Borderline bodies

This chapter is about borders that are made and broken at gay pride parades. Specifically, I examine the discursive and material borders maintained in tourism discourse. Binary oppositions such as self/other, straight/gay, and tourist/host provide a focus for this chapter. I am interested in where these borders wear thin and threaten to break and disrupt social order. I explore the bodies of gay pride parades because it is bodies such as these that threaten the borders of corporeal acceptability

Borderline experience: madness, mimicry and Scottish gothic

This essay draws on Julia Kristeva's concept of 'borderline' experience, a feature of psychotic discourse, to examine the representation of madness, split personality and sociopathic behaviour in James Hogg's The Private Memoirs and Confessions of a Justified Sinner and the contemporary, muted Gothic of John Burnside's The Locust Room (2001). The main characteristics of borderline experience - a concern with authenticity and the proper name, with uncertain boundaries between inside and outside, truth and delusion - are central concerns in Hogg and Burnside, and the essay assesses the value of borderline discourse for a critical reading of madness in Gothic

Mental health nurses’ attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder:systematic, integrative literature review

Aims and objectives To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. Background There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses’ attitudes have had limited success. Design Systematic, integrative literature review. Methods Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses’ attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Results Forty studies were included. Only one used direct observation of clinical practice. Nurses’ knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals’ and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Conclusions Mental health nurses’ responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. Relevance to clinical practice There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working with patients with borderline personality disorder

Impulsivity, Rejection Sensitivity, and Reactions to Stressors in Borderline Personality Disorder

This research investigated baseline impulsivity, rejection sensitivity, and reactions to stressors in individuals with borderline personality disorder compared to healthy individuals and those with avoidant personality disorder . The borderline group showed greater impulsivity than the avoidant and healthy groups both in a delay-discounting task with real monetary rewards and in self-reported reactions to stressors; moreover, these findings could not be explained by co-occurring substance use disorders. Distress reactions to stressors were equally elevated in both personality disorder groups (relative to the healthy group). The borderline and avoidant groups also reported more maladaptive reactions to a stressor of an interpersonal versus non-interpersonal nature, whereas the healthy group did not. Finally, self-reported impulsive reactions to stressors were associated with baseline impulsivity in the delay-discounting task, and greater self-reported reactivity to interpersonal than non-interpersonal stressors was associated with rejection sensitivity. This research highlights distinct vulnerabilities contributing to impulsive behavior in borderline personality disorder

Student health professionals' attitudes and experience after watching 'Ida's diary', a first-person account of living with borderline personality disorder:mixed methods study

BACKGROUND: There is increasing interest in the use of commercial movies in nursing education, or 'cinenurducation'. There is a need for educational interventions which target mental health nurses' attitudes towards people with borderline personality disorder.OBJECTIVES: To investigate and evaluate the experience and effects of attendance at a screening of the movie Ida’s Diary, a first-person account of living with borderline personality disorder.DESIGN: Mixed methods design comprising a within-subjects AB longitudinal survey, and a qualitative analysis of participant-generated data and researcher field notes from a World Ca-fé discussion group.SETTINGS: One university in Scotland.PARTICIPANTS: N=66 undergraduate and postgraduate mental health nursing and coun-selling students.METHODS: Participants completed measures of cognitive and emotional attitudes towards, and knowledge about, people with borderline personality disorder before and after one of two film screenings. We conducted a World Café discussion group after the second screen-ing. Resulting data were subject to a qualitative thematic analysis.RESULTS: Quantitative analysis revealed a five-factor cognitive and a single-factor emo-tional attitude structure. Cognitive-attitudinal items related to treatment deservingness and value of mixed treatment approaches improved across iterations. Total knowledge score did not change, but one item about borderline personality disorder as a precursor to schizophrenia received considerably more incorrect endorsement post-screening. Qualitative analysis re-vealed five themes: Facilitation and inhibition of learning; promotion but not satiation of appe-tite for knowledge; challenging existing understanding; prompting creativity and anxiety; and initiating thinking about the bigger picture.CONCLUSIONS: Participants found the film thought provoking; it increased their appetite for knowledge. Findings suggest that screening should be delivered in conjunction with more didactic information about borderline personality disorder

Inequalities in Health and Service Use among People with Borderline Intellectual Impairment

This report, produced in collaboration with Professor Angela Hassiotis and others, sets out the extent to which people with borderline intellectual impairment face inequalities in health and use of services compared with the rest of the population, and seeks to improve awareness of these inequalities. Findings - Borderline intellectual impairment is common, affecting at least one adult in ten in England. The term is used here to refer to people with good verbal skills and living in private households, but who may experience cognitive impairments. - The findings in this report are consistent with previous research: people with borderline intellectual impairment are a disadvantaged group and their needs are not well understood. - Such adults face high levels of poor mental health, poorer general health, and many limitations in their daily lives. - Their level of use of mental health treatment and services does not appear to be commensurate with their higher level of need. This indicates that they are underserved compared with the rest of the population. - This may be due to a lack of professional awareness of their needs, to services not adapting enough to meet those needs, or to difficulties the individual faces in seeking treatment and support. - Adults with borderline intellectual impairment constitute key users of primary and secondary health care, and employment, education and welfare support. Improving awareness of the needs of this group should form part of wider plans to reduce inequalities in health and service use in England. Methods Secondary analysis of data from the Adult Psychiatric Morbidity Survey (APMS) was conducted to profile the circumstances of people with borderline intellectual impairment. APMS is one of the most authoritative and comprehensive national household surveys to assess both intellectual functioning and mental health in adults in England

Paratubal serous borderline tumor in an 85 years old woman: A case report

Paratubal cysts are incidental, common and benign lesions with few cases of borderline tumor and adenocarcinoma been reported in the literature. Herein, we are discussing a case of an 85 years old woman who visited her Obstetrics and Gynecologist for a chief complaint of post-menopausal bleeding. Physical examination revealed a slightly enlarged uterus. The diagnosis of fibroids were made on ultrasound. A total hysterectomy with bilateral salpingo-oophorectomy was performed without complications. The gross examination of the specimen was most remarkable for multiple intramural fibroids and a right simple paratubal cyst meausirng 1 × 1 cm. Microscopical evaluation of the paratubal cyst showed a simple cyst lined by stratified cuboidal epithelium with mild cytologic atypia and no stromal invasion, findings consistent with serous borderline tumor rising in a paratubal cyst. Due to the small size of the tumor and its confinement to the cyst, a follow-up was advised. Serous borderline tumors arising in paratubal cyst are very rare with only eight cases reported in the literature. Their existence should be acknowledged to plan patient treatment and outcome

Book Review: Towards a Practical Guide to the Therapy of the Borderline Patient

EFFECTIVE PSYCHOTHERAPY WITH BORDERLINE PATIENTS:CASE STUDIES Robert J. Waldinger, M.D .John G. Gunderson, M.D. New York, Macmillan 1987, 232 page