Skip to main content Accessibility help
×
Home

Assessment of borderline personality disorder: considering a diagnostic strategy

  • C. K. W. Schotte (a1) (a2)

Abstract

Background:

Borderline personality disorder (BPD) represents a highly prevalent, severe and difficult-to-treat mental health problem.

Objective:

This paper considers methods, instruments and strategies for assessing BPD as described within the frame of the DSM-IV classification.

Conclusions:

Following the general diagnostic approach introduced by Van Praag in biological psychiatry, a two-tier diagnostic strategy for the descriptive diagnostic assessment of BPD is recommended. Axis one results in a DSM-IV Axis II categorical diagnosis, whereas axis two refers to a symptomatological, dimensional or functional approach, in which the psychological dysfunctions of the nosological syndrome are depicted. Moreover, in a clinical context a basic aim of the diagnostic evaluation is to obtain therapeutically valid information that leads to a constructive conceptual framework, to a case formulation in which therapeutic interventions are understood, selected and implemented. This framework should be based on a biopsychosocial theoretical model and its application in the clinical context involves feedback to the patient, in which the descriptive evaluation is integrated with etiological; and pathogenic elements using an idiographic approach. This therapeutically orientated diagnostic strategy is illustrated by the use of the ADP-IV (Assessment of DSM-IV personality disorders) questionnaire within a cognitive behavioral orientation.

Copyright

Corresponding author

Department Psychiatry, University Hospital Antwerp (U.Z.A.), Wilrijkstraat 10, B-2650 Edegem, Belgium. Tel: 32 3 821 51 57; Fax: 32 3 825 16 41; E-mail: chris.schotte@uza.be

References

Hide All
1.Zanarini, MC, Frankenburg, FR.Pathways to the development of borderline personality disorder. J Pers Disord 1997;11: 93104.
2.Gunderson, JG. Borderline personality disorder. Washington, DC: American Psychiatric Press, 1984.
3.Widiger, TA.Personality disorders in the 21st century. J PersDisord 2000;14: 316.
4.Van Praag, HM.Two-tier diagnosing in psychiatry. Psychiatr Res 1990;34: 111.
5.Verheul, R.Classificatie en differentiële diagnostiek. In: Van Tiburg, W, Van Den Brink, W, Arntz, A, eds. Behandelingsstrategieën Bij de Borderline Persoonlijkheidsstoornis. Houten: Bohn Stafleu Van Loghum, 1998: 131.
6.Costa, PT, Widiger, TA.Personality disorders and the five-factor model of personality. Washington, DC: American Psychological Association, 1994.
7.Cloninger, CR.A practical way to diagnose personality disorder: a proposal. J Pers Disord 2000;14: 99108.
8.Costa, PT, McCrae, RR.Revised NEO personality inventory (NEO-PI-R) and NEO five-factor inventory (NEO-FFI): professional manual. Odessa, FL: Psychological Asssessment Resources, 1992.
9.Cloninger, CR, Przybeck, TR, Svrakic, D, Wetzel, RD.The temperament and character inventory (TCI): a guide to its development and use. Washington, DC: Washington University,Center for Psychobiology of Personality, 1994.
10.Sloore, H, Derksen, JJL, Hellenbosch, G, De Mey, HRA.Nederlandstalige Versie MMPI-2: Minnesota Multiphasic Personality Inventory, 2. Nijmegen: Pen Test Publisher, 1996.
11.Maesschalck, C, Vertommen, H.Diagnostiek van persoonlijkheidsstoornissen: een overzicht van Nederlandstalige instrumenten aansluitend bij de DSM-classificatie en bij andere benaderingen. Diagnostiekwijzer 1997;1: 176199.
12.Schotte, CKW.New instruments for diagnosing personality disorders. Curr Opin Psychiatry 2001, in press.
13.Perry, JC.Problems and considerations in the valid assessment of personality disorders. Am J Psychiatry 1992;149: 16451653.
14.Schotte, CKW, De Doncker, D, Vankerckhoven, C, Vertommen, H, Cosyns, P. Self-report assessment of the DSM-IV personality disorders. Psychol Med 1998;28: 11791188.
15.Schotte, CKW, De Doncker, D.De ADP-IV: een vragenlijst voor een therapeutisch georiënteerde diagnostiek van de DSM-IV persoonlijkheidsstoornissen. Psychopraxis 2000; 22672273.
16.Siever, LJ, Davis, KL.A psychobiological perspective on the personality disorders. Am J Psychiatry 1991;148: 16471658.
17.Rinne, T, Westenberg, HG, Den Boer, JA, Van Den Brink, W.Serotonergic blunting to meta-chlorophenylpiperazine (m-CPP) highly correlates with sustained childhood abuse in impulsive and autoaggressive female borderline patients. Biol Psychiatry 2000;47: 548556.
18.Ladd, CO, Huot, RL, Thrivikraman, KV, Nemeroff, CB, Meaney, MJ, Plotsky, PM.Long-term behavioral and neuroendocrine adaptations to adverse early experience. Prog Brain Res 2000;122: 81103.
19.Benjamin, LS.Interpersonal diagnosis and treatment of personality disorders. New York, NY: Guilford Press. 1996.
20.Young, JE.Cognitive therapy for personality disorders: a schema-focused approach, rev. edn. Sarasota, Fl: Professional Resource Press, 1999.
21.Linehan, MM.Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press, 1993.
22.Paris, J.Social factors in the personality disorders. a Biopsychosocial Approach to Etiology and Treatment. New York, NY: Cambridge University Press, 1996.
23.Millon, T, Davis, R.Personality disorders in modern life. New York, NY: John Wiley & Sons, 2000.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed