Conclusion (mine, not the authors)
We have very little evidence for what helps those who end up being given a diagnosis of ‘personality disorder’ when they are in crisis.
The studies with the best evidence were those most related to what we know helps people with this diagnosis (or what helps people with recurrent self-harm and suicidality with histories of abandonment and abuse).
It could be argued that the areas without the evidence are the ones that move furthest from what is known to help.
It would be useful if services for this group of people were designed with them in mind, rather than creating environments that include what is known to be unhelpful, while a failure to thrive is attributed to their diagnosis.
The endeavour to comprehend why certain individuals develop posttraumatic stress disorder (PTSD) symptoms subsequent to experiencing traumatic events, while others do not, underscores the paramount importance of pretraumatic risk factors. This meta-analysis summarises the extant results of studies assessing risk factors prior exposure and PTSD symptoms following an index event on the same participants. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Group schema therapy (GST) is increasingly popular as a treatment for personality disorders (PDs), including Cluster-C PDs. Individual ST has proven to be effective for Cluster-C PD patients, while the evidence for GST is limited. This study aimed to investigate the effectiveness of GST for Cluster-C PD. Moreover, differences between the specific Cluster-C PDs (avoidant PD, dependent PD and obsessive-compulsive PD) were explored.
Recent diagnostic developments suggest that paranoia is a transdiagnostic characteristic common to several personality disorders rather than a personality disorder per se. Nonetheless, empirical literature fails to provide comprehensive and univocal findings on whether and how paranoid presentations relate to different personality disorders. In the present scoping review, we map the empirical literature on paranoid presentations in personality disorders, considering the entire spectrum of paranoid manifestations (i.e., the paranoia hierarchy). To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The schema mode model offers a new conceptualisation of complex dissociative disorders (CDD) as it explains shifts between identities as shifts between schema modes. Furthermore, in this model CDD is conceived as personality pathology, incorporating core features of personality disorders. This study tested the assumptions of this schema mode model of CDD.
This work aims to demonstrate, through the International Affective Picture System (IAPS) responses, an altered emotional pattern in borderline personality disorder (BPD) patients and to find a specific emotional response pattern by understanding their relationship with traumatic experiences and attachment bonds towards their primary caregivers. https://onlinelibrary.wiley.com/doi/10.1002/cpp.2893?af=R
Although complex post-traumatic stress disorder and borderline personality disorder are distinct disorders, there is confusion in clinical practice regarding the similarities between the diagnostic profiles of these conditions. We summarise the differences in the diagnostic criteria that are clinically informative and we illustrate these with case studies to enable diagnostic accuracy in clinical practice. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The paper we (David Foreman and Keir Harding) are blogging about allows us to ask a crucial question: does making the diagnosis do more harm than good?
Borderline personality disorder (BPD) is a prevalent condition associated with high rates of hospitalizations. The purpose of this manuscript was to detect the factors associated with duration of untreated illness (DUI) in BPD. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Orla, a Bipolar UK peer support officer, shares her personal experiences and how nurses can help to destigmatise the condition. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Since the age of 14 I have had symptoms of bipolar, with alternating periods of depression and hypomania.
Structured clinical management is an evidence-based intervention for people with borderline personality disorder (BPD). There is a lack of evidence on crisis interventions for people with BPD, who are often admitted to hospital or supported in emergency care settings when they present with acute mental health needs. The home-based treatment team (HBTT) at an English NHS mental health trust undertook a pilot service improvement project in which they designed a ‘managing distress pathway’ – a crisis intervention for people with BPD adapted from the structured clinical management model. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Studies suggest that adverse childhood events (ACEs) may contribute to the onset and development of cluster C personality disorders. However, the association between ACEs and these disorders remains unclear in terms of consistency across studies and effect magnitude, as well as generalizability within cluster C. The current meta-analysis aimed to examine the associations between ACEs and cluster C personality disorders based on the available literature. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The purpose of this discussion paper is to describe the transition over the past five years of a highly specialist group treatment programme to a tiered public health delivery model within the offender personality disorder (OPD) pathway. The focus of this journey of transformation has been the Challenge programme, currently the only OPD specialist service for men with sexual convictions in the community in England and Wales, and now a pan-London service. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
People with a diagnosis of borderline personality disorder (BPD) are often in contact with mental health services at a point of crisis and in the UK this includes Crisis Resolution Home Treatment teams (CRHTT). There is a drive for services to be recovery orientated, however, there is little evidence about the degree to which community services achieve this for people with a diagnosis of BPD when in crisis. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
To our knowledge, treatment of personality disorder (PD) comorbidity in autistic adults is understudied, and is still in its infancy. We investigated the effectiveness of Schema Therapy (ST) for autistic adults with personality disorder (PD). To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The International Classification of Diseases, 11th edition includes a new personality disorder diagnosis, in light of growing concerns of the categorical personality disorder diagnoses. The purpose of the current study was to examine the reliability and validity of the severity dimension of the new International Classification of Diseases, 11th edition diagnosis, through multi-method assessment. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
This study tested the effectiveness of schema therapy (ST) for borderline personality disorder (BPD) and comorbid alcohol dependence (AD). Twenty patients participated in a case series study with multiple baselines. The baseline phase consisted of treatment as usual. It was followed by a case conceptualization phase, an experiential techniques phase and a behavioural change phase. Patients showed a significant decrease in BPD and AD symptoms; change was mainly accomplished in the experiential techniques phase, with medium to large effect sizes.