The problem of reinterpretive distortions in group psychotherapy with borderline patients

Nonpsychotic thought disorder: objective clinical identification of somatization and antisocial personality in language patterns

This report describes a new method of using language patterns to identify somatization and antisocial personality (ASPD) disorders in clinical practice. A set of definitions describing characteristic speech patterns was developed to identify "nonpsychotic thought disorder" (NPTD). Speech patterns of subjects with somatization disorder and/or ASPD were compared with those of controls. Blind raters assessed audiotaped samples of speech obtained through open-ended interviews for instances of elements of NPTD. Women with somatization or ASPD had significantly more NPTD speech responses than controls, and women with both disorders showed the greatest amount. Antisocial men did not demonstrate more NPTD than controls, nor was somatization in men associated with NPTD. Clinical attention to speech patterns in patients may help alert clinicians to these disorders in women and serve as indicators for screening for these disorders. More study is needed to develop psychometric properties of the instruments on larger samples, and to identify speech indicators of personality disorder in men. It is likely that other personality disorders, e.g., borderline personality disorder, can be identified through speech patterns, and they deserve study with these methods.

Developing a systems approach to caring for persons with borderline personality disorder

Most community mental health centers have not established a treatment approach for seriously ill persons with borderline personality disorder that is multi-focused, coordinated, comprehensive, and continuous. The authors propose that the systems approach to caring for persons with schizophrenia (Stein, Diamond, & Factor, 1990) be modified and tested for its efficacy in helping seriously ill persons with borderline personality disorder. The rationale for proposing this model of care and its underlying principles and clinical components is described in this paper.

Borderline personality disorder and group therapy

This study examined the process and outcome of group therapy for community health center clients with borderline personality disorder. The results indicated that group members rated Yalom's curative factors to be increasingly helpful over time, and that universality and existential factors were consistently ranked as very helpful group process variables. The group sessions also were associated with positive outcomes, as evidenced by significant improvement in Goal Attainment Scale scores and the depression and hostility scales of the Brief Symptom Inventory. The results of this study suggest that group therapy is a valued and effective treatment option for people with borderline personality disorder.