Verbal interaction pattern analysis in clinical psychology.

Of 50 patients with borderline personality disorder, 100% reported disturbed but nonpsychotic thought, 40% (N = 20) reported quasi-psychotic thought, and none reported true psychotic thought during the past 2 years; only 14% (N = 7) reported ever experiencing true psychotic thought. Disturbed and quasi-psychotic thought was significantly more common among these patients than among patients with other axis II disorders or schizophrenia and normal control subjects; however, true psychotic thought was significantly more common among schizophrenic patients. While disturbed thought was also common among axis II disorder and schizophrenic patients, quasi-psychotic thought was reported by only one of these subjects, suggesting that quasi-psychotic thought may be a marker for borderline personality disorder.

Since the 2001 publication of APA’s Practice Guideline for the Treatment of Patients With Borderline Personality Disorder (1), more studies have been published on borderline personality disorder (BPD) than on any other personality disorder (2, 3). New analyses of the validity of the DSMIV-TR criteria–defined construct of BPD have been published, new data on the prevalence of BPD are available, risk factors for and biological characteristics of BPD are being elucidated, and new studies on the treatment of BPD have been carried out. This guideline watch highlights the most important of these developments.

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This study evaluated the effectiveness of well-defined outpatient psychotherapy for patients with borderline personality disorder. Thirty patients with borderline personality disorder diagnosed according to the DSM-III criteria were given twice weekly outpatient psychotherapy for 12 months by trainee therapists who were closely supervised. The treatment approach was based on a psychology of self (this term being used in its broad sense), and strong efforts were made to ensure that all therapists adhered to the treatment model. Outcome measures included frequency of use of drugs (both prescribed and illegal), number of visits to medical professionals, number of episodes of violence and self-harm, time away from work, number of hospital admissions, time spent as an inpatient, score on a self-report index of symptoms, and number of DSM-III criteria (weighted for frequency, severity, and duration) fulfilled. The subjects showed statistically significant improvement from the initial assessment to the end of the year of follow-up on every measure. Moreover, 30% of the subjects no longer fulfilled the DSM-III criteria for borderline personality disorder. This improvement had persisted 1 year after the cessation of therapy. The results suggest that a specific form of psychotherapy is of benefit for patients with borderline personality disorder.

Borderline Personality Disorder

Aim: The present study was conducted with the aim of predicting borderline and obsessive-compulsive personality disorders based on the dimensions of childhood traumas and thematic relationships in conflictual couples. Method: The research method was descriptive-correlation. Sociostatistics of married men and women referring to counseling centers in 1400 in Tehran. 8 regions of Tehran city were selected using multi-stage cluster sampling method and 15 counseling centers were selected in these regions. Based on the cut-off point of 75 and above in the Milon-3 questionnaire, according to the research entry criteria and according to Klein (2005), 205 participants with borderline personality disorder and 209 participants with obsessive-compulsive personality disorder were selected, and Milon's clinical multi-axis questionnaires 3 (1994), supplemented Bell's (1986) thematic relationships and Bernstein et al.'s (2003) childhood trauma. Data were analyzed using Pearson's correlation coefficient and multivariate regression simultaneously. Results: The results showed that the dimensions of subjective relationships and childhood injuries have a positive and significant relationship with borderline personality disorder and obsessive-compulsive disorder (p<0.01). Also, the results of regression analysis showed that the dimensions of subject relationships and childhood traumas can predict borderline personality disorder and obsessive-compulsive disorder (P<0.01). Conclusion: Therefore, it can be concluded that thematic relationships and traumatic childhood experiences have an effect on the occurrence of borderline and obsessive-compulsive personality disorders in couples. Therefore, it is suggested to pay attention to the role of these variables in counseling sessions and treatment of borderline and obsessive-compulsive personality disorders.

The authors determined the risk for psychiatric disorders in the first-degree relatives of 36 probands with schizotypal personality disorder (13 definite, 23 probable), 17 probands with borderline personality disorder (two definite, 15 probable), and 90 normal control probands. The relatives of probands with schizotypal personality disorder without a concurrent diagnosis of borderline personality disorder had a significantly greater risk for schizotypal personality disorder than the relatives of normal control probands, borderline probands, or schizotypal probands with coexisting borderline personality disorder. The relatives of borderline probands had a significantly greater risk for definite and probable borderline personality disorder than the relatives of normal control probands.

This review of the descriptive literature on borderline patients indicates that accounts of such patients vary depending upon who is describing them, in what context, how the samples are selected, and what data are collected. The authors identify six features that provide a rational means for diagnosing borderline patients during an initial interview: the presence of intense affect, usually depressive or hostile; a history of impulsive behavior; a certain social adaptiveness; brief psychotic experiences; loose thinking in unstructured situations; and relationships that vacillate between transient superficiality and intense dependency. Reliable identification of these patients will permit better treatment planning and clinical research.

Personality Disorders Over Time: Precursors, Course, and Outcome

Background Evidence of negative perceptions of clients with ‘borderline personality disorder’ (BPD) in mental health professionals has been well documented. However, few researchers have focused upon perspectives of clinical psychologists on this client group. The aim of the present research was to explore clinical psychologists' experiences and perceptions of clients with BPD. Method Sixteen female clinical psychologists (including trainees and qualified staff) participated in focus groups, 12 of whom had direct clinical experience with this client group. All four groups' audio recordings were transcribed verbatim and analysed using interpretative phenomenological analysis (Smith, 1996). Results The following eight superordinate themes emerged from the analysis: ‘negative perceptions of the client’, ‘undesirable feelings in the psychologist’, ‘positive perceptions of the client’, ‘desirable feelings in the psychologist’, ‘awareness of negativity’, ‘trying to make sense of the chaos’, ‘working in contrast to the system’ and ‘improving our role’. Discussion Implications include concerns regarding negativity, yet also the suggestion of hope and optimism in working with this client group. Copyright © 2012 John Wiley & Sons, Ltd.

Target Complaints as Criteria of Improvement

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Borderline personality disorder (BPD) with auditory hallucinations (AHs) may inadvertently be misdiagnosed with a primary psychotic disorder, such as schizophrenia (SZ). This misidentification can lead to challenges in providing effective psychological treatment. This review therefore aims to identify the phenomenological characteristics of AHs in BPD in comparison to SZ, as well as psychological interventions that explicitly target AHs in BPD. A systematic review was conducted to summarise the existing evidence base regarding the phenomenological similarities and differences of AHs in BPD and SZ, along with the identification of psychological interventions for AHs in BPD. Eighteen studies were eligible for inclusion. Compared to the SZ group, BPD clients were characterised by more persistent and repetitive AHs, significantly more voice-related distress and appraisals of omnipotence, and an earlier age of onset of AHs. The BPD group also reported more severe depression and anxiety, a higher incidence of childhood trauma, and more negative self-schema. Cognitive Behaviour Therapy Coping Strategy Enhancement (CBT-CSE) might be a promising intervention to reduce AH-related distress in BPD, although further studies are required to determine its effectiveness. In order to prevent misdiagnosis of AHs in BPD, the DSM-5 may need to acknowledge the broader and more frequent occurrence of psychosis symptoms in BPD clients. Such clarification may enhance diagnostic practices and facilitate more timely access to treatment. There is also a need to develop and trial psychological interventions that explicitly target AHs in BPD.

Ambassadors of Clinical Psychology and Psychological Treatment Authors Claudi Bockting Department of Psychiatry, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, The Netherlands Winfried Rief Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany Abstract No abstract available. Most read articles by the same author(s) Tania M. Lincoln, Winfried Rief, (How) Can Clinical Psychology Contribute to Increasing Vaccination Rates in Europe? , Clinical Psychology in Europe: Vol. 3 No. 3 (2021) Winfried Rief, Cornelia Weise, Make a Wish – What Are the Wishes for Clinical Psychology and Psychological Treatment? , Clinical Psychology in Europe: Vol. 3 No. 4 (2021) Winfried Rief, Melina Kopp, Roya Awarzamani, Cornelia Weise, Selected Trends in Psychotherapy Research: An Index Analysis of RCTs , Clinical Psychology in Europe: Vol. 4 No. 2 (2022) PDF HTML XML Article info Impact Citations How to Cite License Published at 31. March 2022 https://doi.org/10.32872/cpe.8545 Issue: Vol. 4 No. 1 (2022) Section: Letter to the Editor, Commentary Share: Z Bockting, C., & Rief, W. (2022). Ambassadors of Clinical Psychology and Psychological Treatment. Clinical Psychology in Europe, 4(1), 1-2. https://doi.org/10.32872/cpe.8545 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX This work is licensed under a Creative Commons Attribution (CC BY) 4.0 International License. PlumX Dimensions Views: Total Abstract PDF HTML XML 244 141 73 20 10 Downloads: Download data is not yet available.

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