Understanding Psychosis and Borderline Personality Disorder - Part 2

In this video we will examine BPD and psychotic symptoms, the confusion of their comorbidity, prevalence and how they relate to those dealing with and managing this disorder. If you haven’t watched part 1, please do so as it will provide a nice foundation of understanding about what we’re going to discuss in this video.

One of the confusing aspects of BPD and psychosis classifications such as the DSM-5 and the International Classification of Diseases and Related Health Problems [ICD-10] specify that the presence of a major psychotic disorder precludes BPD as a diagnosis.

Psychotic features among patients with BPD are typically defined as mild and transient and hallucination-like in nature. These symptoms often represent an increase in levels of distress, more frequent suicide plans and attempts, and substantially higher needs for hospitalization.

There is a difference between the types of hallucinations in those with BPD, these include benign types of hallucination and pathological ones (neutral vs. negative content, high vs. low control, and low vs. high frequency).

In patients with BPD psychotic symptoms tend to occur in reaction to stressful events. This may be a consequences of childhood trauma, specifically high sensitivity to stress, and symptoms of PTSD.

What to do about it?
Research findings are all over the place, some showing benefit and some showing none. When taken together, the results show some support to the use of atypical antipsychotics (Risperdal, Zyprexa, Seroquel, for example) in BPD patients with psychotic symptoms. Given that psychotic symptoms in patients with BPD are often related to stress and acute emotional crises, it has been suggested that psychotherapy should focus on managing crises in the treatment of psychotic symptoms in BPD (see my video).

Daniel J. Fox, Ph.D., is a licensed psychologist in Texas, international speaker, and a multi-award winning author. He has been specializing in the treatment and assessment of individuals with personality disorders for over 15 years in the state and federal prison system, universities, and in private practice. His specialty areas include personality disorders, ethics, burnout prevention, and emotional intelligence.

He has published several articles in these areas and is the author of:

The Borderline Personality Disorder Workbook: An Integrative Program to Understand and Manage Your BPD. Available at: https://goo.gl/LQEgy1

Antisocial, Borderline, Narcissistic and Histrionic Workbook: Treatment Strategies for Cluster B Personality Disorders (IPBA Benjamin Franklin Gold Award Winner): https://goo.gl/BLRkFy

Narcissistic Personality Disorder Toolbox: 55 Practical Treatment Techniques for Clients, Their Parents & Their Children (IPBA Benjamin Franklin Silver Award Winner):: https://goo.gl/sZYhym

The Clinician’s Guide to Diagnosis and Treatment of Personality Disorders: https://goo.gl/ZAVe9v

Dr. Fox maintains a website of various treatment interventions focused on working with and attenuating the symptomatology related to individuals along the antisocial, borderline, narcissistic, and histrionic personality spectrum (www.drdfox.com).

YouTube: https://www.youtube.com/c/DrDanielFox
Dr. Fox’s website: http://www.drdfox.com/
Facebook: https://www.facebook.com/appliedpsychservices/
Twitter: https://twitter.com/DrDanielJFox1
LinkedIn: https://www.linkedin.com/in/drdfox/
Instagram: https://www.instagram.com/drdfox
Amazon Author’s Page: amazon.com/author/drfox

Thank you for your attention and I hope you enjoy my videos and find them helpful and subscribe. I always welcome topic suggestions and comments.

Citations:

Kelleher I, Connor D, Clarke MC, Devlin N, Harley M, Cannon M. Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies. Psychol Med 2012;42:1857–1863.

Linscott RJ, van Os J. An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychol Med 2013;43:1133–1149.

Niemantsverdriet, M.B.A., Slotema, C.W., Blom, J.D. et al. Hallucinations in borderline personality disorder: Prevalence, characteristics and associations with comorbid symptoms and disorders. Sci Rep 7, 13920 (2017) doi:10.1038/s41598-017-13108-6

Schroeder K, Fisher HL, Schäfer I. Psychotic symptoms in patients with borderline personality disorder: prevalence and clinical management. Curr Opin Psychiatry (2013) 26:113–9. doi:10.1097/YCO.0b013e32835a2ae7

Видео Understanding Psychosis and Borderline Personality Disorder - Part 2 канала Dr. Daniel Fox