Function and Psychotherapy of Chronic Suicidality in Borderline Personality Disorder: Using the Reinforcement Model of Suicidality

Although great advancements in evidence-based therapies, chronic suicidal patients with borderline personality disorder (BPD) still challenge our mental health system. While BPD patients continue suffering from distress and aversive emotions, therapists and relatives feel often stunned and helpless when confronted with suicidality resulting in interruption of therapies, repeated presentations to emergency rooms and referrals to hospitals. Reviewing the current knowledge of the functions and background of non-suicidal self-injury, we learned that reinforcement mechanisms play an important role to understand why individuals act in deliberate self-mutilation. While individual motives for non-suicidal self-injury and suicidal behavior including suicidal ideations can differ, the principle mechanisms appear to be transferrable. Elucidating the individual motives and function of suicidal behavior is an important therapeutic step, giving us access to very central maladaptive schemes and false believes that we need to address in order to reduce chronic suicidality in BPD patients. This Perspective article aims to give a better idea of what is behind and what are the differences between non-suicidal self-injury, suicidal ideations and suicide attempts. It further integrates recent developments of behavioral science in a reinforcement model of suicidality that can provide therapists a practical armamentarium in their work with chronic suicidal clients.
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research

Related Links:

CONCLUSIONS: Our assessments showed beneficial effects on all primary outcomes in favour of BPD-tailored psychotherapy compared with TAU. However, only the outcome of BPD severity reached the MIREDIF-defined cut-off for a clinically meaningful improvement. Subgroup analyses found no evidence of a difference in effect estimates between the different types of therapies (compared to TAU) . The pooled analysis of psychotherapy versus waiting list or no treatment found significant improvement on BPD severity, psychosocial functioning and depression at end of treatment, but these findings were based on low-quality evidence, and ...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Although great advancements in evidence-based therapies, chronic suicidal patients with borderline personality disorder (BPD) still challenge our mental health system. While BPD patients continue suffering from distress and aversive emotions, therapists an...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Suicide and Self-Harm Source Type: news
Comorbidity is the presence of one or more additional conditions co-occurring with a primary condition. In this episode, host schizophrenic Rachel Star Withers with her cohost Gabe Howard will be discussing comorbidity with schizophrenia. Comorbidity is associated with worse health outcomes, more complex clinical management and increased health care costs. Occupational therapist and host of the podcast Occupied, Brock Cook, will be joining us to discuss ways that he works with people with schizophrenia to manage multiple health issues.  Highlights from “Comorbidity with Schizophrenia” Episode [01:28] What ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Antipsychotic Inside Schizophrenia Mental Health and Wellness Psychiatry Psychology Psychotherapy Bipolar disorder and schizophrenia comorbid comorbid psychiatric conditions Comorbidities Comorbidity Diagnosis Of Schizophrenia Livi Source Type: blogs
CONCLUSIONS: There is a growing variety of psychotherapeutic interventions for adolescents with BPD symptomatology that appears feasible and effective in the short term, but efficacy is not retained in follow-up-particularly for frequency of suicide attempts. PMID: 31558033 [PubMed - as supplied by publisher]
Source: Canadian Journal of Psychiatry - Category: Psychiatry Authors: Tags: Can J Psychiatry Source Type: research
Authors: Wongpakaran N, Wongpakaran T, Kuntawong P Abstract The study aimed to development a short screening scale for borderline personality disorder (Short-Bord), and to validate its psychometric properties using Rasch analysis. Ninety-eight outpatients undergoing psychotherapy were evaluated using a semistructured diagnostic interview for DSM-IV Personality disorders. Correlational analysis and Rasch analysis were used to identify the best-fitted items for the shorter scale. Rasch analysis identified three underfitted items. The best five items were selected for the Short-Bord using two analyses, resulting in tw...
Source: Asian Journal of Psychiatry - Category: Psychiatry Tags: Asian J Psychiatr Source Type: research
Conclusion It is clear that clinically, there is still much to be learnt about alexithymia and its relationship with a range of related phenomena. Firstly, is alexithymia a continuous and stable trait independent of psychological or somatic symptomology that is developed during childhood? Or is it instead a reactive state induced by trauma and distress at any age, which serves to defend against intense and upsetting emotions? This impacts on treatment options. For example, should we be focussing on early childhood interventions which target the child's emotional environment and parenting to encourage emotional exp...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
This study will be conducted in the city of Porto Alegre in the state of Rio Grande do Sul in far-southern Brazil. This region has Portuguese, Italian, German, and African influence. It has a population of 1.4 million, and it is the 10th most populous city in Brazil. Its ethnic distribution is as follows: White (79.2%), Black (10.2%), and Pardo (multiracial) people (10.6%). Its religious distribution is as follows: Catholic (83%), Protestant (9%), and others and atheists (8%). Brazil is a country with a high level of religiosity, and it is common for people to associate improvements in their health as being due to their fa...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
DiscussionThe expected results will be a major step forward in establishing empirically supported psychological treatments for survivors of CA suffering from Complex PTSD.Trial registrationGerman Clinical Trials Register: registration numberDRKS00005578, date of registration 19 December 2013.
Source: Borderline Personality Disorder and Emotion Dysregulation - Category: Psychiatry Source Type: research
This study aims to increase knowledge of how such cr...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Suicide and Self-Harm Source Type: news
Prolonged exposure therapy (PE) is a highly efficacious and effective treatment for posttraumatic stress disorder (PTSD). In addition to reducing PTSD symptoms, PE ameliorates a wide-variety of related symptoms, including anxiety, depression, functional impairment, mild suicidal ideation, and anger. Furthermore, PE is effective in patients with comorbid conditions, including dissociation, substance use, borderline personality disorder and psychosis. How does PE achieve these outcomes? Emotional processing theory (EPT) is the conceptual model from which PE was derived. Three key concepts were originally proposed as indicato...
Source: Journal of Psychotherapy Integration - Category: Psychiatry & Psychology Source Type: research
More News: Borderline Personality Disorder | Depression | Emergency Medicine | Hospitals | Men | Psychiatry | Psychotherapy | Science | Suicide