinic in the Department of Psychiatry at the University of Alberta Hospital in Edmonton, Canada. Thirty-seven percent of the MDD patients, 78% of the BPD patients, and 77% of patients with comorbid MDD and BPD reported a history of self-harm. Suicidal intent was measured by asking the patients whether they expected to die as a result of their self-harm. There was no statistically significant difference between the diagnostic groups in this regard. This suggests that BPD patients are no less serious about their intent to die than those with MDD.

Doctor of Health Science / The public mental health setting wherein clinicians work with clients diagnosed with borderline personality disorder (BPD) provides a continual challenge for clinicians. For many decades a pervasive therapeutic pessimism has surrounded any discussions of attempts to work with clients with BPD with this population being viewed as ‘too difficult’ and ‘impossible to work with’. This pessimism and the ensuing counter therapeutic responses have been well documented in the psychiatric literature. The development of treatments such as dialectical behaviour therapy (DBT), a cognitive-behavioural therapy, for BPD has provided a basis for therapy for which there is increasing evidence of successful outcomes. Despite this evidence, the pervasive pessimism has been slow to lift. A limited literature explores attempts to positively influence clinician responses to this clientele. Within the public mental health service in which this research is based, DBT is well-established as a therapeutic modality. In the course of providing training, consultation and supervision for parts of this service, anecdotal evidence emerged suggesting that the impact of practising as a DBT therapist was greater than anticipated and DBT may provide a tool for facilitating a positive change in clinician responses. Given that this perception is not described in the literature it was appropriate to begin research in this area employing a qualitative methodology. This research explored the experience and impact upon mental health clinicians in a public mental health service undertaking training in DBT and practicing as DBT therapists. In-depth, semi structured interviews were conducted in July 2005 with clinicians practising as DBT therapists. Data analysis revealed a marked shift in perspective from ‘management to treatment’. Participants described positive professional and personal impacts of training and practising as DBT therapists. An enhanced capacity for self-awareness and ‘living life to the full’ was described by a number of participants. This initial research suggests that the practice of DBT by clinicians can generate a positive shift in both personal and professional identities that translates into a more optimistic and humanistic approach to clients diagnosed with BPD. Such a change may represent a significant challenge to the prevailing mental health discourse and practice

Thesis (PhD)--Macquarie University, Division of Linguistics & Psychology, Department of Linguistics, 2006. / Bibliography: p. 319-326. / Introduction: the complex tale of self in psychotherapy -- Literature review -- Introduction to the corpora and general linguistic analysis -- Introduction to the lexicogrammatical analysis of scripts, chronicles and narratives -- Chronicles: this is my normality: the complex tale of the everyday -- Scripts: I am not normal: the complex tale of alienation -- Narratives: this is how I would like normal to be: the complex tale of normality as imagination and memory -- A complex tale of normality: lexicogrammatical features across scripts, chronicles and narratives -- The contexts of psychotherapy -- Generic structure -- A complex tale of self. / This thesis investigates the complex tales of self which emerge from conversations between psychotherapists and patients with borderline personality disorder. These patients struggle in establishing a border between themselves and significant others, which is itself fundamental to a deeper construal of their own existence. They are being treated within the Conversational Model of psychotherapy. The model is strongly oriented to techniques based on language and linguistic evidence and thus offers a linguistic site at which the study of the complex interaction of self and language can be made tractable.--Within a broad corpus of transcribed audio recordings of patient-therapist discourse, the principal focus of my linguistic study is the Conversational Model's claims about three conversational types-Scripts, Chronicles and Narratives. According to Meares, they present 'self as shifting state in the therapeutic conversation' (1998:876). The thesis investigates a selection of texts to represent these three conversational types, which I have chosen according to the claims in the Conversational Model literature. It tests the evidence of Meares' claims concerning the semantic characteristics which distinguish the three conversational types, as well as the linguistic evidence concerning the claims of change in the self in particular the presentation of 'self as shifting state' (1998:876). To achieve the levels of complexity required for this linguistic study of self, this thesis uses Systemic Functional Linguistics, which has a social, interactional orientation and a multidimensional and in particular, multistratal approach. The research demonstrates that therapeutically relevant aspects of the self can be productively described, across linguistic strata, in a consistent and reproducible way as a construction of meaning. The meanings which speakers offer in wordings can provide a reliable index for evaluating the emergence and maintenance of self. The Conversational Model's 'conversations' are confirmed as linguistically distinguishable text types and the research further shows that key terms of the Conversational Model can be defended theoretically on the basis of linguistic evidence, for example, the contrastive linearlnon-linear. Together the findings describe the complexity in the tale of self.--This investigation of the Conversational Model data also tests the claims of a functional linguistics at the same time that it evaluates the Conversational Model with respect to that model's consistent appeals to language as evidence. It establishes an opportunity to extend the dialogue between linguists and practitioners of the Conversational Model: the tools of the one group increase the reflective capabilities of the other. / Mode of access: World Wide Web. / xx, 385 p. ill

Research Doctorate - Doctor of Philosophy (Clinical Psychology) / Overgeneral autobiographical memory is thought to be a clinically meaningful phenomenon which is related to affect regulation, problem solving ability, and treatment outcome in clinical populations (see J. M. G. Williams et al., 2007, for review). Individuals with Borderline Personality Disorder (BPD) are thought to be particularly prone to developing an overgeneral style of memory due to their temperamental difficulties in controlling affect (J. M. G. Williams, 1996). However, research in this population has so far yielded inconsistent findings. In a series of three studies, this thesis addresses the question whether overgeneral memory is associated with BPD, as well as exploring the relationship between memory specificity, affect regulation, problem solving ability, and response to treatment in this population. Findings indicate that individuals with BPD display reduced autobiographical specificity relative to controls, however, this appears to be a reflection of differences in cognitive ability as IQ and education mediated the association between specificity and diagnosis. Reduced specificity was not associated with Borderline traits in a non-clinical sample. Results failed to confirm the hypothesis that autobiographical memory specificity would be related to affect regulation in individuals with BPD, although there was some indication that memory specificity is associated with reduced rates of deliberate self-harm. Specificity was related to problem solving performance in individuals with BPD, although this relationship did not extend to self-reported problem solving ability. Memory specificity also appeared to change significantly over the course of treatment in a year-long Dialectical Behavior Therapy program, however, there was little indication that change in memory specificity was associated with the observed improvement in symptomatology, affect regulation or problem solving ability. Lastly, an experimental study with university students found no relationship between memory specificity and affect dysregulation, although low specific students reported greater reductions in positive affect following a negative event than individuals with a specific style of autobiographical recall. The assimilation model is considered as a framework for conceptualising these results.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 6 uppsatser.