Mentalization-Based Treatment of Borderline Personality Disorder

2012 ◽  
pp. 766-784 ◽  
Author(s):  
Anthony W. Bateman ◽  
Peter Fonagy
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Professionals ◽  
Psychological Trauma ◽  
Mental States ◽  
Borderline Personality ◽  
Interpersonal Interaction ◽  
The Face ◽  
Disorder Treatment ◽  
Core Problem

An outline of the developmental origins of mentalizing and its relevance to borderline personality disorder is provided. Mentalizing, a capacity to understand intentions of oneself and others in terms of mental states, develops in the context of attachment relationships. Disruption of the attachment relationship due to psychological trauma leads to a vulnerability in adulthood to a loss of mentalizing in the context of interpersonal interaction, which is a core problem for people with borderline personality disorder. Treatment requires a focus on mentalizing, and mentalization-based treatment has been developed with the aim of helping patients improve their ability to maintain mentalizing in the face of emotional stimulation in the context of close relationships. The treatment has been subjected to research trials and shown to be effective in reducing many of the symptoms of borderline personality disorder when implemented by generic mental health professionals with limited specialist training.

scholarly journals Mentalization-based treatment for patients with borderline personality disorder: an overview

2009 ◽  
Vol 31 (1) ◽  
pp. 72-75 ◽  
Author(s):  
Mariana Eizirik ◽  
Peter Fonagy
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Professionals ◽  
Therapeutic Process ◽  
Psychological Trauma ◽  
Borderline Personality ◽  
Randomized Controlled ◽  
Effective Interventions ◽  
Psychodynamically Oriented ◽  
The Individual

OBJECTIVE: To describe the concept of mentalization, and its application in understanding the development of psychopathology in patients with borderline personality disorder; to give an account of the main features of mentalization-based treatment; to summarise the evidence supporting its effectiveness. DISCUSSION: Mentalization is a predominantly preconscious mental activity that enables the individual to understand him/herself and others in terms of subjective states and mental processes. Psychological trauma in childhood is associated with deficits in mentalization and with the development of borderline personality disorder. Mentalization-based treatment is a psychodynamically-oriented manualized psychotherapy for borderline personality disorder that aims to develop a therapeutic process in which the patient's capacity for mentalization becomes the focus of treatment. Randomized controlled trials have demonstrated the effectiveness of this treatment for patients with borderline personality disorder. CONCLUSIONS: The development of a psychodynamically-oriented therapeutic intervention that specifically targets the deficits involved in the psychopathology of borderline personality disorder is a crucial step in increasing the effectiveness of treatment. Mental health professionals should be adequately prepared to deliver effective interventions to their patients, such as mentalization-based treatment.

scholarly journals Proportion of Psychiatry Outpatients with Borderline Personality and Associated Clinical Syndromes using the Millon Clinical Multiaxial Inventory-III: A Retrospective Study

2021 ◽  
Author(s):  
Shaunak Ajit Ajinkya ◽  
Pranita Shantanu Sharma ◽  
Aparna Ramakrishnan
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Mental Health Professionals ◽  
Borderline Personality ◽  
Personality Types ◽  
Care Hospital ◽  
Millon Clinical Multiaxial Inventory ◽  
Clinical Syndromes ◽  
Thought Disorders

Introduction: Personality disorders are a group of behavioural patterns associated with significant personal and socio-occupational disturbances. Numerous studies have demonstrated borderline personality to be one of the most common personality disorders. It’s less often diagnosed with just a clinical assessment. Aim: To examine the proportion of patients with Borderline Personality Disorder (BPD), and its associated personality types and clinical syndromes, using the Millon Clinical Multiaxial Inventory version-III (MCMI-III). Materials and Methods: A retrospective observational study was carried out on 450 adult patients who attended the psychiatry outpatient department of an urban tertiary care hospital. They had been administered the MCMI-III, a self-rating questionnaire commonly used to provide information on personality types and associated clinical syndromes. Statistical Package for the Social Sciences (IBM SPSS, Windows) version 20.0 was used for statistical analyses. Data was expressed in terms of actual number, mean and percentages. Chi-Square or Fisher’s-exact test, as appropriate, was used for categorical data to test for associations. Odds ratio was estimated to measure strength of the association. Results: Borderline was the most common personality type comprising nearly half (46.63%) of the study population. 25.5% had borderline traits while 21.1% had Borderline Personality Disorder (BPD). BPD was significantly higher in females (p<0.001), younger age group below the age of 40 years (p<0.001) and unmarried persons (p<0.001). It was comorbid most with Anxiety (90.91%; OR=4.05; p<0.001), Major Depression (85.23%; OR=18.39; p<0.001), Post Traumatic Stress Disorder (PTSD) (46.59%; OR=6.30; p<0.001) and Thought disorders (56.82%; OR=18.15; p<0.001). Alcohol (22.73%; OR=3.54; p<0.001) and Drug dependence (13.64%; OR=11.52; p<0.001) were also seen significantly higher in patients with BPD. Personality types significantly comorbid with BPD were Sadistic, Depressive, Masochistic, Negativistic, Schizotypal, Avoidant, Dependent, Antisocial and Paranoid types, with odds being most for Sadistic personality (OR=9.44). Conclusion: It is recommended that mental health professionals and clinicians should start to look for underlying symptoms of BPD in patients of anxiety and mood syndromes. If found these patients should be directed for psychotherapy as early as possible. The MCMI psychological test would be an important contribution to this area, given the need for systematic, quick, and objective testing methods that facilitate the diagnosis.

scholarly journals The person behind the label: co-production as a tool in teaching about borderline personality disorder

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S122-S122
Author(s):  
Nyakomi Adwok ◽  
Sharon Nightingale
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Mental Health Professionals ◽  
Service User ◽  
Borderline Personality ◽  
Junior Doctors ◽  
Service Users ◽  
Teaching Session ◽  
Negative Attitudes

AimsThe overarching aim of the session was to address and reduce stigma around Borderline Personality Disorder among doctors. The three main objectives were:To increase empathy and understanding around Borderline Personality Disorder by exposing junior doctors to service user perspectives outside a clinical setting;To address knowledge gaps identified by junior doctors in a self-reported questionnaire disseminated prior to the teaching session;To offer junior doctors a basic psychological framework to base their assessment and formulation of service users with personality disorders.Background‘Borderline Personality Disorder: The Person Behind the Label’ was the title of the first co-produced teaching session in the Leeds and York Partnership Foundation Trust (LYPFT). Prior to the teaching session, an online questionnaire was sent out to trainees. The results highlighted three key issues:Negative attitudes towards service users with personality disorders;Poor subjective knowledge of the psychological models of personality disorders;Perception among trainees that they do not receive adequate training to deal with the challenges service users with personality disorders present.MethodA teaching session was co-produced by a team of two service users, a principal clinical psychologist within the Leeds Personality Disorder Network (PDN) and a core Psychiatry trainee. It was delivered in a 75 minute session to 40 attendees consisting of both trainee doctors and consultants.ResultFeedback was collected immediately after the session through the use of anonymous feedback forms. The response to the training was overwhelmingly positive with all 28 respondents rating the session as 4/5 or 5/5 on a satisfaction scale ranging from 1 (poor) to excellent (5). Key themes from the feedback included appreciation for the service user perspective and teaching on psychological theory. The fourth question in the questionnaire: “How will this teaching impact your work?” produced the highest number of responses (25/28) and provided evidence that the above listed objectives of the session were met.ConclusionCo-produced teaching has great potential to address negative attitudes around highly stigmatised conditions by bridging the gap that often exists between service users and mental health professionals.

scholarly journals Mentalizing Based on External Features in Borderline Personality Disorder Compared With Healthy Controls: The Role of Attachment Dimensions and Childhood Trauma

2019 ◽  
Vol 33 (6) ◽  
pp. 736-750 ◽  
Author(s):  
Martijn Van Heel ◽  
Patrick Luyten ◽  
Celine De Meulemeester ◽  
Dominique Vanwalleghem ◽  
Rudi Vermote ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Childhood Trauma ◽  
Mental States ◽  
Borderline Personality ◽  
Control Group ◽  
Healthy Controls ◽  
Avoidant Attachment ◽  
The Mind ◽  
Attachment Dimensions

Extant research suggests that borderline personality disorder (BPD) is associated with impairments in mentalizing, that is, comprehending behavior in terms of underlying mental states. However, the precise nature of these impairments remains unclear. The literature is mixed concerning mental-izing based on external features of others, and specifically facial emotion recognition (FER) in BPD patients. This study investigated FER differences in 79 BPD patients and 79 matched healthy controls using the Reading the Mind in the Eyes Test (RMET). The authors also investigated attachment dimensions and childhood trauma in relation to mentalizing based on external features. Results showed that BPD patients performed worse on positive and negative emotions. Furthermore, avoidant attachment was negatively related to FER for neutral emotions, particularly in the control group. Trauma was negatively related to FER at trend level, particularly in BPD patients. The implications for this understanding of mentalizing based on external features in BPD are discussed.

Staff attitudes towards patients with borderline personality disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 1010-1010
Author(s):  
E. Bodner ◽  
S. Cohen-Fridel ◽  
I. Ianco
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Professionals ◽  
Negative Emotions ◽  
Borderline Personality ◽  
List Type ◽  
Staff Attitudes ◽  
Community Settings ◽  
Common Diagnosis ◽  
Level Of Agreement

IntroductionBDP is a common diagnosis in hospitals and community settings, estimated at 20% and 11%, respectively. Nevertheless, the attitudes and skills of all mental health professionals regarding the treatment of these patients had hardly been studied.ObjectivesDevelop tools and use them to understand staff attitudes towards BDP patients.Aims(1)To develop two inventories for the measurement of cognitive and emotional attitudes towards borderline personality disorder (BPD) patients and their treatment;(2)To use these tools to understand and compare attitudes of psychiatrists, psychologists and nurses toward BPD patients.MethodTwo lists of items referring to cognitive and emotional attitudes towards BPD patients were formulated. Nurses, psychologists and psychiatrist (n = 57), working in public psychiatric institutions rated their level of agreement with each item. Both lists of attitudes yielded three factors (cognitive: required treatment, suicidal tendencies, and antagonistic judgment, and emotional: negative emotions, experienced difficulties in treatment, and empathy, respectively).ResultsPsychologists scored lower than psychiatrists and nurses on antagonistic judgments. Nurses scored lower than psychiatrists and psychologists on empathy. Regression stepwise analyses on the three emotional attitudes separately showed that suicidal tendencies of BPD patients mainly explained negative emotions and difficulties in treating these patients. All groups were interested in learning more about the treatment of these patients.ConclusionsSuicidal tendencies of BPD patients provoke antagonistic judgments among the three professions. Psychiatrists, psychologists and nurses hold distinctive cognitive and emotional attitudes towards these patients. Staff training programs regarding BDP patients should consider these differences and concerns.

scholarly journals PSYCHOLOGICAL FEATURES OF PEOPLE WITH BORDERLINE PERSONALITY DISORDERS

2018 ◽  
pp. 47-51
Author(s):  
V. Morozova
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personal Characteristics ◽  
Mental States ◽  
Borderline Personality ◽  
Borderline Personality Disorders ◽  
Borderline Disorder ◽  
High Level ◽  
Psychological Features ◽  
The Relationship

The article presents the results of an empirical study of the psychological features of people with signs of borderline personality disorder. The study involved 40 people with signs of borderline personality disorder aged 14-56 years. According to the purpose of the study, the following tasks have been set: To investigate personality with borderline disorder; Identify and evaluate the neurotic states of a person with a borderline personality disorder; Conduct correlation analysis to investigate trends in the relationship between the indicator of the number of signs of borderline disorder and personal characteristics. The following research methods were used: 5PFQ Big Five technique (R. McCray, P. Costa), Clinical questionnaire for the detection and evaluation of neurotic conditions (KK Yakhin, DM Mendelevich) and Methods for diagnosing borderline personality disorder (TY Lasovskaya, CP Korolenko, SV Yaechnikov). The data obtained were subjected to a mathematical and statistical analysis procedure using the SPSS Statistic program. It is proved that emotional lability (instability of emotions), impulsiveness and self-harming behavior are important diagnostic criteria of a borderline personality disorder. High level of manifestation of signs of borderline personality disorder is accompanied by such mental states of disadaptation as neurotic depression, asthenia, tension and anxiety.

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