Borderline Personality Disorder DSM-5-TR Essay

 Personality Disorder DSM-5-TR Overview

Borderline Personality Disorder (BPD) is a type of personality disorder that involves an unstable and disturbed pattern of mood and interpersonal relationships, as well as irresponsible behavior. The DSM-5-TR diagnostic criteria for BPD include sudden panic, the absence of a stable and secure attachment figure in their childhood, a constantly shifting sense of self, suicidal tendencies when overwhelmed by negative emotions, bipolar disorder-like tendencies, pervasive and persistent existential depression, rage reactions, brief psychotic episodes that manifest as paranoia, and split-off ego states (Leichsenring et al., 2024). According to DSM 5, the patient requires at least five of these characteristics are necessary for diagnosing the disorder. Interpersonal conflicts and perceived abandonment significantly increase emotional sensitivity, impulsivity, and self-harm in BPD. The sooner the diagnosis is made and treatment commenced, the better the prognosis.

Therapeutic Approach for Managing Borderline Personality Disorder

Dialectical Behavioral Therapy (DBT) is an efficient treatment method for managing BPD. DBT utilizes cognitive-behavioral approaches, but it is based on the principles of mindfulness. This modality aims to equip BPD clients with skills to control their emotions, cope with stress, and enhance their relational capabilities, making it suitable for treating the aspect of BPD that involves poor emotion regulation (Kujovic et al., 2024). This structure of DBT may be useful for clients with BPD, as it encourages the replacement of self-harming behaviors with better coping skills over time (Leichsenring et al., 2023).  Behavioral skills training further incorporates group and individual therapies to establish an organizational format to elicit healthier emotional reactions and improve Interpersonal communication skills Borderline Personality Disorder DSM-5-TR Essay.

Therapeutic Relationship in Psychiatry

In psychiatry, a therapeutic relationship can be described as a working partnership between the therapist and the client that involves trust, helpful communication, and participation in the therapeutic process. It is underpinned by empathy, respect, and positive regard for the client; they are encouraged to discuss their problems in this therapeutic alliance. Developing this trust is vital as it facilitates communication and compliance with the stipulated therapy regimes (Kujovic et al., 2024). Thus, therapists should be aware of possible power relations that impact the process and be open about this to foster a constructive relationship during the therapeutic process Borderline Personality Disorder DSM-5-TR Essay.

Sharing Diagnosis with the Client

The nurse practitioner should provide details on the patient, ensuring an understanding of the condition and the treatment plan that should be implemented. Therefore, when explaining BPD to a patient, concerns should be presented non-judgmentally, emphasizing positive qualities. I would describe the symptoms in basic language, noting how these characteristics may affect feelings and interpersonal connections and stressing the potential for recovery through medication. I emphasize that the diagnosis is driven by explaining the symptoms, prognostication, and treatment strategies (Wheeler, 2020). Applying this strategy could help the client gain more control over the process. It would not compromise the therapeutic alliance that personality disorder diagnoses often produce feelings of stigma or alienation.

 Individual vs. Family vs. Group Session Disclosure

In the individual context, it would be critical for the nurse practitioner to explain the diagnosis, emphasizing the individual impacts of the disease and approaches for enhancing recovery. On the other hand, in the family setting, the approach should focus more on enhancing the family’s understanding of the diagnosis and the existing needs associated with the condition. The family setting interventions focus on empowering the patient and the family to understand their roles in managing the condition and address any myths and misconceptions that may affect the management of the condition. However, a group setting offers optimal opportunities for sharing experiences where patients can learn from one another and develop resilience in managing their conditions and needs (Wheeler, 2020). These settings require managing individual needs and preferences and maintaining privacy to help build trust, maintain therapeutic relationships, and foster mutual support.

References

Kujovic, M., Benz, D., Riesbeck, M., Mollamehmetoglu, D., Becker-Sadzio, J., Margittai, Z., Bahr, C., & Meisenzahl, E. (2024). Comparison of 8-vs-12 weeks adapted dialectical behavioral therapy (DBT) for borderline personality disorder in routine psychiatric inpatient treatment: A naturalistic study. Scientific Reports, 14(1), 11264. https://doi.org/10.1038/s41598-024-61795-9

Leichsenring, F., Fonagy, P., Heim, N., Kernberg, O. F., Leweke, F., Luyten, P., Salzer, S., Spitzer, C., & Steinert, C. (2024). Borderline personality disorder: A comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 23(1), 4–25. https://doi.org/10.1002/wps.21156

Leichsenring, F., Heim, N., Leweke, F., Spitzer, C., Steinert, C., & Kernberg, O. F. (2023). Borderline personality disorder: A review. JAMA, 329(8), 670–679. https://doi.org/10.1001/jama.2023.0589

Wheeler, K. (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing Company Borderline Personality Disorder DSM-5-TR Essay