abstract: Those who have borderline personality disorder (BPD), and those who have subclinical levels of BPD features, experience distress and impairment in important life domains, especially in their interpersonal interactions. It is critical to understand the factors that alleviate BPD symptoms in order to help affected individuals lead healthier lives. Rejection sensitivity and sleep disturbance are two factors that may maintain or exacerbate BPD symptoms, yet new research indicates socially supportive relationships are related to symptom remission. While extensive research exists on the interpersonal impairments associated with borderline personality pathology, little research exists on how individuals with BPD or BPD features perceive and experience their social support. The present study examined the relationships between BPD features, perceived social support, sleep quality, and rejection sensitivity in a racially diverse, large sample of primarily college-aged individuals (N = 396). Results indicated that BPD features had a significant positive relationship with self-reported rejection sensitivity and a significant negative relationship with self-reported perceived social support. Additionally, BPD features had a significant positive relationship with sleep disturbance. Sleep disturbance did not moderate the relationship between BPD features and rejection sensitivity as expected; however, the regression of rejection sensitivity on BPD features and sleep disturbance was significant. Finally, sleep disturbance moderated the relationship between BPD features and rejection sensitivity. Results extend and replicate recent research findings on the possible mechanisms that may maintain and alleviate BPD symptoms. Furthermore, the moderating effect of sleep disturbance on perceived social support for those with higher levels of BPD features is unique to this study. / Dissertation/Thesis / Masters Thesis Counseling Psychology 2016

Introduction: Borderline Personality Disorder (BPD) is characterised by deficits in affect and impulse regulation, along with interpersonal difficulties (Lieb et al., 2004). It is thought to develop through a complex relationship between adverse childhood events, such as childhood abuse and genetics. A recent developmental model of BPD and one that is gaining popularity focuses on mentalization. Following their exposition of the mentalizing model of BPD, Bateman and Fonagy developed the Mentalization Based Treatment (MBT) intervention for BPD (Bateman & Fonagy 2006). This intervention includes both group and individual therapy with the focus on the patient’s relationship with the therapist and other members of the group. Promising evidence that MBT interventions are effective for treating symptoms of BPD is beginning to emerge. Methods: First a systematic review examining the prevalence of childhood abuse in BPD patients was conducted. Second, an empirical study of the efficacy of a group-only adaptation of the MBT intervention for BPD, delivered in a routine health service setting. Finally, planned exploratory analyses were conducted in order to ascertain what factors might predict group completion. Results: The results of the systematic review suggested that that emotional abuse (mean prevalence 63%) and emotional neglect (mean prevalence 63.1%) are the most common forms of abuse reported by this population followed by physical neglect (mean prevalence 40.89%) , sexual abuse (mean prevalence 36.9%) and physical abuse (mean prevalence 32.49%). The results of the second study revealed that the HUB is an acceptable treatment to participants, with indicators of treatment efficacy in relation to reducing overall psychiatric symptoms along with specific symptoms including interpersonal sensitivities, depression, phobic anxiety and paranoid ideation. Finally, exploratory analyses suggested that patients who were older and with less histrionic symptoms (as defined by the Personality Disorder Questionnaire-4) were more likely to complete the HUB. Conclusions: These findings demonstrate that a group-only MBT intervention displays promising effectiveness in treating core symptoms of BPD and is acceptable to patients. Further it suggests that group-only MBT interventions are worth continued investigation both into their efficacies and the potential efficiencies associated a group-based intervention.

Bakgrund: Emotionellt instabilt personlighetssyndrom (EIPS) är en psykiatrisk diagnos som påverkar det psykiska och mentala välbefinnandet. Ungefär 1% av den vuxna befolkningen har diagnosen och 22% av inneliggande patienter inom den psykiatriska slutenvården är diagnostiserad med EIPS. Syfte: syftet med denna litteraturstudie var att beskriva personers upplevelser av att leva med emotionellt instabilt personlighetssyndrom. Metod: en litteraturstudie med en kvalitativ ansats har använts. 10 vetenskapliga studier som svarade mot syftet valdes ut och genomgick en kvalitativ innehållsanalys vilket resulterade i fem kategorier. Resultat: Att känna hopplöshet och vara destruktiv mot sig själv. Att uppleva identitetsförvirring och en inre kamp. Att var rädd för att bli dömd och kritiserad. Att lära sig hantera sina känslor. Att uppleva problem i relation till andra. Slutsats: litteraturstudien visade att personer med EIPS upplever svårigheter i att hantera känslor och ett enormt lidande vilket kunde leda till destruktiva handlingar för att hantera känslorna. Att lindra lidandet och att inge stöd till personer med EIPS är därför en viktig del i sjuksköterskans roll i omvårdnaden. Resultatet från denna litteraturstudie kan användas för att öka kunskapen om upplevelsen av att leva med EIPS inom samhället och vården för att minska stigmatiseringen och bidra med ett tillämpad personcentrerat förhållningssätt för sjuksköterskor. Författarna anser att det behövs mer forskning inom området för att kunna stödja denna patientgrupp på bästa sätt.

Au Québec, les tentatives de suicide chez les adolescents prennent une ampleur considérable dans le réseau public de la santé et un nombre élevé de ces adolescents suicidaires sont épris d’un trouble de personnalité limite (TPL). Ces adolescents TPL présentent de nombreuses crises associées aux conduites suicidaires et aux comportements d’automutilation les amenant à consulter des professionnels de la santé de manière récurrente due, entre autres, aux abandons prématurés de la thérapie. Considérant cette problématique préoccupante, ce mémoire s’est intéressé aux facteurs impliqués dans la complexité de l’intervention auprès des adolescents atteints d’un TPL selon la perception des thérapeutes. Ce projet exploratoire de type qualitatif a été effectué sous forme d’entrevues semi-structurées auprès de onze thérapeutes de troisième ligne en pédopsychiatrie. Dans ce contexte de soins psychiatrique au Québec, les résultats de ce projet confirme la complexité de l’intervention auprès de ces jeunes et font émerger plusieurs facteurs pouvant expliquer les difficultés liées au processus d’intervention en lien, entre autres, à la symptomatologie, au risque suicidaire élevé, au risque d’abandons prématurés, à leur grande instabilité émotionnelle, relationnelle et comportementale influençant, par le fait même, le thérapeute dans son savoir-faire et son savoir-être. / In Quebec, suicide attempts in adolescents take a considerable extent in the public health sector and a high number of suicidal adolescents are often affected with a borderline personality disorder (BPD). These teens have many BDP seizures associated with suicidal behavior and self-injurious behaviors leading them to consult health professionals repeatedly due, among other things, to the premature abandonment of therapy. Considering these issues of concern, this study focused on factors involved in the complexity of representations of adolescents with BPD according to the perception of therapists. This qualitative exploratory project was conducted as semi-structured interviews with eleven therapists in third line child psychiatry. In the context of psychiatric care in Quebec, the results of this project confirms the complexity of working with these young people are emerging and several factors could explain the difficulties in the intervention process related, inter alia, the symptoms, the high suicide risk, the risk of premature abandonment, to their great emotional instability, relational and behavioral influences, for in so doing, the therapist in his know-how and life skills.

Ši magistro baigiamojo darbo tema pasirinkta todėl, kad ji yra mažai nagrinėta Lietuvoje. Europos Sąjungos parama Lietuvai, jos reikšme šalies ekonomikai, lėšų įsisavinimo eiga ir rezultatai nėra pakankamai analizuojami. Europos Sąjungos struktūrinių fondų parama Lietuvai ženkliai prisideda prie spartaus šalies ekonomikos augimo, tačiau paramos panaudojimo procese susiduriama su daugeliu efektyvumą mažinančių problemų, t.y. žemas paramos įsisavinimo lygis kai kuriose srityse yra dėl administruojančių institucijų mažo dėmesio į dalykinius ir turinio aspektus, tuo pačiu sureikšminant biurokratizmo aspektus Darbo tikslas - išanalizuoti Europos Sąjungos paramos įsisavinimo rodiklius Lietuvoje, jų įtaką Lietuvos ekonomikai, iškelti ir palyginti žemo įsisavinimo lygio priežastis ir problemas, ir pateikti jų sprendimo būdus. Darbo tikslui pasiekti ir pradinius duomenis analizei surinkti buvo naudotasi mokslinės literatūros, Lietuvos ir užsienio autorių monografijomis, moksliniais straipsniais dokumentų ir paramą administruojančių institucijų statistinių duomenų ir lyginimo metodais. Pirmoje darbo dalyje apžvelgta Europos Sąjungos struktūrinių fondų vaidmuo įgyvendinant Lietuvos strateginius tikslus, antroje dalyje atlikta paramos įsisavinimo pagal BPD, BPD II-ąjį prioritetą analizė, nustatytos ES struktūrinės paramos įsisavinimo problemos. Trečioje darbo dalyje analizuojama užsienio šalių patirtis įgyvendinant jaunimo... [toliau žr. visą tekstą] / This theme of master’s finishing work is chosen, because it is not much examined in Lithuania. European Union support for Lithuania, its significance to country’s economics, course and results of resources assimilation are analyzed insufficiently. The support of European Union specifically contributed to rapid growth of country’s economics, however, during the process of support usage there is being faced with many problems, which reduce effectiveness, i.e., low level of support assimilation in some areas is over too little attention of administering institutions on matter-of-fact and content aspects, at the same time giving prominence to aspects of bureaucracy. The purpose of work is to analyze indicators of assimilation of European Union structural funds in Lithuania, its influence on Lithuanian economics, to suggest and compare causes and problems of low level of assimilation, and provide solutions. In order to achieve the purpose of work and to collect initial data for analysis, it was used scientific literature, monographs of Lithuanian and foreign authors, scientific articles, and statistical data and comparison methods of documents and institutions, which administer the support. In the first part of work there was reviewed the role of European Union structural funds, while realizing strategic purposes of Lithuania, in the second part there was performed the analysis of support assimilation, according to GPD, GPD II... [to full text]

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Clinicians’ attitudes and behaviors toward patients with borderline personality disorder (BPD) are affected by the label’s stigma. Complex posttraumatic stress disorder (CPTSD) was proposed as a comprehensive and less stigmatizing diagnostic category for clients with BPD and a history of complex trauma. Given considerable similarities across both disorders’ diagnostic criteria, the CPTSD framework holds promise as a means to improve therapists’ attitudes towards clients with BPD and a history of complex trauma. However, this quality of CPTSD had not yet been examined empirically. Using vignettes in a between-subjects experimental design, this study investigated whether CPTSD is a less stigmatizing label than BPD for trauma survivors. Participants were 322 practicing psychotherapists. Evidence of BPD stigma was found, as was an affinity for CPTSD. Results generally supported CPTSD as a less stigmatizing label than BPD; therapists presented with a CPTSD-labeled vignette were somewhat less likely to blame the client for her symptomatic behavior and expected slightly stronger working alliance with the client than therapists presented with the BPD-labeled vignette. However, therapists’ agreement with the BPD diagnosis and theoretical orientation were found to be more salient than diagnostic label in affecting concepts related to the stigmatization of BPD clients. Additionally, familiarity with CPTSD was related to more favorable attitudes toward the client and her course of treatment. Regardless of CPTSD’s recognition as a formal diagnosis, education about the construct is widely recommended for therapists.

Darnaus vystymosi švietimo prielaidos BPD 2.4 priemonės projektuose. Raktiniai žodžiai: darnus vystymasis, darnaus vystymosi švietimas, BPD 2.4 priemonė, mokymasis visą gyvenimą. Darnaus vystymosi siekis – užtikrinti tinkamą asmens gyvenimo kokybę, siekti visuomenės gerovės ir saugumo, išmintingai derinant ekonomikos, socialinės raidos bei aplinkos apsaugos uždavinius. Išsilavinimas yra vienas svarbiausių faktorių, nuo kurio priklauso žmogaus ir visuomenės pasirengimas ir motyvacija spręsti daugialypes darnaus vystymosi problemas. Švietimui, visuomenės informavimui, įvairių sričių specialistų kvalifikacijos tobulinimui čia tenka ypatingas vaidmuo. Kadangi visuomenės darnaus vystymosi koncepcija yra dinamiška, jos įgyvendinimo modeliai yra nuolat plėtojami priklausomai nuo įgytų žinių ir patirties: darnus vystymasis yra nuolatinio mokymosi vyksmas. Todėl visos veiklos, prisidedančios prie mokymosi visą gyvenimą kokybės gerinimo, sykiu kuria prielaidas darnaus vystymosi nuostatoms įgyvendinti. Magistro baigiamasis darbas susideda iš keturių dalių dalių: Pirmoje dalyje apibrėžiamas švietimo vaidmuo įvairaus lygmens darnaus vystymosi strateginiuose dokumentuose. Antroje - nagrinėjamos mokymosi visą gyvenimą strateginės nuostatos, atskleidžiamos jų sąsajas su Lietuvos švietimo prioritetais. Trečioje - nurodomi tyrimo metodai ir suformuluojami tyrimo kriterijai. Ketvirtoje – pateikiami BPD 2.4 priemonės „Mokymosi visą gyvenimą sąlygų plėtojimas“ projektų paraiškų analizės... [toliau žr. visą tekstą] / Prerequisites for sustainable development of education in the projects of SPD 2.4 facility. Key words: Sustainable Development, Education for Sustainable, SPD 2.4 Facility, Lifelong Learning. The goal of sustainable development is ensuring the proper quality of individual life, seeking for public safety and welfare by wisely coordinating economic, societal development and environmental tasks. Education is one of the key factors determining the preparation and motivation of individual and society on solving the multifaceted problems of sustainable development. Education, public notification, and qualification improvement of specialists in various fields here plays a special role. As the concept of sustainable development of society is dynamic, its models of implementation are being continuously advanced depending upon the level of gained knowledge and experience: sustainable development is a process of continuous learning. Therefore every activity contributing to the quality improvement of lifelong learning likewise generates prerequisites for implementation of sustainable development provisions. The Master Final Thesis consists of four parts: The first part contains a description of education in strategic documents of sustainable development of different levels. The second part contains the analysis of strategic provisions of lifelong learning and their links with Lithuanian educational priorities. Methods of research and research criteria are specified in the third part... [to full text]

Borderline Personality Disorder (BPD) is a debilitating personality disorder that impacts anywhere between 1% to 5% of Americans. Studies claim that women are significantly more at risk than men to suffer from this disorder and may experience stronger symptoms. Previous research has found that victims of childhood abuse such as sexual abuse, physical abuse, and neglect are more at risk for developing Borderline Personality Disorder as adults, particularly when abuse is paired with genetic susceptibility. Some researchers claim that there are no detectable racial differences in Borderline Personality Disorder, but previous studies often have very small sample sizes taken from clinical patients. To examine the sociological patterns of BPD diagnosis with a representative population sample, data was analyzed from the National Epidemiologic Survey on Alcohol and Related Conditions to examine gender, race, and childhood abuse as predictors. Results show that racial minority status is actually a stronger predictor than gender. Examining intersectional effects shows that black women and Native American men have significantly elevated risks for BPD in adulthood. Overall, a history of sexual and emotional abuse are the most significant driving factors of BPD, regardless of race and gender.

Ce mémoire s’intéresse aux processus cognitifs sous-tendant les comportements agressifs réactifs auprès d’une population possédant des traits de la personnalité limite (TPL), mais pas nécessairement le diagnostic TPL. Une association a été démontrée entre le biais d’attribution d’intention hostile (BAIH) et les comportements agressifs, mais cette relation n’a pas encore été considérée auprès d’une population possédant des traits TPL. Pour atteindre cet objectif, une réplication méthodologique de l’étude de Gagnon et coll. (2016) qui propose une méthode d’évaluation du BAIH par le biais de la méthode de potentiel relié aux évènements (PRÉ) a été effectuée. La tâche de violation des attentes hostiles utilisée permet d’éliciter une composante N400, représentant une déflexion négative dans le tracé des PRÉs lorsque les attentes du sujet sont violées. Le second objectif visait à vérifier l’hypothèse selon laquelle le BAIH aurait un effet médiateur dans la relation entre les traits TPL et l’agressivité réactive. Soixante-trois personnes ont participé à l’étude. Le Personality Assessment Inventory-Borderline (PAI-BOR) a permis de mesurer les traits TPL des participants et le Reactive-Proactive Aggression Questionnaire (RPQ) de mesurer leur tendance à réagir de manière agressive. Les résultats ont permis de confirmer la relation entre les traits TPL et l’agressivité réactive, et entre le BAIH et l’agressivité réactive. L’effet médiateur attendu n’a pas été retrouvé entre l’effet N400 de la condition non hostile mesurant la violation des attentes hostiles, et la relation entre les traits TPL et l’agressivité réactive. D’autres études seraient nécessaires avant de pouvoir affirmer que des interventions basées sur les interprétations en situation sociale seraient efficaces. / This thesis examined cognitive processes underlying aggressive behaviour in a population with borderline personality traits (BPD), but not necessarily the diagnosis. The association between hostile attributional bias (HAB) and aggressive behaviour has been demonstrated in the literature, but this relationship has never been considered in people with BPD traits that show reactive aggressive behaviour. Our first aim was to conduct a methodological replication of the results of Gagnon and al. (2016) that used an event-related potential (ERP) method to evaluate HAB. The hostile expectancy violation paradigm elicits an N400 component, representing a negative-going ERP deflection when intention expectations are violated. The second aim was to verify the hypothesis that HAB would mediate the relationship between BPD traits and reactive aggressive behaviour. Sixty-three participants participated in the study. The Personality Assessment Inventory-Borderline (PAI-BOR) was used to measure BPD traits and the Reactive-Proactive Aggression Questionnaire (RPQ) was used to measure their tendency to react in aggressive manner. The results confirmed the existing relationship between BPD traits and reactive aggression, and between HAB and reactive aggression. The expected N400 effect in the non-hostile condition measuring the violation of hostile expectations, on the relationship between BPD traits and reactive aggression was not found. Other studies are necessary before suggesting that treatment based on biased interpretations in social interaction is effective.