Emotional dysregulation, depression, self harm, and suicidality in adolescents and young adults: Emerging traits of BPD?

Conference Videos

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[wptabtitle]Chicago Validation Conference – Video 1[/wptabtitle]
[wptabtitle]Chicago Validation Conference – Video 2[/wptabtitle]
[wptabtitle]Chicago Validation Conference – Video 3[/wptabtitle]
[wptabtitle]Chicago Validation Conference – Video 4[/wptabtitle]

Conference Sponsors

The National Education Alliance for Borderline Personality Disorder
In collaboration with
NorthShore University HealthSystem
NAMI Chicago
NAMI Cook County North Suburban

Time and Location

Friday, May 30, 2014
Registration opens at 7:30 a.m.
Conference: 8:30 a.m. – 4:30 p.m.

Hilton Orrington/Evanston
1710 Orrington Avenue
Evanston, IL 60201

The conference venue at the Orrington/Evanston is two blocks from the Evanston Davis Street commuter and CTA rail station.  This station is served by the Metra Union Pacific North Line and the CTA Purple line.
Valet parking is available at $8/car.
Map and specific directions are available at: www.hotelorrington.com
For information on continuing education, special needs, and group rates contact conference registrar at 
info@neabpd.org or call 802-527-1419

Continuing Education Credits

Continuing Education Credit 6.0 hours applications through NorthShore University HealthSystem
Professional Counselor/Clinical Counselor License # IL 197-00086
Social Worker License # 159-000227
RN  INA-CE Provider # 0115-013-SL-11

Statement of Need for NEABPD conferences

  • Borderline Personality disorder (BPD) is a severe and generally chronic disorder and people who suffer from it are underserved.
  • 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.
  • Diagnosis and treatment interventions of borderline personality disorder should begin as early as possible.
  • Treatment programs for those with BPD need to be more readily available.
  • Friends and families are often bewildered and often do not know how to help.
  • Families need access to programs such as those already developed for several other mental illnesses.


  • Mental health professionals and medical practitioners working with adolescents and young adults.
  • The program will also be of benefit to family members, consumers and persons interacting with adolescents and young adults in schools, community agencies and juvenile justice settings.

Course Description

Adolescents and young adults presenting with a complex combination of symptoms and behaviors pose significant diagnostic and treatment challenges for clinicians, professionals and families. This presentation may include: dysregulated emotions, depression, anxiety, impulsivity, unstable self-image, self-injury and/or suicidality and may be further complicated by eating disorders, substance abuse, and PTSD.

Drawing from clinical experience and empirical research, speakers will address the importance of early recognition of symptom patterns as potential emerging traits of BPD, appropriate clinical treatment modalities, and outcomes.

Significant conference themes include progress in treatment interventions such as DBT, the impact of trauma, identifying and managing the suicidal and self-injuring patient, the cultivation of compassionate patient care, and support for treating clinicians.

Conference Objectives

On the completion of this conference participants will be able to:

  • Identify the nature and course of symptoms and dysfunctional behaviors in adolescents and young adults including early identification of emerging traits of BPD
  • Recognize the role of, and advances in, Dialectical Behavioral Therapy in treating adolescents and young adults, including clinician support models
  • Identify co-morbid psychiatric conditions as they impact treatment
  • Recognize the role and impact of trauma and PTSD on the course of dysfunctional behaviors and how it influences treatment
  • Recognize the roles of self harm and suicidality, distinguish between the two and learn clinical practice tools to effectively manage these behaviors
  • Describe the role of family involvement in treatment of adolescents and young adults


7:30 am   Registration and Coffee

8:30 Welcome

Perry D. Hoffman, PhD, NEABPD President and Fred Miller, MD, Chair, Department of  of Psychiatry NorthShore University HealthSystems

8:45 – 12:00 Morning session

Emerging Traits of BPD? – Brian Palmer, MD, MPH
Diagnosis, neurobiology, course and outcome of BPD and emerging traits in adolescents and young adults

DBT in the treatment of BPD and other diagnoses – Blaise Aguirre, MD
Clinical DBT practice model and outcomes in addressing dysfunctional areas of emotional, behavioral, relational, cognitive and self dysregulation in adolescents and young adults

Family Support in Treatment, and Patient and Family Perspectives – Perry D.  Hoffman, PhD

Lunch on your own 12:00 -1:15 pm

1:15 – 4:30 Afternoon session

Identifying and Treating Suicidality and Self-Harm in Adolescents and Young Adults – Jill Rathus, PhD
Identifying who is at risk, differentiating suicidality and self-harm, treatment options, and clinician support models

The Impact of Childhood Trauma – Cynthia Kaplan, PhD
Types and incidence of trauma in adolescents showing emerging traits of BPD, treatment considerations and new clinical approaches

Panel  – Case study – Q&A
Panelists: Blaise Aguirre, MD; Cynthia Kaplan, PhD;
Brian Palmer, MD, MPD; Jill Rathus, PhD
Moderator: Perry Hoffman, PhD

4:30 pm Adjourn


(In order of Program presentations)

Brian Palmer, MD, MPH
Assistant Professor of Psychiatry, Mayo Clinic College of Medicine
Senior Associate Consultant, Department of Psychiatry and Psychology, Mayo Clinic

Emerging Traits of BPD?
Diagnosis, neurobiology, course and outcome of BPD and emerging traits in adolescents and young adults

Overview of BPD from perspective of what can be learned from BPD research and treatment when presented with emerging traits or similar psychological profiles in adolescents and young adults.  Overview of treatment options and efficacy.

Borderline Personality Disorder (BPD) is a common and severe mental illness. It has high rates of other associated illnesses, including depression, and it is responsible for a substantial amount of “treatment-resistant” depression.  The biology of BPD is still being researched, but abnormalities in the emotion- processing system in the brain, as well as planning/sequencing areas, are seen. Data on the course and outcome show that BPD can and usually does improve, though impairments in functioning can persist for many years. The treatment of BPD is primarily psychosocial, though medications can help. Specific principles of treatment appear to cut across the empirically-validated treatments for the disorder.  Families can benefit from learning key principles for involvement, particularly when BPD traits are emerging.


  • Describe the basics of the diagnosis, neurobiology, course, and outcome of BPD, including insights on emerging traits in adolescents and young adults.
  • Articulate treatment principles for therapy, medications, family involvement, and treatment structure.
  • Review data on the course and outcome of BPD and implications for emerging traits in adolescents and young adults

Brian Palmer, MD, MPH
Dr. Palmer graduated from Mayo Medical School and then served full time as National President of the American Medical Student Association.  After completing d his psychiatry residency at MGH and McLean hospitals where he was chief resident he stayed on the staff of McLean Hospital to work with the Gunderson Residence and outpatient BPD treatment and research programs under the mentorship of John Gunderson, MD.  In addition to caring for patients with BPD, he led treatment and educational programs for family members of those with BPD. He joined the staff of the Mayo Clinic in 2011 and is active as a clinician, educator, and researcher in inpatient psychiatry care and the interface between mood and personality disorders and is associate director of the general psychiatry residency and directs the medical school clerkship in psychiatry.

Blaise Aguirre, MD
Medical Director, 3East- Adolescent DBT Program, McLean Hospital
Assistant Professor of Psychiatry, Harvard Medical School

DBT in the Treatment of BPD and other diagnoses
Overview of clinical DBT practice model and outcomes in addressing dysfunctional areas of emotional, behavioral, relational, cognitive and self dysregulation in adolescents and young adults.

Overview of Dialectical Behavior Therapy (DBT) and its application in the treatment of adolescents and young adults. The treatment components and skill modules of DBT will be presented. Hierarchical targeting will be explained.  The lecture will focus on the components of DBT and 1) techniques used in DBT based individual and group therapies; 2) the therapy’s focus on the adolescent’s skill deficits in targeted areas of their life, and 3) DBT’s focus on the “here and now”, as opposed to looking for the “root cause” of the problems.  Importance of early identification of symptoms and behaviors in effective treatment intervention will be addressed.


  • Provide an overview of the clinical Dialectical Behavioral Therapy (DBT) practice model
  • Explain hierarchical targeting of behaviors in treatment methodology
  • Explain the skill set and its application as used in adolescent populations

Blaise Aguirre, MD (Course Director)
Dr. Aguirre is an expert in child, adolescent and adult psychotherapy, including dialectical behavior therapy (DBT), and psychopharmacology. He is medical director of 3East at Harvard – affiliated McLean Hospital, a unique, residential DBT program for young women exhibiting self-endangering behaviors and borderline personality traits. Dr. Aguirre has been a staff psychiatrist at McLean since 2000 and is widely recognized for his extensive work in the treatment of mood and personality disorders in adolescents.

Dr. Aguirre is the author of Borderline Personality Disorder in Adolescents: A Complete Guide to Understanding and Coping When Your Adolescent Has BPD;  Depression (Biographies of Disease; and, co-authored a new book, Mindfulness for Borderline Personality Disorder. He is also a co-author of Helping Your Troubled Teen: Learn to Recognize, Understand, and Address the Destructive Behavior of Today’s Teens.

Dr. Aguirre is an Assistant Professor of Psychiatry at Harvard and Medical Director, Adolescent DBT Center, McLean Hospital, Belmont, Mass.

He holds a MD degree from the University of the Witwatersrand, Johannesburg, South Africa, 1989; and did residencies at Boston University School of Medicine Residency in Psychiatry, 1991-1994, and Rotating Internship VAMC Boston, MA, 1990, followed by a Boston Medical Center Boston, Massachusetts Child and Adolescent Fellowship, 1994-1996. He holds Board Certification with the American Board of Psychiatry and Neurology Board, Certified in Psychiatry, 1996.

Perry Hoffman, PhD (Course Director)
President, National Education Alliance for Borderline Personality Disorder

Family Support in Treatment, and Patient and Family Perspectives     

Understanding and helping families: Families of relatives with borderline personality disorder experience higher levels of stigma and burden than families with an Axis I relative. (Hoffman, Streuning, 2002). In addition, more than 50% meet criteria for posttraumatic stress disorder (Harned, Hoffman et al, 2013).   Conversely, the families also may play a central role in patient recovery (Hooley, Hoffman, 1999). To effectively manage this central dialectic, families require unique skills and strategies to stay the course with their loved ones. Other examples of family challenges include:  hope versus despair, individual needs versus family needs, patient as fragile or fearsome, wish to control or wish to detach.


  • Review current research on families
  • Identify the family dilemmas that exist, in short video clips to illustrate each
  • Outline the researched-based program, Family ConnectionsTM which offers coping skill strategies

Perry D. Hoffman, Ph.D.
Dr. Hoffman is the President and co-founder of the National Education Alliance for Borderline Personality Disorder (NEABPD) and Consultant in Psychology, McLean Hospital. She has had 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. Under the auspices of NEABPD she has been the course director of more than 40 national and international conferences over the past decade including the past seven NEABPD Yale Conferences.  She is 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. Dr. Hoffman, who is intensively trained in Dialectical Behavior Therapy (DBT), has been the director of several DBT treatment programs in the New York area and now is in private practice in New York City and Westchester County, NY. The National Alliance on Mental Illness (NAMI) has recently recognized the efforts of NEABPD by awarding Dr. Hoffman its 2011 Excellence in Community Mental Health Award.   She also accepted on behalf of NEABPD, the 2012 Distinguished Service Award  given by the American Psychiatric Association at their annual conference in May 2012.

Jill Rathus, PhD
Professor of Psychology
Director of Clinical Training, CW Post Campus of Long Island University
Co-Director, Cognitive Behavioral Associates, Great Neck, NY

Identifying and Treating Suicidality and Self-Harm in Adolescents and Young Adults
Identifying who is at risk, differentiating suicidality and self-harm, treatment options, and clinician support models

Overview of issues relating to suicide and non-suicidal self-injury (NSSI) in adolescents/young adults: those at risk, diagnosis and assessment, treatment considerations, and issues around hospitalization as an intervention. Consideration will be given to suicidal ideation and how this might serve as a coping mechanism. Research will also be presented on NSSI and how it differs from suicidality. Approaches and practice models which can serve to reduce the stress of the clinician and the practical management of this population in a clinical setting will be discussed. DBT as a treatment of choice for suicidality and research on its effectiveness will also be examined.


  • Present background on adolescent and young adult suicidality-:who is at risk; defining suicidal behaviors; define relationship to BPD and associated disorders, and clinical support models
  • Provide overview of diagnosis and assessment, treatment decisions; present research on the effectiveness of DBT and practice models to support the treater.
  • Define NSSI: how it is different from suicidality, and present research research on the relationship between the two and the impact on treatment decisions.

Jill Rathus, PhD
Jill H. Rathus, PhD, is Professor of Psychology, Director of Clinical Training, and Director of the Family Violence Program at Long Island University/CW Post Campus in Brookville, New York. She is also co-founder of Cognitive Behavioral Associates in Great Neck, New York, where she directs the Dialectical Behavior Therapy Program. She co-authored the primary text on adolescent DBT (DBT with Suicidal Adolescents, Guilford Press); in addition, she currently has two books in progress, on DBT Skills Training with Adolescents and on Applying DBT in School Settings. In addition to clinical work, teaching, and research, Dr. Rathus trains mental health professionals nationally in DBT. Dr. Rathus received her BA from Cornell, completed her internship at Einstein/Montefiore Medical Center, and received her PhD from the University at Stony Brook. She has published dozens of peer-reviewed research and clinical articles and chapters. In addition to the above books, she has published Marital Distress – Cognitive Behavioral Interventions for Couples (Jason Aronson); Assessment of Family Violence – A Handbook for Researchers and Practitioners (APA Press); Assessment of Partner Violence – A Handbook for Researchers and Practitioners (APA Press).

Cynthia Kaplan, PhD
Associate Clinical and Administrative Director, Child and Adolescent Services,
McLean Hospital – Belmont Campus
Assistant Professor of Psychology, Harvard Medical School

The Impact of Childhood Trauma
Childhood trauma and its relationship to course of emerging traits and dysfunctional behaviors, treatment approaches and prognosis

Overview and review  of the evidence on the prevalence and impact of childhood maltreatment on the later development of and severity of BPD criterion behaviors and the use of an effective, integrated treatment approach to target PTSD in this population

Adolescents seen in psychiatric treatment are found to have a high incidence of childhood trauma and maltreatment. For many of these patients, Post-Traumatic Stress Disorder (PTSD) is a co-occurring diagnosis that requires targeted intervention. Although empirical support is robust for Cognitive Behavioral Therapy (CBT) with Prolonged Exposure (PE) as the treatment of choice for both adults and adolescents with PTSD, traditionally clients with ‘emerging Borderline Personality Disorder’ (BPD) have been excluded from this treatment due to suicidality and self-harming behaviors. Recent research has indicated that after relatively brief periods of DBT treatment, clients are motivated and able to control these life-threatening behaviors in order to qualify for a targeted treatment that will afford them relief from their PTSD symptoms. This presentation will explore some of the reasons for emphasizing the early identification and thorough assessment of childhood trauma, provide examples of newer, alternative approaches to the treatment of co-occurring PTSD+BPD and discuss relevant clinical issues including the challenges of family involvement.


  • Describe the type and incidence of childhood trauma in adolescent BPD populations
  • Recognize the standard exclusion criteria for prolonged exposure (PE) treatments and how these have been recently modified
  • Formulate how to apply novel approaches to treating adolescents with PTSD plus self-harm