Hostname: page-component-8448b6f56d-cfpbc Total loading time: 0 Render date: 2024-04-20T01:20:45.166Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessment of borderline personality disorder: considering a diagnostic strategy

Published online by Cambridge University Press:  24 June 2014

C. K. W. Schotte
C. K. W. Schotte*
Affiliation:
Department of Psychiatry, University Hospital of Antwerp, Belgium Faculty of Psychology, Free University Brussels (V.U.B.), Belgium
*
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
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

borderlinepersonality disorderassessmentdiagnosisDSM-IV axis IIADP-IV
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 14 , Issue 2 , April 2002 , pp. 55 - 59
Copyright
Copyright © Acta Neuropsychiatrica 2002

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

Zanarini, MC, Frankenburg, FR.Pathways to the development of borderline personality disorder. J Pers Disord 1997;11: 93–104. CrossRefGoogle ScholarPubMed
Gunderson, JG. Borderline personality disorder. Washington, DC: American Psychiatric Press, 1984. Google Scholar
Widiger, TA.Personality disorders in the 21st century. J PersDisord 2000;14: 3–16. Google ScholarPubMed
Van Praag, HM.Two-tier diagnosing in psychiatry. Psychiatr Res 1990;34: 1–11. CrossRefGoogle Scholar
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: 1–31. Google Scholar
Costa, PT, Widiger, TA.Personality disorders and the five-factor model of personality. Washington, DC: American Psychological Association, 1994. CrossRefGoogle Scholar
Cloninger, CR.A practical way to diagnose personality disorder: a proposal. J Pers Disord 2000;14: 99–108. CrossRefGoogle Scholar
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. Google Scholar
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. Google Scholar
Sloore, H, Derksen, JJL, Hellenbosch, G, De Mey, HRA.Nederlandstalige Versie MMPI-2: Minnesota Multiphasic Personality Inventory, 2. Nijmegen: Pen Test Publisher, 1996. Google Scholar
Maesschalck, C, Vertommen, H.Diagnostiek van persoonlijkheidsstoornissen: een overzicht van Nederlandstalige instrumenten aansluitend bij de DSM-classificatie en bij andere benaderingen. Diagnostiekwijzer 1997;1: 176–199. Google Scholar
Schotte, CKW.New instruments for diagnosing personality disorders. Curr Opin Psychiatry 2001, in press.Google Scholar
Perry, JC.Problems and considerations in the valid assessment of personality disorders. Am J Psychiatry 1992;149: 1645–1653.Google ScholarPubMed
Schotte, CKW, De Doncker, D, Vankerckhoven, C, Vertommen, H, Cosyns, P. Self-report assessment of the DSM-IV personality disorders. Psychol Med 1998;28: 1179–1188.CrossRefGoogle ScholarPubMed
Schotte, CKW, De Doncker, D.De ADP-IV: een vragenlijst voor een therapeutisch georiënteerde diagnostiek van de DSM-IV persoonlijkheidsstoornissen. Psychopraxis 2000; 2267–2273. Google Scholar
Siever, LJ, Davis, KL.A psychobiological perspective on the personality disorders. Am J Psychiatry 1991;148: 1647–1658.Google ScholarPubMed
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: 548–556.CrossRefGoogle ScholarPubMed
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: 81–103.CrossRefGoogle ScholarPubMed
Benjamin, LS.Interpersonal diagnosis and treatment of personality disorders. New York, NY: Guilford Press. 1996. Google Scholar
Young, JE.Cognitive therapy for personality disorders: a schema-focused approach, rev. edn. Sarasota, Fl: Professional Resource Press, 1999. Google Scholar
Linehan, MM.Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press, 1993. Google ScholarPubMed
Paris, J.Social factors in the personality disorders. a Biopsychosocial Approach to Etiology and Treatment. New York, NY: Cambridge University Press, 1996. CrossRefGoogle Scholar
Millon, T, Davis, R.Personality disorders in modern life. New York, NY: John Wiley & Sons, 2000. Google Scholar