Changes in the Emotion Recognition of Borderline Patients during Psychodynamic Part-time Treatment

Abstract

Borderline personality disorder (BPD) is a personality disorder within cluster B according to the DSM (American Psychiatric Association, 2013). It is a common disorder in psychiatric care: in the normal population the prevalence is 1.6-5.9% (American Psychiatric Association, 2013). However, the numbers in clinical care rise: up to 60-80% in forensic care (Fonagy & Bateman, 2010). Self-mutilation and suicide occur in 69-80% of cases (Fonagy & Bateman, 2010), showing the seriousness of the disorder and the importance to treat it properly. The borderline personality disorder is described in the DSM-5 as: a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following symptoms: (1) frantic efforts to avoid real or imagined abandonment, (2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation, (3) identity disturbance: markedly and persistently unstable self-image or sense of self, (4) impulsivity in at least two areas that are potentially self-damaging, (5) recurrent suicidal behaviour, gestures, or threats, or selfmutilating behaviour, (6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days) (7) Chronic feelings of emptiness, inappropriate, intense anger or difficulty controlling anger, transient, stress-related paranoid ideation or severe dissociative symptoms (American Psychiatric Association, 2013, also included in appendix 1).