John G. Gunderson – författare

In Borderline Personality and Mood Disorders: Comorbidity and Controversy, a panel of distinguished experts reviews the last two decades of progress in scientific inquiry about the relationship between mood and personality disorders and the influence of this empirical data on our ways of conceptualizing and treating them. This comprehensive title opens with an introduction defining general trends both influencing the expansion of the mood disorder spectrum and undermining clinical recognition and focus on personality disorders. The overlaps and differences between MDD and BPD in phenomenology and biological markers are then reviewed, followed by a review of the overlaps and distinctions between more atypical mood disorder variants. Further chapters review the current state of thinking on the distinctions between bipolar disorder and BPD, with attention to problems of misdiagnosis and use of clinical vignettes to illustrate important distinguishing features. Two models explaining the relationship between mood, temperament, and personality are offered, followed by a review of the literature on risk factors and early signs of BPD and mood disorders in childhood through young adulthood as well as a review of the longitudinal studies on BPD and mood disorders. The last segment of the book includes three chapters on treatment. The book closes with a conclusion with a synthesis of the current status of thinking on the relationship between mood and borderline personality disorder.

An invaluable contribution to the literature, Borderline Personality and Mood Disorders: Comorbidity and Controversy insightfully addresses the mood and personality disorders realms of psychiatry and outlines that it has moved away from contentious debate and toward the possibility of synthesis, providing increasing clarity on the relationship between mood and personality to inform improvements in clinical management of the convergence of these psychiatric domains in common practice.

The diagnosis and treatment of patients with BPD can be fraught with anxiety, uncertainty, and complexity. How welcome, then, is the Handbook of Good Psychiatric Management for Borderline Personality Disorder, which teaches clinicians what to do and how to do it, as well as what not to do and how to avoid it. The author, a renowned researcher and clinician, has developed a new evidence-based treatment, Good Psychiatric Management (GPM) that comfortably utilizes cognitive, behavioral, and psychodynamic interventions that are practical and simple to implement. Because psychoeducation is an important component of GPM, the book teaches clinicians how to educate their patients about BPD, including the role of genetics and the expected course of the disease. This approach offers advantages both to practitioners, who become more adept at honest communication, and to patients, who are encouraged to have realistic hopes and to focus on strategies for coping with BPD in daily life.

The book is structured for maximum learning, convenience, and utility, with an impressive array of features. • Section I provides background on BPD, including the myths that sometimes discourage clinicians from treating these patients and that hamper the effective treatment of the disorder.• Section II, the GPM Manual, provides a condensed and clear description of the most essential and specific GPM interventions that clinicians can learn from and use in everyday practice.• Section III, the GPM Workbook, offers case vignettes which reference chapters from the manual. Each vignette has a number of "decision points" where alternative interventions are proposed and discussed. • To further facilitate learning, a set of nine interactions is found in a series of online video demonstrations. Here, readers can see in vivo illustrations of the GPM model in practice.• Finally, a set of appendices provides critical information, such as a comparison of GPM with other evidence-based treatments of BPD, scaling risk and response strategies, and family guidelines.

Designed to be a basic case management text for all hospital, outpatient clinic, or office-based psychiatrists or mental health professionals who assume primary responsibility for the treatment of those with BPD, the Handbook of Good Psychiatric Management for Borderline Personality Disorder constitutes a breakthrough in the treatment of these often misunderstood patients.

Understanding and Treating Borderline Personality Disorder: A Guide for Professionals and Families offers both a valuable update for mental health professionals and much-needed information and encouragement for BPD patients and their families and friends. The editors of this eminently practical and accessible text have brought together the wide-ranging and updated perspectives of 15 recognized experts who discuss topics such as • A new understanding of BPD, suggesting that individuals may be genetically prone to developing BPD and that certain stressful events may trigger its onset• New evidence for the success of various forms of psychotherapy, including Dialectical Behavior Therapy (DBT), in reducing self-injury, drug dependence, and days in the hospital for some groups of people with BPD• Pharmacology research showing that the use of specific medications can relieve the cognitive, affective, and impulsive symptoms experienced by individuals with BPD, as part of a comprehensive psychosocial treatment plan• New resources for families to help them deal with the dysregulated emotions of their loved ones with BPD and to build effective support systems for themselves

Yet much remains to be done. Research on BPD is 20 to 30 years behind that on other major psychiatric disorders such as schizophrenia and bipolar disorder. Despite evidence to the contrary, much of the professional literature on BPD continues to focus on childhood trauma, abuse, and neglect as triggers for BPD -- to the detriment of both patient and family.

Families of people with BPD must deal with an array of burdens in coping with the illness, often without basic information. The chapters on families and BPD give voice to the experience of BPD from the perspective of individuals and family members, and offer the hope that family involvement in treatment will be beneficial to everyone.

Above all, this book is about the partnership between mental health professionals and families affected by BPD, and about how such a partnership can advance our understanding and treatment of this disorder and provide hope for the future.

Defined by stable, long-term, subjective distress and/or social impairment, personality disorders affect up to 18% of the population. Social impairment and health care usage are far more prevalent among people with personality disorders than among people with major depressive disorders. Personality disorders are highly prevalent, variable, and notoriously difficult to treat, and they continue to challenge the therapeutic community and represent a formidable public health concern.

This volume ably addresses personality disorders as one of the top priorities of psychiatry for the new millennium, offering a thorough and updated review and analysis of empirical work to point up the issues central to developing a therapeutic model for treatment as well as current research challenges. A review of extant research yields the heartening conclusion that psychotherapy remains an effective treatment for people with personality disorders. An examination of psychodynamic treatment for borderline personality disorder speaks to its efficacy. An analysis of the rationale for combining psychotherapy and psychopharmacology emphasizes the importance of identifying temperament and target conditions. A well-documented and reasoned treatise on antisocial personality disorder makes the crucial point that clinicians must acquire a depth of understanding and skill sufficient to determine what the cut-off point is for treatable versus nontreatable gradations. With the caveat that evidence supporting the efficacy of cognitive treatments for personality disorders is slight and that such approaches require tailoring, a strong case is made for their validity.

This timely volume both answers and reframes many stubborn questions about the efficacy of psychotherapy for treating personality disorders.

Covering the range of clinical presentations, treatments, and levels of care, Borderline Personality Disorder: A Clinical Guide, Second Edition, provides a comprehensive guide to the diagnosis and treatment of borderline personality disorder (BPD). The second edition includes new research about BPD''s relationship to other disorders and up-to-date descriptions of empirically validated treatments, including cognitive-behavioral and psychodynamic approaches. Compelling new research also indicates a much better prognosis for BPD than previously known.

A pioneer in the field, author John Gunderson, M.D., director of the Borderline Personality Disorder Center at McLean Hospital, draws from nearly 40 years of research and clinical experience. The guide begins with a clear and specific definition of BPD, informed by a nuanced overview of the historical evolution of the diagnosis and a thoughtful discussion of misdiagnosis. Offering a complete evaluation of treatment approaches, Dr. Gunderson provides an authoritative overview of the treatment options and describes in-depth each modality of treatment, including pharmacotherapy, family therapy, individual and group therapy, and cognitive-behavioral therapies.

Unlike other works, this book guides clinicians in using multiple modalities, including the sequence of treatments and the types of changes that can be expected from each mode. The discussion of each treatment emphasizes empirically validated therapies, helping clinicians choose modalities that work best for specific patients. In addition, Borderline Personality Disorder: A Clinical Guide, Second Edition, also outlines therapeutic approaches for multiple settings, such as hospitalization, partial hospitalization or day hospital programs, and levels of outpatient care.

Complementing the well-organized treatment guide are a series of informative and intriguing sidebars, providing insight into the subjective experience of BPD, addressing myths about therapeutic alliances in BPD, and questioning the efficacy of contracting for safety. Throughout the book, Dr. Gunderson recommends specific do''s and don''ts for disclosing the diagnosis, discussing medications, meeting with families, starting psychotherapy, and managing suicidality.

A synthesis of theory and practical examples, Borderline Personality Disorder: A Clinical Guide, Second Edition, provides a thorough and practical manual for any clinician working with BPD patients.

Practitioners encounter patients with borderline personality disorder (BPD) with surprising frequency; indeed, 1 in 10 emergency room visits and 1 in 20 primary care appointments are estimated to involve people with BPD. Applications of Good Psychiatric Management for Borderline Personality Disorder: A Practical Guide was written not for the psychiatrist engaged in lengthy and complex psychotherapy with these patients but for the generalist who needs the basic skills to deliver good care to this sizeable patient population in need of help. This guide condenses the vast expanse of the latest scientific research and describes the use of good psychiatric management (GPM) with different patient populations, in conjunction with different modalities, for different professions, and in different treatment settings. Constructed carefully by two leading psychiatrists in the field of BPD, the book is designed for maximum utility with stand-alone chapters offering clear guidelines for managing BPD. Topics and features include the following: • Case vignettes, which are designed to make the book practical and eminently useful, provide "decision points" where alternative interventions are proposed and discussed, demonstrating how to apply the concepts outlined in the chapter. Although the authors review the relative merits of these interventions, the presentation promotes active learning and the ability to adapt to unpredictable clinical realities. • Challenges to implementing GPM that are specific to a particular treatment setting -- consultations, inpatient and outpatient settings, emergency departments, and colleges -- are directly addressed so the guidelines are immediately relevant to the target audience of each chapter.• Clinicians from a variety of fields, including social workers, primary care providers, psychopharmacologists, and training supervisors, care for patients with BPD, and the book makes concrete suggestions about how to apply GPM in a range of practice types.• Implementation of GPM in a brief format and how it can be applied to other personality disorders is also addressed. It explains how GPM can be integrated with other evidence-based treatments for BPD, such as dialectical behavior therapy, mentalization-based treatment, and transference-focused psychotherapy.

Written in a down-to-earth style, this case management text will appeal to the resident on call, the specialist, and the generalist. Above all, Applications of Good Psychiatric Management for Borderline Personality Disorder: A Practical Guide addresses the challenges specific to different treatment contexts to help busy clinicians provide informed, effective care for their patients with BPD.