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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.

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2008. / Typescript. Includes bibliographical references (leaves 61-65).

Thesis (M.S.)--State University of New York at Binghamton, Department of Psychology, 2009. / Includes bibliographical references.

Thesis (M.S.)--Florida State University, 2004. / Advisor: Dr. Justin Schwartz, Florida State University, College of Arts and Sciences, Dept. of Psychology. Title and description from dissertation home page (viewed Sept. 24, 2004). Includes bibliographical references.

<p> </p><p>Borderline personlighetsstörning (BPS) är en psykiatrisk diagnos som kännetecknas av emotionell instabilitet och problem med relationer. Både anhöriga och vårdpersonal uttrycker svårigheter i kontakten med en person som har BPS. Syftet med denna litteraturstudie är att sammanställa och belysa forskning och självbiografier som beskriver hur personer med BPS upplever sin livsvärld. För denna studie användes en kombination av två metoder, en litteraturstudie av empiriska studier och analys av självbiografier. Fyra teman utgör resultatet: hur de upplever <em>affekter</em>, att leva med känslomässig smärta. Deras syn på <em>relationer</em>, hur de upplever <em>diagnosen </em>som användbar eller inte och hur de upplever <em>vårdkontakt</em>. Resultatet kan tillämpas i klinisk praxis. Genom att se självskadebeteende som en copingstrategi för emotionell smärta kan relationen mellan sjuksköterska och patient underlättas. Att möta patienten med respekt, förståelse och en bekräftande attityd är eftersträvansvärt, likaså att hjälpa patienten att hitta bättre strategier för att hantera emotionell smärta.</p><p> </p> / <p>Borderline personality disorder (BPS) is a psychiatric diagnosis which is characterized by emotional instability and relation problems. Both family members and health care personnel express difficulties in contact with persons with BPS. The purpose of this literature review is to compile and highlight research and autobiographies that describe how people with BPS perceive their life world. For this study a combination of two methods was used, a literature review of empirical studies and analysis of autobiographies. Four themes shows in the result: how they experience their <em>affects, </em>to live with emotional pain. Their view of <em>relationships</em>, how they experience the <em>diagnosis </em>as helpful or not and their <em>contact with healthcare</em>. The results can be applied to clinical practice by viewing deliberate self harm as a coping strategy for emotional pain and by meeting the patient with respect, understandning and a confirming attitude. Helping the person to find better strategies to handle emotional pain is also a way to apply the results of this study on clinical practice.</p>