Borderline personality disorder and emotion dysregulation

Chapman, Alexander L.

doi:10.1017/s0954579419000658

Cited by 94 publications

(62 citation statements)

References 151 publications

(210 reference statements)

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“…Patients with borderline personality disorders (BPD) are known to suffer significant periods of affective dysregulation which can resemble Mixed States. While the clinical presentations of emotional disturbance in each of these disorders are characterised by common features of multiple emotional, cognitive and behavioural disturbances, there are important distinguishing features of each (Bassett, 2012; Bassett et al, 2017; Bayes et al, 2016a, 2019; Chapman, 2019).…”

Section: Classificationmentioning

confidence: 99%

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

Malhi

Bell

Bassett³

et al. 2020

Aust N Z J Psychiatry

348

365

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Objectives: To provide advice and guidance regarding the management of mood disorders, derived from scientific evidence and supplemented by expert clinical consensus to formulate s that maximise clinical utility. Methods: Articles and information sourced from search engines including PubMed, EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (e.g. books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Relevant information was appraised and discussed in detail by members of the mood disorders committee, with a view to formulating and developing consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous consultation and external review involving: expert and clinical advisors, key stakeholders, professional bodies and specialist groups with interest in mood disorders. Results: The Royal Australian and New Zealand College of Psychiatrists mood disorders clinical practice guidelines 2020 (MDcpg2020) provide up-to-date guidance regarding the management of mood disorders that is informed by evidence and clinical experience. The guideline is intended for clinical use by psychiatrists, psychologists, primary care physicians and others with an interest in mental health care. Conclusion: The MDcpg2020 builds on the previous 2015 guidelines and maintains its joint focus on both depressive and bipolar disorders. It provides up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus. Mood disorders committee: Gin S Malhi (Chair), Erica Bell, Darryl Bassett, Philip Boyce, Richard Bryant, Philip Hazell, Malcolm Hopwood, Bill Lyndon, Roger Mulder, Richard Porter, Ajeet B Singh and Greg Murray.

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Section: Classificationmentioning

confidence: 99%

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

Malhi

Bell

Bassett³

et al. 2020

Aust N Z J Psychiatry

348

365

View full text Add to dashboard Cite

show abstract

“…In contrast, borderline personality disorder is characterised by a history of major difficulties with interpersonal relationships, severe affective dysregulation with frequent episodes of rage, heightened sensitivity to interpersonal interactions, prominent fear of abandonment, significant depressive symptoms but an absence of threshold manic episodes and intensely negative self‐image 46 . A key differentiating feature is the presence of sustained episodes of mood in bipolar disorder as opposed to fluctuating and evanescent mood in borderline personality disorder.…”

Section: Bipolar Disorder and Borderline Personality Disorder Interfacementioning

confidence: 99%

The 2020 Royal Australian and New Zealand College of psychiatrists clinical practice guidelines for mood disorders: Bipolar disorder summary

et al. 2020

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Objectives To provide a succinct, clinically useful summary of the management of bipolar disorder, based on the 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders (MDcpg2020). Methods To develop the MDcpg2020, the mood disorders committee conducted an extensive review of the available literature to develop evidence‐based recommendations (EBR) based on National Health and Medical Research Council (NHMRC) guidelines. In the MDcpg2020, these recommendations sit alongside consensus‐based recommendations (CBR) that were derived from extensive deliberations of the mood disorders committee, drawing on their expertise and clinical experience. This guideline summary is an abridged version that focuses on bipolar disorder. In collaboration with international experts in the field, it synthesises the key recommendations made in relation to the diagnosis and management of bipolar disorder. Results The bipolar disorder summary provides a systematic approach to diagnosis, and a logical clinical framework for management. It addresses the acute phases of bipolar disorder (mania, depression and mixed states) and its longer‐term management (maintenance and prophylaxis). For each phase it begins with Actions, which include important strategies that should be implemented from the outset wherever possible. These include for example, lifestyle changes, psychoeducation and psychological interventions. In each phase, the summary advocates the use of Choice medications for pharmacotherapy, which are then used in combinations along with additional Alternatives to manage acute symptoms or maintain mood stability and provide prophylaxis. The summary also recommends the use of electroconvulsive therapy (ECT) for each of the acute phases but not for maintenance therapy. Finally, it briefly considers bipolar disorder in children and its overlap in adults with borderline personality disorder. Conclusions The bipolar disorder summary provides up to date guidance regarding the management of bipolar disorder, as set out in the MDcpg2020. The recommendations are informed by evidence and clinical expertise and experience. The summary is intended for use by psychiatrists, psychologists and primary care physicians but will be of interest to anyone involved in the management of patients with bipolar disorder.

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“…Consistent with the evidence mentioned above, MIT focuses on the following domains of psychopathology in BPD presentation: (1) impaired sense of self (Livesley, 2017); (2) maladaptive interpersonal schemas (Dimaggio et al, 2015(Dimaggio et al, , 2019; (3) impaired metacognition or mentalizing capacity (Bateman & Fonagy, 2004;Semerari et al, 2007); (4) emotional dysregulation and impulsivity (Carpenter & Trull, 2013;Chapman, 2019;Linehan, 1993).…”

Section: Mit Perspective On Bpd Pathologymentioning

confidence: 90%

Metacognitive Interpersonal Therapy for Borderline Personality Disorder: A Single Case Study

Salvatore

Bianchi

Buonocore

et al. 2020

Clinical Case Studies

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Borderline personality disorder (BPD) is a severe disease, characterized by severe instabilities in identity, affect and relationships. Clinical improvement of BPD can be facilitated by psychotherapy aimed at tackling multiple specific cross-modality impairments and their patterns of interaction: impaired sense of self, maladaptive interpersonal schemas, impaired metacognition, emotion dysregulation and impulsivity. Herein, we describe the steps in the treatment of a young woman meeting the criteria for with BPD with paranoid traits, successfully treated with Metacognitive Interpersonal Therapy, a treatment based on comprehensive assessment of domains. In the initial phase, treatment focused on promoting emotion regulation, integrating opposing patient representations of the therapist, enhancing metacognition, and increasing focus on the maladaptive schema that elicited dysregulated behaviors. Later in therapy, treatment focused on supporting the patient to realize her ideas about self and others were schema-driven; and improving metacognitive capacity to understand others’ minds. General implications for psychotherapy of BPD are discussed.

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Borderline personality disorder and emotion dysregulation

Cited by 94 publications

References 151 publications

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

The 2020 Royal Australian and New Zealand College of psychiatrists clinical practice guidelines for mood disorders: Bipolar disorder summary

Metacognitive Interpersonal Therapy for Borderline Personality Disorder: A Single Case Study

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