COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006
Living on the Edge: Substance
Use Disorders & Borderline
Personality Disorder
Pasquale Russoniello, MA
&
Veronica O. Bowlan, MSW, LSW
Borderline Personality As A
Diagnosis (PBD)
• DSM-IV-TR Personality Disorder: Axis II in
the DSM multi-axial assessment system
• Is a Cluster B Personality disorder
• Is over represented in all treatment
modalities, e.g. inpatient, outpatient, crisis
and Emergency Room services
• Is often co-morbid with other Axis I and
Axis II DSM disorders.
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Other DSM-TR Co-occurring
Axis I and Axis II Disorders
• Substance Use Disorders (SUD)
• Mood Disorders
• Brief Psychotic Episodes
• Dissociative identity Disorder
• Antisocial Personality Disorder
• Anxiety Disorders, including Panic D/O,
OCD, & PTSD
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Controversies/Problems
With The BPD Diagnosis
• Is evolving diagnosis
• High degree of heterogeneity among
persons diagnosed with the disorder
• Is highly sensitive to sociocultural factors
• Often confounded with features of other
disorders
• Different views of etiology
• Stigma of diagnosis affects consumer and
practitioner
• Limited research on effective treatment
• Highly stressful for practitioners to treat.
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Epidemiology (APA, 2001)
• Borderline Personality Disorder is the
most common personality disorder in
clinical settings.
– 10% seen in outpatient settings
– 15-20% seen in psychiatric inpatient settings
– 30%-60% of clinical populations with
personality disorders
– 2% of general population
Epidemiology (cont’d)
(APA, 2001)
– Diagnosed predominately in womenratio
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– Present in cultures around the world
– 5 times more common in first degree
biological relatives
– Greater familial risk for substancerelated
disorders, antisocial personality
disorder, and mood disorders
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