The aim of the present study was to further understand psychological well-being (PWB) and future-directed thinking in individuals with a diagnosis of Borderline Personality Disorder (BPD). A cross-sectional mixed design was used with 24 individuals with a diagnosis of BPD and 24 community participants (Controls). Participants were measured on PWB and a measure of future-directed thinking. Future-thoughts provided by participants were also content analysed, and it was hypothesised the BPD Group would have particularly marked deficits within interpersonal future thoughts. Consistent with previous findings (MacLeod et al., 2004), BPD participants had fewer positive future-directed thoughts compared to Controls, in the absence of any differences in negative future-directed thoughts. The BPD Group had significantly lower PWB scores on all six of the Ryff Psychological Well-being dimensions. The Control Group generated significantly more positive future-directed thoughts related to Relations with Others and Recreational activities, as well as more thoughts related to Having/Raising Children than the BPD Group. The findings extend the understanding of BPD individuals by profiling their well-being and describing in more detail their future-directed thinking.

This study investigated the discharge practice of a Community Mental Health Team (CMHT) by examining records (electronic and file) of clients discharged between April 2005 and March 2006. Out of a total of 211 discharged clients a random sample of 20 clients was selected to examine the extent to which records and reasons for discharge adhere to current CMHT policies and guidelines. In addition, a sample of clients who had been engaged by the CMHT for 6 months or less was compared to a sample of clients who have been engaged for 1 year or longer to establish whether these differed in sociodemographic characteristics, diagnoses and extent of service provision. The majority of clients discharged during the specified period consisted of clients engaged for 6 months or less. The sampling process revealed that a proportion of these included clients seen for one-off assessments or duty calls, indicating that there is room for improvement to clarify referral criteria (e.g. to GPs) and the role of the CMHT. Similarly, the examination of recording practice also revealed room for improvement in the closing of care packages electronically and inclusion of required information in discharge letters. Almost 50% of clients in the sample were discharged following a decline of any further intervention the reasons for which it will be important to investigate in the form of an audit or survey of service user’s views. Clients engaged for 6 months or less and 1 year or longer seemed to differ mostly in terms of employment rates, diagnosis and previous inpatient admission and mental health act sections. The findings are discussed in relation to the limitations of this study, implications for the service and further research.

Bakgrund: I det dagliga arbetet träffar sjuksköterskor ofta på personer med psykisk ohälsa. Borderline personlighetsstörning (BPD) är ett sjukdomstillstånd som karaktäriseras av en instabil självbild, impulsivitet, skiftande stämningsläge och stormiga relationer. Sjuksköterskorna har ett stort ansvar vid mötet med människor med olika behov, där sjuksköterskan ska vara en god lyssnare, ha empati, inge hopp, lugn och tröst. Därför är det viktigt att sjuksköterskorna har en medvetenhet kring sitt eget agerande och bemötande. En persons känslomässiga, beteendemässiga och kognitiva delar ligger som grund till hur en attityd utformas. Syfte: Syftet med denna litteraturstudie var att utifrån ABC-modellen beskriva sjuksköterskornas attityder till patienter med Borderline personlighetsstörning, samt att beskriva de inkluderade artiklars datainsamlingsmetod. Metod: En beskrivande litteraturstudie med deduktiv innehållsanalys, baserad på nio kvantitativa och fem kvalitativa artiklar. Sökningarna har gjorts via databaserna PubMed, Cinahl, PsykINFO och Scopus via Gävle Högskolan. Huvudresultat: Resultatet visar att sjuksköterskor har en övervägande negativ attityd mot patienter med BPD. Sjuksköterskor beskriver BPD patienter som manipulativa, oärliga, farliga, oberäkneliga och svåra att arbeta med. Sjuksköterskorna beskriver hur de distanserat sig och undvikt att vårda dessa patienter i den mån det gått på grund av dessa känslor mot BPD patienter. Sjuksköterskorna visade även lite empati och sympati för patienter med BPD. Sjuksköterskor med en positiv attityd mot BPD patienter beskrev hur de kände sig glada att de lagt ner tid på patienten istället för och ge upp. Metodologiska aspekten i den föreliggande studien utgjordes av nio kvantitativa och fem kvalitativa artiklar. Slutsats: Sjuksköterskor upplever sig ha en negativ attityd gentemot patienter med borderline personlighetsstörning. Sjuksköterskorna anser även att denna patientgrupp manipulativ och energiuttömmande. Vidare beskriver sjuksköterskor hur dom distanserar sig mot dessa patienter på grund av irritation, aggressivitet och utpressning hos patienterna. Genom mer kunskap och utbildning för sjuksköterskor som arbetar med patienter med Borderline personlighetsstörning kan en större förståelse uppnås och för att på ett professionellt sätt hantera sina egna känslor och tankar, när olika trängda situationer uppstår. / Background: In the daily work, nurse often meet people with mental illness. Borderline personality disorder (BPD) is a disease state characterized by an unstable self-image, impulsiveness, mood shifting and stormy relationships. Nurses have a great responsibility whit meeting with those people with different needs, where the nurse should be a good listener, have empathy, inspire hope, peace and consolation. Therefore, it is important that nurses have an awareness of their own actions and treatment. A person's emotional, behavioral and cognitive components are the basis for how an attitude designed. Objective: To describe nurses' attitudes towards people with borderline personality disorder according to the ABC-model and to describe the articles data collection methods. Method: A descriptive literature with a deductive content analysis, based on nine quantitative and five qualitative articles, in which the searches were made through the databases PubMed, CINAHL, and Scopus PsychINFO by Gävle University. Main Results: The results show that nurses have a predominantly negative attitude towards patients with BPD. Nurses describe BPD patients as manipulative, dishonest, dangerous, unpredictable and difficult to work with. The nurses describe how they distanced themselves and avoided caring for these patients as little as possible because of these feelings against BPD patients. The nurses also showed little empathy and sympathy for patients with BPD. Nurses with a positive attitude towards the BPD patients described how they felt satisfied that they spent time with the patient rather than give up on them. Methodological aspects in the present study consisted of nine quantitative and qualitative five articles. Conclusion: Nurses feel they have a negative attitude towards patients with borderline personality disorder. The nurses also consider this patient as manipulative and energy exhaustive. Furthermore, nurses describe how they distance themselves from these patients because of the irritability, aggression and blackmail from these patients. Through knowledge and training a greater understanding is achieved for the nurses who work with patients with borderline personality disorder as well as tools given to professionally manage their own emotions and thoughts, when various difficult situations arise.

Bipolar disorder and borderline personality disorder are common psychiatric diagnoses. One is a mood disorder with a strong genetic basis while the other is a disorder of personality commonly related to abusive experiences in childhood. Despite contrasting aetiologies they can be difficult to differentiate because of overlapping clinical presentations and symptoms. Diagnostic accuracy is important because of their polarised treatment approaches: long term treatment with mood stabilizers for bipolar disorder and psychotherapy for borderline personality disorder. A qualitative study of psychiatrists revealed comprehensive knowledge of the diagnostic criteria however, many expressed the view that diagnostic criteria did not assist diagnostic differentiation. These findings were validated in a large electronic survey of UK psychiatrists. A detailed study of actual diagnostic processes revealed that this scepticism appeared to influence actual practice. Clinicians largely ignored diagnostic criteria but continued to give diagnoses. Age and IQ matched women with bipolar disorder, borderline personality disorder and a healthy control group were compared in a series of cognitive tasks. Borderline personality disorder was associated with a failure to establish and maintain reciprocal cooperation in a game theoretic measure of social exchange. This behavioural change was not seen in euthymic bipolar disorder. Borderline personality disorder was also associated with an insensitivity to reward and losses in a risky decision-making task. Using a simple two-choice reaction task post error slowing was significantly amplified in the borderline group despite overall reaction times and error rates being similar in all three groups. Clinical diagnostic practice as revealed in this study is not adequate to reliably differentiate between bipolar disorder and borderline personality disorder. Laboratory measures of social exchange, decision making and post-error slowing highlight fundamental difficulties in borderline personality disorder not seen in euthymic bipolar disorder. These findings support the differentiation of bipolar disorder from borderline personality disorder and offer translational models for developing and evaluating new treatments for borderline personality disorder.

Thesis advisor: Thomas O'Hare / Psychopathy has received a marked increase in attention in the research literature over the past 2 decades since the validation and standardization of assessment tools designed to measure this construct, particularly the Psychopathy Checklist-measures (Hare, 1991/2003; Hart, Cox, & Hare, 1995; and Forth, Kosson, & Hare, 2003). Psychopathy has been identified as the best single predictor of violence among adult offenders (Hart, 1998). Such findings have led some to conclude that "psychopathy is the most important psychological construct for policy and practice in the criminal justice system" (Harris, Skilling, & Rice, 2001). Despite the overwhelming evidence of substantial societal and individual costs attributable to this disorder, little is known about psychosocial precursors of psychopathy. This study examines risk factors related to the development of psychopathy, as measured by the PCL:SV, in a sample of 446 psychiatric patients using structural equation modeling (SEM). The final SEM includes five predictor variables measuring early-life physical abuse, paternal antisocial behavior, and cognitive ability. Severe physical abuse (&beta; = 0.17, <italic>p</italic> = .043), biological father's alcohol abuse history (&beta; = .16, <italic>p</italic> =.004), biological father's arrest history (&beta; = 0.13, <italic>p</italic> = .02), and the subject's cognitive ability (&beta; = -0.18, <italic>p</italic> < .001) were found predictive of psychopathy in this sample. Post hoc analyses comparing male and female subjects, and black and white subjects, indicate different causal pathways in the development of psychopathy among these groups. Future research designed to assess these potentially different causal pathways are recommended. Implications to clinical theory, practice, and policy are also discussed. / Thesis (PhD) — Boston College, 2009. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Interview strategies applied in adult criminal justice settings focus on the interviewer and concentrate on obtaining information for the courts, while simultaneously neglecting a forensic understanding of interviewees, including the interviewee's decision-making and behavioral health impairments. As a consequence, there is a deficiency of evidence-based research regarding interview practices with persons diagnosed with antisocial personality disorder (ASPD). Using social control and neutralization theories as the foundation, the purpose of this case study of a single justice system in the United States was to better understand the perspectives and experiences of ASPD diagnosed inmates (n =5) compared to incarcerated participants without any mental health diagnosis (n =5) regarding willingness to cooperate with the interviewer. Interview data were triangulated with the Gudjonsson Confession Questionnaire – Revised. Data were inductively coded and then subjected to a thematic analysis procedure. Results indicate that external and internal pressures, intoxication, perception of proof, involvement of third parties, and/or a lack of insight into diagnostic features of ASPD influenced decisions to cooperate with an interviewer, thereby impacting the quality of interview results. The positive social change implications of this study include recommendations to criminal justice systems to explore holistic interview strategies that may improve interview outcomes. Adhering to this recommendation may improve the quality of interviews and ensure that justice system objectives related to truthfulness and accuracy are enhanced as well as improve mental health outcomes of criminal offenders.

Thesis (Ph. D.)--University of Missouri-Columbia, 2007. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on December 14. 2007) Vita. Includes bibliographical references.

<p>The aim of this paper was to illuminate the effect of mentalizationbased psychotherapy. The patients in the survey group were interviewed before and after treatment with regard to specific symptoms of borderline personality disorder and symptoms of other personality disorders with the semi structured interviews ZAN-BPD and SCID-II. Open interview questions that were worked up in a qualitative manner were as well put to the patients that had received the treatment program. A focus group interview with the staff working with the concept within the frame of the MBT-team of Psychiatry southwest in Stockholm was also carried out. The result shows on a group level between the pre and post measuring a reduction of specific borderline symptoms like impulsivity and cognitive symptoms. Symptoms referring to relations were stable and affective symptoms increased. All of the nine interviewed patients experienced that they to different extent felt more stable after treatment. That was an impression shared of the MBT team personnel. In the discussion part of the paper the discrepancy of the result that were gained from the two semi structured interviews and the questions put to patients and staff are discussed. Of interest to further research would be to study closer if there are common factors in background and comorbidity for the patients that seamed to have most benefit from treatment.</p>

<p>Anknytning handlar om betydelsen av tidig kontakt med närmast anhörig. Barndomsupplevelser skapar mönster inom individen, bild av själv och bild av andra, vilket uttrycks via anknytningsstilarna säker, rädd, upptagen och avfärdande. En enkätundersökning genomfördes på en högskola i Mellansverige, 75 studenter deltog. Syftet med studien var att se samband mellan val av anknytningsstil och medvetenhet om stiltillhörighet samt vilken betydelse stiltillhörighet har för individens relationer. Studien bekräftade den tidigare forskningen, majoriteten av populationen svenska studenter tillhör den säkra stilen. Starkt samband fanns mellan vilken stil deltagarna tror sig tillhöra och verklig stiltillhörighet. Anknytning har stor betydelse för individens relationer livet ut. Vidare forskning är viktig, den skapar medvetenhet om barns behov av god omvårdnad och konsekvenserna av brist på densamma.</p>

Anknytning handlar om betydelsen av tidig kontakt med närmast anhörig. Barndomsupplevelser skapar mönster inom individen, bild av själv och bild av andra, vilket uttrycks via anknytningsstilarna säker, rädd, upptagen och avfärdande. En enkätundersökning genomfördes på en högskola i Mellansverige, 75 studenter deltog. Syftet med studien var att se samband mellan val av anknytningsstil och medvetenhet om stiltillhörighet samt vilken betydelse stiltillhörighet har för individens relationer. Studien bekräftade den tidigare forskningen, majoriteten av populationen svenska studenter tillhör den säkra stilen. Starkt samband fanns mellan vilken stil deltagarna tror sig tillhöra och verklig stiltillhörighet. Anknytning har stor betydelse för individens relationer livet ut. Vidare forskning är viktig, den skapar medvetenhet om barns behov av god omvårdnad och konsekvenserna av brist på densamma.