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Randy A Sansone

Publications and source records attributed to Randy A Sansone.

At least 37 records · Page 2Linked to original sources
PubMed2002

Assessment tools for self-harm behavior among those with eating disorders.

There appears to be a substantial minority of eating disorder patients who report self-harm behaviors. This paper reviews the available assessment tools relating to individuals with eating disorders and self-harm behaviors. Current eating disorder assessments do not contain any items relating to self-harm behaviors. Several of the self-harm measures contain some eating disorder items, but not a sufficient number to provide an eating disorder diagnosis. Among the self-harm measures, only three offer items relating to eating pathology as well as overt self-harm and high-lethal behaviors. One of the three has an established scoring that predicts borderline personality disorder. In summary, there are no currently available assessment tools that are able to simultaneously diagnose eating disorder pathology as well as measure self-harm behaviors.

Journal Article↗
PubMed2002

Self-harm behaviors among those with eating disorders: an overview.

Large epidemiological studies on the prevalence of self-harm behavior among those with eating disorders are not currently available. Using the Medline and PsycINFO databases, the authors collectively summarize data from available studies. The largest group of studies reports the prevalence of suicide attempts among outpatients with bulimia nervosa to be 23% (n = 1211). The prevalence of suicide attempts among bulimic inpatients was 39% (n = 260), alcoholic bulimics 54% (n = 76), and outpatient anorexics 16% (n = 261). Self-injury among bulimic outpatients was 25% (n = 574), inpatient bulimics 25% (n = 260), and outpatient anorexics 23% (n = 52). The authors discuss the possible implications of these findings.

Journal Article↗
PubMed2002

The relationships among childhood abuse, borderline personality, and self-harm behavior in psychiatric inpatients.

The current study was undertaken to explore the relationships among childhood abuse subtypes (sexual, physical, and emotional abuse; witnessing violence), three diagnostic screenings for borderline personality disorder (BPD), and self-harm behavior. Psychiatric inpatients (N = 77) were evaluated for childhood abuse histories through a survey. Participants also underwent assessment for BPD using a self-report measure, clinical diagnosis, and a DSM-IV checklist. Finally, each was assessed for self-harm behavior using the 22-item Self-Harm Inventory (SHI). Compared with non-abused participants, those with abuse histories (with the exception of witnessing violence) had a significantly greater number of BPD confirmations (i.e., self-report, clinical diagnosis, DSM-IV checklist) as well as self-harm behaviors. When examining the total number of endorsed abuse subtypes, there was a significant correlation with the number of self-harm behaviors, but not the number of BPD diagnoses. Among psychiatric inpatients, childhood abuse demonstrates a complex relationship to BPD diagnoses and self-harm behavior.

Adult↗
PubMedDate not supplied

Childhood abuse, mental healthcare utilization, self-harm behavior, and multiple psychiatric diagnoses among inpatients with and without a borderline diagnosis.

Although borderline personality disorder (BPD) has defined diagnostic criteria, a number of other clinical features are associated with this diagnosis. These features may include childhood histories of abuse (eg, sexual, physical, and emotional abuse; the witnessing of violence), high mental healthcare utilization, self-harm behavior, and polysymptomatic presentations that result in multiple Axis I diagnoses. Although each of these variables has been described in the empirical literature, only 1 other study has explored all 4 of these variables in a single study population--the Collaborative Longitudinal Personality Disorders Study. Using clinical diagnoses and self-report surveys, we explored these variables among psychiatric inpatients in a community hospital. We found that, compared with patients with no BPD, those with BPD reported significantly more types of childhood trauma, higher utilization of particular mental health services (ie, number of times and days of hospitalization for mental health or substance abuse, number of psychiatrists and therapists ever seen, number of courses of psychotherapy treatment), and a higher number of self-harm behaviors. Although not significant, there were positive trends for the remaining variables. The authors discuss the implications of these findings as they relate to patients with BPD.

Adult↗
PubMedDate not supplied

Patient attitudes toward weight gain with medications.

OBJECTIVE: The purpose of this study was to examine patient attitudes toward weight gain with medications under 4 conditions-medical vs psychiatric and life-threatening vs non-life-threatening. METHOD: In a suburban primary care practice, 241 patients completed surveys that explored the 4 study conditions and the amount of weight, from 0 to 20 or more pounds, willing to be gained on medication. RESULTS: Participants were willing to gain an average of 5.51 lb for a non-life-threatening medical condition, 5.37 lb for a non-life-threatening psychiatric condition, 13.30 lb for a life-threatening medical condition, and 12.70 lb for a life-threatening psychiatric condition. Participants were willing to gain significantly more weight with a medical vs psychiatric condition and with a life-threatening vs non-life-threatening condition. There were no significant gender differences in responses. CONCLUSIONS: There appear to be distinct patterns of acceptability of weight gain with medications. This information may enhance prescribers' ability to strategize medication compliance among patients.

Adolescent↗
PubMedDate not supplied

Borderline personality and psychotropic medication prescription in an outpatient psychiatry clinic.

Borderline personality is a complex disorder and pharmacological intervention is typically focused on target symptoms. Previous studies indicate that patients with borderline personality disorder (BPD) are prescribed a greater number of psychotropic medications than those without BPD. However, these studies were self-report in design and/or preceded the use of newer psychotropic medications such as selective serotonin reuptake inhibitors (SSRIs). In this study, we explored among 280 psychiatric outpatients the relationships between an axis II diagnosis of BPD and the number of axis I diagnoses, psychotropic medications, and psychotherapy sessions. Compared to those with other types of personality disorders (n=128) or no personality disorder at all (n=91), those with BPD (n=61) were diagnosed with significantly more axis I disorders, prescribed significantly more psychotropic medications, and attended significantly more psychotherapy sessions. These findings suggest that: (1) BPD patients will probably be prescribed more psychotropic medications than other psychiatric outpatients, and (2) in addition to psychotropic medication prescription, there may be additional variables (e.g., psychotherapy sessions) that make a meaningful contribution to the overall healthcare utilization among those with BPD.

Adolescent↗
PubMedDate not supplied

The acceptability of psychotropic vs. other medications among a small urban primary care sample.

In a small urban sample of primary care patients, this pilot study was designed to explore attitudes toward various types of medications, comparing psychotropic vs. non-psychotropic types. Sixty-two participants (77% female, 66% African American) completed a two-page survey developed by the authors. Participants were asked "How acceptable would it be to you if a doctor prescribed the following medications?" For analyses, the 12 medications were divided into 3 categories: 1) psychotropic; 2) mixed (medications that could be categorized as either psychotropic or not); and 3) nonpsychotropic. Results indicated that participants rated psychotropic medications as less acceptable than nonpsychotropic medications, which in one of the analyses was more pronounced among female participants. The possible implications of these findings are discussed.

Adult↗
PubMedDate not supplied

Self-harm behaviors across the life cycle: a pilot study of inpatients with borderline personality disorder.

The purpose of this study was to explore, throughout the life cycle, the prevalence of self-harm behaviors among psychiatric inpatients with and without borderline personality disorder (BPD). Psychiatric inpatients with BPD (n = 43) were compared to those without BPD (n = 40) with regard to self-reported self-harm behaviors during their lifetime. The mean number of self-harm behaviors, including high-lethal behaviors (i.e., suicide attempts, cutting oneself, overdosing), among those with BPD dramatically increased between the ages of 18 and 24 years and was sustained through ages 50 to 59 years. Non-BPD patients showed a similar pattern, but the means were notably less. These data suggest that the behavioral "burn out" theory of personality disorders does not necessarily occur among inpatients with BPD.

Adolescent↗
PubMedDate not supplied

The prevalence of personality disorders among those with eating disorders.

The genuine prevalence of personality disorders among those with eating disorders is unknown. However, in this paper, we summarize the existing data, with careful acknowledgment of our approach to interpretation as well as the limitations of previous studies. Our findings indicate that obsessive-compulsive personality is the most common personality disorder in restricting-type anorexia nervosa, while borderline personality is the most common personality disorder in binge-eating/purging type anorexia nervosa. Borderline personality is the most common personality disorder in bulimia nervosa, as well. In those with binge eating disorder, obsessive-compulsive personality is the most common personality disorder although, compared with the preceding eating disorder diagnoses, there are broader clusters of personality disorders represented in this group. We discuss the implications of these findings.

Journal Article↗
PubMedDate not supplied

Borderline personality and eating disorders.

Borderline personality disorder (BPD) is an Axis II disorder that is characterized by an intact façade, longstanding self-regulation difficulties and self-harm behavior, and unstable interpersonal relationships and mood. According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994), the prevalence of BPD in the general population is around 2%. The symptoms of the disorder appear to be influenced by gender. Despite defined diagnostic criteria, BPD tends to have polymorphic clinical presentations with both multiple psychological and somatic symptoms. The etiology of BPD appears to be related to genetic predisposition, early developmental trauma, and biparental failure, although other contributory factors may be involved. We discuss, through the use of several models, the possible relationships between BPD and eating disorders.

Journal Article↗
PubMedDate not supplied

The use of psychotropic medications in eating disorder patients with personality disorders.

The use of psychotropic medications in eating disorder patients with personality disorders (PDs) is a complex topic. In this overview, we do not focus on individual studies, but rather on the philosophical issues and broader management principles of medications in this comorbid population. We review a general construct of personality and PD development, the theories that underlie how medications might work in PDs, and the target-symptom approach to treatment. We also discuss the essential elements of the prescribing context, an approach to psychotropic medication selection in the borderline personality population, and general caveats for medication use in those with eating disorders. Despite available data, significantly more research is needed in this area.

Journal Article↗