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Results for “Borderline personality disorder”

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At least 19 recordsLinked to original sources
PubMed1979

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↗
PubMed2026

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↗
PubMed2026

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 (&#x394;CAPS) 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&#x202f;=&#x202f;0.049), particularly for those with higher non-planning impulsivity (p&#x202f;=&#x202f;0.012). In participants randomized to CPT improvement in PTSD symptom severity (&#x394;CAPS) was negatively related to baseline total impulsivity (p&#x202f;=&#x202f;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↗
PubMed2026

Long-term consequences of childhood sexual abuse: An umbrella review of diagnostic meta-analyses.

BACKGROUND: Childhood sexual abuse (CSA) is a public health issue with an estimated worldwide prevalence of 12.7%, potentially leading to a host of lifelong and significant mental, physical, and behavioral health. The aim of this study was to comprehensively map the long-term consequences of childhood sexual abuse on physical, psychiatric, and behavioral health outcomes. METHODS: An umbrella review of meta-analyses of observational studies, registered on PROSPERO, was conducted to examine the diverse repercussions of childhood sexual abuse on adult health. Three bibliographic databases (PsycINFO, PubMed and Scopus) were searched from the inception of the respective databases to November 1st, 2022. Thirty-eight meta-analyses representing about 20 million individuals were analyzed, revealing a range of long-lasting consequences associated with CSA. RESULTS: Among physical pathologies, cervical cancer and functional neurological syndromes emerged as the most prominent, exhibiting significantly elevated odds ratios (ORs) of 4.18 IC95% and 3.30 IC95%, respectively. Sleep disorders and borderline personality disorders were the most prevalent mental health disorders associated with CSA, with respective ORs of 16.17 IC95% and 5.96 IC95%. Early sexual initiation (OR=3.59 IC95%, sexual assault (OR=3.36 IC95%, and prostitution (OR=3.24 IC95%) emerged as the most common behavioral consequences. Notably, no significant differences in the consequences of CSA were observed between men and women, except for reproductive health outcomes. DISCUSSION: When faced with certain pathologies, clinicians should consider and discuss sexual abuse with their patients. The consequences of abuse have a multifactorial origin, which is a weakness, as are the problems of defining abuse. The strength of our study is that it lists the consequences published in high-quality studies. CONCLUSION: This umbrella review provides compelling evidence of the profound and far-reaching impact of childhood sexual abuse on a broad spectrum of physical, mental, and behavioral health issues.

Humans↗
PubMed1979

Adolescent suicide attempts.

The conditions of 40 adolescents in treatment following a suicide attempt were diagnosed according to the multiaxial classification of the American Psychiatric Association's proposed third edition of the diagnostic and statistical manual. All were psychiatrically ill before the suicide attempt. The most common diagnoses were those of depressive disorders and substance abuse disorders on the clinical psychiatric syndrome axis and borderline personality disorder on the personality and developmental disorder axis. The typical patient was a polydrug-abusing girl with a borderline personality disorder and a superimposed major depressive disorder. The most prominent personality characteristics associated with suicide attempts by these adolescents were a tendency to react severely to a loss, poorly controlled rage, and impulsivity. Suicide attempts by adolescents should be taken seriously by the physician and necessitate a thorough search for a possible underlying pathological condition.

Adolescent↗
PubMed2026

Clinical and psychological characteristics of adolescents at risk of mood disorders compared with adolescents with suicidal behavior.

Suicide is one of the leading causes of death among adolescents, yet little is understood about the biopsychosocial factors related to suicidality. The demographic, clinical, and biological characteristics of adolescents with and without psychiatric histories may help inform mechanistic approaches to treatment of mood disorders and suicidality. The 'characterizing the inflammatory profile and suicidal behavior in adolescents' and 'RAD arm of the Texas Resilience Against Depression' studies aimed to characterize the clinical and biological profiles of youth with suicidal behavior and youth at risk for mood disorders, compared to healthy adolescents (n&#xa0;=&#xa0;75 in each group). Here, we report the descriptive baseline clinical and psychological characteristics of adolescents at risk of mood disorders and those with suicidal behavior. The adolescents with suicidal behavior reported 3.53 lifetime suicidal events on average, predominantly reported moderate to very severe depression (34.7%, 24%, to 9.3%), moderate to severe anxiety (58.6%), low optimism (91.9%), and mild (39.2%) to moderate (28.4%) degree of hopelessness. The at-risk adolescents predominantly reported no depression (60%) or anxiety (68.9%), moderate optimism (50%), and a positive outlook (85.7%). Healthy adolescents predominantly reported no depression (88.3%) or anxiety (93.2%), moderate optimism (59%), and a positive outlook (87%). The adolescents with suicidal behavior and those at risk of mood disorders exhibited significantly higher irritability and borderline personality disorder features (uncorrected p&#xa0;=&#xa0;0.02 to p&#xa0;<&#xa0;0.001) and lower resilience compared to healthy adolescents. Ongoing investigations using the longitudinal clinical and biological data will help identify the immune biosignatures of suicidality in youth.

Humans↗
PubMed1979

Marital therapy with borderline patients: is it beneficial?

Marital therapy has developed techniques which do not, for the most part, rely on the individual psychiatric diagnosis of the 2 partners. When both spouses suffer from Borderline personality disorders, the standard techniques do not seem to apply, are difficult to put into effect and the results of therapy are poor. The authors illustrate their experience with the description of a 3 month trial of marital therapy involving a borderline couple. The outcome suggests the need for careful individual and interactional diagnosis prior to marital therapy. Specific psychotherapeutic techniques should be tested for use with Borderline marriage partners.

Adult↗
PubMed1979

Crossing the border into borderline personality and borderline schizophrenia. The development of criteria.

Although there is a large psychiatric literature on various "borderline" conditions, there has been no agreement as to the definition of the concept. A review of the literature reviewed two major uses of the term: Borderline Schizophrenia and Borderline Personality. Two item sets were developed to provide diagnostic criteria for the two concepts. High sensitivity and specificity were demonstrated for both item sets using data describing 808 borderline and 808 control patients. These criteria will be used in the forthcoming DSM-III classification for the categories of Borderline Personality Disorder and Schizotypal Personality Disorder.

Adolescent↗
PubMed1979

The concept of "classical" psychoanalysis.

In this essay, the term classical psychoanalysis is discussed historically and conceptually. What characterizes classical analysis and distinguishes it from current innovative trends in the practice of psychoanalysis is reviewed from a comparative standpoint. The impact of the widened scope of conditions the psychoanalyst currently includes in his therapeutic work is considered, with special attention to the distinction between psychoanalysis per se in the classical sense and psychoanalytic psychotherapy.

Awareness↗
PubMed1979

The myth of the alliance with borderline patients.

The author questions the concept of a therapeutic alliance in the psychotherapy of patients with borderline and narcissistic personality disorders. The motivating elements in their treatment are the emerging, sustaining transferences, which also allow the patients to appreciate the real qualities of their therapist. As they internalize aspects of their interactions with the therapist, including the therapist's real characteristics that are lacking in themselves, the patients gradually develop the capacity to work collaboratively with him or her. When a solid therapeutic alliance is established, the patients have reached a neurotic level of functioning.

Adult↗
PubMed1979

Minimal brain dysfunction in childhood: outcome in late adolescence and early adult years.

Seventy-three patients, diagnosed in childhood as having minimal brain dysfunction syndrome and further classified as either developmental lag (38%) or organic brain syndrome (62%), were followed into late adolescence and early adult life. At follow-up 7% were free of psychiatric disorder, 80% had various types of personality disorder, and 14% were borderline psychotic. Global outcome was rated as satisfactory in 20%, unsatisfactory in 80%. Associated with an unsatisfactory outcome were these initial findings: low normal or borderline intelligence, multiplicity of behavioral and neuropsychological findings, learning disabilities, special class placement, and initial classification of organic brain syndrome. Initial differentiation between developmental lag and organic brain syndrome foreshadowed different psychopathological features having significant polarities and little overlap, as well as different global outcome.

Adolescent↗
PubMed1977

The symbiosis scale: inkblot responses of children from symbiotically and non-symbiotically oriented families.

Describes the development and subsequent attempts at validation of an objective measure of the concept of symbiosis based on children's responses to inkblot stimuli. It was hypothesized that children reared in symbiosis inducing versus non-symbiosis inducing family settings would obtain higher scores on the symbiosis scale. The hypothesis was supported in a first study involving 36 children evidencing neurotic and personality disorders (p less than .01), but was not supported in a second study involving 35 children of whom over 70 percent evidenced borderline psychotic or psychotic disorders. In a third study involving 27 neurotic and personality disordered children the scaled again differentiated between children from symbiotically oriented versus non-symbiotically oriented families (p less than .01).

Child↗
PubMed1978

[The cardiovascular risk profile of subjects with normal, marginally disordered and proven pathological glucose tolerance].

In 1.035 persons with reduced glucose tolerance (borderline diabetics, diabetic biophan G test admissions, spontaneous admissions and diabetics treated already for a longer time) the cardiovascular factors of risk over-weight (Broca-weight greater than or equal to 110%), hypertension (RR greater than or equal to 160/and/or 95 Torr), hypertriglyceridaemia (greater than or equal to 200 mg/100 ml), hypercholesterolaemia (greater than or equal to 300 mg/100 ml) and hyperuricaemia (greater than or equal to 6.5 mg/100 ml in males and 6.0 mg/100 ml in females) were determined and compared with the frequency of the same danger indicators of 255 persons with certainly normal glucose tolerance. Taking into consiteration the reduction of the glucose tolerance as cardiovascular factor of risk the glucosuria test admissions with 3.48 factor of risk/proband had no less factors of risk than the spontaneous diabetic admissions (3.29 factor of risk/proband). Already the borderline diabetic differed in the frequency of overweight, hypertension and hypertriglyceridaemia significantly (p less than 0.01) from the normal case of the same age. Thus the glucose tolerance disturbed in its limit deserves increased consideration from the diabetological as well as from the cardiological point of view.

Adult↗