Australia and Switzerland are the only nations to have issued recommendations focused on borderline personality disorder in mothers during the perinatal period. Perinatal interventions for mothers with borderline personality disorder (BPD) can draw upon reflexive theoretical models or address the emotional dysregulation characteristic of this population. Early, intensive, and multi-professional involvement is required. Due to the paucity of studies scrutinizing the effectiveness of their initiatives, no intervention presently emerges as superior; thus, continued research appears crucial.
Within the confines of a psychiatric hospital unit at the University Hospitals of Geneva (Switzerland), our team carries out its work. Individuals experiencing suicidal thoughts or behaviors can count on seven days of refuge and support within our welcoming environment. Life events, marked by profound interpersonal struggles or threats to self-image, often act as catalysts for suicidal crises in these individuals. In our clinical patient records, approximately 35% demonstrate a diagnosis of borderline personality disorder (BPD). Repeated episodes of crisis and suicidal behavior, a characteristic of these patients, frequently resulted in damaging disruptions of their therapeutic and interpersonal bonds. A specific solution to this medical challenge is what we seek to develop. We've designed a brief psychological intervention, influenced by mentalization-based treatment (MBT), which unfolds through four distinct stages: engaging the patient, examining the emotional impact of the crisis, identifying the problem's core, planning for discharge, and supporting continued outpatient care. This intervention is well-suited for the expertise of a medical-nursing team. The initial stage of the MBT method, the welcoming phase, is primarily characterized by mirroring and the regulation of emotions, in order to lessen the extent of psychological disorganization. Employing a narrative analysis of the crisis, with an affective focus, activates the ability to mentalize, encompassing a curiosity about mental states. We then engage with individuals, crafting a problem definition that allows them to assume a character. A key aspect is empowering them to become agents who resolve their own crises. Completing the intervention will necessitate addressing both the separation and a projection into the near future. The subsequent psychological work initiated within our unit will be expanded to encompass an ambulatory network. The attachment system's re-activation, coupled with the reemergence of obstacles once absent from the therapeutic context, characterizes the termination phase. The clinical application of MBT proves effective for BPD, especially in mitigating suicidal actions and reducing the frequency of hospital stays. We have modified the theoretical and clinical apparatus intended for individuals hospitalized for suicidal crises, exhibiting a range of comorbid psychopathologies. MBT's ability to adapt and assess empirically based psychotherapeutic tools extends across different clinical settings and populations.
To achieve the goal of this study, we propose developing a complete logic model for the Borderline Intervention for Work Integration (BIWI) and defining its content thoroughly. Repeat hepatectomy BIWI's architecture is derived from Chen's (2015) principles for the construction of a change model and an action model. Focused groups involving occupational therapists and service providers from community organizations in three Quebec regions, paired with individual interviews of four women diagnosed with borderline personality disorder (BPD), constituted the study's methodology (n=16). The group and individual interviews' inception was marked by a presentation of data gathered from field studies. The conversation then transitioned to the difficulties faced by people with BPD in career decisions, work performance, job longevity, and the crucial components of an effective intervention strategy. The transcripts from individual and group interviews were analyzed using a content analytic method. Validation of the change and action models' components was undertaken by these same participants. Inflammation and immune dysfunction The BIWI intervention's change model addresses six suitable themes for individuals with BPD returning to the workforce: 1) the value attributed to work; 2) developing self-understanding and work efficacy; 3) managing sources of mental strain at work, both personal and environmental; 4) creating positive working relationships; 5) disclosing a mental health diagnosis at work; and 6) engaging in enriching activities beyond work hours. The intervention, as detailed in the BIWI action model, is executed through collaboration with health professionals from public and private sectors, and service providers based in community and government institutions. The curriculum includes group sessions (10) and individual meetings (2), offering options for in-person or virtual participation. Fundamental to the success of a sustainable employment reintegration project is to reduce the perceived obstacles to work reintegration and to elevate the level of mobilization for this project. Work participation serves as a crucial focal point within interventions designed for individuals diagnosed with borderline personality disorder. A logic model facilitated the identification of crucial schema components for this intervention. The components detailed here relate to core issues important to this particular clientele, such as their perceptions of work, understanding themselves as workers, sustaining work performance and well-being, their relationships with their work colleagues and outside partners, and the integration of work into their established professional skills. These components are now part of the broader BIWI intervention. Testing this intervention's impact on unemployed individuals with BPD who are motivated to reintegrate the workforce is the next logical step.
Patients with personality disorders (PD) experience considerable attrition rates in psychotherapy, with dropout figures often fluctuating between 25% and 64%, particularly in those with borderline personality disorder. Motivated by this observation, researchers developed the Treatment Attrition-Retention Scale for Personality Disorders (TARS-PD; Gamache et al., 2017) to precisely pinpoint patients with Personality Disorders facing a high likelihood of abandoning therapy. This scale utilizes 15 criteria, grouped into 5 factors: Pathological Narcissism, Antisocial/Psychopathy, Secondary Gain, Low Motivation, and Cluster A Features. However, there exists a degree of uncertainty regarding the significance of self-reported questionnaires, commonly administered to Parkinson's Disease individuals, for forecasting the success of treatment regimens. Hence, the objective of this research is to examine the link between these instruments and the five facets of the TARS-PD. Tanespimycin manufacturer From the Centre de traitement le Faubourg Saint-Jean, 174 participants, evaluated and comprising 56% with borderline traits or personality disorder, retrospectively contributed data from their clinical files. These participants completed French versions of the following questionnaires: Borderline Symptom List (BSL-23), Brief Version of the Pathological Narcissism Inventory (B-PNI), Interpersonal Reactivity Index (IRI), Buss-Perry Aggression Questionnaire (BPAQ), Barratt Impulsiveness Scale (BIS-11), Social Functioning Questionnaire (SFQ), Self and Interpersonal Functioning Scale (SIFS), and Personality Inventory for DSM-5- Faceted Brief Form (PID-5-FBF). The TARS-PD project, a testament to the dedication of well-trained psychologists, was finished by those specializing in Parkinson's Disease treatment. Statistical prediction of clinician-rated TARS-PD variables, including its five factors and total score, was examined via descriptive analysis and regression modeling of self-reported questionnaires completed by participants. Empathy (SIFS), Impulsivity (negatively impacting; PID-5), and Entitlement Rage (B-PNI) are the significant subscales relating to the Pathological Narcissism factor, evidenced by an adjusted R-squared of 0.12. The Antisociality/Psychopathy factor (adjusted R2 = 0.24) is composed of subscales such as Manipulativeness, Submissiveness (inversely related), Callousness from the PID-5, and Empathic Concern (IRI). Frequency (SFQ), Anger (measured negatively using BPAQ), Fantasy (measured negatively), Empathic Concern (IRI), Rigid Perfectionism (measured negatively), and Unusual Beliefs and Experiences (PID-5) are the scales that substantially contribute to the Secondary gains factor, as evidenced by the adjusted R-squared value of 0.20. Significantly correlated with low motivation (adjusted R2=0.10) are the Total BSL score (inversely) and the Satisfaction (SFQ) subscale. In conclusion, the subscales most strongly connected to Cluster A traits (adjusted R-squared = 0.09) are Intimacy (SIFS) and Submissiveness (inversely, PID-5). Significant but limited connections between TARS-PD factors and specific scales from self-reported questionnaires were evident. In the assessment of the TARS-PD, these scales could be instrumental, adding to the clinical clarity for patients.
High prevalence and substantial functional impact, characteristic of personality disorders, represent significant societal issues demanding solutions from mental health services. Various treatments have demonstrably produced marked gains, successfully easing the burdens associated with these conditions. Mentalization-based therapy (MBT), which operates within a group therapy framework, is an evidence-supported approach to treating borderline personality disorder. Psychotherapists face numerous complexities when utilizing the mentalization-based group therapy (MBT-G) modality. According to the authors, the group intervention's power resides in its capacity to encourage a mentalizing perspective, cultivate group unity, and enable a constructive and remedial reappropriation of conflictual situations, which they view as undervalued within this therapeutic modality. This article examines the interventions that promote a mentalizing mindset. We examine strategies for focusing on the present, resolving interpersonal conflict, and developing metacognitive abilities to boost group unity and, in turn, advance the efficacy of the therapeutic method.