Borderline Personality Disorder in Clinical Practice
American Journal of PsychiatryPublished 30 April 2005
Carolyn Zittel Conklin, Drew Westen
Citations134
SJR quartileQ1
SJR score5.27
SNIP3.68
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TL;DR
A portrait of borderline personality disorder symptoms that places greater weight than the DSM-IV description on the intense psychological pain of these patients is replicated and suggests candidate diagnostic criteria for DSM-V.
Abstract
Borderline personality disorder patients in research samples are highly similar to those seen in a cross-section of clinical practice. However, several studies have now replicated a portrait of borderline personality disorder symptoms that places greater weight than the DSM-IV description on the intense psychological pain of these patients and suggests candidate diagnostic criteria for DSM-V.
Keywords
Psychology
Journal of the Royal Statistical Society Series D (The Statistician)Meta-Analytic Procedures for Social Research.
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2,881 Citations1995Otto F. Kernberg
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American Journal of PsychiatryThe diagnostic interview for borderline patients
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Archives of General PsychiatryThe Chestnut Lodge Follow-up Study
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American Journal of PsychiatryPersonality disorders in DSM-III and DSM-III-R: convergence, coverage, and internal consistency
265 Citations1988Leslie C. Morey
A substantial divergence between DSM- III and DSM-III-R diagnoses, increased coverage accompanied by a large increase in overlap among personality disorders, and internal consistency estimates of DSM-II-R criterion sets comparable to those in DSM-3 are demonstrated.
American Journal of PsychiatryPersonality Diagnoses in Adolescence: DSM-IV Axis II Diagnoses and an Empirically Derived Alternative
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American Journal of OrthopsychiatryPhysical and sexual abuse in adolescent girls with borderline personality disorder.
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American Journal of PsychiatryDSM-III-R axis II comorbidity in dysthymia and major depression
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Journal of Abnormal PsychologyMalevolent object representations in borderline personality disorder and major depression.
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