Problems Relating To Assessing And Classifying/ Diagnosing 16 To 20 Year Olds With Patterns Of Impulsivity, Instability In Interpersonal Relationships, Self Image And Affect

2894 words - 12 pages

Table of Contents
1 Introduction 3
1.1 Borderline Personality Disorder (BPD) in 18 to 20 year olds 3
1.1.1 Problems classifying / diagnosing BPD in 18 to 20 year olds 3
1.1.2 Problems assessing / diagnosing BPD in 18 to 20 year olds 4
1.2 Borderline Personality Disorder (BPD) in 16 to 18 year olds 7
1.2.1 Problems classifying / diagnosing BPD in 16 to 18 year olds 7
1.2.2 Problems assessing BPD in 16 to 18 year olds 8
2 References 11


1 Introduction
Borderline Personality Disorder (BPD) is characterised by a pattern of instability in interpersonal relationships, self-image, affect, and marked impulsivity, according to the DSM-IV-TR (Diagnostic and Statistical Manual of Mental ...view middle of the document...

According to Grove & Tellegen (1991), there are some pitfalls with research strategy and procedure in personality disorder classification. They proposed that the research emphasis should be on basic rather than applied questions and that findings from normal personality research should be incorporated with the use of appropriate statistical methods. They suggest the ‘loosening of ties to official PD nomenclature, the development of instruments embodying concepts shaped through interaction of ideas with data, and quasi-parallel self and other report versions to allow study of agreement and discrepancies among different sources of information.
1.1.2 Problems assessing / diagnosing BPD in 18 to 20 year olds
The reliability and validity of Borderline Personality Disorder as well as the utility of the construct has caused a lot of contention (Tyrer, 1999). It is also not clear how satisfactorily clinical and research diagnosis capture the experiences of people identified with this disorder (Ramon et al., 2001). According to Hoffman (2007), with nine possible symptoms, the disorder can present itself in over 200 ways. Research shows that there are so many overlaps that ‘pure’ borderline personality disorder only occurs in 3 – 10% of cases (Pfohl et al.,1986). According to Widiger (2003), patients often meet diagnostic criteria for more than one disorder although comorbidity is greatly under-recognised due to clinicians diagnosing personality disorders hierarchically. Once one disorder is diagnosed, they often fail to assess whether additional personality traits are present. Multiple diagnoses are not provided as they are problematic to distinct disorder categories. According to Hoffman (2007), Borderline Personality Disorder is often missed or ignored if another diagnosis is made. On average five years elapse before a patient is accurately diagnosed, according to research data. A patient is often on three or more medications although no medication had been specifically researched or approved for BPD (Hoffman, 2007). There is often a lag in correct diagnosis which results in ineffective medication (Phend, 2009). ‘Surplus stigma’ has been placed on the disorder by varying theories placed on the it’s development, frequent refusal by clinicians to treat it, negative and sometimes uncomplimentary web site information and clinical controversies about the legitimacy of the diagnosis leading to insurance companies refusing to pay for it. If a patient’s insurance company does not reimburse for borderline personality disorder, they might be officially diagnosed with another disorder (Phend, 2009).
Comparison between the International Classification of Diseases, 10th revision (ICD-10; World Health Organisation, 1992) and the DSM criteria have shown little agreement when applied to the same group of patients with less than a third receiving the same primary personality disorder diagnosis (Zimmerman, 1994).
The reliability of diagnostic assessment has...

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