1531 - A DAILY LIFE WORTH LIVING: A QUALITATIVE DESCRIPTION OF THE DAILY LIVING FUNCTIONING OF PEOPLE DIAGNOSED WITH BORDERLINE PERSONALITY DISORDER (BPD)

Session: P_D06S005 - Poster Session 5 - Division 6
AUTHORS:
Tepper Dillon (University of South Australia ~ Adelaide ~ Australia) , Shipley Sheryl (University of South Australia ~ Adelaide ~ Australia) , Sellar Ben (University of South Australia ~ Adelaide ~ Australia) , Smith Rachel (University of South Australia ~ Adelaide ~ Australia) , Murray Carolyn (University of South Australia ~ Adelaide ~ Australia)
Abstract text:
Introduction
People diagnosed with borderline personality disorder (BPD) experience persistent functional impairment despite current psychotherapeutic treatment. Functional impairment traditionally refers to vocational and relational domains. However, daily life extends beyond symptoms, work and relationships. Daily living functioning encompasses multiple domains, including routine establishment, sleep, leisure and self-care.


Purpose
This qualitative study aimed to describe the daily living functioning of people diagnosed with BPD using a multi-stakeholder approach, triangulating perspectives of consumers, carers and clinicians.


Method
Purposive sampling recruited consumers diagnosed with BPD (n = 4), carers (n = 5) and clinicians (n = 13). Semi-structured interviews explored participants' perspectives of the daily living functioning of people diagnosed with BPD. Interview transcripts were analysed using Braun and Clarke's reflexive thematic analysis.


Results
Four themes emerged. First, emotional intensity disrupts daily living functioning. While cognitive ability to perform activities was retained, emotional activation made self-care and other important activities difficult. Further, masking emotions required considerable energy.
Second, external structure provides stability. External obligations offered routine that reduced the functional impacts of emotional intensity. Lack of structure increased risk, aimlessness and made it harder to establish new routines.
Third, boom and bust activity patterns dominated. Intense activity levels when feeling good were followed by crashes, rather than balanced, sustainable activity levels. All-or-nothing thinking and swings from totally perfect to utterly incapable influenced both activity levels and self-expectations.
Fourth, meaning depends on external validation. People diagnosed with BPD struggle to find inherent meaning in daily activities, relying instead on others' approval. Without an internal values compass, they allowed others to dictate time use and activity choices. Daily living functioning was also linked to relationship states.


Conclusions
Functional recovery for people diagnosed with BPD extends beyond traditional work and relationship domains. These findings highlight the need to emphasise all activities and routines in daily life to inform a more person-centred, comprehensive and integrated treatment approach.