bluuebunny/crossref_metadata_2025_split huggingface dataset:
Origins of the label “borderline personality disorder”
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
The term “borderline personality disorder” arose out of the experiences of psychoanalysts. They identified a cluster of clients who responded differently in treatment to clients categorised at the time as “neurotic)) or “psychotic)). The presentation was initially similar to those who were “neurotic” but response to treatment was very different. The term “borderline)) referred to the belief that these people were on the “border” between neurosis and psychosis. Whilst some clients do have psychotic or psychotic-like experiences, the notion that clients meeting diagnostic criteria for borderline personality disorder are on the border between neurosis and psychosis is no longer held.
History of treatment
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
History of treatment had psychoanalysts finding a poor response to treatments available at the time. They concluded that treatment was not possible and stopped engaging these clients in treatment. Cognitive-behaviourists were focusing their treatment on clients who had well-defined target problems and who were more cooperative with treatment suggestions. There was little interest in the treatment of people meeting diagnostic criteria for borderline personality disorder. After a number of decades both groups modified their practices and began to successfully treat people meeting diagnostic criteria for borderline personality disorder with the area becoming increasingly a focus of research and treatment (see “Outcome studies” section). The belief that these clients were untreatable, whilst understandable at the time, has had far-reaching and long-lasting effects. It has been used to support individual and institutional policies of not providing resources and treatment; policies no longer tenable.
Morbidity and mortality
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
The high frequency of self-harm, substance abuse, anxiety disorders, depressive disorders and suicide are markers of the high morbidity that exists (see “Comorbidity” section). Clients’ histories indicate a marked vulnerability to adult abuse, with 46% becoming victims of violence (rape -31%; physically abusive partner 33%) (Zanarini et al. 1999). Possible reasons for this include impulsivity, substance use, and limited capacity for self-protection (Zanarini et al. 1999). Koons et al.’s (2001) small study of women war veterans meeting diagnostic criteria for borderline personality disorder reported an even higher rate of adult abuse with 65% reported being battered by a partner and 85% being raped.
Different treatment models
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
Psychodynamic theorists view the client as having a poorly formed or fragmented identity due to incomplete or disrupted psychological developmental in childhood. Normal development involves the early establishment of a secure attached relationship. From this solid base, the child can develop a sense of self whilst psychologically separating and individuating. Problems developing a secure attachment, or with separation and individuation, can lead to insecure ambivalent attachments and problems with development of identity and sense of self. If these problems progress into adulthood, there will be a poor sense of self, poorly formed identity and associated problems with self-esteem. Relationships may be associated with avoidance, intense ambivalence, or with loss of identity and individuality.
Commonalities between different models
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
Different models tend to have firm, explicit contracts, a high degree of clinician engagement and a proactive, disciplined approach to impulsive behaviour (Allen 1997; Milton, Dawson, Kazmierczak et al. I 999). All models highlight the importance of the clientclinician relationship, of the therapeutic alliance and of patterns of client behaviours manifesting in the client-clinician relationship (Allen 1997; Milton et al. 1999). All models require clinicians to remain relatively calm in crisis, be mindful of their feelings and to set limits to assist the clinician in maintaining warmth for the client, so essential for a positive outcome (Allen 1997; Milton et aL 1999). In exploring similarities in four different models, Allen (1997) notes the acceptance that therapists will make errors, which need to be acknowledged (perhaps with a brief apology) and used if possible to therapeutic advantage.
Outcome studies
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
The evidence-based research review organization, the Cochrane Collaboration has not done a systematic review on borderline personality. There is a growing literature base on evidenced-based outcome studies. In 1998 in “A guide to treatments that work”, a text focused on evidence-based research, Crits-Christoff (1998) named only two randomized controlJed trials published at the time. By the end of 2001 there have been a further four randomized controlled trials published making six randomized controlled trials published to date (Linehan et al. 1991; Linehan, Schmidt, Dimeff et al. 1999; Munroe-Blum and Marziali 1995; Bateman and Fonagy 1999; Turner 2000; Koons, Robins, Tweed et al. 2001). In addition there is one waiting list controlled study published (Stevenson and Meares 1992; Stevenson and Meares 1999). These studies are described below in order of date of publication.
In summary
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
The term “borderline personality disorder” is unsatisfactory Point prevalence is about 1.8% of 19-55-year-oldsPeople meeting criteria are well represented in mental health facilities, with estimates of 11% at community dinics and 20% in inpatient units High percentage of those attending drug and alcohol services meet criteria75% are female
Introduction
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
Effective treatment requires a skilled balance between encouraging client responsibility and autonomy, and offering clear supportive structures when needed. This section outlines how well-defined and well-supported roles for key clinicians and treatment teams can be developed in a system culture that minimizes burn-out and processes staff differences. Careful assessment, clinical plans and contracts encourage collaboration between dients and staff to improve dient outcomes. Clinician empathy, validation and containment are imbedded in dealing with inevitable crises, which for the client, are an essential opportunity to practice dealing with distress. To enable hospitalizations to be brief requires clear understandings of issues around acute versus chronic suicidality and short versus long-term risks/gains. Skills development offers clients alternatives to self-harm and suicidality as ways of relieving internal distress and communicating to others. The principles of effective treatment outlined in this section can provide a foundation to firm up current skilful practice and address hurdles to effective treatments.
Interventions
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
A desire for a solid, consistent, caring, enduring relationship is almost universal. People meeting diagnostic criteria for borderline personality disorder frequently have childhood and adult histories of relationships that have been notable for problems in attachment. Evidence-based treatments, and for that matter virtually all treatment schools, have a secure, firm, attached relationship with the therapist as central to the treatment. This firm, attached relationship is not easy to establish and maintain for clinician and client alike. Fear of abandonment and difficulty being alone have been named as core client feelings (Gunderson 1996). It is common for clients to want more from their clinicians than clinicians can provide. This threatens the therapeutic relationship because of associated feelings of hurt, anger, disappointment, rejection and abandonment.
Stigma and discrimination
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
Unlike the stigma the community puts on mental illness, the stigma associated with borderline personality disorder has been shown to come from within the mental health profession (Fraser and Gallop 1993; Gallop, Lancee and Garfinkel 1989; Lewis and Appleby 1988). Sometimes there is individual and institutional avoidance of treating people meeting diagnostic criteria for borderline personality disorder. When they are seen, it may be with ambivalence or annoyance. Linehan (1995) describes how clients who come to services with a diagnosis of borderline personality disorder may already be disliked before they have even been seen. Clients in treatment are often embroiled in clinician attitudes that are derogatory or deny the legitimacy of their right to access resources. Studies have demonstrated that clinicians have less empathy for people meeting diagnostic criteria for borderline personality disorder than other diagnostic groups and make more belittling comments (Fraser and Gallop 1993; Gallop, Lancee and Garfinkel 1989). Consumers have identified this stigma (Haswell and Graham 1996; Mazelis 1997; Mazelis 1998) and drawn parallels with the stigma associated with AIDS in the early 1980s (Mazelis 1998).
language-negative terminology
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
Words are important carriers of information and significantly shape the future. Some commonly used terminology such as “PD”, “worried well” and “just behavioural” delegitimizes clients, is offensive and almost certainly leads to poorer outcome. We need to explore terminology that is more helpful. “Attention seeking might be better replaced with “in need of attention”, “manipulation” with “manoeuvre, “worried well” with “walking wounded” and “greedy” with “in need”. The term “splitting”, as described earlier, whilst conveying an important concept, has frequently been corrupted to bJame the client for all staff differences and depower clinicians to do anything about the situation. Therapists who hold non-pejorative conceptualizations of their dients have been shown to achieve better results as measured by a decrease in client self harm episodes and suicidal thoughts (Shearin and Linehan 1992).
Professionally indicated risk-taking
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
Staff anxiety in any mental health organization is directly proportional to how recently the hit the fan (ie a poor client outcome led to an inquiry or was reported in the media)(Workshop participant commenting on professional anxiety in treating people meeting diagnostic criteria for borderline personality disorder)I know what the right clinical decision is, but I am going to look after myself.(Workshop participant commenting about defensive practice at the expense of client outcome)I think sometimes when doctors and nurses try and protect themselves they’re not really making decisions in the best interest of the patient.(clinician quoted in: O’Brien and Flote 1997)
Limit-setting
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
Literature over the last decade has legitimized the importance and appropriateness of limit-setting to prevent dinician bum-out (Adler 1993; Linehan 1993a; Young 1996a; Young 1996b). Limit setting is appropriately used to increase clients’ adaptive behaviours and interpersonal skills and has been written about extensively, however there has been little written on the legitimacy of limit setting for the needs of the clinician. The culture of the health professions as “giving)) and “caring)) has discouraged the legitimate rights of dinicians to look after themselves. It is in the client’s interest that clinicians look after themselves and set limits accordingly, as a burnt-out dinician who resents their client will not be therapeutic. Naming limit-setting as necessary for the clinician is associated with a more benevolent attitude towards the client. Therapists holding a “non-pejorative conceptualization)) of people meeting diagnostic criteria for borderline personality disorder has been shown by Shearin and Linehan (1992) to be associated with better client outcomes measured by a decrease in client self-harm and suicide thoughts.
Supervision
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
Supervision provides an essential “safe space for clinicians to think and reflect on, rather than deny and flee from, problems and feelings” (Owen 1998). Working with suicidal people who frequently want assistance that can’t be provided and turn down offers of what can be provided, may lead to feelings of powerlessness, anger and despair. Supervision provides a space where these feelings can be recognized, normalized and worked with, to the benefit of client and clinician. “Supervision benefits the therapist by offering a relationship which aims to guide, mentor, inspire, emotionally support and develop insight and understanding in the therapist (NZAP 1997).
In summary
Authors: Krawitz Roy , Watson Christine 
Published: November 2023

Abstract
Limit-setting for the clinician’s needs is legitimate to enable the clinician not to burn-out and retain positivity for the client+ Successful outcomes are likely to be the biggest factor maintaining enthusiasm+ Holding a long-term perspective and being mindful of small gains provides a realistic framework on which to measure successValue and status given to the client, clinician and the work willhelp sustain enthusiasm+ What is good for the clinician is usually good for current and future clients+ Clients will not benefit from an apathetic. de-energized clinician
Ethical aspects of psychotherapy practice
Authors: Dyer Allen R , Bloch Sidney 
Published: November 2023

Abstract
Ethics is fraught with ambiguity both theoretically and in its application. Who should judge what is right and wrong? What principles, methods, and sources should be used? Ethics and morality may be used synonymously. Alternatively, a distinction is made, morality referring to the correctness of personal behaviour and ethics connoting more objective standards of behaviour, particularly as they might apply to professional practice. The ethics of psychotherapy fall into the latter category, although the practice itself— given that it entails self-reflectiveness—contributes to an understanding of moral action that transcends philosophy.
What is psychotherapy?
Authors: Frank Jerome D 
Published: November 2023

Abstract
In this introductory, now classic chapter, the late, much esteemed Jerome Frank (1910–2005) attempts to answer the complex question ‘what is psychotherapy?’ by approaching the subject in historical and cultural contexts. After describing psychotherapy’s practitioners, the kinds of treatment they offer, and the patients who receive it, he pays particular attention to the common therapeutic functions of the rationales and procedures of all psychotherapies. The chapter ends with general principles and guidelines for the trainee setting out to practise psychotherapy.
Individual long-term psychotherapy
Authors: Mizen Susan , Holmes Jeremy 
Published: November 2023

Abstract
Long-term therapy is usually correctly equated with psychoanalysis, which, unlike almost all other forms of therapy, values the importance of treatment over a matter of years. Supportive psychotherapy (see Chapter 10) also implies long-term treatment. In this chapter, we shall be concerned mainly with psychoanalysis (usually 3–5 sessions a week, lasting 2–5 years) and its derivative, psychoanalytic psychotherapy (commonly 1–2 sessions per week, lasting 18 months–3 years). Other forms of therapy, such as Cognitive Behaviour Therapy and Dialectical Behaviour Therapy, when applied to people suffering from complex problems may last longer than was originally envisaged.
Sex therapy
Authors: Bancroft John 
Published: November 2023

Abstract
Since the third edition significant changes have occurred in treating sexual dysfunction in men. This has mainly resulted from the introduction of drugs, such as sildenafil (Viagra), which have had a major impact on the treatment of erectile dysfunction, and other pharmacological agents aimed at improving low sexual desire (e.g. apomorphine) or treating premature ejaculation (e.g. serotonin re-uptake inhibitors) (Leiblum and Rosen 2000). Female sexual dysfunction has not benefited in the same way, but not for want of trying.
The Pervasive Influence of European Community Law in the United Kingdom
Authors: Grief Nicholas 
Published: November 2023

Abstract
MUCH has been written about the uniqueness of Community law and the significance of the fact that the European Community is a supranational system, its hallmark being the creation of rights and duties for individuals and the supremacy of Community law over national law in the event of a conflict. It is clear that Community law reaches parts of the domestic legal system which other kinds of international law3 cannot reach. Lord Denning once stated: ‘The treaty does not touch any of the matters which concern solely the mainland of England and the people in it. They are still governed by English law. They are not affected by the treaty. But when we come to matters with a European element, the treaty is like an incoming tide. It flows up the estuaries and up the rivers.
The Ethological Theory of Stress: About Work Stress and Wisdom
Authors: Schabracq Marc 
Published: November 2023

Abstract
People do not adapt to any situation: they specialize, select their environment from the pool of situations available to them, rearrange them-if possible-to their own taste and preferences, and adapt to them. So, human functioning is characterized by a specific ecology: an individual develops a relatively stable niche to live in. For example, most people live in only one house, together with only a few fixed family members; they have their daily, weekly, and yearly routines, interact with a very limited number of other people in customary ways, have their favorite ways of relaxing, and work in standardized ways and settings. The repetition inherent in such a life enables the actor to develop skills to handle a situation at a more or less ‘automatic’ level. In this way, attention can be focused on what is deemed important at that moment, such as the optimal performance of situated roles, the solution of specific task-related problems or further development of skills.
Brief notes on dermatological therapy
Authors: Path Rona M 
Published: November 2023

Abstract
Prinect Trap Editor Therapy for skin disease can be broadly divided into topical preparations, physical therapy such as ultraviolet light or laser treatment, and systemic therapy. In the past 5 years the use of potent systemic agents in chronic or severe psoriasis, acne, and eczema has become much commoner. Oral retinoids and a wide range of immunosuppressive agents are now used fairly routinely in hospital departments of dermatology, and the use of cytokine modulating therapy, such as anti-TNF alpha agents is becoming commoner for patients with severe psoriasis. While use of these drugs has revolutionized the control of severe dermatological problems for many patients, they all have toxicity profiles, and must be used with appropriate monitoring. Oral retinoid use in acne without absolute contraception has led to tragic foetal malformations.
A background to addiction and its treatment
Authors: Gossop Michael 
Published: November 2023

Abstract
What this book means by drug addiction is most often manifested) psychologically and behaviourally, in feelings of compulsion to use drugs and difficulty in resisting those urges. Addiction is a learned behavioural problem, a habit disorder. It differs fundamentally from the mere use of illegal drugs in that an addiction represents an altered relationship between the user and their drug(s). The precise psychological and neurophysiological foundations upon which this altered relationship is based have yet to be fully identified.
Psychological health, physical health, and mortality
Authors: Gossop Michael 
Published: November 2023

Abstract
Drug users who present for treatment often have physical and psychological health problems in addition to their drug problems. Many dependent drug users have generally poor health associated with their lifestyles, and many physical health problems are directly associated with drug use. Intravenous drug users can develop respiratory complications from granuloma formation after injecting insoluble adulterants (Glassroth et al. 1986), and the inhalation of high-temperature vapours such as those of heroin, crack, or free-base cocaine can also cause respiratory disease or damage (Hughes and Calverley 1988), especially when the drug contains contaminants (Tashkin et al. 1987). Regular cannabis smoking can lead to respiratory symptoms such as wheezing, shortness of breath, and tightness in the chest Such symptoms are similar to those induced by cigarette smoking but can occur (independently of cigarette smoking) even after a relatively short duration of cannabis use (Taylor et al. 2000).
The relationship between the drug user and treatment
Authors: Gossop Michael 
Published: November 2023

Abstract
The role played by treatment in helping addicts to give up drugs is complex, and the evidence about the effectiveness of specific treatments is often difficult to interpret. To understand the effectiveness of treatment it is necessary first to ask the right questions. The apparently straightforward question, ‘what is the most effective way to treat opiate addiction?’, is misleading and cannot be answered directly. The problems of drug misuse cannot be fitted within a single unitary category.
Dental radiology
Authors: Brocklebank Laetitia 
Published: November 2023

Abstract
Radiography and radiology are in all the dental clinical disciplines, to aid in diagnosis, treatment planning and management of patients. Dentists usually undertake their own radiography and therefore require to be competent at producing images, and interpreting the findings. They have a duty under the regulations currently in force to comply with legal requirements, and to be aware of those requirements, and any changes made to them. The specific requirements to be fulfilled at graduation are specified in The First Five Years(GDC 2002), and the QAA Benchmark document (QAA 2002). Relevant sections in The First Five Yearsare: Paragraph 96 Students should receive instruction and practical experience in the referral criteria, taking, processing and interpretation of intraand extraoral radiographs and the writing of radiology reports. They should be aware of alternative imaging techniques. It is highly desirable that instruction in this part of the programme is under the direction of a registered specialist in dental radiology.
Impression-making General and special circumstances
Authors: Burke Francis 
Published: November 2023

Abstract
An impression is a ‘negative likeness or copy in reverse of the surface of an object; an imprint of the teeth and adjacent structures for use in dentistry’ (Journal of Prosthetic Dentistry 1999). From this negative likeness a cast is made which can be used in the planning and/or provision of care. In 2003 the Dental Practice Board for England and Wales reported that 1.7 million units of crown and bridge work were placed as well as one million dentures and 470,000 courses of orthodontic treatment. For all of these procedures as well as for diagnostic reasons impressions were necessary (DPB 2003).The ability to carry out appropriate impression-making is likely to continue to play an essential role in the undergraduate curriculum. Provision of such care will also need to encompass an understanding of behaviour management (Chapter 1.10), infection control (Chapter 1.5), law and ethics (Chapter 1.2), dental materials (Chapter 1.16), removable prostheses (Chapter 2.7), and restorative dentistry (Chapter 2.5).