Skip to main content Accessibility help
×
Home
Hostname: page-component-544b6db54f-s4m2s Total loading time: 1.554 Render date: 2021-10-17T05:00:59.839Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Book contents

10a - Further Reflections on Assessment, Etiology, and Treatment: Commentary on Borderline Personality Disorder

from Part III - Individual Disorders and Clusters

Published online by Cambridge University Press:  24 February 2020

Carl W. Lejuez
Affiliation:
University of Kansas
Kim L. Gratz
Affiliation:
University of Toledo, Ohio
Get access

Summary

This commentary expands on some key issues in the assessment, developmental psychopathology, and treatment of borderline personality disorder (BPD). The authors review evidence suggesting that BPD severity can be assessed along a continuum based on number of DSM criteria, which form a unitary dimension. However, to advance the clinical impact of alternative trait-based dimensional models of BPD, there is a need for measures and clinically validated thresholds that can inform early detection, diagnosis, and treatment planning along the full spectrum of BPD severity and at various stages of its development. They also highlight the importance of longitudinal studies examining dynamic transactional processes contributing to the onset and developmental course of BPD that have implications for individual and family-based interventions and prevention efforts. Regarding treatment, the authors emphasize the importance of addressing functional impairments in major social roles and improving interpersonal relatedness with close attachment figures as valuable means for improving emotion regulation and enhancing long-term recovery and rehabilitation from BPD. Finally, they encourage the use of assessment and analytic strategies capable of modeling idiographic dynamic processes, which may lead to the development of person-specific case conceptualization and treatment approaches.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beltz, A. M., Wright, A. G. C., Sprague, B. N., & Molenaar, P. C. M. (2016). Bridging the nomothetic and idiographic approaches to the analysis of clinical data. Assessment, 23(4), 447458.CrossRefGoogle ScholarPubMed
Bowlby, J. (1969). Attachment and Loss, Volume 1: Attachment. New York: Basic Books.Google Scholar
Clarkin, J. F., Hull, J. W., & Hurt, S. W. (1993). Factor structure of borderline personality disorder criteriaJournal of Personality Disorders, 7(2), 137143.CrossRefGoogle Scholar
Clifton, A., & Pilkonis, P. A. (2007). Evidence for a single latent class of Diagnostic and Statistical Manual of Mental Disorders borderline personality pathology. Comprehensive Psychiatry, 48(1), 7078.CrossRefGoogle ScholarPubMed
Cristea, I. A., Gentili, C., Cotet, C. D., Palomba, D., Barbui, C., & Cuijpers, P. (2017). Efficacy of psychotherapies for borderline personality disorder: A systematic review and meta-analysis. JAMA Psychiatry, 74(4), 319328.CrossRefGoogle ScholarPubMed
Feske, U., Kirisci, L., Tarter, R. E., & Pilkonis, P. A. (2007). An application of item response theory to the DSM-III-R criteria for borderline personality disorder. Journal of Personality Disorders, 21(4), 418433.CrossRefGoogle ScholarPubMed
Gunderson, J. G., & Lyons-Ruth, K. (2008). BPD’s interpersonal hypersensitivity phenotype: A gene-environment-developmental model. Journal of Personality Disorders, 22(1), 2241.CrossRefGoogle ScholarPubMed
Hill, J., Pilkonis, P., Morse, J., Feske, U., Reynolds, S., Hope, H., … Broyden, N. (2008). Social domain dysfunction and disorganization in borderline personality disorder. Psychological Medicine, 38(1), 135146.CrossRefGoogle ScholarPubMed
Hill, J., Stepp, S. D., Wan, M. W., Hope, H., Morse, J. Q., Steele, M., … Pilkonis, P. A. (2011). Attachment, borderline personality, and romantic relationship dysfunction. Journal of Personality Disorders, 25(6), 789805.CrossRefGoogle ScholarPubMed
Hoffart, A., & Johnson, S. U. (2017). Psychodynamic and cognitive-behavioral therapies are more different than you think: Conceptualizations of mental problems and consequences for studying mechanisms of change. Clinical Psychological Science, 5(6), 10701086.CrossRefGoogle Scholar
Keenan, K., Hipwell, A., Chung, T., Stepp, S., Stouthamer-Loeber, M., Loeber, R., & McTigue, K. (2010). The Pittsburgh Girls Study: Overview and initial findings. Journal of Clinical Child and Adolescent Psychology, 39(4), 506521.CrossRefGoogle ScholarPubMed
Lazarus, S. A., Scott, L. N., Beeney, J. E., Wright, A. G., Stepp, S. D., & Pilkonis, P. A. (2018). Borderline personality disorder symptoms and affective responding to perceptions of rejection and acceptance from romantic versus nonromantic partners. Personality Disorders: Theory, Research, and Treatment, 9(3), 197206.CrossRefGoogle ScholarPubMed
Levy, K. N. (2008). Psychotherapies and lasting change. American Journal of Psychiatry, 165(5), 556559.CrossRefGoogle ScholarPubMed
Links, P. S. (1993). Psychiatric rehabilitation model for borderline personality disorder. Canadian Journal of Psychiatry, 38(Suppl. 1), 3538.CrossRefGoogle ScholarPubMed
Links, P. S., & Heslegrave, R. J. (2000). Prospective studies of outcome: Understanding mechanisms of change in patients with borderline personality disorder. Psychiatric Clinics of North America, 23(1), 137150.CrossRefGoogle ScholarPubMed
Morey, L. C. (1991). Personality Assessment Inventory: Professional Manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
Pagano, M. E., Skodol, A. E., Stout, R. L., Shea, M. T., Yen, S., Grilo, C. M., … Gunderson, J. G. (2004). Stressful life events as predictors of functioning: Findings from the collaborative longitudinal personality disorders study. Acta Psychiatrica Scandinavica, 110(6), 421429.CrossRefGoogle ScholarPubMed
Patrick, C. J., & Hajcak, G. (2016). RDoC: Translating promise into progress. Psychophysiology, 53(3), 415424.CrossRefGoogle ScholarPubMed
Sanislow, C. A., Grilo, C. M., & McGlashan, T. H. (2000). Factor analysis of the DSM-III-R borderline personality disorder criteria in psychiatric inpatients. American Journal of Psychiatry, 157(10), 16291633.CrossRefGoogle ScholarPubMed
Scott, L. N., Zalewski, M., Beeney, J. E., Jones, N. P., & Stepp, S. D. (2017). Pupillary and affective responses to maternal feedback and the development of borderline personality disorder symptoms. Developmental Psychopathology, 29(3), 10891104.CrossRefGoogle ScholarPubMed
Shaver, P. R., & Mikulincer, M. (2007). Adult attachment strategies and the regulation of emotion. In Gross, J. J. (Ed.), Handbook of Emotion Regulation (pp. 446465). New York: Guilford Press.Google Scholar
Soloff, P. H., & Chiappetta, L. (2018). Ten-year outcome of suicidal behavior in borderline personality disorder. Journal of Personality Disorders, 33(1), 119.CrossRefGoogle Scholar
Stepp, S. D., & Lazarus, S. A. (2017). Identifying a borderline personality disorder prodrome: Implications for community screening. Personality and Mental Health, 11(3), 195205.CrossRefGoogle ScholarPubMed
Stepp, S. D., Lazarus, S. A., & Byrd, A. L. (2016). A systematic review of risk factors prospectively associated with borderline personality disorder: Taking stock and moving forward. Personality Disorders: Theory, Research, and Treatment, 7(4), 316323.CrossRefGoogle ScholarPubMed
Stepp, S. D., Pilkonis, P. A., Hipwell, A. E., Loeber, R., & Stouthamer-Loeber, M. (2010). Stability of borderline personality disorder features in girls. Journal of Personality Disorders, 24(4), 460472.CrossRefGoogle ScholarPubMed
Stepp, S. D., Scott, L. N., Jones, N. P., Whalen, D. J., & Hipwell, A. E. (2015). Negative emotional reactivity as a marker of vulnerability in the development of borderline personality disorder symptoms. Development and Psychopathology, 28(1), 213224.CrossRefGoogle ScholarPubMed
Stepp, S. D., Whalen, D. J., Scott, L. N., Zalewski, M., Loeber, R., & Hipwell, A. E. (2014). Reciprocal effects of parenting and borderline personality disorder symptoms in adolescent girls. Development and Psychopathology, 26(2), 361378.CrossRefGoogle ScholarPubMed
Trull, T. J., Useda, J. D., Conforti, K., & Doan, B. T. (1997). Borderline personality disorder features in nonclinical young adults: 2. Two-year outcome. Journal of Abnormal Psychology, 106(2), 307314.CrossRefGoogle ScholarPubMed
Winsper, C., Lereya, S. T., Marwaha, S., Thompson, A., Eyden, J., & Singh, S. P. (2016). The aetiological and psychopathological validity of borderline personality disorder in youth: A systematic review and meta-analysis. Clinical Psychology Review, 44, 1324.CrossRefGoogle ScholarPubMed
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. (2012). Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and Axis II comparison subjects: A 16-year prospective follow-up study. American Journal of Psychiatry, 169(5), 476483.CrossRefGoogle ScholarPubMed
Zanarini, M. C., Temes, C. M., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. M. (2018). Description and prediction of time-to-attainment of excellent recovery for borderline patients followed prospectively for 20 years. Psychiatry Research, 262, 4045.CrossRefGoogle ScholarPubMed

Send book to Kindle

To send this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Send book to Dropbox

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox.

Available formats
×

Send book to Google Drive

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive.

Available formats
×