Borderline personality disorder, substance abuse and disordered eating : perceptions of treatment and recovery within community mental health

Journal article


Mooney, Anna, Crafti, Naomi and Broadbear, Jillian. (2023). Borderline personality disorder, substance abuse and disordered eating : perceptions of treatment and recovery within community mental health. The Journal of Mental Health Training, Education and Practice. 18(6), pp. 377-396. https://doi.org/10.1108/JMHTEP-01-2022-0003
AuthorsMooney, Anna, Crafti, Naomi and Broadbear, Jillian
Abstract

Purpose: Borderline personality disorder (BPD) is a debilitating illness characterised by a pervasive pattern of emotional instability, interpersonal difficulties and impulsive behaviour in association with repeated self-injury and chronic suicidal ideation. People diagnosed with BPD also have high rates of co-occurring psychopathology, including disorders associated with disturbed impulse control, such as substance use disorder (SUD) and disordered eating behaviours. The co-occurrence of BPD and impulse control disorders contributes to the severity and complexity of clinical presentations and negatively impacts the course of treatment and recovery. This study qualitatively documents aspects of the lived experience and recovery journeys of people diagnosed with BPD and co-occurring SUD and/or disordered eating. This study aims to identify similarities with respect to themes reported at different stages of the recovery process, as well as highlight important factors that may hinder and/or foster recovery.

Design/methodology/approach: In-person, in-depth, semi-structured interviews were conducted with 12 specialist service consumers within a clinical setting. Ten women and two men (22–58 years; mean: 35.5 years) were recruited. Interview transcripts were analysed using thematic analysis principles.

Findings: As expected, participants with co-occurring disorders experienced severe forms of psychopathology. The lived experience descriptions aligned with the proposition that people with BPD engage in impulsive behaviours as a response to extreme emotional states. Key emergent themes and sub-themes relating to recovery comprised three domains: factors hindering adaptive change; factors assisting adaptive change and factors that constitute change. An inability to regulate negative affect appears to be an important underlying mechanism that links the three disorders.

Practical implications: This study highlights the potential shortcomings in the traditional approach of treating co-occurring disorders of BPD, SUD and eating disorders as separate diagnoses. The current findings strongly support the adoption of an integrative approach to treating complex mental health issues while concurrently emphasising social connection, support and general health and lifestyle changes.

Originality/value: The findings of this study contribute to the burgeoning BPD recovery literature. A feature of the current study was its use of in-depth face-to-face interviews, which provided rich, many layered, detailed and nuanced data, which is a major goal of qualitative research (Fusch and Ness, 2015). Furthermore, the interviews were conducted within a safe clinical setting with engagement facilitated by a clinically trained professional. There was also a genuine willingness among participants to share their stories in the belief that doing so would inform effective future clinical practice. Their willingness and engagement as participants may reflect their progress along the path to recovery in comparison to others with similar diagnoses. Finally, most of the interviewees were engaging in dialectical behavioural therapy (DBT)-style therapies; two were receiving mentalisation-based therapy treatment, and most had previously engaged in cognitive behavioural therapy or acceptance and commitment therapy-based approaches. The predominance of DBT-style therapy may have influenced the ways that themes were articulated. Future studies could supplement this area of research by interviewing participants receiving therapeutic interventions other than DBT for the treatment of BPD and heightened impulsivity.

KeywordsMental health treatment; Mental health recovery; Disordered eating; Borderline personality disorder; Qualitative research; Substance misuse
Year01 Jan 2023
JournalThe Journal of Mental Health Training, Education and Practice
Journal citation18 (6), pp. 377-396
PublisherEmerald Group Publishing Limited
ISSN1755-6228
Digital Object Identifier (DOI)https://doi.org/10.1108/JMHTEP-01-2022-0003
Web address (URL)https://www.emerald.com/insight/content/doi/10.1108/JMHTEP-01-2022-0003/full/html
Open accessPublished as non-open access
Research or scholarlyResearch
Page range377-396
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Print10 Nov 2023
Publication process dates
Accepted25 Aug 2023
Deposited20 Mar 2024
Additional information

Copyright © 2023, Emerald Publishing Limited.

Place of publicationUnited Kingdom
Permalink -

https://acuresearchbank.acu.edu.au/item/904qq/borderline-personality-disorder-substance-abuse-and-disordered-eating-perceptions-of-treatment-and-recovery-within-community-mental-health

Restricted files

Publisher's version

  • 13
    total views
  • 0
    total downloads
  • 5
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as