Exam (elaborations)
NR 547 Differential Diagnosis Week_7_discussion_NR_547.
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- Chamberlain College Of Nursing
NR 547 Differential Diagnosis
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1. Define NSSI behavior.Non-suicidal self-injury (NSSI) behavior is self-harming behavior without intent to
commit suicide. Some of the self-harming behaviors are self-cutting, overdosing,
substance abuse and other risky behaviors. NSSI is common in borderline personality
disorder. According to Perez et al. (2020), theories explain the main component of NSSI
is emotional dysregulation. People tend to engage in self harm behavior to feel good
when they are emotionally overwhelmed.
Discuss how the psychiatric mental health nurse practitioner (PMHNP)
differentiates between NSSI and suicide attempts.
It is difficult to differentiate between NSSI and suicide attempts as they both involve
self-injury. PMHNP can differentiate between NSSI and suicide attempt by interviewing
patient thoroughly. If the patient who have involved in self harm expresses the feelings
of hopelessness, worthlessness and wish to be dead, we know it’s suicide attempt but if
the patient expresses that they are emotionally overwhelmed and self-harming reduces
their emotional pain or make them feel better, that’s a sign of NSSI.
2. Discuss evidence-based therapy for BPD. How does therapy interrupt the patterns
of NSSI and suicidality?
There are many evidence-based effective therapies available for BPD, most common
being Dialectical behavioral therapy (weekly individual and weekly group). It is
effective therapy and easily accessible. It is available as individual therapy, group
therapy, phone consultation and consultation team. Its main goal is to increase
interpersonal skills and decrease self-harming behavior. DBT teaches mindfulness,
distress tolerance, emotion regulation and interpersonal effectiveness. Mentalization is
another type of therapy for BPD. This therapy helps patient be aware of one’s own
mental state and of others. “MBT is based on a theory that borderline personality
symptoms, such as difficulty regulating emotions and managing impulsivity, are a result
of patients’ reduced capacities to mentalize” (Boland et al., 2022). Transference-focused
psychotherapy diminishes the need for splitting, improves object relation, and
functioning in BPD. Dynamic deconstructive psychotherapy (DDP) is the newer
psychotherapy treatment for BPD and is significantly effective treatment. The quasi-
randomized observational study shows DDP is highly effective in the treatment of BPD,
depression and suicide related behaviors in comparison to DBT and other treatment
(Majdara et al., 2021).
3. What specific ethical and clinical challenges might the clinician face when treating
clients with BPD who are suicidal?
Clinician may face ethical and clinical challenges while treating patient with BPD.
These population may negatively react to the situation and treatment making it more
challenging. Patients with BPD are most likely to engage in self-harming behavior and
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