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Borderline Personality Disorder, Obesity, and Eating Disorders – May 7, 2010

Borderline Personality Disorder, Obesity, and Eating Disorders

SIXTH ANNUAL CONFERENCE

Use links below to view / listen to conference presentations!

Program

Welcome Perry D. Hoffman, PhD
Opening Remarks John H. Krystal, MD
BPD and Eating Disorders Comorbidity Carlos M. Grilo, PhD
Objectives

  1. Define the Borderline Personality Disorder (BPD), Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder diagnoses.
  2. Discuss leading etiological models, course of illness, and prognosis of these disorders.
  3. Review the literature on the comorbidity of BPD with eating disorders, with specific attention to the controversies and complications of their co-occurrence
The 10-year Course and Predictors of Obesity and Obesity-related Illnesses in Patients with BPD Mary C. Zanarini, EdD
Objectives

  1. Review the rates of obesity found in patients with BPD over 10 years of prospective follow-up
  2. Review the rates of obesity-related illnesses in patients with BPD followed prospectively for a decade
  3. Review the risk factors for obesity in borderline patients, including the common practice of aggressive polypharmacy
Family and Consumer Perspectives Marie-Paule de ValdiviaJanice Brabaw
Personality Subtypes of EDs: Treatment response, longitudinal course, and clinician countertransference Heather Thompson-Brenner, PhD
Objectives

  1. Identify personality subtypes of EDs, including those with borderline features and those without
  2. Understand the differences in treatment outcome and longitudinal course for the different personality subtypes
  3. Understand the evidence supporting the efficacy of integrative psychotherapy for personality subtypes with BPD features
  4. Identify differences in clinicians’ positive and negative reactions to patients with EDs based on personality features
Dialectical Behavior Therapy for difficult-to-treat eating disorders Eunice Chen, PhD
Objectives

  1. Identify groups with difficult-to-treat eating disorders
  2. Reasons for adapting Dialectical Behavior Therapy for individuals with eating disorders
  3. Identify how Dialectical Behavior Therapy has been adapted for individuals with eating disorders
When the eating disorder is life threatening: Using DBT to treat multi-diagnostic ED patients Lucene Wisniewski, PhD
Objectives

  1. Identify ED groups (AN, BN, EDNOS) for which using DBT has empirical support
  2. Determine under which target in DBT a particular behavior should be categorized
  3. Recognize which components of standard CBT for EDs need to be included in the treatment of multidiagnostic ED patients who are underweight.
Panel Discussion Moderator: Seth Axelrod, PhD
Lunchtime presentation to residents and trainees (by invitation only) DBT Adapted for Suicidal and Self-harming Children
Francheska Perepletchikova, PhD
Objectives

  1. Review findings on the rise in suicidal and self-injurious behaviors in children, and strategies for identifying those at risk
  2. Understand the rational for modifying DBT for children suicidal and self-injurious behaviors
  3. Became familiar with specific strategies for teaching DBT concepts to children including multimedia presentations, as well as examples of how DBT materials have been modified to be age-appropriate.

Conference Details

Sponsors
The National Education Alliance for Borderline Personality Disorder
Yale University School of Medicine, Department of Psychiatry
Yale-New Haven Psychiatric Hospital
NAMI Connecticut

Time and Location
Friday, May 7, 2010
8:00 a.m. @ 4:00 p.m.

Mary S. Harkness Auditorium,
Sterling Hall of Medicine,
333 Cedar Street, New Haven, CT 06510

For information on continuing education and special needs, contact conference registrar at 802-527-1419 or email neabpd@aol.com.

Statement of Need

  • Diagnosis and treatment interventions of borderline personality disorder should begin as soon as possible
  • Borderline Personality disorder (BPD) is a severe and generally chronic disorder and people who suffer from it are underserved.
  • Friends and families are often bewildered and do not know how to help.
  • Treatment programs for those with BPD need to be more readily available.
  • Families need access to programs such as those already developed for several other mental illnesses.
  • BPD presents patients, their families, clinicians, and researchers with multiple challenges.
  • BPD frequently co-occurs with obesity and eating disorders, confounding all of the above challenges

Purpose

The complex challenges associated with BPD, obesity, and eating disorders will be addressed in order to inform mental health professionals, families and consumers of the most current diagnostic information and treatment options, as well as other current issues relevant to those affected by these difficulties.

Audience

This conference will provide a forum for professionals, family members, and consumers to better understand BPD, obesity, and eating disorders from various perspectives.

The Conference is for physicians, psychiatrists, psychologists, social workers, family therapists, counselors, nurses, emergency room personnel, law enforcement personnel and agencies, educators, family members, friends, and consumers. Mental health students are particularly encouraged to attend, and those registering are invited to a complementary lunch event.

Continuing Education Credit Hours

This program has been approved for 6.25 Continuing Education Credit Hours by the National Association of Social Workers, CT and meets the continuing education criteria for CT Social Work Licensure renewal.

(To receive a CE certificate at the end of the conference, license number and request for CE’s should be included in the registration information, or at time of sign-in / sign-out at the conference.)

Course Description

Presenters will offer current information on research and best practice relating to BPD, obesity, and eating disorders, and family members and consumers will share their experiences. Each session allows time for questions and answers, and the day will close with an interactive panel discussion that will discuss issues of developing and disseminating relevant treatments.

Conference Objectives

This conference will provide a forum for professionals, family members, and consumers to better understand the disorder from various perspectives. Presentations will focus on:

  • Associations of BPD with Obesity and Eating Disorders (EDs)
  • Longitudinal associations of BPD and Obesity
  • Risk factors for obesity, including aggressive polypharmacy
  • Personality subtypes in eating disorders and treatment implications
  •  Clinicians reactions to patients with eating disorders based on personality features
  • The emotion-regulation function of eating disorder symptoms
  • Adaptations of Dialectical Behavior Therapy (DBT) for Eating Disorders
  • The Integration of cognitive behavioral therapy and DBT
  • Family and consumer experiences

COURSE DIRECTORS

Seth R. Axelrod, PhD
Associate Professor of Psychiatry
Yale University School of Medicine
DBT/DBT-SUD Intensive Outpatient Program Team Leader
Yale-New Haven Psychiatric Hospital

Perry D. Hoffman, PhD
President, National Education Alliance for Borderline Personality Disorder

CONFERENCE COORDINATORS

Emily B. Ansell, PhD
Associate Research Scientist
Department of Psychiatry
Yale University School of Medicine

Nicole Cain, PhD
Post-Doctoral Fellow
New-York Presbyterian Hospital
Department of Psychology
Weill Connell Medical Center

Francheska Perepletchikova, PhD
Post-Doctoral Fellow
Department of Psychiatry
Yale University School of Medicine

CONFERENCE REGISTRARS

Jacquelyn N. Smith, LMSW
Dialectical Behavior Therapy Ward
Creedmore Psychiatric Center

Trish Woodward, MAT
Secretary, National Education Alliance for Borderline Personality Disorde.

COURSE DIRECTORS

Seth Axelrod, PhD
Dr. Axelrod is an associate professor in the Department of Psychiatry at the Yale University School of Medicine and the team leader of the DBT and DBT for Substance Use Disorders (DBT-SUD) intensive outpatient programs at the Yale-New Haven Psychiatric Hospital. He received his PhD from the University of Kentucky, completed his internship focused on DBT with the Connecticut Department of Mental Health and Addiction, and obtained postdoctoral training in personality disorders in the Department of Psychiatry at the Yale University School of Medicine. He founded the Connecticut DBT Network, which promotes DBT Treatment in the State of Connecticut. Dr. Axelrod teaches and supervises mental health trainees and professionals in DBT and personality disorders, and he provides consultation to schools and mental health agencies. His research interests include borderline personality disorder and related difficulties, and DBT adaptations.

Perry D. Hoffman, PhD
Perry D. Hoffman, Ph.D. is the President and a co-founder of the National Education Alliance for Borderline Personality Disorder (NEA-BPD). She has several grants from the National Institute of Mental Health with a focus on families who have a relative with borderline personality disorder. Dr. Hoffman is co-designer of the 12-week psycho-education course for families, Family Connections, which is available in many locations both in the United States as well as other countries. She is a co editor, with John G. Gunderson, MD, of the book Understanding and Treating Borderline Personality Disorder: A Guide for Professionals and Family Member and co editor of Borderline Personality Disorder: Meeting the Challenges to Successful Treatment currently in press. Dr. Hoffman, who is intensively trained in Dialectical Behavior Therapy (DBT), has been the director of several treatment programs in the New York area and now is in private practice in New York City and Westchester County, NY.

CONFERENCE FACULTY

Chen, Eunice, PhD
Eunice Chen is an Assistant Professor in Psychiatry and Behavioral Neurosciences at the University of Chicago. She runs the Adult Eating and Weight Disorders program which focuses upon developing psychosocial treatments for individuals with difficult-to-treat eating and weight disorders. This work so far has included developing Dialectical Behavior Therapy for women with binge-eating disorder/bulimia nervosa and borderline personality disorder and for women with bulimia nervosa and major depression. Currently she is working on a clinical trial to develop Dialectical Behavior Therapy for early rapid non-responders to standard treatment with binge-eating disorder and for women with anorexia nervosa. She is also experienced in the use of cognitive-behavior therapy for binge-eating disorder and bulimia nervosa, previously using this for a randomized controlled trial. In addition to her treatment development work, she runs a translational program to examine emotional processes as they relate to treatment utilizing psychophysiological assessment and behavioral neuroscience methods. She received her PhD from the University of Sydney Australia and completed two postdoctoral fellowships, one with Kelly Brownell, PhD at Yale University and another with Marsha Linehan, PhD at the University of Washington, Seattle.

Carlos M. Grilo, PhD
Dr. Grilo is Professor of Psychiatry and Director of the Program for Obesity, Weight, and Eating Research at the Yale University School of Medicine. Dr. Grilo is also Professor of Psychology at Yale University. Dr. Grilo completed his undergraduate education at Brown University and received his Ph.D. in clinical psychology from the University of Pittsburgh. Following an internship and a fellowship at the Harvard Medical School and McLean Hospital and postdoctoral training at Yale University, Dr. Grilo joined the faculty at Yale University. Dr. Grilo served as Director of Psychology at the Yale Psychiatric Institute until 2000. His primary research focus is on eating disorders and obesity and his secondary interests include personality disorders and psychopathology. Dr. Grilo has been the recipient of numerous research grants and has served as Principal Investigator on eight grants from the National Institutes of Health including a K24 Mid-Career Investigator Award in Eating and Weight Disorders. Dr. Grilo currently serves on the editorial boards of seven professional journals and has published over 260 peer-reviewed journal articles.

John H. Krystal, MD
Dr. Krystal is the Robert L. McNeil, Jr., Professor of Translational Research and Chair of the Department of Psychiatry of the Yale University School of Medicine and Chief of Psychiatry at Yale-New Haven Hospital. He is a graduate of the University of Chicago, Yale University School of Medicine, and the Yale Department of Psychiatry Residency Training Program. He has published over 350 papers and chapters on the neurobiology and treatment of alcoholism, schizophrenia, post-traumatic stress disorder, and depression. His research program unites psychopharmacology, neuroimaging, and molecular genetics. His work on brain glutamate systems contributed to the identification of novel treatment mechanisms for alcoholism, depression, and schizophrenia, that are now in development. He is the Director of the NIAAA Center for the Translational Neuroscience of Alcoholism, VA Alcohol Research Center, and Clinical Neuroscience Division of the VA National Center for PTSD. Dr. Krystal received the Joel Elkes Award of the American College of Neuropsychopharmacology (ACNP), the Han J’nas Weitbrecht Scientific Award from Bayer, the APIRE/Kempf Fund Award of the American Psychiatric Association, the Anna-Monika Foundation Prize, and other awards. He was Chairman of the NIMH Board of Scientific Counselors (2004-2007) and he currently serves on the NIAAA National Alcohol Advisory Council and the Department of Defense Psychological Health Advisory Board. He has served in leadership roles in several professional societies. He currently serves on the boards of directors of the ACNP and the Society of Biological Psychiatry. Since 2006, he has edited one of the leading journals in psychiatry and neuroscience, Biological Psychiatry (IF=8.76).

Francheska Perepletchikova, PhD
Dr. Perepletchikova is a Post Doctoral Fellow at the Department of Psychiatry, Yale University School of Medicine. Dr. Perepletchikova has a long-standing interest in child psychopathology, parental factors and relevant interventions. Specifically, her prior research focused on the examination of parenting practices related to behavior problems in children and adolescents, and she is currently adapting Dialectical Behavior Therapy (DBT) to children. Dr. Perepletchikova was born and raised in Odessa, Ukraine and attended Odessa State University, with major in English Language and Literature. She received her B.A. in Psychology from St. John’s University, M.A. in Developmental Psychology from Columbia University and Ph.D. in Clinical Psychology from Yale University. Her research focused on childhood psychopathology and evaluation of treatment integrity in treatment outcome research. Dr. Perepletchikova has extensive experience in research and treatment of adults, adolescents and children with emotional and behavioral dysregulation, including BPD features. She was trained in DBT while on internship at Yale University School of Medicine, and she obtained intensive and advanced intensive trainings in DBT with Marsha Linehan’s Behavioral Tech. Dr. Perepletchikova is currently working on adapting DBT to treat children exposed to trauma with emotional and behavioral dysregulation, including suicidality and self-harm behaviors.

Heather Thompson-Brenner, PhD
Dr. Thompson-Brenner received her Ph.D. in 2002 from University of Michigan. She conducted her internship training in the Harvard Medical School program at Cambridge Hospital, and completed a post-doctoral fellowship in treatment and research for eating disorders at the Center for Anxiety and Related Disorders. Dr. Thompson-Brenner’s primary research interest is in the treatment of eating disorders, and she has special interests in the particular concerns of individuals with personality disorders and those from minority ethnic/cultural groups. Dr. Thompson-Brenner received a Career Development Award from the National Institute of Mental Health in 2005. She has two NIMH-funded research projects underway, studying psychotherapy for individuals with co-occurring bulimia nervosa and borderline personality features, and treatment outcome in trials of psychotherapy for binge eating disorder for participants from minority ethnic backgrounds.

Lucene Wisniewski, PhD, FAED
Dr. Wisniewski is Clinical Director and co-founder of the Cleveland Center for Eating Disorders. She received her PhD from the University of Pittsburgh and completed an NIMH supported Clinical-Research Post-doctoral fellowship at the Eating Disorders program there. Dr. Wisniewski was Clinical Director of Eating Disorder Programs for Laurelwood Hospital from 2000-2006. She holds an adjunct appointment in the psychology department at Case Western Reserve University. Her research and clinical interests include using empirically founded treatments to inform clinical programs, in particular the use of CBT and DBT. She provides workshops on the CBT and DBT treatment of eating disorders nationally. She is a fellow in the Academy for Eating Disorders as well as the North American Association for Study of Obesity. Her most recent publications involve using DBT in the treatment of eating disorder patients with and without borderline personality disorder.

Mary C. Zanarini, Ed.D.
Dr. Zanarini is currently a Professor of Psychology at Harvard Medical School and the Director of the Laboratory for the Study of Adult Development at McLean Hospital in Belmont, MA. She has been the recipient of research grants from the National Institute of Mental Health, the American Foundation for Suicide Prevention, and the National Alliance for Research on Schizophrenia and Depression. In addition, Dr. Zanarini is Chair of the NIMH Workgroup for the Development of Guidelines for Treatment Research on BPD and Chair of the World Federation of Societies of Biological Psychiatry Task Force on Personality Disorders.

Dr. Zanarini’s research focuses on describing the phenomenology, etiology, and long-term course of borderline personality disorder (BPD). Her work has led to the increasingly accepted view that BPD is a good prognosis diagnosis. She has also conducted numerous treatment trials of psychotropic medications and psychosocial interventions for BPD. More recently, she has been studying early onset BPD in children and adolescents as well as the genetics of BPD. Finally, she has developed interviews that are widely used to diagnose BPD and to assess change over time in treatment studies of BPD.

SPECIAL SPEAKERS

Janice Brabaw
Janice Brabaw is a writer and spoken word artist whose two collections of poetry, Universe, Disturbed and Tongue For Folie explore her struggles with borderline personality disorder, suicide attempts, obesity, and depression. Her first book, Universe, Disturbed, contains passages lifted directly from her teenage journals and garnered critical praise as ‘a chilling and authentic glimpse into the mind of the young, depressed, and desperately alone. She has performed in many venues in New York City and throughout the Northeast including the Cornelia Street Caf’, Bowery Poetry Club, and Otto’s Shrunken Head. Currently, Janice is working on her first non-fiction book, a BPD memoir, And Again. She lives in New Jersey and works in the television and film industry. More information about Janice and samples of her work can be found at www.JaniceBrabaw.com

Marie-Paule de Valdivia
Marie-Paule de Valdivia came to the U.S. 30 years ago from her native France to complement her business education. Upon graduation and armed with an MBA, she decided to make the U.S. her permanent home and gained business experience working for 10 years for Leo Burnett Advertising, and then took seven years off to raise two children she and her supportive husband had adopted in Romania in 1991: a newborn and a 2 1/2 year old hurt little girl. As they started school, she excitedly went back to work, in the marketing research field this time; until three years ago when her daughter presented with severe BPD symptoms. Now that her daughter has made marked progress, Marie-Paule has embarked on the MSW program at Southern Connecticut State University. She is on the board of NEA-BPD and greatly enjoys teaching Family Connections classes, either in person or TeleConnections via phone.

CONFERENCE COORDINATORS

Emily B. Ansell, PhD is an Associate Research Scientist in the Yale University School of Medicine’s Department of Psychiatry. She received her Ph.D. in clinical psychology from the Pennsylvania State University and completed her postdoctoral training at Yale University as project director for the NIH funded Collaborative Longitudinal Personality Disorders Study (CLPS). In 2008, she joined the faculty at Yale University. She has extensive clinical assessment, psychotherapy, and research experience working with clients diagnosed with borderline personality disorder. Her research has examined the psychosocial functioning, treatment utilization, and course of anxiety disorders in individuals with personality disorder diagnoses, particularly borderline, avoidant, narcissistic, and obsessive-compulsive personality disorders. Currently she is investigating the role that interpersonal problems, personality traits, and stress have in maladaptive behaviors, including addiction and suicide-related outcomes. Her research is funded by the American Foundation for Suicide Prevention (AFSP).

Nicole Cain, PhD is a Post-Doctoral Fellow at New York-Presbyterian Hospital, Weill Cornell Medical Center in the Department of Psychology. In her graduate training, she received extensive experience in the treatment and research of individuals diagnosed with personality disorders. Her primary research interests include psychotherapy outcome for personality disorders, examining how interpersonal problems impact psychotherapy course and outcome for various Axis I disorders, and interpersonal theory. As part of her current fellowship, Dr. Cain is conducting research at The Personality Disorders Institute under the mentorship of Drs. Otto Kernberg and John Clarkin examining psychotherapy outcome for borderline personality disorder (BPD). In addition, she is currently receiving supervision in Transference Focused Psychotherapy (TFP) for BPD. She is also receiving training in Dialectical Behavior Therapy (DBT) for BPD and emotion/behavior dysregulation.

Francheska Perepletchikova, PhD is a Post Doctoral Fellow at the Department of Psychiatry, Yale University School of Medicine. Dr. Perepletchikova has a long-standing interest in child psychopathology, parental factors and relevant interventions. Specifically, her prior research focused on the examination of parenting practices related to behavior problems in children and adolescents, and she is currently adapting Dialectical Behavior Therapy (DBT) to children. Dr. Perepletchikova was born and raised in Odessa, Ukraine and attended Odessa State University, with major in English Language and Literature. She received her B.A. in Psychology from St. John’s University, M.A. in Developmental Psychology from Columbia University and Ph.D. in Clinical Psychology from Yale University. Her research focused on childhood psychopathology and evaluation of treatment integrity in treatment outcome research. Dr. Perepletchikova has extensive experience in research and treatment of adults, adolescents and children with emotional and behavioral dysregulation, including BPD features. She was trained in DBT while on internship at Yale University School of Medicine, and she obtained intensive and advanced intensive trainings in DBT with Marsha Linehan’s Behavioral Tech. Dr. Perepletchikova is currently working on adapting DBT to treat children exposed to trauma with emotional and behavioral dysregulation, including suicidality and self-harm behaviors.

CONFERENCE REGISTRAR

Jacquelyn N. Smith, LMSW, came to NYC in 2003 to attend Columbia University School of Social Work. During her second-year year internship at Creedmoor Psychiatric Center she was exposed to and began practicing DBT with patients struggling with dysfunction related to Borderline Personality Disorder. She completed her internship under the auspices of Andre Ivanoff, Ph.D., professor at CUSSW and International Trainer and Consultant for Behavioral Tech, LLC, the agency overseeing the implementation of DBT. From this internship, she was Intensively Trained in DBT at the Bronx VA in 2005. After briefly working at F.E.G.S. upon graduation from CUSSW, she worked for 2 1/2 years at the NYPH/Payne Whitney day program performing individual and group psychotherapy, and half-time in the DBT track. Her professional life then became full circle as she returned to Creedmoor Psychiatric Center on the Dialectical Behavior Therapy ward where she first trained in DBT. ‘DBT is my passion,” she says, ‘and working to create a life worth living for those struggling with dysfunction resulting from BPD. I am always seeking to learn more, expand my knowledge base, and become involved to bring hope to those seeking a better life in spite of BPD. I look forward to working with NEA-BPD in my ongoing quest to spread the word about the support available for individuals with BPD and their loved ones.