Question

1. Referring to the different diagnostic criterial and symptoms of BPD, identify specific symptoms Tegan exhibits.

2. Borderline personality disorder is associated with ‘a pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of idealisation and devaluation’ (APA, 2013, p. 663). What do you think this means?

3. Discuss the phenomena of transference and counter transference and discuss ways in which the nursing team, and nurses individually, can minimise the impact of these phenomena when caring for the person who experiences BPD;

4. DevelopthreequestionsyouwouldaskTeaganduringaninterviewtocompletean MSE. They could be from any MSE area.

5. Discuss the current treatment plan and strategies used in developing a crisis plan for Teagan;

6. Outline the psychological and pharmacologic interventions that may be offered to Teagan.

Teagan is a 21-year-old woman and living with her partner, Amita. Teagan and Amita have been together for 15 months; their relationship is volatile, and they have separated a number of times. Last night, Teagan broke up with Amita again in a fiery exchange of insults and anger. Teagan believed that Amita was about to leave her and fearing this relationship breakdown, she thought she would ‘get in first’. Amita admits things have been tumultuous between them for months now, and that neither is happy, but wanted to work things out by seeing a relationship counsellor. Amita is also concerned about Teagan’s use of cannabis. Amita claims that Teagan’s responses to small indiscretions are extreme and that she is quick to make judgements about people or situations with little information. Recently, Teagan decided that a friend of Amita’s wasn’t allowed to come to their house because she had made some ‘throwaway’ comments about their dog. Amita says Teagan does this often, liking people quickly for frivolous reasons, and disliking others for similar reasons.

Teagan has been cutting herself since she was 13 years old. She finds it difficult to articulate why she does it, only that she gets relief from cutting. On a few occasions she has contemplated suicide, and many more times she has threatened it. Amita finds this aspect of their relationship very difficult to deal with and frequently feels as though Teagan’s threats to self-harm or suicide are a way of manipulating her.

Answer 1

A intellectual disorder characterised via unstable moods, behaviour and relationships.

The purpose of borderline personality disorder is not properly understood. Diagnosis is made primarily based on symptoms.

different types of borderline personality disorder:

• Discouraged borderline personality disorder.
• Impulsive borderline personality disorder.
• Petulant borderline.
• Self-destructive borderline.

Symptoms consist of emotional instability, emotions of worthlessness, insecurity, impulsivity and impaired social relationships.
Behavioural: antisocial behaviour, compulsive behaviour, hostility, impulsivity, irritability, risk-taking behaviours, self-destructive behaviour, self-harm, social isolation, or lack of restraint
Mood: anger, anxiety, popular discontent, guilt, loneliness, mood swings, or sadness.

Psychological: depression, distorted self-image, grandiosity, or narcissism and common: thoughts of suicide.

Treatments include:- cognitive behavioural therapy,anger management, Dialectical behaviour therapy, Transference focused psychotherapy, psychotherapy,schema therapy.

Pharmacological management:- Antidepressants :The- selective serotonin reuptake inhibitors (SSRIs) and more recent antidepressants are safe and life like effective.Anticonvulsant and antipsychotics.

Types of psychotherapy that have been found to be wonderful include:

Dialectical behavior therapy (DBT). ...

Schema-focused therapy. ...

Mentalization-based therapy (MBT). ...

Systems training for emotional predictability and problem-solving (STEPPS). ...

Transference-focused psychotherapy (TFP). ...

Good psychiatric management.

The MSE is an assessment of the patient's current state of mind. It assesses the range, quality, and depth of perception, thought processes, feelings, and psychomotor activities. Direct observation of the patient is required for the completion of the MSE.