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Diagnosing borderline personality disorder: Examination of how clinical indicators are used by professionals in the health setting

机译:诊断边缘性人格障碍:检查专业人员在健康环境中如何使用临床指标

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This paper reviews the history of the recognition of borderline personality disorder as a clinical disorder, followed by a review of the contemporary practice of diagnosing borderline personality disorder in psychiatric settings. Many researchers have cautioned against the conflation of difficult patients with the diagnostic category of borderline personality disorder. The current study examines how clinical indicators used to screen for this complex disorder differ across service settings, professions, specialised training and years of clinical experience. A purpose-designed survey was administered to 108 mental and emergency medicine health practitioners across an Australian health service and a New Zealand health service to record the level of significance placed on different clinical indicators in the application of the diagnosis of borderline personality disorder. A heavy reliance was placed on observable behavioural symptoms, such as self-mutilation and impulsive behaviours that are self-damaging, in the screening of borderline personality disorder as a psychiatric diagnosis. Statistically significant differences were found between emergency medical staff and mental health clinicians in their use of diagnostic indicators of borderline personality disorder, χ2(4) = 17.248, p = .002. Implications of these findings for the screening, assessment and diagnosis of patients with borderline personality disorder are discussed.
机译:本文回顾了将边缘性人格障碍识别为临床障碍的历史,然后回顾了在精神病学领域诊断边缘性人格障碍的当代实践。许多研究人员警告不要将疑难患者与边缘型人格障碍的诊断类别混为一谈。本研究调查了用于筛查这种复杂疾病的临床指标在服务设置,专业,专门培训和多年临床经验之间的差异。对澳大利亚卫生服务局和新西兰卫生服务局的108名精神和急诊医学保健从业人员进行了有针对性的调查,以记录在应用边缘性人格障碍诊断中不同临床指标的重要性水平。在筛查边缘型人格障碍作为精神病学诊断时,严重依赖于可观察到的行为症状,例如自我毁坏和自我伤害的冲动行为。急诊医务人员和精神卫生临床医生在使用边缘型人格障碍的诊断指标方面存在统计学差异,χ 2 (4)= 17.248,p = .002。讨论了这些发现对边缘性人格障碍患者的筛查,评估和诊断的意义。

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