Biological correlates of impulsive disruptive behavior disorders: attention deficit hyperactivity disorder, conduct disorder, and borderline personality disorder.
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Adolescent↗
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Results for “Borderline Personality Disorder”
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Justification for separating schizotypal and borderline personality disorders.
Siever and Gunderson (1979) have questioned the decision to separate Schizotypal Personality Disorder from Borderline Personality Disorder in DSM-III. The justification for this separation rests not on genetic evidence, but rather on the relative independence of the behavioral characteristics of two dimensions that up to now have both been referred to with the appellation "borderline." We believe that this separation provides the tools with which investigators may usefully study the interaction of genetic and environmental factors as they relate to personality and the major psychiatric disorders. The benefits of this separation are already apparent in that research investigators are now using two terms to describe different phenomena, when previously they were using the single term borderline. Proposed diagnostic criteria for Schizotypal Personality Disorder and Borderline Personality Disorder are appended.
Chronic Disease↗
Learning disabilities in children with borderline personality disorder.
Children with borderline personality disorder are known to have a variety of school problems, including low achievement. Clinicians working with these youngsters have estimated that one third or more may be learning disabled; however, no empirical studies have confirmed these estimates. The author reports the results of a study of 56 hospitalized borderline children in which score profiles from academic and cognitive measures were cluster analyzed. She examines the incidence of independent learning disabilities as well as subgroup membership, and discusses implications for treatment.
Achievement↗
Physical and sexual abuse histories among children with borderline personality disorder.
OBJECTIVE: The purpose of the study was to determine whether a history of physical or sexual abuse is more common in children with borderline personality disorder than in other children evaluated in the same outpatient psychiatric clinic. METHOD: The authors contrasted rates of abuse in 44 children diagnosed with borderline personality disorder and in 100 comparison children. RESULTS: The borderline personality disorder group had a significantly greater prevalence of physical and combined physical/sexual abuse. Sexual abuse rates alone did not differ significantly between groups. CONCLUSIONS: The finding of greater abuse in the group with borderline personality disorder supports the hypothesis that a history of trauma is associated with the disorder.
Adult↗
Group therapy for people with borderline personality disorder: interventions associated with positive outcomes.
Group psychotherapy is becoming a more prevalent treatment option for people with borderline personality disorder. Various types of group approaches have been discussed; however, data about specific interventions and their relationship to outcomes for subgroups of people with borderline personality disorder are lacking. The purpose of this study was to explicate the interventions used in a successful group therapy program developed for community mental health center clients with borderline personality disorder. Two independent raters used the Hill Counselor Verbal Response Category System-Revised to describe and categorize the therapists' verbal responses. Coding of eight videotaped sessions indicated that the therapists' level and type of verbal activity did not change over time. The most frequently utilized interventions across sessions were providing information and seeking information. These responses are indicative of a moderate and high degree of structure. The results suggest that clinicians must consider the unique needs of serious and persistently ill people with borderline personality disorder and plan group interventions accordingly.
Adult↗
Gender issues and borderline personality disorder: why do females dominate the diagnosis?
There are significantly more females with the diagnosis of borderline personality disorder than males. This article explores the developmental factors that place females at a greater risk to develop the disorder. Societal expectations that increase the emerging of borderline symptoms are also discussed. Gender differences of "normal" behavior that effect the assigning of the diagnosis are explained. The theory that borderline personality disorder has become the "virus" of psychiatry is presented.
Adult↗
ADCY2 promoter hypomethylation in adolescents with borderline personality disorder: An RRBS study with targeted BSP replication.
BACKGROUND: Borderline Personality Disorder (BPD) is characterized by emotional dysregulation, impulsivity, and interpersonal instability. Although genetic and environmental contributions to BPD have been investigated, epigenetic correlates in adolescents remain poorly understood. The cyclic adenosine monophosphate (cAMP) signaling pathway is implicated in stress responsivity and emotion regulation, but its epigenetic variation in adolescent BPD remains understudied. METHODS: DNA methylation profiling was performed using Reduced Representation Bisulfite Sequencing (RRBS) in buccal epithelial DNA from adolescents with BPD (n = 15) and healthy controls (HC; n = 15). Differentially methylated regions (DMRs) were identified using metilene, a computational tool for detecting DMRs from bisulfite sequencing data, and subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Associations between methylation signals and borderline personality features were examined. Adenylate cyclase 2 (ADCY2) promoter methylation was examined using targeted bisulfite sequencing PCR (BSP) in an independent cohort (BPD n = 5; HC n = 5). RESULTS: RRBS identified 7641 DMRs between BPD and HC, with enrichment in pathways related to neuronal signaling and synaptic organization. A hypomethylated DMR was detected in the ADCY2 promoter, a gene implicated in cAMP signaling. Lower ADCY2 promoter methylation was associated with greater clinical severity, including emotional dysregulation, borderline traits, anxiety symptoms, and self-injury behaviors (r=-0.71 to -0.83; all p < 0.0001). Hypomethylation of the ADCY2 promoter was replicated in the independent cohort. CONCLUSIONS: This exploratory two-stage epigenetic study suggests that ADCY2 promoter hypomethylation in peripheral buccal epithelial DNA is associated with core symptom dimensions of adolescent BPD. These findings support a role for cAMP-related epigenetic variation in BPD and warrant replication in longitudinal studies.
ADCY2↗
Self-structure in borderline personality disorder.
Self-structural theory is applied to the interpersonal aspects of borderline personality disorder. The notion of interpersonal contrasting, a cognitive maneuver, is introduced to account for the sharp changes between divergent self-states characteristic of the disorder. The theory and three prototypical self-states are illustrated with data from a borderline patient by means of a procedure derived from the theory.
Borderline Personality Disorder↗
Social risk factors for borderline personality disorder: a review and hypothesis.
A number of behaviours associated with borderline personality disorder (including attempted suicide, suicide, substance abuse, and antisocial behaviour) are on the increase among the young. The common factor in these disorders is impulsiveness. Evidence is reviewed suggesting that social disintegration reduces the threshold of impulsive behaviours. It is proposed that this is the mechanism through which social risk factors effect the prevalence and morbidity of borderline personality. A number of ways of testing this hypothesis are suggested.
Borderline Personality Disorder↗
Pain perception in self-injurious patients with borderline personality disorder.
Pain ratings during the cold pressor test were significantly lower in female inpatients with borderline personality disorder who report that they do not experience pain during self-injury (BPD-NP group, n = 11), compared with similar patients who report that they do experience pain during self-injury (BPD-P group, n = 11), and normal female subjects (n = 6). Pain ratings were not significantly different in the BPD-P and normal control groups. Self-report ratings of depression, anger, anxiety, and confusion were significantly lower, and ratings of vigor significantly higher following the cold pressor test in the BPD-NP group, but not in the BPD-P group. Only anxiety was significantly lower in the normal control group following the cold pressor test. The implications and limitations of these preliminary findings are discussed.
Adolescent↗
Differentiating symptom clusters of borderline personality disorder.
This study is an attempt to delineate symptom clusters that may be considered most distinctive of patients diagnosed with borderline personality disorder (BPD). Medical records were examined to assess the extent to which each of the eight DSM-III-R BPD criteria was present in 89 psychiatric in-patients diagnosed with BPD. Structural analysis revealed three symptom clusters that can explain symptomatology for a majority of the sample. BPD patients can be identified initially by a core factor and separated subsequently into several BPD subtypes based on the patients' remaining symptomatology. A hierarchical diagnostic scheme for delineating BPD subtypes is proposed, and the implications of these findings for a theoretical separation of several BPD subtypes are discussed.
Adult↗
Does impulsivity predict treatment outcomes in PTSD with borderline personality disorder features? Results from a randomized clinical trial.
BACKGROUND: Trauma-focused psychotherapies are first-line treatments for posttraumatic stress disorder (PTSD). However, a substantial proportion of clients do not respond adequately or drop out of therapy prematurely. This has sparked interest in identifying individual-level predictors of treatment outcomes, including improvement in PTSD severity and dropout. Impulsivity may be a predictor because it may interfere with key therapeutic processes, such as cognitive restructuring and emotional processing. Consequently, we present a hypothesis-driven secondary analysis of a 15-month randomized clinical trial comparing Dialectical Behavior Therapy for PTSD (DBT-PTSD) and Cognitive Processing Therapy (CPT) in women with childhood abuse-related PTSD and borderline personality disorder features to test whether impulsivity, assessed at baseline, predicts PTSD improvement and dropout. We further explore whether the dimensions of impulsivity (non-planning, attentional impulsivity, and motor impulsivity) differentially affect the outcomes in DBT-PTSD vs. CPT. METHODS: A total of 193 cis women with PTSD related to childhood abuse and borderline personality disorder features were assessed using the Clinician-Administered PTSD Scale (CAPS) and the Barratt Impulsiveness Scale (BIS-10). Separate probit models and general linear models were applied to predict dropout and pre-to-post changes in PTSD severity (ΔCAPS) from total impulsivity and subscale scores, i.e. non-planning, attentional and motor impulsivity. RESULTS: Overall, dropout rates were higher for participants with higher baseline impulsivity scores (p = 0.049), particularly for those with higher non-planning impulsivity (p = 0.012). In participants randomized to CPT improvement in PTSD symptom severity (ΔCAPS) was negatively related to baseline total impulsivity (p = 0.021). In participants randomized to DBT-PTSD this relation was not significant. CONCLUSIONS: The results suggest that impulsivity may predict treatment outcomes. Specifically, patients with elevated impulsivity may be less likely to respond adequately to CPT. If replicated, these findings have implications for personalization of treatment.
Humans↗
Borderline personality disorder in incest victims.
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Borderline Personality Disorder↗
An empirical examination into the sexuality of women with borderline personality disorder.
In the last decade, a great deal of research has been accomplished in the study of borderline personality, but the literature is yet to systematically examine the intimate relationships of individuals with this particular personality disorder. In doing so, this study compared a sample of female borderlines with an adequately matched sample of non-personality disorders (aged 23-33 years) using the following measures: the Hurlbert Index of Sexual Assertiveness, the Sexual Opinion Survey, the Sexuality Scale, and the Index of Sexual Satisfaction. In the borderline sample, about 50% of the women reported a childhood history of physical or sexual abuse, as compared to about 15% in the control group. Also, borderline women were found to have significantly higher sexual assertiveness, greater erotophilic attitudes, and higher sexual esteem. Despite these findings, the borderline group evidenced significantly greater sexual preoccupation, sexual depression, and sexual dissatisfaction. Implications for these findings and treatment issues are discussed.
Adult↗
[Borderline personality disorder: a comparative study between the clinical diagnosis and the Rorschach test].
Diagnostic concordance among Rorschach Test, clinical approach and DSM-III-R criteria for BPD is studied in an inpatient sample. A low degree of concordance among the three diagnostic systems was found. Two among 8 DSM-III-R criteria (physically self-damaging acts, and unstable-intense relationships) were the most discriminating symptoms for diagnosing BPD. The importance of considering the diagnostic efficiency of each DSM-III-R criterion is discussed. The most frequent concurrent diagnosis along with BPD were: Affective, and psychotic disorders. Their relationship is analyzed.
Adult↗
The psychoanalytic understanding of narcissistic and borderline personality disorders: advances in developmental theory.
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Adolescent↗
Neurocognitive impairment in dramatic personalities: histrionic, narcissistic, borderline, and antisocial disorders.
Thirty-seven patients with personalities in the dramatic cluster (DSM-III-R histrionic, narcissistic, borderline, and antisocial) and 40 controls matched for age and gender were evaluated on 16 neurocognitive variables. The evaluation screened for deficits in functions of attention, memory, language, abstraction, and behavior planning/sequencing. Analysis of variance revealed significant deficits in neurocognitive performance among patients with dramatic personalities, particularly in subtests requiring multi-step, multi-element associative operations.
Adult↗
Multivariate modelling and the Defence Mechanism Test: a comparative study of defensive structures in borderline, other personality disorders and schizophrenic disorder.
The study aims at discerning discriminating patterns in the perceptual responses according to the projective percept-genetic method Defence Mechanism Test (DMT) among 45 subjects with the diagnoses borderline personality disorder (BPD), other personality disorders (OPD), schizophrenic disorder (SD) and a non-patient group. The overall results show that, by means of partial least squares (PLS) discriminant analysis of 130 DMT variables, it is possible to separate these groups. Patients with a BPD or a SD diagnosis and the non-patient group are clearly separated, whereas the OPD group shows a less homogeneous pattern. The findings support both the validity of the DMT as a method to measure personality features and the psychodynamic validity of BPD. The most characteristic properties of the BPD group are responses of emotional expressions, especially introaggression and frequent distortions of the stimulus picture. Regarding the SD/OPD group, a pattern of high threshold values for perception emerges as a discriminating feature as well as different variants of introjection. The non-patients are characterized by very few DMT distortions and consequently show a good reality orientation. The conclusion is that the DMT and the PLS discriminant analysis are powerful methods in the assessment of personality pathology.
Borderline Personality Disorder↗