Issues in Clinical Psychology: BPD Case Study Analysis

This case study examines Chloe Smith, a 25-year-old woman diagnosed with Borderline Personality Disorder (BPD) following a suicide attempt. The study details Chloe's history of impulsive actions, unstable relationships, and extreme mood swings, highlighting key symptoms like fear of abandonment, emotional instability, and risky behaviors. It identifies potential risk factors, including a stressful childhood marked by abuse and familial instability. The case study then explores treatment options, emphasizing psychotherapy like Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT), alongside potential medication interventions. It underscores the importance of family involvement in the treatment process to improve patient outcomes and overall quality of life. References to relevant research and diagnostic criteria are also included.

Running head: CASE STUDY ON BORDERLINE PERSONALITY DISORDER
CASE STUDY ON BORDERLINE PERSONALITY DISORDER
Name of the student:
Name of the university:
Author note:

1
CASE STUDY ON BORDERLINE PERSONALITY DISORDER
Brief history of the case:
Chloe Smith is a 25-year-old woman who was admitted to the hospital after she tried
to commit a suicide by trying to jump from a cliff. However, the visitors had reached there on
time to save her and got her back to the apartment where she stays with her roommate. Her
roommate revealed that Chloe been always like this with extreme mood swings where she
conducted many impulsive actions. Last week, she had a break up with her boyfriend after a
public fight where she had even slapped him in front of public. She was very angry and
disappointed at that time. The next morning she was not found absent in her room and
therefore her friend had called her many times to which she did not pick up. In the afternoon,
she came back upset and told that her partner did not want to renew the relationship even
when she had apologised. She had been upset for two days where she had frequent bouts of
anger where she broke up things in the house and even shouted at herself in the mirror.
However, as days passed her friend thought that she was gradually healing as she found her
engaging herself in her leisure activities like gardening, painting and going to her job
regularly. All of a sudden, the day before, she was gain found to be disappointed and upset
when she found her partner being engaged into a new relationship. Her friend tried to help
her with the emotions and thought that she was gradually able to pick herself up. Chloe asked
her friend to make her coffee, as she wanted to get over the stress. As her friend had gone to
the kitchen, she heard the door shut, where she found that Chloe had left taking the keys of
the car. From then, she had no news of her until this morning; she was called at the hospital
where Chloe was admitted after the visitors rescued her when she tried to commit suicide.
Identification of the mental disorder:
From the above case scenario, it can be stated that Chloe suffered from borderline
personality disorder (BPD). It can be described as a mental disorder that impact the ways an

2
CASE STUDY ON BORDERLINE PERSONALITY DISORDER
individual think about herself as well as that of the others and thereby causing various kinds
of problems in functioning in their everyday lives. The events in their lives include a pattern
of unstable intense relationships as well as distorted self-image, extreme emotions as well as
impulsiveness (Bateman et al., 2015). Chloe often had bouts of impulsive actions where she
slapped her partner in public, tried to commit suicide and many others. Chloe had repeatedly
failed to control her emotions and she has been always found to have mood swings where she
was angry at one moment, depressed, and withdrawn at the other moment.
Symptoms:
Reviews of literature have stated that when individuals suffer from borderline
personality disorder, they have an intense fear of abandonment as well as instability.The
proposed DSM-V (2013) diagnostic criteria had put forward many symptoms that help in
identifying patients with BPD (Benson et al., 2017). Individuals find it difficult to tolerate in
being alone. The participants of the studies who are caregivers of people suffering from
borderline personality disorder have revealed that anger, frequent mood swings as well as
impulsiveness of the patients push them away from others when though they want to have
lasting as well as loving relationships with others (Linehan, 2018). Another symptom found
among such patients just like Chloe is a pattern of unstable intense relationships like that of
idealizing someone at one moment and then suddenly believing that the person does not care
or is cruel (Paris, 2018). At first, Chloe slapped her partner thinking that he was trying to hurt
her or betray her but the next morning she had a mood swing where she went to her partner
with an apology. Fonagy et al., (2016) have stated another symptom like rapid changes in
self-identity as well as self-image that include shifting values and goals as well as seeing
oneself as bad or as if he or she is not present at all. Others include period of stress related
paranoia as well as loss of contact with that of the reality that last for few minutes or to even
few hours (Baer, 2015). Chloe was often seen talking with herself in the mirror where she

3
CASE STUDY ON BORDERLINE PERSONALITY DISORDER
used to reveal all her agitation, disappointment, and felt completely cut out from reality.
Impulsive and risky behaviours like that of gambling, risky and unsafe sex, rash driving binge
eating, drug abuse or sabotaging success by suddenly quitting or ending of a positive
relationships are some other symptoms (Bateman et al., 2016). Chloe had ended her
relationship based on doubts only. She also engaged in rash driving and even stopped hoping
to her job all of a sudden. All these symptoms helped in identifying that she was suffering
from borderline personality disorder. She also showed suicidal threats, behaviour, or self-
injury in response to fear mainly of separation or that of rejection, which is yet another
symptom of the disorder.
Risk factors:
Choi et al., (2016) has stated that stressful childhood can be one of the contributing
risk factor for BPD. It has been found that people who suffer from this disorder have been
sexually as well as physically abused and neglected during childhood. Many of the
individuals with this disorder are found to have been separated from their parents as well as
close caregiver when they were young or had parents who were involved in substance abuse
and other mental health issues (Harned et al., 2018). Others were found to have been exposed
to different types of hostile conflicts as well as unstable family relationships. Another
important risk factor is called the hereditary predisposition where they might be at a higher
risk of their close relatives like that of father; mother, sister as well as brother had the same
disorder (Sauer-Zavala et al., 2016). As per the information disclosed by Chloe’s roommate,
Chloe had a stressful childhood where his father was alcoholic and often used to engage in
domestic violence affecting both Chloe’s mother and Chloe. Chloe’s mother later fled from
her husband and engaged in small job downtown. However, there had been instances where
their property owner physically abused Chloe when her mother was at work. Though the
police had later caught and punished the perpetrator, the incidences had left a deep mark on

4
CASE STUDY ON BORDERLINE PERSONALITY DISORDER
Chloe as a child. All these might have accumulated in making Chloe develop the disorder of
BPD as she has grown up.
Treatment:
Previously, BPD was considered to be difficult to treat but nowadays, with the help of
evidence based treatments, most of the people with the disorder experienced fewer as well as
less severe symptoms and improved quality of their lives (Zanarini et al., 2018).
Psychotherapy is found to be the first line of treatments for the people suffering with the
disorder. Chloe can be provided dialectical behaviour therapy called the DBT. This therapy
mainly utilises the concepts of mindfulness and acceptance or being aware of and even
attentive to the current situation and the emotional stages. This therapy also teaches the
affected individuals in controlling emotions, reduction in the self-destructive behaviours as
well as improvement of the relationships helping individuals to gain emotional and mental
stability in their lives (Fonagy et al., 2015). Another therapy that can be also provided to
Chloe is the cognitive behavioural therapy. This type of therapy has been found to be helpful
in patients suffering with BPD as it helps them in identifying and even changing their core
beliefs and behaviours that underlie the various types of inaccurate perceptions of
themselves and that of the others and even help in gaining mental stability in managing
problems that occur when interacting with others. CBT is also found to be helpful in
reduction of the range of mood and anxiety symptoms as well as reduction in the number of
suicidal as well as self-harming behaviours (Paris, 2018). Medication therapy is the next set
of interventions that can be provided to the patients who suffer from the disorder just like
Chloe. However, medications are not used typically for the disorder as the benefits are found
to be unclear. Still, in some of the cases, the psychiatrists might be seen recommending
medications that help in treatment of the disorder mainly for the symptoms like mood swings,
depression as well as for the other co-occurring mental disorders (Bateman et al., 2016).

5
CASE STUDY ON BORDERLINE PERSONALITY DISORDER
Some of the BPD therapies are also seen to include caregivers, family members as well as
loved ones in the treatment sessions. This type of therapies are seen to help by allowing the
relative as well as the loved ones in developing skills for better understanding as well as
supporting a person with BPD. The therapies also help in focusing on the needs of the family
members for helping them to understand the obstacles as well as the different strategies that
help in caring an individual with BPD. Although more studies are required to find out the
effectiveness of the family therapies in BPD, researches on other mental disorders have
suggested that including family members can indeed help in treatment of patients (Benson et
al., 2017). The psychotherapists can utilise these therapies to help Chloe get over the disorder
and live quality life.

6
CASE STUDY ON BORDERLINE PERSONALITY DISORDER
References:
Baer, R. A. (Ed.). (2015). Mindfulness-based treatment approaches: Clinician's guide to
evidence base and applications. Elsevier.
Bateman, A. W., Gunderson, J., & Mulder, R. (2015). Treatment of personality disorder. The
Lancet, 385(9969), 735-743.
Bateman, A., O’Connell, J., Lorenzini, N., Gardner, T., & Fonagy, P. (2016). A randomised
controlled trial of mentalization-based treatment versus structured clinical
management for patients with comorbid borderline personality disorder and antisocial
personality disorder. BMC psychiatry, 16(1), 304.
Benson, K. T., Donnellan, M. B., & Morey, L. C. (2017). Gender-related differential item
functioning in DSM-IV/DSM-5-III (alternative model) diagnostic criteria for
borderline personality disorder. Personality Disorders: Theory, Research, and
Treatment, 8(1), 87.
Choi-Kain, L. W., Albert, E. B., & Gunderson, J. G. (2016). Evidence-based treatments for
borderline personality disorder: implementation, integration, and stepped
care. Harvard Review of Psychiatry, 24(5), 342-356.
Fonagy, P., & Luyten, P. (2016). A multilevel perspective on the development of borderline
personality disorder. Developmental psychopathology, 1-67.
Fonagy, P., Luyten, P., & Bateman, A. (2015). Translation: Mentalizing as treatment target in
borderline personality disorder. Personality Disorders: Theory, Research, and
Treatment, 6(4), 380.

7
CASE STUDY ON BORDERLINE PERSONALITY DISORDER
Harned, M. S., Gallop, R. J., & Valenstein-Mah, H. R. (2018). What changes when? The
course of improvement during a stage-based treatment for suicidal and self-injuring
women with borderline personality disorder and PTSD. Psychotherapy
research, 28(5), 761-775.
Linehan, M. M. (2018). Cognitive-behavioral treatment of borderline personality disorder.
Guilford Publications.
Paris, J. (2018). Clinical features of borderline personality disorder. Handbook of Personality
Disorders: Theory, Research, and Treatment, 2, 419.
Sauer-Zavala, S., Bentley, K. H., & Wilner, J. G. (2016). Transdiagnostic treatment of
borderline personality disorder and comorbid disorders: A clinical replication
series. Journal of personality disorders, 30(1), 35-51.
Zanarini, M. C., Conkey, L. C., Temes, C. M., & Fitzmaurice, G. M. (2018). Randomized
Controlled Trial of Web-Based Psychoeducation for Women With Borderline
Personality Disorder. The Journal of clinical psychiatry, 79(3).