Vol. 4 No. 2 (2022): July - Decembre 2022
Integrated therapy

Applied psychotherapeutical treatment of borderline personality disorder in adolescence: an account of a clinical case

Ilaria Monticone
A.S.P.I.C.
Marusca Arcangeletti
Association for the Psychological Development of the Individual and of the Community

Published 2022-12-02

Keywords

  • Borderline personality disorder, adolescence, emotional dysregulation, impulsivity, psychotherapeutical treatment, integrated pluralistic model, Association for the Psychological Development of the Individual and of the Community.

How to Cite

Monticone, I., & Arcangeletti, M. . (2022). Applied psychotherapeutical treatment of borderline personality disorder in adolescence: an account of a clinical case. Phenomena Journal - International Journal of Psychopathology, Neuroscience and Psychotherapy, 4(2), 92–108. https://doi.org/10.32069/PJ.2021.2.177

Abstract

The diagnosis of borderline personality disorder has always been a process of difficult classification in adolescence on the grounds that the latter mentioned phase displays characteristics similar to those observed in borderline personality disorder such as emotional, behavioral and interpersonal dysregulation. In any case, research in recent years has demonstrated the borderline personality disorder begins in adolescence, and this is why it is important to effectuate an early diagnosis combined with effective psychotherapeutical treatment. In the following article we will describe the clinical case of an adolescent with borderline personality disorder. The objective is to illustrate the psychotherapeutical treatment based on the “Gestalt Integrated Experiential Pluralistic Model” (“Modello Esperienziale Pluralistico Integrato Gestaltico”) Association for the Psychological Development of the Individual and of the Community (Associazione per lo Sviluppo Psicologico dell’Individuo e della Comunità). The specificity of the multi-faceted model, that connects clinical phenomenology and humanistic psychotherapy, is to utilize diverse theories and techniques of intervention in the clinical practice which, in our case, have been adapted to the intervened changes in the adolescent and to the goal objectives within the therapeutic project.

References

  1. Sharp, C., Fonagy, P. (2015). Practitioner Review: Borderline personality disorder in adolescence–recent conceptualization, intervention, and implications for clinical practice. Journal of Child Psychology and Psychiatry, 56(12), 1266-1288.
  2. Guilé, J. M., Greenfield, B. (2004). Introduction personality disorders in childhood and adolescence. The Canadian child and adolescent psychiatry review, 13(3), 51.
  3. Lenzenweger, M. F., Cicchetti, D. (2005). Toward a developmental psychopathology approach to borderline personality disorder. Development and Psychopathology, 17(4), 893-898.
  4. Stepp, S. D. (2012). Development of borderline personality disorder in adolescence and young adulthood: Introduction to the special section. Journal of abnormal child psychology, 40(1), 1-5.
  5. Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. The Lancet, 377(9759), 74-84.
  6. S Sharp, C., Tackett, J. (2021). Manuale del Disturbo Borderline di Personalità nell’infanzia e nell'adolescenza. Trad. It. a cura di Riccarsi, I., Fiore, D. Milano: FrancoAngeli.
  7. Paris, J. (2019). Treatment of borderline personality disorder: A guide to evidence-based practice. Guilford Publications.
  8. Chanen, A. M., Kaess, M. (2012). Developmental pathways to borderline personality disorder. Current psychiatry reports, 14(1), 45.
  9. Lancini, M. Turuani, L. (2009). Sempre in contatto. Milano: Franco Angeli.
  10. Fossati, A., (2021). Il disturbo Borderline di personalità in adolescenza: fenomenologia e validità di costrutto, Manuale del Disturbo Borderline di personalità nell’infanzia e nell’adolescenza, Ed. italiana a cura di Riccardi, I e Fiore, D., Milano: Franco Angeli, 3, 41-58.
  11. Poletti, M. (2011). Aspetti neuroevolutivi del Disturbo Borderline di Personalità, di. Psicologia clinica dello sviluppo, 15(1), 7-28.
  12. Giusti, E. Montanari, C. Iannazzo, A. (2021). Psicoterapie Pluralistiche Integrate. Relazione terapeutica, valutazione DSM5. Modelli e piani di trattamento basati su prove di ricerca scientifica. Roma: Armando Editore.
  13. Bleiberg, E., Rossouw, T., Fonagy, P. (2011). Adolescent breakdown and emerging borderline personality disorder. In A.W. Bateman, P. Fonagy, (Eds.), Handbook of mentalizing in mental health practice. Arlington: VA American Psychiatric. 436-509.
  14. Westen, D., Betan, E., DeFife, J. A. (2011). Identity disturbance in adolescence: Associations with borderline personality disorder. Development and psychopathology, 23(1), 305-313.
  15. Lancini, M. (2021). L’eta tradita. Oltre i luoghi comuni sugli adolescenti, Milano: Raffaello Cortina Editore.
  16. Saraceno, C. (2003). Mutamenti della famiglia e politiche sociali in Italia. Bologna: Il Mulino.
  17. Maggiolini, A., Pietropolli Charmet, G., (2016). Manuale di psicologia dell’adolescenza: compiti e conflitti. Milano: FrancoAngeli.
  18. Siegal, D. (2014) La mente adolescente, Milano: Raffaello Cortina Editore
  19. Poletti, M. (2007). Sviluppo cerebrale, processi decisionali e psicopatologia in adolescenza. Giornale Italiano di Psicopatologia, 13, 358-366.
  20. Wang, A. T., Lee, S. S., Sigman, Dapretto, M. (2006). Development changes in the neural basis of interpreting communicative intent. Social Cognitive and AffectiveNeuroscience, 1 (2), 107-121.
  21. Monk, C. S., McClure, E. B., Nelson, E. E., Zarahn, E., Bilder, R. M., Leibenluft, E., Pine, D. S. (2003). Adolescent immaturity in attention-related brain engagement to emotional facial expressions. Neuroimage, 20(1), 420-428.
  22. Killgore, W.D., Oki, M., Yurgelun-Todd, D. A. (2001). Sex-specific developmental changes in amygdala responses to affective faces. Neuroreport, 12, 427-433.
  23. New, A. S., Hazlett, E. A., Buchsbaum, M. S., Goodman, M., Mitelman, S. A., Newmark, R., Siever, L. J. (2007). Amygdala–prefrontal disconnection in borderline personality disorder. Neuropsychopharmacology, 32(7), 1629-1640.
  24. Fonagy, P., Luyten, P. (2009). A development, menthalization-based approach to the understanding and treatment of borderline personality disorder. Development and psychopathology, 21, 1355-1381.
  25. Sharp, C., Wall, K. (2018). Personality pathology grows up: adolescence as a sensitive period. Current Opinion in Psychology, 21, 111-116.
  26. Kenberg, P. F., Weiner, A.S., Berdenstein, K. K., (2000). Personality disorder in children and adolescents. New York: Basic Books.
  27. Crick, N. R., Murray–Close, D. I. A. N. N. A., Woods, K. (2005). Borderline personality features in childhood: A short-term longitudinal study. Development and psychopathology, 17(4), 1051-1070.
  28. Meijer, M., Goedhart, A. W., Treffers, P. D. (1998). The persistence of borderline personality disorder in adolescence. Journal of Personality Disorders, 12(1), 13.
  29. Miller, A. L., Muehlenkamp, J. J., Jacobson, C. M. (2008). Fact or fiction: Diagnosing borderline personality disorder in adolescents. Clinical psychology review, 28(6), 969-981.
  30. American Psychiatric Association (APA) (2000). Diagnostic and statistical manual of mental disorders (4th ed., text Revision). Washington, DC: American Psychiatric Publishing
  31. Paris, J. (2008). The treatment of borderline personality disorders: An evidence based approach. New York: Guilford.
  32. Bornovalova, M. A., Hicks, B. M., Patrick, C. J., Iacono, W. G., & McGue, M. (2011). Development and validation of the Minnesota Borderline Personality Disorder scale. Assessment, 18(2), 234-252.
  33. Stepp, S. D., Whalen, D. J., Scott, L. N., Zalewski, M., Loeber, R., & Hipwell, A. E. (2014). Reciprocal effects of parenting and borderline personality disorder symptoms in adolescent girls. Development and psychopathology, 26(2), 361-378.
  34. Paris, J. (2014). A history of research on borderline personality disorder in childhood and adolescence. In Handbook of borderline personality disorder in children and adolescents (pp. 9-16). New York: NY Springer.
  35. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing, 2013. Edizione italiana: Manuale diagnostico e statistico dei disturbi mentali (2014). Milano: Raffaello Cortina Editore.
  36. Engels, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science 196, p. 129-136.
  37. Paris, J., Tyrer, P. J. (1997). Contesto sociale e disturbi di personalità: diagnosi e trattamento in una prospettiva bio-psico-sociale. Milano: Raffaello Cortina Editore
  38. Crowell, S. E., Kaufman, E. A., & Beauchaine, T. P. (2014). A biosocial model of BPD: Theory and empirical evidence. In Handbook of borderline personality disorder in children and adolescents (pp. 143-157) New York: Springer.
  39. Matusiewicz, A., Weaverling, G., & Lejuez, C. W. (2014). Emotion dysregulation among adolescents with borderline personality disorder. In Handbook of borderline personality disorder in children and adolescents (pp. 177-194) New York, NY: Springer.
  40. Selby, E.A., Kranzler, A., Panza, E. (2014). Development of emotional cascades in borderline personality disorder. In Sharp, Tackett, J.L. (Eds.), Handbook of borderline personality disorder in children and adolescents. 159– 176. New York: Springer.
  41. Paris, J. (2005). The development of impulsivity and suicidality in borderline personality disorder. Development and psychopathology, 17(4), 1091-1104.
  42. Linhean, M. (2011). Trattamento cognitivo comportamentale del disturbo borderline. Milano: Raffaello Cortina Editore.
  43. Paris, J. (2005). The development of impulsivity and suicidality in borderline personality disorder. Development and psychopathology, 17(4), 1091-1104.
  44. Zanarini, M. C., & Frankenburg, F. R. (2007). The essential nature of borderline psychopathology. Journal of Personality Disorders, 21(5), 518-535.
  45. Sellbom M., Jarrett M. A., (2014) La concettualizzazione del disturbo borderline di personalità in giovane età, con l’inquadramento dell’MMPI-A, Manuale del Disturbo Borderline di personalità nell’infanzia e nell’adolescenza, a cura di C. Sharp e J. Tackett, ed. it. Riccardi I. e Fiore D. (2021) Milano: Franco Angeli.
  46. Michonski, J. D., Sharp, C., Steinberg, L., & Zanarini, M. C. (2013). An item response theory analysis of the DSM-IV borderline personality disorder criteria in a population-based sample of 11-to 12-year-old children. Personality Disorders: Theory, Research, and Treatment, 4(1), 15.
  47. Ha, C., Balderas, J. C., Zanarini, M. C., Oldham, J., & Sharp, C. (2014). Psychiatric comorbidity in hospitalized adolescents with borderline personality disorder. The Journal of Clinical Psychiatry, 75(5), 15864.
  48. Shedler J., Westen D., Lingiardi, V. (2014). La valutazione della personalità con la SWAP-200. Milano: Raffaello Cortina Editore
  49. Allen, J. G., Fonagy, P. (2006). Mentalizing in practice. Handbook of mentalization-based treatment, 3-30.
  50. Spalletta, E. (2010). Personalità sane e disturbate. Un’introduzione propedeutica alla cura delle normopatie del quotidiano. Roma: Sovera Edizioni
  51. Lichtenberg, J.D. (1995). Psicoanalisi e sistemi motivazionale. Milano: Raffaello Cortina Editore
  52. Byng-Hall, J. (1998). Le trame della famiglia. Milano: Raffaello Cortina Editore
  53. Bolwlby, J. (1969). Attachment and Loss. Vol. 1: Attachment. Hogarth Press, London. (2nd ed. (1984), Viking Penguin, New York.) (Trad. it.: 1976 [1a ed.], 1989 [2a ed.] Attaccamento e perdita. Vol. 1 Attaccamento alla madre. Torino: Bollati Boringhieri.
  54. Crittenden, P. M. (1997). Truth, error, omission, distortion, and perception: the application attachment theory to the assessment and treatment of psychological disorder. in Dollinger, S. M., DiLalla, L. F. (2013). Assessment and intervention issues across the life span. Psychology Press.
  55. Fonagy, P. (1996). Attaccamento sicuro e insicuro, in Kos Rivista di medicina, cultura e scienze umane, n. 129 Europa Scienze Umane Editrice.
  56. Stern, D. N. (1987). Il mondo interpersonale del bambino. Torino: Bollati Boringhieri.
  57. Stern, D. N. (1998). Le interazioni madre-bambino. Milano: Raffaello Cortina.
  58. Schore, A. N. (1994). Affect regulation and the origin of the self: The neurobiology of emotional development. Psychology Press.
  59. Malher, M., Pine, F., & Bergman, A. (1978). La nascita psicologica del bambino, [Trad. it. Torino: Bollati Boringhieri].
  60. Sameroff, A. J., Emde R.N. (1991). I disturbi delle relazioni nella prima infanzia. Torino: Bollati Boringhieri.
  61. Horowitz, M. J., Kernberg, O. F., & Weinshel, E. M. (1998). Struttura e cambiamento psichico. Milano: FrancoAngeli.
  62. Gardner, H. (1996). Educare al comprendere. Milano: Feltrinelli.
  63. Blandino, G., Garnieri B. (1995). La disponibilità ad apprendere. Milano: Raffaello Cortina Editore
  64. Pontecorvo, C. (1993). La condizione della conoscenza. Firenze: La Nuova Italia.
  65. Vayer, P., Camuffo M. (2000). La faccia nascosta della classe. Roma: Magi.
  66. Walsh, F. (1995). Ciclo vitale e dinamiche familiari. Milano: FrancoAngeli.
  67. Framo, J.L. (1996), Terapia intergenerazionale, un modello di lavoro con la famiglia d’origine. Milano: Raffaello Cortina Editore
  68. Spalletta, E. (2000). Applicazione dell’Integrazione Pluralistica negli interventi di counseling e psicoterapia con bambini e adolescenti, in Integrazione nelle Psicoterapie e nel Counseling. Roma: A.S.P.I.C. Edizioni Scientifiche 7/8, 223-240.
  69. Shirk, S. R., Karven, M. S. (2012). L’alleanza nella terapia rivolta a bambini e adolescenti. Norcross J. C. [ed. it. Quando la relazione funziona. Ricerche scientifiche a prova di evidenza, Vol 1, 97-125] Roma: Sovera.
  70. Rathus, J.H., Miller, A.L. (2016). Manuale DBT per adolescenti. Milano: Raffaello Cortina.
  71. Bateman, A., Fonagy, P. (2010). Guida pratica al trattamento basato sulla mentalizzazione. Per il disturbo borderline di personalità. Milano: Raffaello Cortina Editore.
  72. Rossouw, T., Wiwe M. Vrouva, I. (a cura di) (2022). Il trattamento basato sulla mentalizzazione per gli adolescenti. Milano: Raffaello Cortina Editore.
  73. Livesley, J., Dimaggio, G., & Clarkin, J. (2016). Trattamento integrato per i disturbi di personalità. Un approccio modulare. Milano: Raffaello Cortina Editore.
  74. Monticone, I. (2012). “Il disturbo Borderline in adolescenza. Teoria, modello e trattamento integrato”. Integrazione nelle Psicoterapie, n°2 117-129, Roma: A.S.P.I.C. Edizioni Scientifiche
  75. Giusti, E., Picerni E. (2021). Traumi Psichici. Trattamenti di macro e microcomplessità. Roma: Armando Editore
  76. Norcross, J. C., & Wampold, B. E. (2019). Relationships and responsiveness in the psychological treatment of trauma: The tragedy of the APA Clinical Practice Guideline. Psychotherapy, 56(3), 391.
  77. Norcross J.C. (2012). Quando la relazione psicoterapeutica funziona. vol 1 Roma: Sovera Edizioni.
  78. Norcross J.C., Popple, L.M. (2017). Supervisione in psicoterapia integrata. Roma: Sovera Edizioni
  79. Kernberg, O. (1975). Borderline Conditions and Pathological Narcissism. [Tr. it. Bollati Boringhieri, Torino 1978].
  80. New York: Aronson.
  81. Giusti, E., Spalletta, E. (2020). Metavisione e ri-costruzione di soggetti al limite. La Sindrome Borderline. Rivista Integrazione delle Psicoterapie. n.10 p.11- 48, Roma: A.S.P.I.C. Edizioni Scientifiche
  82. Giusti, E., Rosa, V. (2002). Psicoterapie della Gestalt. Integrazione dell’Evoluzione Pluralistica. Roma: A.S.P.I.C. Edizioni Scientifiche.