Treatment of Patients with Borderline Personality Disorderö).
SusanÆs treatment could be approached from the perspective of cognitive therapy, and in that event it should be augmented by an assessment of her depressive symptoms according to one of the clinician reports such as the 17-item Hamilton Rating Scale for Depression (HRSD-17), the 30-item Inventory for Depressive SymptomatologyùClinician Report (IDS-C-30), or patient reports such as the Beck Depression Inventory (BDI) and the 30-item Inventory for Depressive SymptomatologyùSelf Report (IDS-SR-30), all of which ôreflect essentially the same symptom severity and change constructs during acute-phase cognitive therapyö (Vittengl et al., 693).
Cognitive therapy works by breaking depression down into its four general symptom categoriesùphysical, emotional, behavioral, and cognitiveùso that its various aspects can be identified (Westermeyer). Physical symptoms include low energy, fatigue, agitation, diminished libido, insomnia, and changes in appetite (Westermeyer). Emotional symptoms would be such things as sadness, loneliness, guilt, shame, and anhedonia (Westermeyer). Behavioral symptoms would be inactivity, withdrawal, reduced socialization, reduction in pleasurable activities, social skill deficits, crying, and self-injury/suicide (Westermeyer). The cognitive symptom area is further broken down into deficits and bias; deficits include confusion, short- and long-term memory deficits, and attentional deficits, while bias includes self-focused attention, negative memory bias, hopelessness, helplessness, and worthlessness (Westermeyer). Depression becomes ongoing because ôdepressive symptoms feed one another, and this is what prolongs the stateö (Westermeyer). Patients like Susan who have lost their jobs may conclude, ôIÆm a loser; IÆm unemployable,ö and these self-statements will contribute to her emotional symptoms of sadness, guilt, and depression, pos...