Thank you for your excellent post-Erik! From your analysis, you have stated that Natalie does not meet full criteria for any personality disorders. How and why have you concluded so? Are the characteristics she is portraying not a sign of a disorder? I tend to differ with you because Natalie shows a pervasive pattern of instability of interpersonal relationships, self-image, and affects, as well as impulsivity. She also shows a notable pattern of unstable and intense relationships which alternate between extremes. She has a pretty severe instability when it comes to her self-image and sense of self. Natalie shows recurrent suicidal behavior in the form of threats, which she mentions a few times throughout the session as well as her former self-harm which occurred post-breakup.
Axis I: None
Axis II: 301.83 Borderline Personality Disorder or 301.6 Dependent personality disorder (due to the definition of the need to be taken care of and dependency on her parents)
Axis III: None
Axis IV: history of many different intimate relationships, recent car accident, doesn't have a car, parents not willing to help her anymore, recent breakup with boyfriend, no support system other than parents
Axis V: GAF= 60
Why do I differ with you? A person with borderline personality disorder has unstable moods and behaviors. Their relationships with people become unstable as well because of their actions towards them and situations. They have issues regulating their emotions and thoughts which in turn cause them to act recklessly and impulsively. People with this disorder also have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides (NIH, 2016).Natalie shows all the above meaning she full meets the BPD disorder.
Well done Molly, I love the deep analysis of your answer. I agree with you that Natalie is suffering from borderline personality disorder. However, I will have to ask you this; How do you think Natalie can overcome this situation? If you were a physiologist what advice will you give Natalie?
One of the major aspects of formulating a diagnosis is obtaining a thorough history of the patients present illness otherwise known as the HPI. Borderline personality disorder is a server mental illness that causes the individual to have a distorted image of them. They have difficulty keeping interpersonal relationships, and they have irrational mood swings that cause them to act out impulsively. Their behavior can become reckless and even dangerous. The causes of borderline personality disorder according to studies come from an extreme trauma that is seen in childhood from physical abuse, sexual abuse, and witnessing domestic violence. There are successful interventions and treatments for people with borderline personality disorder and with these therapies it is seen that people with BPD are improving drastically, causing them to be less depressed and less likely to attempt suicide. Natalie should continue to utilize the services of the Marriage and Family Counseling center as these types of disorders are typically treated with therapy. Her parents may want to be involved as well since they seem to be an influence on her mental state. Further information about her emotional responses and feelings as they relate to intimate relationships and her parents may offer confirmation of additional criteria for diagnosis of either Borderline Personality Disorder or Dependent Personality Disorder.
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