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Adolescents with Borderline Personalities

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Adolescents with Borderline Personalities that Self-Mutilate
Terri Lynn McCarley, RN
Ohio Christian University
Nursing Research
NR3300
Professor Snider

Adolescents with Borderline Personalities that Self-Mutilate The purpose of this paper is to discuss adolescents who self-mutilate and how the diagnosis of borderline personality disorder has an effect on it. This author will describe traits of a borderline personality disorder, some of the suggested reasons for self-mutilation and the correlation between the two. This author will provide a synopsis of two literature reviews.
Question
The question is in adolescents, what is the effect on borderline personality disorders as evidence by self-mutilating compared with adolescents with no mental health disorders?
Why This Population is Important? This specific population, adolescents, was chosen because of the impact it has on the future generation. It has a large impact on the children that are coming up in life behind the adolescents. Children are usually influenced by the generation before them and this influence impacts the next generation. Adolescents are known as the “what’s happening now” in society today. This specific population is challenging and full of new views of how they see the world. Is this a phase or an actual mental health disorder for adolescents? The importance of this paper is to look at adolescence receiving earlier treatment and diagnosis. Another important focus of this paper is to understand the correlation of a mental health diagnosis and self-mutilation.
Understanding Borderline Personality Disorder A common and distressing symptom of borderline personality disorder (BPD) is self-harm. People with BPD often act very impulsively whether it is through alcohol or drug abuse, gambling and over-spending, or promiscuous behavior. Self-harm is one of the most excruciating expressions of this need for instant gratification. To those without mental health disorders the idea of self-harm might seem excruciating, bizarre or even pointless. However, to many who feel overwhelmed it can seem like a logical and effective way to momentarily relieve the pain that they feel inside. In reality, however, self-harm only adds to and deepens existing problems. Unfortunately, the need to deal with the immediate physical threat posed by self-harming behavior can cause distraction from the complex problems behind it. Many may simply think of cutting when they think of self-harm; However, sufferers look to achieve a similar effect in a number of different ways, including self-inflicted burns, hair-pulling, or simply not taking care to avoid accidents. Whatever method a BPD-sufferer chooses to use, a number of common causes are to relieve their emotional pain. For someone who feels unloved and ignored, self-harm can be the only way of communicating the pain they feel inside. This method of gaining people’s attention may seem simpler and more direct than trying to talk to someone to make them understand. Unfortunately, many potentially helpful people may, understandably, be scared off by this sort of behavior. For so many disorders, unless people are informed and aware of the symptoms, causes and results it may lead to misunderstanding and confusion. Whether dealing with BPD-sufferers, people with other mental health disorders or anyone who self-harms, it is vital that others surrounding the sufferer understand what the sufferer is going through and how the disorder might manifest itself, to promote the acceptance and compassion that is necessary to help deal with it. When constantly overwhelmed by emotional pain or anxiety, the act of cutting oneself or pulling one’s hair or inflection pain upon themselves may seem like a welcome distraction. Additionally, self-harm can result in the release of endorphins into the body, which act as natural pain killers. Oddly, then, causing oneself pain can be seen to help relieve it; in reality, of course, much more harm is done than good. A BPD sufferer whose life has been taken over by the symptoms of their illness, and who finds relationships difficult, will often be wracked by feelings of inadequacy and guilt. As well as beating themselves up mentally for their apparent shortcomings, many sufferers choose to punish themselves by hurting their own bodies. Sometimes however, self-harm can also be inflicted in order to punish someone else; For example, a self-harmer may hurt themselves in order to demonstrate the effect that a friend’s inattentiveness is having on them. As many BPD sufferers’ problems are rooted in abuse suffered at an earlier age, self- harm can sometimes be seen as a way to continue this pattern. Someone with BPD may feel that they deserve abuse – even when free from harm, they decide to carry it on. Clearly, self-harm is a complex problem; There is no simple explanation for the motives behind it. Any one case of self-harming will have a unique group of motivations underlying it. For this reason, it is important not to make assumptions about why any individual chooses to self-harm, or to over-simplify the problem. Fortunately, there are a variety of different ways in which one can help stop themselves from continuing such behavior.
Article One with Synopsis Article one is titled Reported Childhood Onset of Self-Mutilation among Borderline Patients. This purpose of this qualitative study was to determine the percentage of borderline personality patients who first engaged in self-mutilation as children compared to those who first harmed themselves at an older age. Two hundred and ninety inpatients were interviewed at an inpatient psychiatric facility. The results of this study suggest that self-harm may begin earlier than previously thought in minority of borderline personality disorder patients.
Article Two with Synopsis Article two is titled Reasons for Self-Mutilation Reported by Borderline Patients over16 Years of Prospective Follow-Up. The purpose of this qualitative study was to assess the reasons for episodes of self-mutilation engaged in by patients with borderline personality disorders. Two hundred and ninety patients were interviewed over a period of 2 years, who had at some point been hospitalized in an inpatient psychiatric facility. The results of this study suggest that borderline personality disorder patients with a more extensive baseline history of self-mutilation deliberately harm themselves physically for reasons that are more private and more difficult for mental health professionals to know and understand.
Conclusion
There were several limitations to the two studies reviewed. One of the main limitations to both studies was that the patients that were interviewed and tested were all inpatients at a psychiatric facility. The results may not reflect to healthier outpatients or non-patients with BPD. The second limitation was that some patients had received various treatments, other patients had not received any treatment and some had just started treatment. The third limitation was that there was no validity data concerning the events of self-mutilation. The events included the age of onset, the age of diagnosis, the children who were at risk and the determination of when the self-mutilation started as opposed to acts of self-soothing. The final limitation was due to the varying of diagnostic criteria and the different studies used. The patients had been given different test and were diagnosed at a variety of different ages. The subject of BPD and self-harm is still being studied today and continues to be ongoing. There is still a need for research to be conducted to try to provide an understanding of the correlation between BPD and self-mutilation and gain further knowledge of both topics.
References
An Open Letter from Those of Us with Borderline Personality Disorder. (n.d.). Retrieved from http://www.youtube.com/watch?v=tEkUD-XvfDw&feature=player_detailpage#t=0
Self-Harm. (2009). Retrieved from http://www.youtube.com/watch?v=uWJTDG1SWC8&feature=player_detailpage#t=0
Zanarini, M., Frankenburg, F., Ridolfi, M., Jager-Hyman, S., Hennen, J., & Gunderson, J.
(2006). Reported childhood onset of self-mutilation among borderline patients. Journal of Personality Disorders, 20(1), 9-15
Zanarini, M., Laudate, C.S., Frankenburg, F. R., Wedig, M.M., & Fitzmaurice, G. (2013). Reasons for Self-Mutilation Reported by Borderline Patients Over 16 Years of
Prospective Follow-Up. Journal of Personality Disorders, 27(6), 783-794. doi: 10.1521/pedi.

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