Tratamento Videolaparoscópico de Endometriomas Ovarianos
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Lopez Adriana C.S.
2000-01-01
Full Text Available Objetivo: avaliar os resultados do tratamento videolaparoscópico de 32 pacientes com endometrioma ovariano. Métodos: estudo retrospectivo que incluiu trinta e duas pacientes encaminhadas ao setor de Endoscopia Ginecológica do Serviço de Ginecologia e Obstetrícia do Hospital do Servidor Público Estadual "Francisco Morato de Oliveira" - São Paulo, as quais tinham diagnóstico clínico e ultra-sonográfico de endometrioma ovariano e foram tratadas por videolaparoscopia. Onze pacientes com endometriomas com diâmetro menor que 3 cm foram submetidas à drenagem do endometrioma e exérese da cápsula na primeira laparoscopia. Vinte e uma pacientes com endometriomas com diâmetros maior que 3 cm foram submetidas à drenagem do endometrioma e lavagem do cisto na primeira laparoscopia. A seguir, utilizaram análogo do GnRH por quatro meses (1 ampola mensal e então foram submetidas à segunda laparoscopia para retirada da cápsula do endometrioma. O exame histopatológico do material obtido na cirurgia foi realizado em todos os casos. Avaliou-se o resultado imediato do procedimento e a freqüência de recidivas. Resultados: não se registraram intercorrências cirúrgicas ou complicações pós-operatórias. Ocorreram três recidivas em um período de seis a doze meses, todas no grupo de 21 pacientes com endometriomas com o diâmetro maior que 3 cm. Conclusão: o tratamento videolaparoscópico dos endometriomas ovarianos com retirada da cápsula apresenta bons resultados e baixo índice de recidiva.
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Ceschin Álvaro Pigatto
2004-01-01
Full Text Available OBJETIVO: O transplante autólogo de tecido ovariano tem sido objeto de estudo de diversos pesquisadores pela perspectiva de manter a funcionalidade deste órgão, mesmo não localizado em seu sítio habitual, sendo daí removido, a fim de minimizar os efeitos causados, por exemplo, pela radioterapia. Este trabalho visa a analisar a efetividade da técnica de autotransplante subcutâneo de tecido ovariano bisseccionado em região inguinal de ratas albinas, próximo aos vasos femorais, através do estudo indireto da produção hormonal, feita pela avaliação da citologia de esfregaços vaginais e do estudo direto da viabilidade tecidual, realizado por meio da análise histológica. MÉTODOS: Analisaram-se 30 ratas, que sofreram ooforectomia bilateral, sendo 15 delas destinadas ao controle e 15 submetidas ao transplante ovariano. Decorridos 28 dias, recuperaram-se e avaliaram-se os enxertos. As análises da citologia dos esfregaços vaginais efetuaram-se no momento 0, ou seja, pré-transplante, e no momento 1, pós-transplante, para os animais de ambos os grupos e a avaliação histológica realizou-se no momento 0 para os dois grupos e no momento 1 para os animais transplantados. RESULTADOS: Os resultados do experimento demonstraram a viabilidade e funcionalidade dos enxertos em 100% das lâminas analisadas, isso verificado através da obtenção de esfregaços em fase de estro para todas as ratas do grupo experimento e da presença de folículos em vários estágios de desenvolvimento, observados nos enxertos recuperados, indicando diretamente a viabilidade do tecido ovariano. CONCLUSÃO: o transplante de tecido ovariano é uma alternativa viável, nas condições do experimento, para a preservação hormonal e folicular, em ratas.
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Eliana Aguiar Petri Nahás
2002-06-01
Full Text Available Objetivo: avaliar os efeitos da histerectomia total abdominal (HTA sobre o fluxo sangüíneo ovariano, em mulheres no menacme, por meio da dopplervelocimetria e ultra-sonografia transvaginal. Métodos: estudo prospectivo no qual foram incluídas 61 mulheres, com idade igual ou inferior a 40 anos. As pacientes foram divididas em dois grupos: G1, com 31 pacientes submetidas à HTA, e G2, com 30 mulheres normais não submetidas à cirurgia. Somente foram incluídas pacientes eumenorréicas, ovulatórias, não-obesas ou fumantes, sem cirurgias ou doenças ovarianas prévias. Avaliou-se o fluxo sangüíneo das artérias ovarianas, inicialmente e aos 6 e 12 meses, pelo índice de pulsatilidade (IP na dopplervelocimetria, e o volume ovariano pela ultra-sonografia transvaginal (US. Para análise estatística empregou-se teste t pareado, análise de perfil, teste de Friedman e teste de Mann-Whitney. Resultados: na comparação estatística inicial os grupos foram homogêneos quanto às características epidemiológicas e quanto aos demais parâmetros avaliados neste estudo. Nas pacientes submetidas à histerectomia, observaram-se aos 6 e 12 meses aumento do volume ovariano ao US e diminuição do IP avaliado pela dopplervelocimetria (pPurpose: to evaluate the effect of total abdominal hysterectomy on ovarian blood supply in women in reproductive age, using transvaginal color Doppler. Methods: a prospective study was carried out on 61 40-year-old or younger women. They were divided into two groups: G1, 31 patients submitted to hysterectomy, and G2, 30 normal women. Criteria of inclusion: normal ovarian function at baseline, normal body weight, without expasure to tobacco, no history of laparotomy or ovarian pathology. The pulsatility index (PI of ovarian arteries determined by Doppler and the transvaginal ultrasonographic measurement of the ovarian volume were performed at three moments: baseline, 6 and 12 months. Results: at baseline the groups were
Santos, Fernanda Araujo dos
2015-01-01
Xenotransplante ovariano é uma técnica reprodutiva auxiliar que permite a conservação do germoplasma de espécies de alto valor zootécnico ou em perigo de extinção. O uso de gonadotrofinas exógenas auxilia no desenvolvimento desses tecidos xenotransplantados e na obtenção de folículos viáveis para produção in vitro de embriões (PIVE), entretanto esse uso não foi relatado em xenotransplante de ovários de gatas com fêmeas C57BL/6 SCID como receptora. Dessa forma, o objetivo desse trabalho ...
Borderline Personality in the Medical Setting
Sansone, Lori A.
2015-01-01
Objective: Individuals with borderline personality disorder in mental health settings tend to present with relationship difficulties, mood instability/dysphoria, and overt self-harm behavior. In contrast, it appears that individuals with borderline personality disorder in medical settings manifest physical symptoms that are medically difficult to substantiate. Through a review of the literature, we examine 2 symptom manifestations among patients with borderline personality in primary care and general medical settings—namely pain sensitivity and multiple somatic complaints. In addition to reviewing the research of others, we also highlight our own investigations into these 2 areas. Data Sources: We conducted a literature search of the PubMed database and a previous version of the PsycINFO search engine (no restrictions). Search terms included borderline personality, borderline personality disorder, personality disorders; chronic pain, pain, pain syndromes; and somatization disorder, Briquet’s syndrome, somatic preoccupation, somatic. Study Selection: Published articles related to borderline personality, pain and somatic symptoms (ie, somatization disorder, somatic preoccupation) were examined. Results: According to our review, the literature indicates higher-than-expected rates of borderline personality disorder among patients in primary care and general medical settings who present with chronic pain conditions and/or somatic preoccupation. Conclusions: Unlike patients with borderline personality disorder in mental health settings, who tend to present with relationship difficulties, mood instability/dysphoria, and overt self-harm behavior, patients with borderline personality disorder in primary care settings tend to present with unsubstantiated chronic pain of various types as well as somatic preoccupation. PMID:26644960
VIANA, Carlos Henrique Cabral; ARRUDA, Rubens Paes de; MORETTI, Anibal Saint'Anna; VISINTIN, José Antonio
1998-01-01
Foram abordados alguns conceitos sobre a fisiopatologia e a semiologia de cistos ovarianos em fêmeas suínas, descrevendo-se dois casos clínicos, um sintomático e outro assintomático. No caso sintomático, observou-se infertilidade, cios irregulares, edema de vulva e clitóris aumentado de volume. À palpação retal, constataram-se cistos em ambos os ovários da fêmea com sintomas e um cisto no ovário esquerdo da assintomática. A ultra-sonografia possibilitou visualizar, assim como avaliar com prec...
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Ahmad Mirgol
2018-03-01
Full Text Available Background and Objectives: The borderline personality disorder includes a cluster of syndromes and symptoms characterized by instable and impulsive behaviors. The aim of the present study was to investigate the correlation of alexithymia in people with borderline tendencies with impulsivity, self-harm and borderline personality traits. Material and Methods: In a descriptive-correlational and cross sectional research approach, 350 students from Tabriz University were selected using random cluster sampling. From this sample, 115 people with a borderline score higher than the cut-off point were chosen and labeled as people with borderline tendencies. Toronto Alexithymia Scale-20, STB, and SHI questionnaires were used to collect data. The data were analyzed using Pearson product-moment correlation and simultaneous multiple regression by SPSS software v.21. Results: The findings indicated that alexithymia has a positive and meaningful relationship with borderline personality traits (r=0.36, p Conclusion: Based on these findings, we can conclude that alexithymia and problems in identifying feelings are the main determinants of borderline personality traits and impulsivity. Also, alexithymia and problems in identifying feelings and problems in describing feelings subscales are the main determinants of self-harm.
MRI appearances of borderline ovarian tumours
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Bent, C.L. [Department of Diagnostic Imaging, St Bartholomew' s Hospital, West Smithfield, London (United Kingdom)], E-mail: clare.bent@bartsandthelondon.nhs.uk; Sahdev, A.; Rockall, A.G. [Department of Diagnostic Imaging, St Bartholomew' s Hospital, West Smithfield, London (United Kingdom); Singh, N. [Department of Pathology, St Bartholomew' s Hospital, West Smithfield, London (United Kingdom); Sohaib, S.A. [Department of Radiology, Royal Marsden Hospital, London (United Kingdom); Reznek, R.H. [Cancer Imaging, St Bartholomew' s Hospital, West Smithfield, London (United Kingdom)
2009-04-15
This review was performed to describe the range of magnetic resonance imaging (MRI) appearances of borderline ovarian tumours. The MRI findings in 26 patients with 31 borderline ovarian tumours (mean age: 40.1 years, range: 14-85 years) were retrospectively reviewed. For each tumour, site, size, MRI characteristics, and enhancement following gadolinium administration were recorded. There were 20 serous and 11 mucinous borderline ovarian subtypes. Nine of 26 patients demonstrated bilateral disease on MRI; synchronous contralateral ovarian disease included three benign, five serous borderline, and one serous invasive tumour. A history of a metachronous mucinous borderline tumour was identified in one patient. MRI appearances were classified into four morphological categories: group 1 (6/31, 19%), unilocular cysts; group 2 (6/31, 19%), minimally septate cysts with papillary projections; group 3 (14/31, 45%), markedly septate lesions with plaque-like excrescences; and group 4 (5/31, 16%), predominantly solid with exophytic papillary projections, all of serous subtype. There was a significant difference in mean volume between serous (841.5 cm{sup 3}) and mucinous (6358.2 cm{sup 3}) subtypes (p = 0.009). All tumours demonstrated at least one MRI feature suggestive of malignancy. The present review demonstrates the variable MRI appearances of borderline ovarian tumours along with imaging features suggestive of tumour subtype. In patients in whom the clinical features are suggestive of a borderline ovarian tumour (young age and normal or minimally elevated CA125), the ability to predict a borderline disease using morphological features observed on MRI would be extremely helpful in surgical planning, with the potential to offer fertility or ovary-preserving surgery. Future studies are required to further this aim.
Genome-wide analyses of borderline personality features
Lubke, G.H.; Laurin, C.; Amin, N.; Hottenga, J.J.; Willemsen, G.; Grootheest, G.; Abdellaoui, A.; Karssen, L.C.; Oostra, B.A.; van Duijn, C.M.; Penninx, B.W.J.H.; Boomsma, D.I.
2014-01-01
The heritability of borderline personality (BP) features has been established in multiple twin and family studies. Using data from the borderline subscale of the Personality Assessment Inventory Borderline Features Scale (PAI-BOR) collected in two Dutch cohorts (N=7125), the Netherlands Twin
Transtorno borderline: história e atualidade
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Paulo Dalgalarrondo
Full Text Available No presente trabalho é feita uma revisão histórica e psicopatológica do distúrbio borderline. O autor sugere que a categoria clínica introduzida por Kahlbaum, em 1890, “heiboidophenie”, pode ser considerada como um protoconceito na origem do conceito de transtorno borderline. No final dos anos 70 e 80, sob a influência do DMS-III, a esquizofrenia latente ou borderline se transformava em dois subtipos de transtorno de personalidade: borderline e esquizotípico. Alguns aspectos psicopatológicos do Transtorno de Personalidade Borderline são revistos, com especial ênfase sobre os sintomas afetivos e as alterações no plano das relações interpessoais.
Azerbaijan-Russia Borderline Security
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Ekaterina V. Arkhipova
2017-03-01
Full Text Available The Azerbaijan-Russia borderline mainly goes by the Caucasian mountain range and close to the Samur riverbed. Main border posts are situated close to the Caspian seashore while the locals living in the Upper Dagestan area have difficulties with crossing borderline. The locals are represented by the so called “divided peoples” whose living area was divided with the state border after 1991. The former inner borders ignored ethnic areas but now they became the lines crossing the ethnic groups of Legins, Avars, Tzakhurs and Rutuls. Certainly, those peoples are interested in specific rules for crossing the border. At the same time, their areas have not got the equipped border offices and they have to spend a lot of time and money for travelling to the neighboring districts via Baku or Vladikavkaz. Such problems arouse the radical demands among locals. The Lezgin movement for an independent Lezgistan is the most famous among them. Its supporters were involved in a terrorist attack in Baku in 1990-s and now they collect files about any problems connected with border issues, including the results of a demarcation process. They attract attention to the facts of all assignments made by Russian representatives. The activity of other ethnic groups was comparatively lower and they could make an agreement with local authorities about division of powers. Obviously, any solution about development of the border infrastructure may stabilize the separatism activity in the area. The author determines the key challenges and threats to cross-border security at Azerbaijan-Russia borderline on the basis of analysis of Federal and regional media, declarations made by representatives of the local and borderline authorities, as well as online activities of national movements. The author reveals the infrastructure factors of ensuring cross-border activity, social and economic conditions of borderline districts development. The suggestion is made on the need to develop
Neurochemical alterations associated with borderline personality disorder.
Atmaca, Murad; Karakoc, Tevfik; Mermi, Osman; Gurkan Gurok, M; Yildirim, Hanefi
2015-01-01
In neuroimaging on borderline personality disorder, prior studies focused on the hippocampus and amygdala, as mentioned above. However, no study investigated whether there were neurochemical changes in the patients with borderline personality disorder. Therefore, in the present study, we aimed to investigate neurochemical change of patients diagnosed with borderline disorder and hypothesized that neurochemicals would change in the hippocampus region of these patients. Seventeen patients and the same number of healthy control subjects were analyzed by using a 1.5 Tesla GE Signa Imaging System. N-acetylaspartate (NAA), choline compounds (CHO), and creatine (CRE) values of hippocampal region were measured. The mean NAA/CRE ratio in the hippocampus region was significantly reduced in the patients with borderline personality disorder compared to that of healthy control subjects, In addition, NAA/CHO ratio of the patients with borderline personality disorder was also significantly reduced when compared to that of healthy subjects. There was no difference in the ratio of CHO/CRE. In summary, we present evidence for reduced NAA in the patients with borderline personality disorder. © 2015, The Author(s).
Developmental aspects of borderline personality disorder.
Reich, D B; Zanarini, M C
2001-01-01
This study examined whether patients with borderline personality disorder and controls with other personality disorders remember their childhoods differently with respect to separation difficulties, evocative memory, temperamental factors such as frustration tolerance and mood reactivity, and onset of symptoms. Two hundred and ninety patients with borderline personality disorder and 72 with other personality disorders were assessed using an instrument to rate memories of separation difficulties, temperamental problems, and onset of symptoms before age 18. Patients with borderline personality disorder remembered more difficulties with separation between ages 6 and 17 years, more mood reactivity and poorer frustration tolerance between ages 6 and 17, and the onset of more symptoms (most prominently sadness, depression, anxiety, and suicidality) before age 18 than did patients with other personality disorders. The groups did not differ in reports of evocative memory before age 18. These results indicate that many of the features of adult patients with borderline personality disorder may initially appear during childhood and adolescence and that these features may be used to differentiate borderline from other personality disorders.
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Joyce Luciana Covre
2011-04-01
Full Text Available OBJETIVO: Avaliar a eficácia e aspecto estrutural de células límbicas epiteliais humanas cultivadas sobre membrana amniótica (MA com e sem epitélio. MÉTODOS: As culturas límbicas foram obtidas a partir de rima corneoescleral remanescentes de transplantes de córnea de 6 diferentes doadores. Cada explante foi cultivado em três diferentes grupos: MA desepitelizada por tripsina (Grupo 1, MA com epitélio íntegro (Grupo 2 e controle (Grupo 3. A migração epitelial foi avaliada por microscopia de contraste de fase. Após 15 dias, as células cultivadas sobre MA foram submetidas à microscopia eletrônica para avaliar migração e adesão epitelial. RESULTADOS: Todas as células do grupo controle cresceram até atingir confluência. Somente uma das culturas em membrana amniótica desepitelizada não apresentou crescimento epitelial. O crescimento de células epiteliais sobre membrana amniótica epitelizada foi observada em apenas uma cultura. CONCLUSÃO: Baseando-se nestes achados, o uso de membrana amniótica desepitelizada aparenta ser o melhor substrato para migração e adesão epitelial comparando com membrana amniótica epitelizada. Remover o epitélio da membrana amniótica demonstra ser um importante passo para estabelecer culturas de células sobre membrana amniótica.
Affective disorders among patients with borderline personality disorder.
Sjåstad, Hege Nordem; Gråwe, Rolf W; Egeland, Jens
2012-01-01
The high co-occurrence between borderline personality disorder and affective disorders has led many to believe that borderline personality disorder should be considered as part of an affective spectrum. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders. In a national cross-sectional study of patients receiving mental health treatment in Norway (N = 36 773), we determined whether psychiatric outpatients with borderline personality disorder (N = 1 043) had a higher prevalence of affective disorder in general, and whether they had an increased prevalence of depression, bipolar disorder or dysthymia specifically. They were compared to patients with paranoid, schizoid, dissocial, histrionic, obsessive-compulsive, avoidant, dependent, or unspecified personality disorder, as well as an aggregated group of patients with personality disorders other than the borderline type (N = 2 636). Odds ratios were computed for the borderline personality disorder group comparing it to the mixed sample of other personality disorders. Diagnostic assessments were conducted in routine clinical practice. More subjects with borderline personality disorder suffered from unipolar than bipolar disorders. Nevertheless, borderline personality disorder had a lower rate of depression and dysthymia than several other personality disorder groups, whereas the rate of bipolar disorder tended to be higher. Odds ratios showed 34% lower risk for unipolar depression, 70% lower risk for dysthymia and 66% higher risk for bipolar disorder in patients with borderline personality disorder compared to the aggregated group of other personality disorders. The results suggest that borderline personality disorder has a stronger association with affective disorders in the bipolar spectrum than disorders in the unipolar spectrum. This association may reflect
Affective disorders among patients with borderline personality disorder.
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Hege Nordem Sjåstad
Full Text Available BACKGROUND: The high co-occurrence between borderline personality disorder and affective disorders has led many to believe that borderline personality disorder should be considered as part of an affective spectrum. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders. METHODS: In a national cross-sectional study of patients receiving mental health treatment in Norway (N = 36 773, we determined whether psychiatric outpatients with borderline personality disorder (N = 1 043 had a higher prevalence of affective disorder in general, and whether they had an increased prevalence of depression, bipolar disorder or dysthymia specifically. They were compared to patients with paranoid, schizoid, dissocial, histrionic, obsessive-compulsive, avoidant, dependent, or unspecified personality disorder, as well as an aggregated group of patients with personality disorders other than the borderline type (N = 2 636. Odds ratios were computed for the borderline personality disorder group comparing it to the mixed sample of other personality disorders. Diagnostic assessments were conducted in routine clinical practice. RESULTS: More subjects with borderline personality disorder suffered from unipolar than bipolar disorders. Nevertheless, borderline personality disorder had a lower rate of depression and dysthymia than several other personality disorder groups, whereas the rate of bipolar disorder tended to be higher. Odds ratios showed 34% lower risk for unipolar depression, 70% lower risk for dysthymia and 66% higher risk for bipolar disorder in patients with borderline personality disorder compared to the aggregated group of other personality disorders. CONCLUSIONS: The results suggest that borderline personality disorder has a stronger association with affective disorders in the bipolar spectrum than
Affective Disorders among Patients with Borderline Personality Disorder
Sjåstad, Hege Nordem; Gråwe, Rolf W.; Egeland, Jens
2012-01-01
Background The high co-occurrence between borderline personality disorder and affective disorders has led many to believe that borderline personality disorder should be considered as part of an affective spectrum. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders. Methods In a national cross-sectional study of patients receiving mental health treatment in Norway (N = 36 773), we determined whether psychiatric outpatients with borderline personality disorder (N = 1 043) had a higher prevalence of affective disorder in general, and whether they had an increased prevalence of depression, bipolar disorder or dysthymia specifically. They were compared to patients with paranoid, schizoid, dissocial, histrionic, obsessive-compulsive, avoidant, dependent, or unspecified personality disorder, as well as an aggregated group of patients with personality disorders other than the borderline type (N = 2 636). Odds ratios were computed for the borderline personality disorder group comparing it to the mixed sample of other personality disorders. Diagnostic assessments were conducted in routine clinical practice. Results More subjects with borderline personality disorder suffered from unipolar than bipolar disorders. Nevertheless, borderline personality disorder had a lower rate of depression and dysthymia than several other personality disorder groups, whereas the rate of bipolar disorder tended to be higher. Odds ratios showed 34% lower risk for unipolar depression, 70% lower risk for dysthymia and 66% higher risk for bipolar disorder in patients with borderline personality disorder compared to the aggregated group of other personality disorders. Conclusions The results suggest that borderline personality disorder has a stronger association with affective disorders in the bipolar spectrum than disorders in the unipolar
Borderline Personality and the Detection of Angry Faces.
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Johanna Hepp
Full Text Available Many studies have assessed emotion recognition in patients with Borderline Personality Disorder and considerable evidence has been accumulated on patients' ability to categorize emotions. In contrast, their ability to detect emotions has been investigated sparsely. The only two studies that assessed emotion detection abilities found contradictory evidence on patients' ability to detect angry faces.To clarify whether patients with Borderline Personality Disorder show enhanced detection of angry faces, we conducted three experiments: a laboratory study (n = 53 with a clinical sample and two highly powered web studies that measured Borderline features (n1 = 342, n2 = 220. Participants in all studies completed a visual search paradigm, and the reaction times for the detection of angry vs. happy faces were measured.Consistently, data spoke against enhanced detection of angry faces in the Borderline groups, indicated by non-significant group (Borderline vs. healthy control × target (angry vs. happy interactions, despite highly satisfactory statistical power to detect even small effects.In contrast to emotion categorization, emotion detection appears to be intact in patients with Borderline Personality Disorder and individuals high in Borderline features. The importance of distinguishing between these two processes in future studies is discussed.
The prevalence of borderline personality symptoms in adolescents.
Mohammadi, Mohammad Reza; Shamohammadi, Morteza; Salmanian, Maryam
2014-07-01
This study aimed to assess the prevalence of borderline personality symptoms in 16-18 year old adolescents. In this cross sectional - descriptive study, 422 high school students (211 boys, 211 girls) aged 16-18 were selected by cluster random sampling and simple random sampling in 2011-2012. The participants were assessed using the revised diagnostic interview for borderline questionnaire (DIB-R) and demographic questionnaire. Data were analyzed using Pearson correlation coefficient and Spearman correlation coefficient. Of the participants, 0/9% (0/22 % of the 16 year olds, 0.45 % of the 17 year olds and 0/22% of the 18 year olds) were diagnosed with borderline personality symptoms. Also, the prevalence of borderline personality symptoms in boys was 0/45 % of the total sample and it was 0/45 % of the total sample in girls. With respect to the relationship between demographic variables (age, sex, location, parents' occupation, parents' kinship, parents' education and birth order) and borderline personality symptoms, only parents' kinship showed a weak correlation with borderline personality symptoms. In the view of the prevalence of 0.9% of the borderline personality symptoms in adolescents, attention should be paid to the diagnosis and treatment of this disorder. Furthermore, works need to be done to improve the mental health and quality of life of adolescents.
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Andy Petroianu
2004-06-01
Full Text Available INTRODUÇÃO: A insuficiência ovariana decorre de ooforectomia bilateral em diversas afecções do ovário, como neoplasia e sepse, além de quimioterapia, radiação pélvica e fatores relacionados à idade. Suas complicações sistêmicas, como insuficiências hormonais, podem ser de difícil controle. OBJETIVOS: Avaliar aspectos endócrinos e histológicos ovarianos após seu transplante ortotópico, sem anastomose vascular e submetidos à imunossupressão pela ciclosporina. MATERIAL E MÉTODO: Foram utilizadas 12 coelhas da raça Nova Zelândia Branca (n = 6 e Califórnia (n = 6, divididas em dois grupos: grupo 1 (n = 4, de controle, submetido apenas a laparotomia, sem outro procedimento cirúrgico; e grupo 2 (n = 8, submetido a ooforectomia bilateral e transplante ortotópico dos ovários, que foram trocados entre as duas raças de animais. De um lado, foi transplantado o ovário íntegro e, do outro, o ovário fatiado. Não houve anastomose vascular. As coelhas foram imunossuprimidas com ciclosporina (10mg/kg ao dia. No final do período de acompanhamento de seis meses, foram feitas dosagens de estradiol, progesterona, hormônio foliculoestimulante (FSH e hormônio luteinizante (LH, além de estudo histológico de ovários, tuba uterina e útero. RESULTADOS: Os ovários transplantados estavam rodeados por tecido conjuntivo, bem vascularizados, mostrando folículos em diferentes estádios de desenvolvimento. A histologia tubária e uterina também foi preservada em ambos os grupos. A dosagem hormonal foi normal em todas as coelhas, indicando que, do ponto de vista endócrino, o ovário transplantado estava funcionando. O transplante ovariano homógeno ortotópico, sem pedículo vascular e submetido à imunossupressão pela ciclosporina, foi eficaz para a manutenção de hormônios ovarianos em níveis normais.INTRODUCTION: Ovarian failure may be due to bilateral oophorectomy on several ovarian diseases, such as infection and neoplasm
The prevalence of borderline personality symptoms in adolescents.
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Mohammad Reza Mohammadi
2014-09-01
Full Text Available This study aimed to assess the prevalence of borderline personality symptoms in 16-18 year old adolescents.In this cross sectional - descriptive study, 422 high school students (211 boys, 211 girls aged 16-18 were selected by cluster random sampling and simple random sampling in 2011-2012. The participants were assessed using the revised diagnostic interview for borderline questionnaire (DIB-R and demographic questionnaire. Data were analyzed using Pearson correlation coefficient and Spearman correlation coefficient.Of the participants, 0/9% (0/22 % of the 16 year olds, 0.45 % of the 17 year olds and 0/22% of the 18 year olds were diagnosed with borderline personality symptoms. Also, the prevalence of borderline personality symptoms in boys was 0/45 % of the total sample and it was 0/45 % of the total sample in girls. With respect to the relationship between demographic variables (age, sex, location, parents' occupation, parents' kinship, parents' education and birth order and borderline personality symptoms, only parents' kinship showed a weak correlation with borderline personality symptoms.In the view of the prevalence of 0.9% of the borderline personality symptoms in adolescents, attention should be paid to the diagnosis and treatment of this disorder. Furthermore, works need to be done to improve the mental health and quality of life of adolescents.
Hormone therapy and ovarian borderline tumors
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Mørch, Lina Steinrud; Løkkegaard, Ellen; Andreasen, Anne Helms
2012-01-01
Little is known about the influence of postmenopausal hormone therapy on the risk of ovarian borderline tumors. We aimed at assessing the influence of different hormone therapies on this risk.......Little is known about the influence of postmenopausal hormone therapy on the risk of ovarian borderline tumors. We aimed at assessing the influence of different hormone therapies on this risk....
Parental qualities as perceived by borderline personality disorders.
Goldberg, R L; Mann, L S; Wise, T N; Segall, E A
1985-01-01
This study explores the contribution of parental qualities to the borderline personality disorder. The Parental Bonding Inventory is used to compare four parental qualities (caring mother, caring father, overprotective father, and overprotective mother) across three groups (borderline personality disorders, assorted psychiatric controls and normal controls). The major finding was that the borderline patients perceived their parents to be significantly less caring and more overprotective than both the psychiatric control or nonclinical control groups. This study was verified previous reports that patients diagnosed with an affective illness (in either the borderline group or psychiatric control group) reported no significant differences on the inventory. Pinpointing parental characteristics which antecede mental disorders may be an important first step in devising primary preventive interventions for adult disorders.
Substance abuse in borderline personality disorder: clinical and etiological correlates
van den Bosch, L. M.; Verheul, R.; van den Brink, W.
2001-01-01
This work examines differences between female borderline patients with and without substance abuse problems and between borderline patients from different treatment settings. A total of 64 female borderline patients were recruited from mental health services (n = 34) and addiction treatment services
Clinical status of comorbid bipolar disorder and borderline personality disorder.
Parker, Gordon; Bayes, Adam; McClure, Georgia; Del Moral, Yolanda Romàn Ruiz; Stevenson, Janine
2016-09-01
The status and differentiation of comorbid borderline personality disorder and bipolar disorder is worthy of clarification. To determine whether comorbid borderline personality disorder and bipolar disorder are interdependent or independent conditions. We interviewed patients diagnosed with either a borderline personality disorder and/or a bipolar condition. Analyses of participants grouped by DSM diagnoses established that those with comorbid conditions scored similarly to those with a borderline personality disorder alone on all key variables (i.e. gender, severity of borderline personality scores, developmental stressors, illness correlates, self-injurious behaviour rates) and differed from those with a bipolar disorder alone on nearly all non-bipolar item variables. Similar findings were returned for groups defined by clinical diagnoses. Comorbid bipolar disorder and borderline personality disorder is consistent with the formal definition of comorbidity in that, while coterminous, individuals meeting such criteria have features of two independent conditions. © The Royal College of Psychiatrists 2016.
Borderline Personality Disorder
... of a mood disorder—not borderline personality disorder Self-harming behavior, such as cutting Recurring thoughts of suicidal ... symptoms and reduce the number of suicidal or self-harming behaviors. Read more on NIMH’s Psychotherapies health topic ...
Borderline lepromatous leprosy with neurofibromatosis
Directory of Open Access Journals (Sweden)
Angoori Gnaneshwar
2010-01-01
Full Text Available The coexistence of leprosy with neurofibromatosis is rare both the diseases present with nerve thickening and skin lesions (patches and nodules. The coexistence of neurofibroma with borderline tuberculoid, lepromatous, histoid, and neuritic leprosy has been reported in the past. We report here a case of borderline lepromatous leprosy coexisting with neurofibromatosis in a 60 year-old male, who presented with neurofibromata and nerve thickening. Histopathology of skin biopsy from the leprosy and neurofibroma nodules confirmed the diagnosis of leprosy and neurofibroma.
Role of biological factors in etiopathogenesis of borderline personality disorder
Directory of Open Access Journals (Sweden)
Jolanta Rabe-Jabłońska
2012-09-01
Full Text Available Emotionally labile personality of borderline type (borderline personality occurs in 1-2% of individuals from general population; 75% of this group are women. Similarly to most of the other mental disorders, the borderline personality results from a combination of biological, social and psychological factors. The subject of this study is a survey of the current knowledge on biological factors of borderline personality. Most researchers are of the opinion that these personality disorders are determined genetically, with such inherited temperamental traits as: dysregulation, impulsivity, and hypersensitivity. Perhaps hereditary is also a defect within the serotonergic system, endogenous opioid system and/or dopaminergic system related to the reward system. Many researchers have recently perceived the dysfunction of endogenous opioid system as an integral component of borderline personality. There is now a lot of evidence showing that this dysfunction as well as that of the reward system may account for most of the borderline personality symptoms which constitute an involuntary attempt of stimulating the inefficient systems. This is how e.g. the presence of reckless sexual behaviours, unstable interpersonal relationships and inability to delay the reward in borderline personality is accounted for. Such observations may in the future constitute an important indication for seeking a more effective pharmacotherapy for patients with borderline personality. It is possible that in some patients the described dysfunctions may be alleviated with time. This is implied by the results of comprehensive prospective studies which show a significant regression of symptoms and improvement in functioning of most patients with borderline personality after at least several years.
Directory of Open Access Journals (Sweden)
Luiz Ronaldo Alberti
2002-01-01
Full Text Available Objetivos: avaliar os aspectos morfofuncionais de ovários implantados no omento maior, bem como a melhor técnica para implantação do ovário: se íntegro ou fatiado. Métodos: foram divididas aleatoriamente 40 ratas Wistar com ciclos estrais normais em quatro grupos: Grupo I (n = 5, controle - laparotomia; Grupo II (n = 5, ooforectomia total bilateral; Grupo III (n = 15, implante autólogo íntegro no omento maior e Grupo IV (n = 15, implante autólogo fatiado no omento maior. Realizaram-se esfregaços vaginais nos 3º e 6º mes pós-operatório e estudos histológicos dos implantes ovarianos, avaliando-se: degeneração, fibrose, reação inflamatória, angiogênese, cistos foliculares, desenvolvimento folicular e corpos lúteos. Resultados: os animais do Grupo I ciclaram normalmente. As ratas do Grupo II não apresentaram ciclo, permanecendo em diestro. No Grupo III, 11 ratas permaneceram em diestro, três apresentaram ciclos incompletos e apenas uma ciclou normalmente. No Grupo IV, três animais não ciclaram, oito tiveram esfregaços vaginais incompletos e quatro ciclaram normalmente. Os achados histológicos dos animais pertencentes ao Grupo III evidenciaram histoarquitetura normal em dez ratas, porém nas outras cinco, houve degeneração ovariana. No Grupo IV, 14 ratas tiveram ovários com histoarquitetura preservada e em apenas uma houve sinais de degeneração. Conclusões: o implante autólogo ovariano no omento maior foi viável, obtendo-se melhor preservação morfofuncional com a implantação de fatias.Purpose: in order to maintain the gonadal function after oophorectomy, morphofunctional aspects of ovarian autotransplantation to the greater omentum and the best kind of implantation, intact or sliced, were investigated. Methods: forty cycling female Wistar rats were randomly divided into four groups: Group I (n = 5, control - laparotomy; Group II (n = 5, bilateral oophorectomy; Group III (n = 10, intact ovarian
Co-occurrence of dissociative identity disorder and borderline personality disorder.
Ross, Colin A; Ferrell, Lynn; Schroeder, Elizabeth
2014-01-01
The literature indicates that, among individuals with borderline personality disorder, pathological dissociation correlates with a wide range of impairments and difficulties in psychological function. It also predicts a poorer response to dialectical behavior therapy for borderline personality disorder. We hypothesized that (a) dissociative identity disorder commonly co-occurs with borderline personality disorder and vice versa, and (b) individuals who meet criteria for both disorders have more comorbidity and trauma than individuals who meet criteria for only 1 disorder. We interviewed a sample of inpatients in a hospital trauma program using 3 measures of dissociation. The most symptomatic group was those participants who met criteria for both borderline personality disorder and dissociative identity disorder on the Dissociative Disorders Interview Schedule, followed by those who met criteria for dissociative identity disorder only, then those with borderline personality disorder only, and finally those with neither disorder. Greater attention should be paid to the relationship between borderline personality disorder and dissociative identity disorder.
Treatment of borderline personality disorder and co-occurring anxiety disorders
Valenstein, Helen R.
2013-01-01
Anxiety disorders are highly prevalent among individuals with borderline personality disorder, with comorbidity rates of up to 90%. Anxiety disorders have been found to reduce the likelihood of achieving remission from borderline personality disorder over time and to increase the risk of suicide and self-injury in this population. Evidence-based treatments for borderline personality disorder have not sufficiently focused on targeting anxiety disorders, and their effects on these disorders are either limited or unknown. Conversely, evidence-based treatments for anxiety disorders typically exclude suicidal, self-injuring, and seriously comorbid patients, thereby limiting their generalizability to individuals with borderline personality disorder. To address these limitations, recent research has begun to emerge focused on developing and evaluating treatments for individuals with co-occurring borderline personality disorder and anxiety disorders, specifically posttraumatic stress disorder (PTSD), with promising initial results. However, there is a need for additional research in this area, particularly studies evaluating the treatment of anxiety disorders among high-risk and complex borderline personality disorder patients. PMID:23710329
Characterizing somatization, hypochondriasis, and hysteria in the borderline personality disorder.
Snyder, S; Pitts, W M
1986-03-01
Somatization, hypochondriasis, and hysteria have often been considered as associated features of the borderline personality disorder. This study was designed to characterize these three syndromes in the borderline patient. Inpatients with DSM-III borderline personality disorder were compared with controls with dysthymic disorder. Scales and items from standardized rating instruments which measured the three syndromes were scored and compared between groups. Although the hysteria-obvious and hypochondriasis scales of the MMPI and the Hamilton Depression Scale item measuring hypochondriasis were elevated in the borderline group, there were no significant differences between groups. Scores of dysthymic patients significantly exceeded those of borderline patients on four of five MMPI codetypes measuring the three syndromes. Findings are discussed in light of previous psychodynamic, empirical, and research literature.
Capaciteitsproblemen grote belemmering: de behandeling van borderline persoonlijkheidsstoornis
Hermens, M.; van Splunteren, P.; van den Bosch, A.; Verheul, R.
2012-01-01
Barriers to implementing the clinical guideline on borderline personality disorder in the Netherlands. Objective: This study determined the gap between actual care and optimal care (recommended in the clinical guideline) for patients with borderline personality disorder in the Netherlands. Factors
Gratz, Kim L; Tull, Matthew T; Reynolds, Elizabeth K; Bagge, Courtney L; Latzman, Robert D; Daughters, Stacey B; Lejuez, C W
2009-01-01
Although research has been conducted on the course, consequences, and correlates of borderline personality disorder (BPD), little is known about its emergence in childhood, and no studies have examined the extent to which theoretical models of the pathogenesis of BPD in adults are applicable to the correlates of borderline personality symptoms in children. The goal of this study was to examine the interrelationships between two BPD-relevant personality traits (affective dysfunction and disinhibition), self- and emotion-regulation deficits, and childhood borderline personality symptoms among 263 children aged 9 to 13. We predicted that affective dysfunction, disinhibition, and their interaction would be associated with childhood borderline personality symptoms, and that self- and emotion-regulation deficits would mediate these relationships. Results provided support for the roles of both affective dysfunction and disinhibition (in the form of sensation seeking) in childhood borderline personality symptoms, as well as their hypothesized interaction. Further, both self- and emotion-regulation deficits partially mediated the relationship between affective dysfunction and childhood borderline personality symptoms. Finally, results provided evidence of different gender-based pathways to childhood borderline personality symptoms, suggesting that models of BPD among adults are more relevant to understanding the factors associated with borderline personality symptoms among girls than boys.
Borderline personality symptoms and work performance: a population-based survey.
Juurlink, Trees T; Ten Have, Margreet; Lamers, Femke; van Marle, Hein J F; Anema, Johannes R; de Graaf, Ron; Beekman, Aartjan T F
2018-06-19
This study aims to elucidate the interplay between borderline personality symptoms and working conditions as a pathway for impaired work performance among workers in the general population. Cross-sectional data from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2) were used, including 3672 workers. Borderline personality symptoms were measured with the International Personality Disorder Examination (IPDE) questionnaire. Working conditions (decision latitude, psychological job demands, job security and co-worker support) were assessed with the Job Content Questionnaire (JCQ). Impaired work performance was assessed as total work loss days per month, defined as the sum of days of three types of impaired work performance (inability to work, cut-down to work, and diminished quality at work). These were assessed with the WHO Disability Assessment Schedule (WHO-DAS). Common mental disorders (CMD) were assessed with the Composite International Diagnostic Interview (CIDI). Number of borderline personality symptoms was consistently associated with impaired work performance, even after controlling for type or number of adverse working conditions and co-occurrence of CMD. Borderline personality symptoms were associated with low decision latitude, job insecurity and low co-worker support. The relationship between borderline personality symptoms and work performance diminished slightly after controlling for type or number of working conditions. The current study shows that having borderline personality symptoms is a unique determinant of work performance. This association seems partially explained through the impact of borderline personality symptoms on working conditions. Future studies are warranted to study causality and should aim at diminishing borderline personality symptoms and coping with working conditions.
Definition and Management of Borderline Resectable Pancreatic Cancer.
Denbo, Jason W; Fleming, Jason B
2016-12-01
Patients with localized pancreatic ductal adenocarcinoma seek potentially curative treatment, but this group represents a spectrum of disease. Patients with borderline resectable primary tumors are a unique subset whose successful therapy requires a care team with expertise in medical care, imaging, surgery, medical oncology, and radiation oncology. This team must identify patients with borderline tumors then carefully prescribe and execute a combined treatment strategy with the highest possibility of cure. This article addresses the issues of clinical evaluation, imaging techniques, and criteria, as well as multidisciplinary treatment of patients with borderline resectable pancreatic ductal adenocarcinoma. Copyright © 2016 Elsevier Inc. All rights reserved.
Treating borderline personality disorder as a trainee psychologist ...
African Journals Online (AJOL)
Clients with borderline personality disorder are viewed as difficult to work with. They also have high drop-out rates and unpredictable treatment outcomes. The characteristics of patients with borderline personality disorder often have a negative effect on the therapeutic process and on clinicians themselves. Challenges are ...
Maternal empathy, family chaos, and the etiology of borderline personality disorder.
Golomb, A; Ludolph, P; Westen, D; Block, M J; Maurer, P; Wiss, F C
1994-01-01
Psychoanalytic writers have traced the etiology of borderline personality disorder (BPD) to be a preoedipal disturbance in the mother-child relationship. Despite the prevalence of theories focusing on the role of mothering in the development of BPD, few empirical studies have tested the hypothesis that borderlines were the recipients of unempathic mothering. The current preliminary study compared 13 mothers of borderline adolescents with 13 mothers of normal adolescents. This study found that mothers of borderlines tended to conceive of their children egocentrically, as need-gratifying objects, rather than as individuals with distinct and evolving personalities. This study also found that the mothers of borderlines reported raising their daughters in extremely chaotic families struggling to cope with multiple hardships, including divorce and financial worries. The stressful environmental circumstances reported by the mothers likely affected the borderline daughters directly as well as the mothers' ability to parent effectively and empathically. The results of this study suggest that, as predicted by psychoanalytic theory, a problematic mother-child relationship may play a significant role in the genesis of borderline pathology; however, the life circumstances that contextualize the mother-child relationship also need to be considered when accounting for the etiology of BPD.
Experiences of women living with borderline personality disorder ...
African Journals Online (AJOL)
There is limited understanding of the experiences of women living with borderline personality disorder. It was therefore decided to discover how women living with this disorder would tell their life story. For the researcher, who worked in a psychotherapy ward where most women were living with borderline personality ...
Richman, Mara J; Unoka, Zsolt
2015-12-01
Patients with major depression and borderline personality disorder are characterised by a distorted perception of other people's intentions. Deficits in mental state decoding are thought to be the underlying cause of this clinical feature. To examine, using meta-analysis, whether mental state decoding abilities in patients with major depression and borderline personality disorder differ from those of healthy controls. A systematic review of 13 cross-sectional studies comparing Reading in the Mind of the Eyes Test (RMET) accuracy performance of patients with major depression or borderline personality disorder and healthy age-matched controls (n = 976). Valence scores, where reported, were also assessed. Large significant deficits were seen for global RMET performance in patients with major depression (d = -0.751). The positive RMET valence scores of patients with depression were significantly worse; patients with borderline personality disorder had worse neutral scores. Both groups were worse than controls. Moderator analysis revealed that individuals with comorbid borderline personality disorder and major depression did better than those with borderline personality disorder alone on accuracy. Those with comorbid borderline personality disorder and any cluster B or C personality disorder did worse than borderline personality disorder alone. Individuals with both borderline personality disorder and major depression performed better then those with borderline personality disorder without major depression for positive valence. These findings highlight the relevance of RMET performance in patients with borderline personality disorder and major depression, and the importance of considering comorbidity in future analysis. © The Royal College of Psychiatrists 2015.
The borderline conditions--an introduction from a Scandinavian perspective
DEFF Research Database (Denmark)
Simonsen, E
1994-01-01
disorder--impulsive or borderline subcategory. This closer demarcation of prototypes in the classification system may facilitate less confusion in future. All Scandinavian countries have contributed a great deal to the research in the field of borderline conditions, especially with regard to genetic...... and nosological issues. A brief summary of these contributions is presented. Some important notions in the phenomenologic and prototypically oriented European tradition of classifying personality disorders are explained in order to understand the rather ambiguous reaction to the borderline concept in European...
Accuracy of frozen section in borderline ovarian tumor
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Maryam Dadzan
2015-01-01
Full Text Available Borderline ovarian tumor or low malignant ovarian tumor presents in 10-15% of all ovarian cancers, which usually affects younger women and have favorable prognosis even with conservative surgery, in which fertility can be preserved. Lack of reliable diagnostic tool to indicate the type of malignancy before or at the time of surgery makes the borderline ovarian tumor one of the most controversial topics in gynecology. This might lead to many overtreatment cases with radical surgery or undertreatment with conservative surgery with the higher rate of overtreatment compared to under treatment.In this review article, we extensively searched for all reported data regarding the accuracy of frozen section in borderline ovarian tumor. Reviewing the results of six studies, which specifically considered the accuracy of frozen section in borderline ovarian tumors, revealed an accuracy of 60% with an agreement between final pathology and frozen section results. Overall, 24.5% of under-diagnosed malignant cases interpreted to be benign and 4.9% overdiagnosed cases with benign tumor considered as a malignant. Frozen section is a reliable tool to exclude benign tumor from borderline and malignant but underdiagnosed percentage is higher. There are limitations in this review including the small number of enrolled cases, different time of diagnosis and different investigated countries and the discrepancies between the studied articles in this review.
Shame and implicit self-concept in women with borderline personality disorder.
Rüsch, Nicolas; Lieb, Klaus; Göttler, Ines; Hermann, Christiane; Schramm, Elisabeth; Richter, Harald; Jacob, Gitta A; Corrigan, Patrick W; Bohus, Martin
2007-03-01
Shame is considered to be a central emotion in borderline personality disorder and to be related to self-injurious behavior, chronic suicidality, and anger-hostility. However, its level and impact on people with borderline personality disorder are largely unknown. The authors examined levels of self-reported shame, guilt, anxiety, and implicit shame-related self-concept in women with borderline personality disorder and assessed the association of shame with self-esteem, quality of life, and anger-hostility. Sixty women with borderline personality disorder completed self-report measures of shame- and guilt-proneness, state shame, anxiety, depression, self-esteem, quality of life, and clinical symptoms. Comparison groups consisted of 30 women with social phobia and 60 healthy women. Implicit shame-related self-concept (relative to anxiety) was assessed by the Implicit Association Test. Women with borderline personality disorder reported higher levels of shame- and guilt-proneness, state shame, and anxiety than women with social phobia and healthy comparison subjects. The implicit self-concept in women with borderline personality disorder was more shame-prone (relative to anxiety-prone) than in women in the comparison groups. After depression was controlled for, shame-proneness was negatively correlated with self-esteem and quality of life and positively correlated with anger-hostility. Shame, an emotion that is prominent in women with borderline personality disorder, is associated with the implicit self-concept as well as with poorer quality of life and self-esteem and greater anger-hostility. Psychotherapeutic approaches to borderline personality disorder need to address explicit and implicit aspects of shame.
Höhner, Gesche; Teismann, Tobias; Willutzki, Ulrike
2014-02-01
Do women suffering from borderline symptomatology differ from women without these symptoms regarding their motives for body modifications?A sample of 289 women with body modifications were questioned about their tattoos, piercings and motives for body modifications as well as about symptoms of borderline personality disorder. Women with borderline symptomatology were compared to women without borderline symptomatology concerning the extent of and motives for body modification.The 2 groups showed no differences in regard to amount and extent of body modifications. The "borderline"-group considered individuality, coping and management of negative life-events to be more crucial reasons for body modification than the non-borderline females.The degree of a person's body modification is not a feasible indicator for psychopathological strain. Though, for people with borderline tendency body modification may serve as a coping strategy similar to self-injury. © Georg Thieme Verlag KG Stuttgart · New York.
The continuum between Bipolar Disorder and Borderline Personality Disorder.
Elisei, Sandro; Anastasi, Serena; Verdolini, Norma
2012-09-01
Several studies have been carried out regarding the possible overlap between Bipolar Disorder and borderline personality disorder. Up to now, it is not possible to provide a definitive picture. In fact, there is currently significant debate about the relationship between Borderline Personality Disorder and Bipolar Disorder. MEDLINE searches were performed to identify the latest studies of these disorders, considering psychodynamic aspects. Bipolar disorder and borderline personality disorder share common clinical features, namely affective instability and impulsivity which however differ in quality. Consequently, to better understand these aspects, it is necessary to trace the stages of childhood psychological development. It has been claimed that Bipolar Disorder Type II can be divided into two subtypes: one stable and functional between episodes and one unstable between episodes which is related to Borderline Personality Disorder. However, better diagnostic theories, psychiatrist's empathy and patience remain the essential tool to understand and to face human suffering.
Sex Bias in Classifying Borderline and Narcissistic Personality Disorder.
Braamhorst, Wouter; Lobbestael, Jill; Emons, Wilco H M; Arntz, Arnoud; Witteman, Cilia L M; Bekker, Marrie H J
2015-10-01
This study investigated sex bias in the classification of borderline and narcissistic personality disorders. A sample of psychologists in training for a post-master degree (N = 180) read brief case histories (male or female version) and made DSM classification. To differentiate sex bias due to sex stereotyping or to base rate variation, we used different case histories, respectively: (1) non-ambiguous case histories with enough criteria of either borderline or narcissistic personality disorder to meet the threshold for classification, and (2) an ambiguous case with subthreshold features of both borderline and narcissistic personality disorder. Results showed significant differences due to sex of the patient in the ambiguous condition. Thus, when the diagnosis is not straightforward, as in the case of mixed subthreshold features, sex bias is present and is influenced by base-rate variation. These findings emphasize the need for caution in classifying personality disorders, especially borderline or narcissistic traits.
[Mentalization based treatment and borderline personality disorder].
De Oliveira, C; Rahioui, H; Smadja, M; Gorsane, M A; Louppe, F
2017-08-01
The borderline personality disorder is a complex psychiatric disorder that represents a high number of patients in a psychiatric adult service. Even if some therapies have shown to be effective in the therapeutic care of the borderline personality disorder they only target certain symptoms (e.g. anxiety, sadness, self-mutilation). The aim of this paper is to introduce a therapeutic model little known in France: the mentalization based therapy (MBT) developed in 2004 by Bateman and Fonagy. This therapeutic model apprehends the borderline personality disorder in all its complexity and is based on two main concepts: Bowlby's attachment theory and the concept of mentalization. The MBT is based on the hypothesis that a deficit of mentalization leads to the development of borderline disorder. The capacity of mentalization, also known as reflexive function, is acquired in infancy through interpersonal relationships, in particular those of attachment, and is the ability to understand the mental state (emotions, needs, thoughts, etc.) of oneself and others which underlies explicit behaviour. This reflexive capacity is of a better quality when the person has a secure attachment style. Indeed, borderline patients have, mainly, a deficit of mentalization capacity associated with an insecure attachment style. Thus, the main objective of the Bateman and Fonagy approach is to develop and reinforce the mentalization capacity through a therapeutic relationship as a secure base, a group therapy and the concept of insight. Classically, MBT is structured over a period of 18 months divided into 3 distinct phases distributed in two therapeutic axes: group and individual therapy. The initial phase aims to engage the patient in the therapy by evaluating attachment style, mentalization's ability, interpersonal functioning; providing psychoeducation about borderline disorder and establishing a therapeutic contract. To evaluate attachment style, the authors strongly recommend the use of the
Neurobiologien ved borderline-personlighedsforstyrrelse
DEFF Research Database (Denmark)
Simonsen, Erik; Andersen, Rune
2012-01-01
Borderline personality disorder (BPD) is a severe psychiatric disorder characterised by instability of affect regulation, impulse control, interpersonal relationships, and self-image. The aim of this status article is to provide a brief overview of the neurobiological underpinnings of the core...
Psychodrama and the Treatment of Narcissistic and Borderline Patients.
Olsson, Peter A
2018-01-01
Psychiatric clinicians are faced with the challenge of remaining flexible and psychotherapeutically relevant to the broadening scope of patients with severe narcissistic and borderline personality disorders. Diagnostic sophistication among mental health professionals, increased availability of psychotherapy services, and economic pressures combine to cause the public to expect cost-effective, successful, and shorter duration of treatments. These treatment challenges are particularly poignant with the treatment of those narcissistic and borderline patients who have meager capacity for insight and limited verbal skills. This article describes the use of psychodynamically oriented and informed psychodrama for the treatment of narcissistic and borderline patients.
Autobiographical Memory in Borderline Personality Disorder – A Review
DEFF Research Database (Denmark)
Beck, Morten; Elklit, Ask; Simonsen, Erik
2015-01-01
Borderline personality disorder is a severe psychiatric illness. A key feature of the disorder is a disorganized sense of self often referred to as identity diffusion. Autobiographical memory is memory for personal life events. One of the main functions of these memories is to enable us...... to understand who we are by connecting past, present and future experiences. It seems that autobiographical memory is in some way disrupted in individuals with borderline personality disorder. A systematic review is conducted looking at studies that focus on the potential connections. We find that although......, autobiographical memory and borderline personality disorder....
Directory of Open Access Journals (Sweden)
Priscila Cardoso Cristovam
2008-10-01
Full Text Available OBJETIVO: Avaliar a importância da presença de células 3T3 para estabelecer cultura de suspensão de células epiteliais do limbo obtido de rimas córneo-esclerais. MÉTODOS: Rimas de diferentes doadores tiveram seus estroma posterior e endotélio removidos (n=6. Cada rima foi dividida em três segmentos iguais, que foram colocados em cultura em três diferentes condições: um segmento foi colocado na placa de cultura com o lado epitelial para cima (Grupo A. Os dois segmentos restantes foram tripsinizados e a suspensão de células obtida foi cultivada com (Grupo B ou sem (Grupo C células 3T3 irradiadas. As células foram mantidas em meio de cultura "supplemental hormonal epithelial médium" (SHEM, a migração epitelial e a formação de clones nos grupos A, B e C foram avaliadas pela microscopia de contraste de fase e por coloração pela rodamina B. Os resultados foram comparados estatisticamente. RESULTADOS: O crescimento de células epiteliais foi observado em 4/6 rimas (Grupo A. Todas as suspensões de células epiteliais que foram cultivadas com células 3T3 (Grupo B formaram clones. Nenhuma adesão ou formação de clones verdadeiros (holo ou meroclones foi observada na cultura de células que foi cultivada sem 3T3 (Grupo C (p=0,009. CONCLUSÕES: Suspensão de células epiteliais límbicas obtidas de rimas córneo-esclerais no modelo utilizado precisa ser cultivada com células 3T3 para formar clones e estabelecer colônias epiteliais com perspectivas para uso terapêutico na reconstrução da superfície ocular.PURPOSE: To evaluate the importance of the presence of 3T3 fibroblasts for establishing limbal epithelial cultures from cell suspension obtained from corneo-scleral rims (CSR. METHODS: Corneo-scleral rims from different donors (n=6 had their posterior stroma and endothelium stripped away. Each corneo-scleral rim was divided into three equal segments that were set up in tissue culture in three different conditions: one of the
Directory of Open Access Journals (Sweden)
Hélder Silva e Luna
2010-12-01
Full Text Available A criopreservação de folículos ovarianos pré-antrais pode ajudar na conservação de muitas espécies domésticas e selvagens. Neste trabalho, objetivou-se verificar o efeito do etileno glicol, em diferentes concentrações, na morfometria e número de células da granulosa de folículos pré-antrais inclusos em tecido ovariano bovino. O teste de toxicidade foi realizado com fragmentos ovarianos expostos ao etileno glicol em concentrações de 10, 20 ou 40%. O tecido foi analisado por técnica histológica clássica. Os folículos primordiais expostos à concentração de 40% apresentaram redução do diâmetro folicular e ovocitário quando comparados ao grupo controle (sem exposição, 10% e 20% (P0,05. Esses resultados sugerem que folículos primários são mais resistentes aos efeitos do etileno glicol quando comparados aos primordiais.The cryopreservation of the ovarian preantral follicles could help the conservation of several domestic and wild animal species. The objective of this study was to verify the effect of different concentrations of ethylene glycol on the morphometry and number of granulosa cells of the preantral ovarian follicles. A toxicity test was conducted with strips of ovarian cortex using ethylene glycol (10, 20 or 40%. Tissue analysis was done using classical histology techniques. The primordial follicles expose at a concentration of 40% showed reduction of the follicular diameter and oocyte when compared to the control (non exposing, 10 and 20% groups (P0.05. These results suggest that primary follicles are more resistant to the effect of ethylene glycol when compared to primordial ones.
Experiences of women living with borderline personality disorder
Directory of Open Access Journals (Sweden)
N. Ntshingila
2016-10-01
Full Text Available There is limited understanding of the experiences of women living with borderline personality disorder. It was therefore decided to discover how women living with this disorder would tell their life story. For the researcher, who worked in a psychotherapy ward where most women were living with borderline personality disorder, the care of these women was of vital importance, as they were less understood by mental health care providers.The research aimed to explore and describe the experiences of women living with borderline personality disorder. A qualitative, explorative, descriptive and contextual study design was used. Data was collected through in-depth phenomenological interviews that focused on the central question, “Tell me your life story”. Eight participants living with borderline personality disorder were interviewed. Tesch's method for data analysis was used (Creswell, 2009:186, along with an independent coder. Measures to ensure trustworthiness and ethical principles were applied throughout the research. From the findings obtained by means of the interviews of women living with borderline personality disorder, it was evident that there were childhood experiences of living in an unsafe space, related to unhealthy family dynamics, boundary violations and educational challenges. They experienced chronic feelings of emptiness in their relationships with theself. They also presented with a pattern of unstable interpersonal relationships and compromised mental health, which was apparent through the early on set of mental problems, emotional upheaval, looking for emotional escape and having different triggerfactors. Lastly, all these women yearned for facilitated mental health.
Is research on borderline personality disorder underfunded by the National Institute of Health?
Zimmerman, Mark; Gazarian, Doug
2014-12-30
The relationship between bipolar disorder and borderline personality disorder has generated intense interest. Similar to patients with bipolar disorder, patients with borderline personality disorder are frequently hospitalized, are chronically unemployed, abuse substances, attempt and commit suicide. However, one significant difference between the two disorders is that patients with borderline personality disorder are often viewed negatively by mental health professionals. In the present paper we examined whether this negative bias against borderline personality disorder might be reflected in the level of research funding on the disorder. We searched the National Institute of Health (NIH) Research Portfolio Online Portfolio Reporting Tool (RePORT) for the past 25 years and compared the number of grants funded and the total amount of funding for borderline personality disorder and bipolar disorder. The yearly mean number of grants receiving funding was significantly higher for bipolar disorder than for borderline personality disorder. Results were the same when focusing on newly funded grants. For every year since 1990 more grants were funded for bipolar disorder than borderline personality disorder. Summed across all 25 years, the level of funding for bipolar disorder was more than 10 times greater than the level of funding for borderline personality disorder ($622 million vs. $55 million). These findings suggest that the level of NIH research funding for borderline personality disorder is not commensurate with the level of psychosocial morbidity, mortality, and health expenditures associated with the disorder.
Women’s Views on Their Diagnosis and Management for Borderline Gestational Diabetes Mellitus
Directory of Open Access Journals (Sweden)
Shanshan Han
2015-01-01
Full Text Available Introduction. Little is known about women’s views relating to a diagnosis of borderline gestational diabetes mellitus (GDM and the subsequent management. This study aimed to explore women’s experiences after being diagnosed with borderline GDM, their attitudes about treatment, and factors important to them for achieving any lifestyle changes. Methods. We conducted face-to-face, semistructured interviews with women diagnosed with borderline GDM. Results. A total of 22 women were interviewed. After a diagnosis of borderline GDM, 14 (64% women reported not being concerned or worried. Management of borderline GDM was thought by 21 (95% women to be very important or important. Eighteen (82% women planned to improve their diet and/or exercise to manage their borderline GDM. The most frequently mentioned enabler for achieving intended lifestyle change was being more motivated to improve the health of their baby and/or themselves (15 women. The most frequent barrier was tiredness and/or being physically unwell (11 women. Conclusions. A diagnosis of borderline GDM caused some concern to one-third of women interviewed. The majority of women believed managing their borderline GDM was important and they planned to improve their lifestyle. Women’s own and their babies’ future health were powerful motivators for lifestyle change.
[Emotional and impulsive dimensions in bipolar disorder and borderline personality disorder].
Leblanc, A; Jarroir, M; Vorspan, F; Bellivier, F; Leveillee, S; Romo, L
2017-05-01
Studies have shown that patients with borderline personality disorder are often misdiagnosed to have bipolar disorder and conversely. Indeed, a number of characteristics common to both disorders could explain this problem: emotional instability as well as impulsivity represent confounding factors and contribute to the risk of misdiagnosis. However, it appears that these characteristics manifest themselves in different ways according to the pathology. The aim of the study is to show differences between affective lability, emotional intensity and impulsivity dimensions. The clinical aim is to refine bipolar disorder and borderline personality disorder diagnosis, to improve psychological care for these patients in the long-term. We compared the emotional and impulsive dimensions in two groups of patients: a group of 21 patients with bipolar disorder and a group of 19 patients with borderline personality disorder. Tools: ALS, a self-report questionnaire to evaluate affective lability, AIM, a self-report questionnaire to see affective intensity, and UPPS, a self-report questionnaire to measure impulsivity according to several dimensions. The results indicate that borderline patients scored significantly higher than bipolar patients at the ALS and AIM scales. Regarding the UPPS, borderline patients scored significantly higher than bipolar patients for the dimensions "lack of premeditation" and "lack of perseverance"; however, bipolar patients had significantly higher scores than borderline patients for the dimension "negative emergency". This study shows that bipolar disorder and borderline personality can be differentiated thanks to emotional dimensions as well as different dimensions of impulsivity: borderline patients appear to have an affective lability and intensity more important than bipolar patients; it also appears that impulsivity manifests itself differently according to the disorder. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All
Relationship between EDNOS and its subtypes and borderline personality disorder.
Marino, M F; Zanarini, M C
2001-04-01
The purpose of this study was to assess the prevalence of eating disorder not otherwise specified (EDNOS) and four well-defined subtypes of this disorder found in a sample of female borderline patients. The lifetime prevalence of EDNOS and its various subtypes among 233 female borderline patients and 46 female Axis II comparison subjects was assessed using the Structured Clinical Interview for DSM-III-R Axis I disorders. Thirty-three percent of female borderline patients met DSM-III-R criteria for EDNOS at some point in their lives. Of these 76 women, 20% reported a pattern of restricting without low weight, 37% reported a pattern of binging without purging, 37% reported a pattern of purging without binging, and 33% reported a pattern of low weight without loss of menses. However, less than 25% of these 76 borderline women had ever met criteria for anorexia nervosa or bulimia nervosa. The results of this study suggest that EDNOS is a separate cluster of eating disorders among borderline women, rather than a prodromal or residual form of a more clear-cut case of anorexia or bulimia nervosa. Copyright 2001 by John Wiley & Sons, Inc.
Four factors of impulsivity differentiate antisocial and borderline personality disorders.
DeShong, Hilary L; Kurtz, John E
2013-04-01
Impulsivity is a shared criterion for the diagnosis of antisocial and borderline personality disorders, and this link may account for the high comorbidity rates between the two disorders. The current study aimed to differentiate between borderline and antisocial personality disorders using the four factors of impulsivity identified by Whiteside and Lynam (2001). Five hundred thirty-six undergraduate participants completed the personality assessment inventory (PAI; Morey, 1991) to assess borderline and antisocial personality features and the NEO personality inventory, third edition (NEO-PI-3; McCrae & Costa, 2010) to assess the four factors of impulsivity. Results indicate that negative urgency and lack of perseverance were significantly and uniquely related to borderline features, while sensation seeking and lack of premeditation were significantly and uniquely related to antisocial features. The implications of these results for improved differential diagnosis are discussed.
Gallium-67 scintigraphy in borderline lepromatous leprosy
International Nuclear Information System (INIS)
Mouratidis, B.; Lomas, F.E.
1993-01-01
A middle aged woman with a pyrexia of unknown origin was shown to have borderline lepromatous leprosy. Early gallium-67 scintigraphy demonstrated increased uptake in the subcutaneous tissues of the face and thighs. As a result of these findings skin biopsy was obtained from the right thigh which gave a diagnosis of borderline lepromatous leprosy. The authors have been unable to find other reports of gallium-67 scintigraphy in leprosy but the pattern of gallium-67 distribution should suggest the diagnosis. 5 refs., 1 fig
Borderline personality disorder and polycystic ovary syndrome: A review of the literature.
Tan, Raelene Ym; Grigg, Jasmin; Kulkarni, Jayashri
2018-02-01
This review examines the existing evidence for the relationship between borderline personality disorder and polycystic ovary syndrome, and to identify commonalities in etiological mechanisms of borderline personality disorder and polycystic ovary syndrome that might explain the relationship between these seemingly disparate disorders. A search of Medline, EMBASE and Cochrane Central was undertaken on 5 December 2016 to identify studies investigating women with borderline personality disorder and polycystic ovary syndrome (or symptoms and markers specific to polycystic ovary syndrome). Nine studies were identified, including three cross-sectional studies investigating symptoms of polycystic ovary syndrome in women with borderline personality disorder, two cross-sectional and one cohort study examining the prevalence of psychiatric diagnoses in women with polycystic ovary syndrome and three case reports of comorbid borderline personality disorder and polycystic ovary syndrome. Overall, the literature shows women with borderline personality disorder to have higher than expected serum androgen levels and incidence of polycystic ovaries, which can be key features of polycystic ovary syndrome. However, this research is still in its infancy, which limits our understanding of this potential comorbid phenomenon. Given the emerging anecdotal and empirical evidence to date, a theoretical discussion of the potential psychoneuroendocrinological mechanism underlying the borderline personality disorder and polycystic ovary syndrome comorbidity is provided. Further rigorous studies using standardized diagnostic criteria for polycystic ovary syndrome are warranted. Specifically, the use of prospective controlled cohort studies may be able to determine the causality and temporality of observed comorbid borderline personality disorder and polycystic ovary syndrome.
Borderline organization of personality in adulthood and adolescence
Alessandra Mura
2011-01-01
About the middle of the 1950 it was proposed the definition of borderline disorder to classify some of the clinical manifestations that they are not explained by neurosis and psychosis theory. The structural approach of Otto Kernberg has been particular relief to understand the borderline disorder. O. Kernberg has been suggested theborderline organization of personality, to outline a typical permanent pathological functioning underlying string of psychopathologic syndromes associated by a sta...
Merza, Katalin; Harmatta, János; Papp, Gábor; Kuritárné Szabó, Ildikó
2017-05-01
Childhood traumatization plays a significant role in the etiology of borderline personality disorder. Studies found a significant association between childhood traumatization, dissociation, and nonsuicidal self-injurious behavior. The aim of our study was to assess dissociation and nonsuicidal self-injury among borderline inpatients and to reveal the association between childhood traumatization, dissociation, and self-injurious behavior. The sample consisted of 80 borderline inpatients and 73 depressed control patients. Childhood traumatization, dissociation and self-injurious behavior were assessed by questionnaires. Borderline patients reported severe and multiplex childhood traumatization. Cumulative trauma score and sexual abuse were the strongest predictors of dissociation. Furthermore, we have found that cumulative trauma score and dissociation were highly predictive of self-injurious behavior. Our results suggest that self-injurious behavior and dissociation in borderline patients can be regarded as indicators of childhood traumatization. Orv Hetil. 2017; 158(19): 740-747.
False memories and memory confidence in borderline patients.
Schilling, Lisa; Wingenfeld, Katja; Spitzer, Carsten; Nagel, Matthias; Moritz, Steffen
2013-12-01
Mixed results have been obtained regarding memory in patients with borderline personality disorder (BPD). Prior reports and anecdotal evidence suggests that patients with BPD are prone to false memories but this assumption has to been put to firm empirical test, yet. Memory accuracy and confidence was assessed in 20 BPD patients and 22 healthy controls using a visual variant of the false memory (Deese-Roediger-McDermott) paradigm which involved a negative and a positive-valenced picture. Groups did not differ regarding veridical item recognition. Importantly, patients did not display more false memories than controls. At trend level, borderline patients rated more items as new with high confidence compared to healthy controls. The results tentatively suggest that borderline patients show uncompromised visual memory functions and display no increased susceptibility for distorted memories. Copyright © 2013 Elsevier Ltd. All rights reserved.
Drass, Jessica Masino
2015-01-01
Art therapy has shown benefits for people with borderline personality disorder and borderline personality traits by alleviating interpersonal difficulties such as affect regulation, an unstable sense of self, self-injurious behaviors, and suicidal ideation. Borderline personality disorder is currently viewed as a trauma spectrum disorder, because…
Belsky, Daniel W; Caspi, Avshalom; Arseneault, Louise; Bleidorn, Wiebke; Fonagy, Peter; Goodman, Marianne; Houts, Renate; Moffitt, Terrie E
2012-02-01
It has been reported that borderline personality related characteristics can be observed in children, and that these characteristics are associated with increased risk for the development of borderline personality disorder. It is not clear whether borderline personality related characteristics in children share etiological features with adult borderline personality disorder. We investigated the etiology of borderline personality related characteristics in a longitudinal cohort study of 1,116 pairs of same-sex twins followed from birth through age 12 years. Borderline personality related characteristics measured at age 12 years were highly heritable, were more common in children who had exhibited poor cognitive function, impulsivity, and more behavioral and emotional problems at age 5 years, and co-occurred with symptoms of conduct disorder, depression, anxiety, and psychosis. Exposure to harsh treatment in the family environment through age 10 years predicted borderline personality related characteristics at age 12 years. This association showed evidence of environmental mediation and was stronger among children with a family history of psychiatric illness, consistent with diathesis-stress models of borderline etiology. Results indicate that borderline personality related characteristics in children share etiological features with borderline personality disorder in adults and suggest that inherited and environmental risk factors make independent and interactive contributions to borderline etiology.
[Course of borderline personality disorder: literature review].
Karaklic, D; Bungener, C
2010-10-01
Borderline personality disorder (BPD) is a serious mental disorder associated with severe emotional, behavioral, cognitive and interpersonal dysfunction, extensive functional impairment and frequent self-destructive behaviour, including deliberate self-harm and suicidal behaviour. For quite some time, BPD has been viewed as a chronic disorder and borderline patients as extremely difficult to treat, doomed to a life of misery. However, those views are changing and there is an increasing recognition that BPD has a far more benign course than previously thought. The purpose of this study is to show how those views changed over time by reviewing longitudinal studies of the course of BPD. We have reviewed the literature published from 1968 to March 2009, using the following key words: borderline personality disorder, outcome, follow-up studies with some additional references. The aim of the longitudinal studies conducted prior to the DSM definition of BPD criteria was to determine whether borderline patients could become psychotic over time, but no such evidence was found even though their functioning was at a relatively low level. The studies conducted after the introduction of BPD in the DSM in 1980 tested the stability and the specificity of BPD diagnosis, concluding that the criteria were relatively stable in the short run since the majority of patients continued to meet them at the follow-up assessments. However, those studies had many methodological drawbacks which limited their generalizability such as small sample sizes, high attrition rates, the absence of comparison groups, etc. Four retrospective studies of the 15-year outcome of borderline patients obtained virtually identical results despite methodological differences, showing that the global functioning of borderline patients improved substantially over time with mean scores of the GAF scale falling within a mild range of impairment. One 27-year retrospective study showed that borderline patients continued
Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders.
Perry, J Christopher; Presniak, Michelle D; Olson, Trevor R
2013-01-01
Numerous authors have theorized that defense mechanisms play a role in personality disorders. We reviewed theoretical writings and empirical studies about defenses in schizotypal, borderline, antisocial, and narcissistic personality disorders, developing hypotheses about these differential relationships. We then examined these hypotheses using dynamic interview data rated for defenses in a study of participants (n = 107) diagnosed with these four personality disorder types. Overall, the prevalence of immature defenses was substantial, and all four disorders fit within the broad borderline personality organization construct. Defenses predicted the most variance in borderline and the least variance in schizotypal personality disorder, suggesting that dynamic factors played the largest role in borderline and the least in schizotypal personality. Central to borderline personality were strong associations with major image-distorting defenses, primarily splitting of self and other's images, and the hysterical level defenses, dissociation and repression. Narcissistic and antisocial personality disorders shared minor image-distorting defenses, such as omnipotence or devaluation, while narcissistic also used splitting of self-images and antisocial used disavowal defenses like denial. Overall, differential relationships between specific defenses and personality disorder types were largely consistent with the literature, and consistent with the importance that the treatment literature ascribes to working with defenses.
Peritoneal borderline cystoadenocarcinoma
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Manoel João Batista Castello Girão
Full Text Available Carcinomas of peritoneal origin represent a seldom diagnosed entity of unknown etiology, with important implications in terms of prophylactic oophorectomy. Initially described in patients belonging to families at high risk for ovarian cancer, it possibly has a pathogeny similar to that of endosalpingiosis and of some cases of endometriosis. We report a case of peritoneal borderline mucinous carcinoma with an anatomopathological diagnosis of normal ovaries.
Distel, Marijn A; Trull, Timothy J; Willemsen, Gonneke; Vink, Jacqueline M; Derom, Catherine A; Lynskey, Michael; Martin, Nicholas G; Boomsma, Dorret I
2009-12-15
Recently, the nature of personality disorders and their relationship with normal personality traits has received extensive attention. The five-factor model (FFM) of personality, consisting of the personality traits neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness, is one of the proposed models to conceptualize personality disorders as maladaptive variants of continuously distributed personality traits. The present study examined the phenotypic and genetic association between borderline personality and FFM personality traits. Data were available for 4403 monozygotic twins, 4425 dizygotic twins, and 1661 siblings from 6140 Dutch, Belgian, and Australian families. Broad-sense heritability estimates for neuroticism, agreeableness, conscientiousness, extraversion, openness to experience, and borderline personality were 43%, 36%, 43%, 47%, 54%, and 45%, respectively. Phenotypic correlations between borderline personality and the FFM personality traits ranged from .06 for openness to experience to .68 for neuroticism. Multiple regression analyses showed that a combination of high neuroticism and low agreeableness best predicted borderline personality. Multivariate genetic analyses showed the genetic factors that influence individual differences in neuroticism, agreeableness, conscientiousness, and extraversion account for all genetic liability to borderline personality. Unique environmental effects on borderline personality, however, were not completely shared with those for the FFM traits (33% is unique to borderline personality). Borderline personality shares all genetic variation with neuroticism, agreeableness, conscientiousness, and extraversion. The unique environmental influences specific to borderline personality may cause individuals with a specific pattern of personality traits to cross a threshold and develop borderline personality.
Ryan, Jaymee; Graham, Anne; Nelson, Barnaby; Yung, Alison
2017-06-01
The association between borderline personality disorder and the ultra high risk (UHR) for psychosis state is unclear. The following study aimed to investigate the type of attenuated psychotic symptoms and prevalence of borderline personality pathology in a sample of UHR young people. Additionally, the study aimed to explore whether borderline personality pathology influenced the transition rate to psychosis. Medical records from Orygen Youth Health between 2007 and 2009 were examined. There were 180 patients who met UHR criteria and were included for analysis. Most patients were females (62.8%) and age ranged from 15 to 24 years. A quarter (25.2%) of UHR patients endorsed items consistent with borderline personality pathology. UHR patients with borderline personality pathology experienced a range of attenuated psychotic symptoms and could not be statistically differentiated from UHR patients with less significant or without borderline personality pathology. Borderline personality pathology did not increase or decrease the risk of developing a psychotic disorder. The absence of depression was the only predictor of psychosis. Many UHR patients present with concurrent borderline personality features. The psychotic experiences reported by UHR patients with borderline personality features were not limited to paranoid ideation, supporting the idea that borderline personality disorder may include a wider range of psychotic symptoms than previously thought. It is further possible that the psychotic symptoms experienced in this group could also be indicative of an emerging psychotic disorder. © 2015 Wiley Publishing Asia Pty Ltd.
Zanarini, Mary C.; Barison, Leah K.; Frankenburg, Frances R.; Reich, D. Bradford; Hudson, James I.
2009-01-01
The purpose of this study was to assess the familial coaggregation of borderline personality disorder (BPD) with a full array of axis I disorders and four axis II disorders (antisocial personality disorder, histrionic personality disorder, narcissistic personality disorder, and sadistic personality disorder) in the first-degree relatives of borderline probands and axis II comparison subjects. Four hundred and forty-five inpatients were interviewed about familial psychopathology using the Revi...
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Petroianu Andy
2004-01-01
Full Text Available OBJETIVOS: verificar a possibilidade de gestação natural em coelha, após ooforectomia total bilateral e auto-implante ovariano ortotópico (íntegro e fatiado, sem pedículo vascular e avaliar os aspectos morfofuncionais dos ovários reimplantados. MÉTODOS: foram utilizadas trinta e duas coelhas da raça Nova Zelândia Branca. No grupo controle (GC (n=8 foi realizada apenas laparotomia e laparorrafia. No grupo RI (n=8, reimplantou-se o ovário na forma íntegra. No grupo RF (n=8, reimplantou-se o ovário na forma fatiada e, no grupo RIF (n=8, reimplantou-se, de um lado, o ovário íntegro e, do outro lado, fatiado. A partir do terceiro mês pós-operatório, cada coelha foi colocada em gaiola junto com um macho fértil, para cópula. Dosou-se o estradiol, a progesterona, o hormônio folículo-estimulante e o hormônio luteinizante de cada animal no nono mês pós-operatório. Foram estudadas as morfologias macro e microscópica dos ovários, tubas e útero, de todos os animais. O número de gestações e de filhotes nascidos em cada grupo foi avaliado por meio do teste chi² e as dosagens hormonais foram comparadas pelo teste t de Student, considerando p<0,05 como significância. RESULTADOS: todas as coelhas do GC engravidaram, entre o segundo e terceiro meses após início da cópula, com número de filhotes variando entre 6 e 10 animais. Nos demais grupos, as gestações ocorreram entre o quinto e o oitavo mês pós-operatório. A porcentagem de gravidez observada foi de 37,5% no grupo RI e 50% nos grupos RF e RIF. Não houve diferença entre os números de filhotes dos grupos com ovários reimplantados, que foi de 1 a 4 animais. Os níveis hormonais e o estudo morfofuncional dos ovários, tubas e úteros não apresentaram diferenças entre os grupos. CONCLUSÕES: o auto-implante ovariano ortotópico em coelhas, na forma íntegra ou fatiada, sem pedículo vascular, é viável, além de preservar as funções hormonais e a fertilidade.
The effects of oxytocin on social cognition in borderline personality disorder.
Servan, A; Brunelin, J; Poulet, E
2018-02-01
Deficits in social cognition and interpersonal difficulties are key features in borderline personality disorder. Social cognition refers to the function of perceiving and adequately dealing with social signals, leading to the establishment and maintenance of healthy and positive social relationships. Evidence suggests that oxytocin (OT) may improve social cognition and human social behavior. Recently, several studies have highlighted the beneficial effects of oxytocin in several psychiatric conditions involving social cognition deficits such as schizophrenia, autism or social phobia. However, despite growing interest, the effects of oxytocin in patients with borderline personality disorder are far from being clearly demonstrated. The objective of this work was to review and discuss studies investigating the interest of oxytocin in alleviating social cognition deficits in patients with borderline personality disorder (recognition of emotion, trust and cooperation, affective and cognitive empathy, emotional expression and social problem-solving). A systematic review of the literature was conducted up to September 31, 2016 on the Pubmed, Science direct, Medline and Scopus databases using "borderline personality disorder" and "oxytocin" as keywords. To be included, studies were to include patients with borderline personality disorder; to investigate social cognition and to investigate the effect of oxytocin on social cognition in patients with TPB. The initial search yielded 52 articles. Among them, 11 studies were selected according to the PRISMA criteria. The effect of oxytocin on social cognition in patients with borderline personality disorder was mainly investigated in relation to recognition of emotions and trust and cooperation. We did not find any studies investigating the effect of oxytocin on affective and cognitive empathy, emotional expression or social problem-solving abilities. In patients with borderline personality disorder, oxytocin had a beneficial
Borderline Personality Disorder and Religion: A perspective from a Muslim country.
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Sina Hafizi
2014-09-01
Full Text Available There are still many unanswered questions about psychological and social factors that may affect the development and treatment of borderline personality disorder (BPD. Religion/spirituality (R/S is a factor that could influence the lives of people with BPD.The aim of this study was to evaluate the relationship between religiosity, religious attendance and borderline personality traits.Four hundred twenty- nine medical students of Tehran University of medical sciences participated in this study, and their information on demographics, responses to the Duke University Religion Index (DUREL, and the Structured Clinical Interview for DSM-IV Axis II Disorders (the self-administered section on BPD was obtained.The total score of SCID-II questionnaire and the number of positive borderline personality characteristics on the SCID-II were inversely related with the DUREL total score and individual DUREL items. Those with higher levels of borderline personality traits had lower total DUREL score and lower DUREL subscale scores.Religiosity and religious attendance are negatively correlated with borderline personality traits, especially with anger, instability of mood, feeling of emptiness and self-harming behaviors. These findings are important for understanding the causes of BPD and in developing treatments for this disorder.
Ibrahim, Jeyda; Cosgrave, Nicola; Woolgar, Matthew
2018-01-01
Borderline personality disorder has repeatedly been associated with a history of maltreatment in childhood; however, research on maltreatment and its link to borderline features in children is limited. The aim of this review is to synthesise the existing data on the association between maltreatment and borderline features in childhood. In total, 10 studies were included in this systematic review. Studies indicated that children with borderline features were more likely to have a history of maltreatment, and that children who had been maltreated were more likely to present with borderline features. Other risk factors such as cognitive and executive functioning deficits, parental dysfunction and genetic vulnerability were also identified across studies. This review adds to the literature by highlighting maltreatment as a risk factor for borderline features in childhood. Longitudinal research is required to establish the link between childhood borderline features and adult borderline features. Implications for early identification, prevention and intervention services are discussed.
[Pharmacotherapy in the treatment of borderline personality disorder].
Alliani, Daniela; Tarantelli, Silvia
2009-01-01
The aim of this study is to bring together the previous studies on pharmacotherapy of borderline disorder from the oldest to the recent ones, mainly focusing on atypical antipsychotic, whose success has been underlined in recent medical literature with peculiar reference to olanzapine. Since the '80 the pharmacotherapy in borderline personality disorder has been playing an increasing role in the interest of scientific community and in the medical practice as indicated by APA guidelines (2000). Nowadays the pharmacological approach, supported by some experimental outcomes, follow a so called "dimensional" standard. The targets of this standard drug approach are specific psychopathological "dimensions" of the disorder and related neurotransmitters' changes in particular linked to serotoninergic and dopaminergic systems, both supported by experimental outcomes. The psychopathological dimensions to which pharmacological approach is more suitable are: impulsiveness and emotional dysregulation. During the last past years, effectiveness of atypical antipsychotic drugs became of major interest in medical treatment of borderline disorder, mainly related to their action toward the serotoninergic and dopaminergic systems.
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Luciene Simões de Assis Tafuri
2005-04-01
Full Text Available INTRODUÇÃO: A mamoplastia redutora estética bilateral (MEB é uma cirurgia que tem como objetivo reduzir o volume mamário, melhorando problemas estéticos e posturais, ou obter equilíbrio estético em pacientes submetidas a mamoplastia contralateral (MRC a câncer de mama. A incidência de lesões mamárias nestes espécimes é variável, e a presença de câncer em uma das mamas é fator de risco conhecido para desenvolvimento de câncer na mama contralateral. OBJETIVOS: Comparar a freqüência de lesões proliferativas epiteliais e outras alterações histopatológicas em espécimes de MEB e MRC. MATERIAIS E MÉTODOS: Foram revistas lâminas de 867 peças cirúrgicas de MEB e 72 de MRC, anotando-se as alterações histopatológicas, com ênfase nas hiperplasias epiteliais, e relacionando-as com a faixa etária das pacientes. RESULTADOS: A idade média das pacientes submetidas a MEB foi de 34 anos, e das submetidas a MRC, de 50,3 anos. Alterações fibrocísticas foram as lesões mais comumente diagnosticadas. Cistos e ectasia ductal estavam presentes em 50,9% das MEB e em 59,7% das MRC. Hiperplasias epiteliais foram diagnosticadas em 10,1% das MEB e em 43,1% das MRC, principalmente em mulheres com idade superior a 40 anos. Entre as hiperplasias, o tipo usual foi o mais freqüente nos dois grupos (MEB = 9,8% e MRC = 33,3%. Hiperplasias atípicas estavam presentes em 9,7% dos casos de MRC e em 0,3% de MEB. CONCLUSÃO: A incidência de hiperplasias epiteliais com e sem atipias foi maior nos casos de MRC do que nos de MEB mesmo quando as pacientes foram pareadas pela faixa etária.BACKGROUND: Reduction mammaplasty is a surgery whose objective is to reduce the mammary size, improving aesthetic (MEB, or to attain of aesthetic balance in patients submitted to mammaplasty contralateral to breast cancer (MRC. The incidence of breast lesions in these specimens is variable and the previous cancer in one breast is a known risk factor for cancer in
Reuter, Tyson R; Sharp, Carla; Kalpakci, Allison H; Choi, Hye J; Temple, Jeff R
2016-10-01
Empirical literature demonstrates that sexual minorities are at an increased risk of developing psychopathology, including borderline personality disorder (BPD). The specific link between sexual orientation and BPD has received significantly less attention in youth, and it remains unclear what drives this relation. Given that there are higher rates of psychopathology in both sexual minorities and individuals with BPD, the present study aimed to determine if sexual orientation uniquely contributes to borderline personality pathology, controlling for other psychopathology. An ethnically diverse sample of 835 adolescents completed self-report measures of borderline features, depression, anxiety, and sexual orientation. Sexual minorities scored higher on borderline features compared to heterosexual adolescents. When controlling for depression and anxiety, sexual orientation remained significantly associated with borderline features. The relation between sexual orientation and BPD cannot fully be explained by other psychopathology. Future research is necessary to understand potential mechanisms underlying this relation.
Borderline Personality Disorder in the perinatal period: early infant and maternal outcomes.
Blankley, Gaynor; Galbally, Megan; Snellen, Martien; Power, Josephine; Lewis, Andrew J
2015-12-01
This study examines pregnancy and early infant outcomes of pregnant women with a clinical diagnosis of Borderline Personality Disorder presenting for obstetric services to a major metropolitan maternity hospital in Victoria, Australia. A retrospective case review of pregnancy and early infant outcomes on 42 women who had been diagnosed with Borderline Personality Disorder via psychiatric assessment using DSM-IV-R criteria was undertaken. Outcomes were compared with a control group of 14,313 consisting of women and infants of non-affected women from the same hospital over the same period of time. Women presenting for obstetric services with a clinical diagnosis of Borderline Personality Disorder experienced considerable psychosocial impairment. They anticipated birth as traumatic and frequently requested early delivery. High comorbidity with substance abuse was found and high rates of referral to child protective services. Mothers with Borderline Personality Disorder were significantly more likely to have negative birth outcomes such as lowered Apgar scores, prematurity and special care nursery referral when compared with controls. These findings offer preliminary evidence to be considered by clinicians in developing treatments and services for the perinatal care of women with Borderline Personality Disorder and their infants. Further research is required in order to develop evidence informed clinical guidelines for the management of women with Borderline Personality Disorder and their infants. © The Royal Australian and New Zealand College of Psychiatrists 2015.
Keng, Shian-Ling; Wong, Yun Yi
2017-01-01
Linehan's biosocial theory posits that parental invalidation during childhood plays a role in the development of borderline personality disorder symptoms later in life. However, little research has examined components of the biosocial model in an Asian context, and variables that may influence the relationship between childhood invalidation and borderline symptoms. Self-compassion is increasingly regarded as an adaptive way to regulate one's emotions and to relate to oneself, and may serve to moderate the association between invalidation and borderline symptoms. The present study investigated the association among childhood invalidation, self-compassion, and borderline personality disorder symptoms in a sample of Singaporean undergraduate students. Two hundred and ninety undergraduate students from a large Singaporean university were recruited and completed measures assessing childhood invalidation, self-compassion, and borderline personality disorder symptoms. Analyses using multiple regression indicated that both childhood invalidation and self-compassion significantly predicted borderline personality disorder symptomatology. Results from moderation analyses indicated that relationship between childhood invalidation and borderline personality disorder symptomatology did not vary as a function of self-compassion. This study provides evidence in support of aspects of the biosocial model in an Asian context, and demonstrates a strong association between self-compassion and borderline personality disorder symptoms, independent of one's history of parental invalidation during childhood.
A Non-linear Predictive Model of Borderline Personality Disorder Based on Multilayer Perceptron.
Maldonato, Nelson M; Sperandeo, Raffaele; Moretto, Enrico; Dell'Orco, Silvia
2018-01-01
Borderline Personality Disorder is a serious mental disease, classified in Cluster B of DSM IV-TR personality disorders. People with this syndrome presents an anamnesis of traumatic experiences and shows dissociative symptoms. Since not all subjects who have been victims of trauma develop a Borderline Personality Disorder, the emergence of this serious disease seems to have the fragility of character as a predisposing condition. Infect, numerous studies show that subjects positive for diagnosis of Borderline Personality Disorder had scores extremely high or extremely low to some temperamental dimensions (harm Avoidance and reward dependence) and character dimensions (cooperativeness and self directedness). In a sample of 602 subjects, who have had consecutive access to an Outpatient Mental Health Service, it was evaluated the presence of Borderline Personality Disorder using the semi-structured interview for the DSM IV-TR personality disorders. In this population we assessed the presence of dissociative symptoms with the Dissociative Experiences Scale and the personality traits with the Temperament and Character Inventory developed by Cloninger. To assess the weight and the predictive value of these psychopathological dimensions in relation to the Borderline Personality Disorder diagnosis, a neural network statistical model called "multilayer perceptron," was implemented. This model was developed with a dichotomous dependent variable, consisting in the presence or absence of the diagnosis of borderline personality disorder and with five covariates. The first one is the taxonomic subscale of dissociative experience scale, the others are temperamental and characterial traits: Novelty-Seeking, Harm-Avoidance, Self-Directedness and Cooperativeness. The statistical model, that results satisfactory, showed a significance capacity (89%) to predict the presence of borderline personality disorder. Furthermore, the dissociative symptoms seem to have a greater influence than
A Non-linear Predictive Model of Borderline Personality Disorder Based on Multilayer Perceptron
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Nelson M. Maldonato
2018-04-01
Full Text Available Borderline Personality Disorder is a serious mental disease, classified in Cluster B of DSM IV-TR personality disorders. People with this syndrome presents an anamnesis of traumatic experiences and shows dissociative symptoms. Since not all subjects who have been victims of trauma develop a Borderline Personality Disorder, the emergence of this serious disease seems to have the fragility of character as a predisposing condition. Infect, numerous studies show that subjects positive for diagnosis of Borderline Personality Disorder had scores extremely high or extremely low to some temperamental dimensions (harm Avoidance and reward dependence and character dimensions (cooperativeness and self directedness. In a sample of 602 subjects, who have had consecutive access to an Outpatient Mental Health Service, it was evaluated the presence of Borderline Personality Disorder using the semi-structured interview for the DSM IV-TR personality disorders. In this population we assessed the presence of dissociative symptoms with the Dissociative Experiences Scale and the personality traits with the Temperament and Character Inventory developed by Cloninger. To assess the weight and the predictive value of these psychopathological dimensions in relation to the Borderline Personality Disorder diagnosis, a neural network statistical model called “multilayer perceptron,” was implemented. This model was developed with a dichotomous dependent variable, consisting in the presence or absence of the diagnosis of borderline personality disorder and with five covariates. The first one is the taxonomic subscale of dissociative experience scale, the others are temperamental and characterial traits: Novelty-Seeking, Harm-Avoidance, Self-Directedness and Cooperativeness. The statistical model, that results satisfactory, showed a significance capacity (89% to predict the presence of borderline personality disorder. Furthermore, the dissociative symptoms seem to have a
Broadbear, Jillian H; Nesci, Julian; Thomas, Rosemary; Thompson, Katherine; Beatson, Josephine; Rao, Sathya
2016-12-01
Residential patients diagnosed with borderline personality disorder were evaluated to determine whether borderline personality disorder-focused psychotherapy reduced prescribing, personality disorder and co-morbid symptom severity. Psychotropic prescriptions were measured at admission, discharge and 1 year later in 74 female participants with one or more personality disorder diagnosis and co-morbid mood disorders. Changes in pharmacotherapy were examined in the context of improvements in borderline personality disorder and/or co-morbid disorder symptom severity. Residential treatment included individual and group psychotherapy for borderline personality disorder. The Structured Clinical Interview for DSM-IV was used to confirm the borderline personality disorder diagnosis and associated co-morbid conditions. The Beck Depression Inventory was completed at each time point. A significant reduction in the incidence and severity of self-rated depression as well as clinician assessed personality disorder, including borderline personality disorder, was accompanied by a reduction in prescription of psychoactive medications. Three to six months of intensive borderline personality disorder-specific psychotherapy showed lasting benefit with regard to symptom severity of personality disorders (borderline personality disorder in particular) as well as depressive symptoms. This improvement corresponded with a reduction in prescriptions for psychoactive medications, which is consistent with current thinking regarding treatment for borderline personality disorder. © The Royal Australian and New Zealand College of Psychiatrists 2016.
[Anorexia and borderline personality disorder : bonds pathology].
Cayn, Delphine; Pham-Scottez, Alexandra
Comorbidity with a borderline personality disorder is far from rare in patients suffering from eating disorders. Clinically, this presents as chronic instability in many areas: interpersonal relationships, self-image, emotions, mood and acting out. Treatment is mainly based on a containing and reassuring therapeutic framework. A care plan may be put in place that incorporates reducing impulsive harmful, eating and self-harming behaviours. Dialectical behaviour therapy is intended in particular to prevent suicide risk in borderline personality disorder patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Marques, Sofia; Barrocas, Daniel; Rijo, Daniel
2017-04-28
Borderline personality disorder is the most common personality disorder, with a global prevalence rate between 1.6% and 6%. It is characterized by affective disturbance and impulsivity, which lead to a high number of self-harm behaviors and great amount of health services use. International guidelines recommend psychotherapy as the primary treatment for borderline personality disorder. This paper reviews evidence about the effects and efficacy of cognitive-behavioral oriented psychological treatments for borderline personality disorder. A literature review was conducted in Medline and PubMed databases, using the following keywords: borderline personality disorder, cognitive-behavioral psychotherapy and efficacy. Sixteen randomized clinical trials were evaluate in this review, which analyzed the effects of several cognitive-behavioral oriented psychotherapeutic interventions, namely dialectical behavioral therapy, cognitive behavioral therapy, schema-focused therapy and manual-assisted cognitive therapy. All above stated treatments showed clinical beneficial effects, by reducing borderline personality disorder core pathology and associated general psychopathology, as well as by reducing the severity and frequency of self-harm behaviors, and by improving the overall social, interpersonal and global adjustment. Dialectical behavioral therapy and schema-focused therapy also caused a soaring remission rate of diagnostic borderline personality disorder criteria of 57% and 94%, respectively. Although there were differences between the psychotherapeutic interventions analysed in this review, all showed clinical benefits in the treatment of borderline personality disorder. Dialectical behavioral therapy and schema-focused therapy presented the strongest scientific data documenting their efficacy, but both interventions are integrative cognitive-behavioral therapies which deviate from the traditional cognitive-behavioral model. In summary, the available studies support
Reitz, Sarah; Kluetsch, Rosemarie; Niedtfeld, Inga; Knorz, Teresa; Lis, Stefanie; Paret, Christian; Kirsch, Peter; Meyer-Lindenberg, Andreas; Treede, Rolf-Detlef; Baumgärtner, Ulf; Bohus, Martin; Schmahl, Christian
2015-08-01
Patients with borderline personality disorder frequently show non-suicidal self-injury (NSSI). In these patients, NSSI often serves to reduce high levels of stress. Investigation of neurobiological mechanisms of NSSI in borderline personality disorder. In total, 21 women with borderline personality disorder and 17 healthy controls underwent a stress induction, followed by either an incision into the forearm or a sham treatment. Afterwards participants underwent resting-state functional magnetic resonance imaging while aversive tension, heart rate and heart rate variability were assessed. We found a significant influence of incision on subjective and objective stress levels with a stronger decrease of aversive tension in the borderline personality disorder group following incision than sham. Amygdala activity decreased more and functional connectivity with superior frontal gyrus normalised after incision in the borderline personality disorder group. Decreased stress levels and amygdala activity after incision support the assumption of an influence of NSSI on emotion regulation in individuals with borderline personality disorder and aids in understanding why these patients use self-inflicted pain to reduce inner tension. © The Royal College of Psychiatrists 2015.
Autobiographical memory in borderline personality disorder-A systematic review.
Bech, Morten; Elklit, Ask; Simonsen, Erik
2015-05-01
Borderline personality disorder is a severe psychiatric illness. A key feature of the disorder is a disorganized sense of self often referred to as identity diffusion. Autobiographical memory is memory for personal life events. One of the main functions of these memories is to enable us to understand who we are by connecting past, present and future experiences. It seems that autobiographical memory is in some way disrupted in individuals with borderline personality disorder. A systematic review is conducted looking at studies that focus on the potential connections. We find that although a number of studies have been published results remain inconsistent. Furthermore, we find that many of the studies suffer from inadequate designs particularly regarding the reported measures of autobiographical memory. We discuss potential links between personality functioning, identity diffusion, autobiographical memory and borderline personality disorder. Copyright © 2015 John Wiley & Sons, Ltd.
Early Intervention for Borderline Personality Disorder: Psychodynamic Therapy in Adolescents.
Salzer, Simone; Cropp, Carola; Streeck-Fischer, Annette
2014-01-01
Borderline personality disorder (BPD) should be understood as a disorder of development (Streeck-Fischer 2008, 2013) that has its first manifestation in late childhood and adolescence. There are only few treatment studies of adolescents meeting the diagnostic criteria of borderline personality disorder, although early interventions for these patients are urgently needed (see Chanen & McCutcheon 2013). We examined the effectiveness of an inpatient psychodynamic therapy (PDT). Twenty-eight adolescents fulfilling the DSM-IV diagnostic criteria of borderline personality disorder were treated with psychodynamic therapy. The mean duration of treatment was 29.87 weeks (SD = 15.88). Outcomes were remission rates, GAF, GSI, SDQ, IIP and BPI scores. Assessments were made at admission and after treatment. Pre-post comparisons and comparisons with normative data were conducted. At the end of treatment 39.29% of the patients were remitted. We found significant improvements for the GAF, GSI, SDQ, IIP (all p0.001) and the BPI (p = 0.006). These clinically relevant improvements demonstrate the effectiveness of psychodynamic therapy in adolescents with borderline personality disorder and stress the usefulness of an early intervention for these patients.
Sansone, Randy A; Sansone, Lori A
2015-01-01
Borderline personality disorder is a personality dysfunction that is characterized by disinhibition and impulsivity, which oftentimes manifest as self-regulation difficulties. Patients with this disorder have always been present in medical settings, but have been described as "difficult patients" rather than patients with borderline personality disorder. According to empirical findings, a number of behaviors and medical syndromes/diagnoses are suggestive of borderline personality disorder. Suggestive behaviors in the medical setting may include aggressive or disruptive behaviors, the intentional sabotage of medical care, and excessive healthcare utilization. Suggestive medical syndromes and diagnoses in the medical setting may include alcohol and substance misuse (including the abuse of prescription medications), multiple somatic complaints, chronic pain, obesity, sexual impulsivity, and hair pulling. While not all-inclusive or diagnostic, these behaviors and syndromes/diagnoses may invite further clinical evaluation of the patient for borderline personality disorder.
Elzy, Meredith B.
2011-01-01
The relationship between childhood sexual abuse and borderline personality disorder is a prominent issue in the etiological research on borderline personality disorder. This study further explored the relationship between childhood sexual abuse and the development of borderline personality features while evaluating the moderating role of a primary…
Familial resemblance of borderline personality disorder features: genetic or cultural transmission?
Directory of Open Access Journals (Sweden)
Marijn A Distel
Full Text Available Borderline personality disorder is a severe personality disorder for which genetic research has been limited to family studies and classical twin studies. These studies indicate that genetic effects explain 35 to 45% of the variance in borderline personality disorder and borderline personality features. However, effects of non-additive (dominance genetic factors, non-random mating and cultural transmission have generally not been explored. In the present study an extended twin-family design was applied to self-report data of twins (N = 5,017 and their siblings (N = 1,266, parents (N = 3,064 and spouses (N = 939 from 4,015 families, to estimate the effects of additive and non-additive genetic and environmental factors, cultural transmission and non-random mating on individual differences in borderline personality features. Results showed that resemblance among biological relatives could completely be attributed to genetic effects. Variation in borderline personality features was explained by additive genetic (21%; 95% CI 17-26% and dominant genetic (24%; 95% CI 17-31% factors. Environmental influences (55%; 95% CI 51-60% explained the remaining variance. Significant resemblance between spouses was observed, which was best explained by phenotypic assortative mating, but it had only a small effect on the genetic variance (1% of the total variance. There was no effect of cultural transmission from parents to offspring.
Borderline personality disorder and the emerging field of developmental neuroscience.
Crowell, Sheila E; Kaufman, Erin A
2016-10-01
Over the past 2 decades there has been a dramatic shift in understanding of personality disorders, such as borderline personality disorder (BPD). What was historically viewed as an entrenched pattern of antagonistic, interpersonally dependent, and uncorrectable conduct is now seen as the outcome of complex-yet modifiable-developmental processes. The borderline label, which once inspired such harsh opprobrium in clinical communities that early diagnosis was considered taboo, is now increasingly applied to adolescents who are receiving effective treatment and desisting from a borderline trajectory. Research examining the developmental origins and early manifestations of BPD is increasing rapidly, making it an appropriate time to take stock of current developmental research and articulate an agenda for the future. We identify 4 challenges that continue to impede innovative research on borderline personality development: (a) inadequate attention to continuity and discontinuity across development, (b) medical and diagnostic systems that localize personality pathology within the individual, (c) the lingering belief that biological research is antithetical to contextual/interpersonal understandings of psychopathology (and vice versa), and (d) reluctance to reach across disciplinary and developmental boundaries to identify creative paradigms and foster innovative discovery. In order to overcome these challenges, we propose an approach to future research on adolescent borderline pathology that integrates developmental psychopathology, social and affective neuroscience, and personality theory perspectives. This intersection-the developmental neuroscience of personality pathology-offers theoretical and methodological advantages over disciplinary isolation and is fertile ground for generating novel hypotheses on the development and prevention of BPD. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Risk for borderline ovarian tumours after exposure to fertility drugs
DEFF Research Database (Denmark)
Bjørnholt, Sarah Marie; Kjaer, Susanne Krüger; Nielsen, Thor Schütt Svane
2015-01-01
numbers. To obtain information on use of fertility drugs, hospital files and medical records of infertility-associated visits to all Danish fertility clinics were collected and supplemented with information from the Danish IVF register. We used case-cohort techniques to calculate rate ratios (RRs......STUDY QUESTION: Do fertility drugs increase the risk for borderline ovarian tumours, overall and according to histological subtype? SUMMARY ANSWER: The use of any fertility drug did not increase the overall risk for borderline ovarian tumours, but an increased risk for serous borderline ovarian...... tumours was observed after the use of progesterone. WHAT IS KNOWN ALREADY: Many epidemiological studies have addressed the connection between fertility drugs use and risk for ovarian cancer; most have found no strong association. Fewer studies have assessed the association between use of fertility drugs...
Belsky, D.; Caspi, A.; Arseneault, L.; Bleidorn, W.; Fonagy, P.; Goodman, M.; Houts, R.; Moffitt, T.
2012-01-01
It has been reported that borderline personality related characteristics can be observed in children, and that these characteristics are associated with increased risk for the development of borderline personality disorder. It is not clear whether borderline personality related characteristics in
The psychodynamics of borderline psychopathology.
Corradi, Richard B
2015-01-01
The concept of borderline personality disorder (BPD) remains problematic despite psychiatrists' general familiarity with its DSM diagnostic criteria. The diagnosis of BPD is frequently based simply on the DSM checklist of traits and symptoms without knowledge of their origins or significance. Misdiagnosis is common, as is lack of recognition of the full complexity of this severe personality disorder and the nature of the vulnerabilities that underlie its myriad forms of pathology. The stresses of ordinary life are often too much for people with BPD. Knowledge of the nature and origins of their stress points, such as their great fear of loss or rejection, is necessary for adequate diagnosis and treatment. The author addresses how signature features of the disorder relate to psychosocial development, how they correlate with failed developmental milestones, and how they can be understood psychodynamically. This is essential knowledge for psychotherapists because the pathological interpersonal relationships of the borderline patient will be repeated and acted out in the transference, whatever the modality or intensity of treatment.
Canaz, Emel; Kilinc, Metin; Sayar, Hamide; Kiran, Gurkan; Ozyurek, Eser
2017-09-01
Wide variation exists in ovarian cancer incidence rates suggesting the importance of environmental factors. Due to increasing environmental pollution, trace elements and heavy metals have drawn attention in studies defining the etiology of cancer, but scant data is available for ovarian cancer. Our aim was to compare the tissue concentrations of lead, selenium and nickel in epithelial ovarian cancer, borderline tumor and healthy ovarian tissues. The levels of lead, selenium and nickel were estimated using atomic absorption spectrophotometry in formalin-fixed paraffin-embedded tissue samples. Tests were carried out in 20 malignant epithelial ovarian cancer, 15 epithelial borderline tumor and 20 non-neoplastic healthy ovaries. Two samples were collected for borderline tumors, one from papillary projection and one from the smooth surface of cyst wall. Pb and Ni concentrations were found to be higher both in malignant and borderline tissues than those in healthy ovaries. Concentrations of Pb and Ni in malignant tissues, borderline papillary projections and capsular tissue samples were not different. Comparison of Se concentrations of malignant, borderline and healthy ovarian tissues did not reveal statistical difference. Studied metal levels were not found to be different in either papillary projection or in cyst wall of the borderline tumors. This study revealed the accumulation of lead and nickel in ovarian tissue is associated with borderline and malignant proliferation of the surface epithelium. Accumulation of these metals in epithelial ovarian cancer and borderline ovarian tumor has not been demonstrated before. Copyright © 2017 Elsevier GmbH. All rights reserved.
Directory of Open Access Journals (Sweden)
Mariana Eizirik
2009-03-01
Full Text Available OBJECTIVE: To describe the concept of mentalization, and its application in understanding the development of psychopathology in patients with borderline personality disorder; to give an account of the main features of mentalization-based treatment; to summarise the evidence supporting its effectiveness. DISCUSSION: Mentalization is a predominantly preconscious mental activity that enables the individual to understand him/herself and others in terms of subjective states and mental processes. Psychological trauma in childhood is associated with deficits in mentalization and with the development of borderline personality disorder. Mentalization-based treatment is a psychodynamically-oriented manualized psychotherapy for borderline personality disorder that aims to develop a therapeutic process in which the patient's capacity for mentalization becomes the focus of treatment. Randomized controlled trials have demonstrated the effectiveness of this treatment for patients with borderline personality disorder. CONCLUSIONS: The development of a psychodynamically-oriented therapeutic intervention that specifically targets the deficits involved in the psychopathology of borderline personality disorder is a crucial step in increasing the effectiveness of treatment. Mental health professionals should be adequately prepared to deliver effective interventions to their patients, such as mentalization-based treatment.OBJETIVO: Descrever o conceito de mentalização e sua aplicação no entendimento do desenvolvimento da psicopatologia em pacientes com transtorno de personalidade borderline; descrever as principais características da terapia de mentalização; sumarizar as evidências que demonstram sua efetividade. DISCUSSÃO: Mentalização é uma atividade mental predominantemente pré-consciente que capacita o indivíduo a compreender a si mesmo e aos outros em termos de estados subjetivos e processos mentais. Trauma psicológico na infância está associado
Sharp, Carla; Kalpakci, Allison; Mellick, William; Venta, Amanda; Temple, Jeff R
2015-03-01
At least two leading developmental models of borderline personality disorder (BPD) emphasize the role of accurate reflection and understanding of internal states as significant to the development of BPD features (Fonagy, Int J Psycho-Anal 72:639-656, 1991; Linehan, Cognitive-behavioral treatment of borderline personality disorder, 1993). The current study used the construct of experiential avoidance (EA) to operationalize avoidance of internal states and sought to examine (1) the concurrent relations between EA and borderline features in a large and diverse community sample; and (2) the prospective relation between EA and borderline features over a 1-year follow-up, controlling for baseline levels of borderline features. N = 881 adolescents recruited from public schools in a large metropolitan area participated in baseline assessments and N = 730 completed follow-up assessments. Two main findings were reported. First, EA was associated with borderline features, depressive, and anxiety symptoms at the bivariate level, but when all variables were considered together, depression and anxiety no longer remained significantly associated with borderline features, suggesting that the relations among these symptom clusters may be accounted for by EA as a cross-cutting underlying psychological process. Second, EA predicted levels of borderline symptoms at 1-year follow-up, controlling for baseline levels of borderline symptoms, and symptoms of anxiety and depression. Results are interpreted against the background of developmental theories of borderline personality disorder.
Borderline personality disorder in the primary care setting.
Dubovsky, Amelia N; Kiefer, Meghan M
2014-09-01
Borderline personality disorder is estimated to be present in approximately 6% of outpatient primary care settings. However, the time and energy spent on this population can greatly exceed what primary care doctors are able to spend. This article gives an overview of borderline personality disorder, including the clinical characteristics, epidemiology, and comorbidities, as well as pharmacologic and most important behavioral management. It is our hope that, with improved understanding of the disorder and skills for managing this population, caring for patients with the disorder can be more satisfying and less taxing for both primary care doctors and their patients. Copyright © 2014 Elsevier Inc. All rights reserved.
DEFF Research Database (Denmark)
Beck, Emma; Sharp, Carla; Poulsen, Stig
2017-01-01
Background: Insecure attachment is a precursor and correlate of borderline personality disorder. According to the mentalization-based theory of borderline personality disorder, the presence of insecure attachment derails the development of the capacity to mentalize, potentially resulting in borde......Background: Insecure attachment is a precursor and correlate of borderline personality disorder. According to the mentalization-based theory of borderline personality disorder, the presence of insecure attachment derails the development of the capacity to mentalize, potentially resulting...... personality features. Our findings suggest that in a simple mediational model, mentalizing capacity mediated the relation between attachment to peers and borderline features. In the case of attachment to parents, the mediational model was not significant. Conclusions: The current study is the first...... to evaluate this mediational model with parent and peer attachment as separate concepts and the first to do so in a sample of adolescents who meet full or sub-threshold criteria for borderline personality disorder. Findings incrementally support that mentalizing capacity and attachment insecurity, also...
Borderline personality disorder and emotional intelligence
Peter, M.; Schuurmans, H.; Vingerhoets, A.J.J.M.; Smeets, G.; Verkoeijen, P.; Arntz, A.
2013-01-01
The present study investigated emotional intelligence (EI) in borderline personality disorder (BPD). It was hypothesized that patients with BPD (n = 61) compared with patients with other personality disorders (PDs; n = 69) and nonpatients (n = 248) would show higher scores on the ability to perceive
Reinelt, Eva; Stopsack, Malte; Aldinger, Maren; Ulrich, Ines; Grabe, Hans Jörgen; Barnow, Sven
2014-01-01
There is evidence that the borderline symptomatology of the mother longitudinally predicts the number of borderline criteria met by the children. However, possible underlying mechanisms have rarely been examined. In line with transactional models of borderline personality disorder (BPD), we analyzed a broad concept of maladaptive mother-child interactions of mothers with BPD symptoms towards their children, including insensitive parenting and mother-child discrepancies, in reporting the child's psychopathological behavior. SAMPLING/METHODS: The sample was drawn from the population-based Greifswald Family Study and consisted of 295 children and their biological mothers. Both were examined at two points in time, first when the children were about 15 years old (T0) and again 5 years later (T1), using path analyses. Maladaptive mother-child interactions (especially an overprotective and rejecting parenting style and high discrepancies regarding internalizing problems) mediate the longitudinal transmission of borderline symptoms from mother to child. Furthermore, our data revealed that this result is consistent for various youth symptoms which are associated with BPD such as impulsivity or dissociation. The data of the current study imply that the transmission of borderline symptoms from mother to child is mediated by maladaptive mother-child interactions. For this reason early and professional support may be useful to prevent these children from developing severe psychopathology. Copyright © 2012 S. Karger AG, Basel.
Childhood adversity and borderline personality disorder: a focus on adolescence.
Newnham, Elizabeth A; Janca, Aleksandar
2014-01-01
This article explores recent research in the field of childhood exposure to trauma and the development of borderline personality disorder in adolescence. Adolescence is a critical period of development. Exposure to trauma, specifically sexual abuse, prior to and during puberty has specific implications for personality development and heightens risk for borderline personality disorder. Elevated symptom levels in adolescence are likely to decline across adulthood, but social and vocational impairments remain. Impulsivity, difficulties in emotion regulation, and suicidality may characterize adolescent expression of borderline personality disorder, whereas negative affect and functional impairment are more stable features of the disorder. Preliminary findings in treatment models for adults have potential for benefit among adolescence. Further research is required to examine treatment effectiveness and efficiency. Greater attention to low-income and middle-income nations, which are disproportionately affected by adversity, is needed to determine cross-cultural validity and the impact of trauma in adolescent populations.
Directory of Open Access Journals (Sweden)
Allan Crema
2004-06-01
Full Text Available A migração é um fenômeno que pode ocorrer em algumas espécies de insetos e ela geralmente começa quando os ovários não estão desenvolvidos, ou o estão parcialmente. Para traça-das-crucíferas, Plutella xylostella (Lepidoptera: Yponomeutidae já foi observado que a densidade larval afetou o grau de desenvolvimento ovariano. Neste trabalho foi determinado o impacto da temperatura e do fotoperíodo no desenvolovimento ovariano e na oviposição do inseto. Larvas de quarto estágio foram criadas individualmente em placas de Petri à temperaturas de 14 e 25ºC e fotofase de 8 e 14 h. As fêmeas recém-emergidas foram mortas em um freezer, dissecadas sob um microscópio e o ovário observado. Para determinar o impacto da temperatura sobre a oviposição do inseto, larvas de quarto estágio foram criadas a temperaturas de 14 e 25ºC e, quando os machos e fêmeas emergiram, casais foram colocados individualmente em placas de Petri. Foi determinado o período de pré-oviposição e o número de ovos depositados no primeiro dia. Os resultados mostraram que o grau de desenvolvimento ovariano não foi afetado pela temperatura e fotoperíodo empregados, indicando que estes fatores não afetaram o potencial migratório da espécie. Fêmeas criadas a 25ºC depositaram seus ovos dois dias após a emergência enquanto que fêmeas criadas a 14ºC o fizeram aos cinco dias, sugerindo que o período de pré-oviposição é aumentado a baixas temperaturas. O impacto destes resultados sobre a migração e dispersão da TDC são discutidos.Migration occurs in some insect species, and in many cases it commences when the ovaries are immature. Environmental conditions can affect the rate of ovarian development and oviposition of insects. In the Diamondback Moth (DBM, Plutella xylostella (Lepidoptera: Yponomeutidae, the larval density affected the rate of ovarian development. In this work we determined the impact of temperatures and photoperiods on DBM ovarian
[Laparoscopic management of ovarian borderline tumors].
Cortés Algara, A; Charles, L; González Ramírez, P; Río de la Loza, F; Aranda Flores, C E
2001-09-01
The objective of this communication is to present a patient case with ovarian borderline tumor. The conservative management for laparoscopy, and we performed an analysis of the mundial literature in which respect to the conservative and laparoscopy management, in spite of the laparoscopy management are of controversy.
Vulnerability, Borderline Personality Disorders. Clinical and ...
African Journals Online (AJOL)
Borderline personality disorder and vulnerability are difficult to assess and are rather elusive to define. A case study material is presented from a cognitive analytical model. An attempt of the dominant features of cognitive analytical therapy and discussion of vulnerability in relation to personality disorder is provided.
Generation borderline: Insecurity of family bondings and the world of addiction
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Nicolò Terminio
2014-09-01
Full Text Available The article concerns of the psychopathology of drug addiction, with an emphasis on the phenomenology of borderline personality disorder. The attention is focused on setting up of family ties in subjects with substance abuse disorders. In particular the anthropological frame of trauma is studied which presents itself as the core on which the therapeutic work is based. Keywords:Addiction; Borderline personality disorder; Trauma
Directory of Open Access Journals (Sweden)
Wei-Hsin Lu
2018-04-01
Full Text Available Purpose: This study examined the differences in mental health and behavioral problems among young adults with borderline personality symptoms of various severities. Methods: 500 college students participated in this study. Borderline personality symptoms were evaluated using the Taiwanese version of the Borderline Symptom List (BSL-23. Mental health problems were assessed using the Symptom Checklist-90-Revised Scale. Suicidality and other behavioral problems were assessed using questions from the epidemiological version of the Kiddie Schedule for Affective Disorders and Schizophrenia and BSL-23 Supplement. According to the distribution of BSL-23 scores at the 25th, 50th, and 75th percentiles, the participants were divided into 4 groups: No/Mild, Moderate, Severe, and Profound. Analysis of variance and the chi-square test were used to compare mental health and behavioral problems among the 4 groups. Results: All mental health problems differed significantly among the 4 groups. The severity of nearly all mental health problems increased with that of borderline personality symptoms. The proportions of most behavioral problems differed significantly among the 4 groups. The Profound group was more likely to have behavioral problems than the other 3 groups. Conclusion: Young adults who had more severe borderline personality symptoms had more severe mental health and behavioral problems. Keywords: Borderline personality, Mental health, Suicidality
Grandiose and Vulnerable Narcissism in Borderline Personality Disorder.
Euler, Sebastian; Stöbi, Dominik; Sowislo, Julia; Ritzler, Franziska; Huber, Christian G; Lang, Undine E; Wrege, Johannes; Walter, Marc
2018-02-21
Little is known about narcissistic traits in borderline personality disorder (BPD). This exploratory study aimed to illustrate the associations between total, grandiose, and vulnerable narcissism and gender, diagnostic features of BPD and narcissistic personality disorder (NPD), and psychopathology in BPD patients. The Pathological Narcissism Inventory and psychometric measures for impulsivity, anger, borderline symptom severity, personality organization, depression, and rejection sensitivity were completed by 65 BPD patients. Statistical analyses were conducted using the t test, Pearson correlation, and multivariate regression analyses. Male BPD patients displayed higher narcissistic scores than females (p personality disorders. Future studies are advised to apply complementary measures and take new diagnostic approaches of DSM-5 and ICD-11 into account. © 2018 S. Karger AG, Basel.
Koenigsberg, Harold W; Denny, Bryan T; Fan, Jin; Liu, Xun; Guerreri, Stephanie; Mayson, Sarah Jo; Rimsky, Liza; New, Antonia S; Goodman, Marianne; Siever, Larry J
2014-01-01
Extreme emotional reactivity is a defining feature of borderline personality disorder, yet the neural-behavioral mechanisms underlying this affective instability are poorly understood. One possible contributor is diminished ability to engage the mechanism of emotional habituation. The authors tested this hypothesis by examining behavioral and neural correlates of habituation in borderline patients, healthy comparison subjects, and a psychopathological comparison group of patients with avoidant personality disorder. During fMRI scanning, borderline patients, healthy subjects, and avoidant personality disorder patients viewed novel and repeated pictures, providing valence ratings at each presentation. Statistical parametric maps of the contrasts of activation during repeated versus novel negative picture viewing were compared between groups. Psychophysiological interaction analysis was employed to examine functional connectivity differences between groups. Unlike healthy subjects, neither borderline nor avoidant personality disorder patients exhibited increased activity in the dorsal anterior cingulate cortex when viewing repeated versus novel pictures. This lack of an increase in dorsal anterior cingulate activity was associated with greater affective instability in borderline patients. In addition, borderline and avoidant patients exhibited smaller increases in insula-amygdala functional connectivity than healthy subjects and, unlike healthy subjects, did not show habituation in ratings of the emotional intensity of the images. Borderline patients differed from avoidant patients in insula-ventral anterior cingulate functional connectivity during habituation. Unlike healthy subjects, borderline patients fail to habituate to negative pictures, and they differ from both healthy subjects and avoidant patients in neural activity during habituation. A failure to effectively engage emotional habituation processes may contribute to affective instability in borderline
Keuroghlian, Alex S; Palmer, Brian A; Choi-Kain, Lois W; Borba, Christina P C; Links, Paul S; Gunderson, John G
2016-08-01
The effect that attending a 1-day workshop on Good Psychiatric Management (GPM) had on attitudes about borderline personality disorder (BPD) was assessed among 297 clinicians. Change was recorded by comparing before and after scores on a 9-item survey previously developed to assess the effects of workshops on Systems Training for Emotional Predictability and Problem Solving (STEPPS). Participants reported decreased inclination to avoid borderline patients, dislike of borderline patients, and belief that BPD's prognosis is hopeless, as well as increased feeling of competence, belief that borderline patients have low self-esteem, feeling of being able to make a positive difference, and belief that effective psychotherapies exist. Less clinical experience was related to an increased feeling of competence and belief that borderline patients have low self-esteem. These findings were compared to those from the STEPPS workshop. This assessment demonstrates GPM's potential for training clinicians to meet population-wide needs related to borderline personality disorder.
On the role of oxytocin in borderline personality disorder.
Brüne, Martin
2016-09-01
Interpersonal dysfunction is central to borderline personality disorder (BPD). Recent research has focused on the role of oxytocin (OT) in BPD, particularly regarding associations of OT activity with symptoms, genetic polymorphisms of the oxytocin receptor coding gene (OXTR) in BPD, and experimental modification of interpersonal core problems of patients with BPD such as hypervigilance towards threat detection, mistrust, and non-verbal behaviour during social interaction by intranasal application of OT. A literature ('medline') review was performed using the keywords 'oxytocin' and 'borderline personality disorder'. Secondary literature on trauma and attachment in relation to OT was also considered relevant. Together, findings suggest that in BPD OT is associated with enhanced defensive mechanisms and avoidance behaviour. Moreover, gene-environment interaction concerning polymorphic variations of the OXTR gene and childhood adversity in BPD suggests that these genes convey developmental flexibility or 'differential susceptibility' to environmental contingencies, whereby BPD resides at the poor outcome end of the spectrum. In view of the conflicting literature, it needs to be studied carefully whether OT can serve as a therapeutic agent given adjunct to psychotherapy in BPD. More research about the role of OT is also required with regard to the prevention of the non-genetic intergenerational transmission of BPD. Clarifying the role of OT in BPD may also benefit from research in non-human animals targeting the interaction between early adversity and OT availability more directly. The study of oxytocin can contribute to the understanding of the neurobiology of borderline personality disorder. Oxytocin is critically involved in attachment security, and methylation of the oxytocin receptor may play a role in the epigenetic modulation of early adversity. The intranasal application of oxytocin may be a useful therapeutic adjunct to psychotherapy. Insecure attachment and
Borderline organization of personality in adulthood and adolescence
Directory of Open Access Journals (Sweden)
Alessandra Mura
2011-12-01
Full Text Available About the middle of the 1950 it was proposed the definition of borderline disorder to classify some of the clinical manifestations that they are not explained by neurosis and psychosis theory. The structural approach of Otto Kernberg has been particular relief to understand the borderline disorder. O. Kernberg has been suggested theborderline organization of personality, to outline a typical permanent pathological functioning underlying string of psychopathologic syndromes associated by a standard and specific structural pathology of Ego that it is based on mechanism of split. Recently there is a build-up the theory about adolescence disorders, where its diagnosis is complicated by lack structural identity and about symptoms that they show the effects of typical change of adolescence.
Schuppert, H. Marieke; Timmerman, Marieke E.; Bloo, Josephine; van Gemert, Tonny G.; Wiersema, Herman M.; Minderaa, Ruud B.; Emmelkamp, Paul M. G.; Nauta, Maaike H.
2012-01-01
Objective: To evaluate the effectiveness of Emotion Regulation Training (ERT), a 17-session weekly group training for adolescents with borderline personality disorder (BPD) symptoms. Method: One hundred nine adolescents with borderline traits (73% meeting the full criteria for BPD) were randomized
Schuppert, H.M.; Timmerman, M.E.; Bloo, J.; van Gemert, T.G.; Wiersema, H.M.; Minderaa, R.B.; Emmelkamp, P.M.G.; Nauta, M.H.
2012-01-01
Objective: To evaluate the effectiveness of Emotion Regulation Training (ERT), a 17-session weekly group training for adolescents with borderline personality disorder (BPD) symptoms. Method: One hundred nine adolescents with borderline traits (73% meeting the full criteria for BPD) were randomized
Risk of Local Recurrence of Benign and Borderline Phyllodes Tumors
DEFF Research Database (Denmark)
Borhani-Khomani, Kaveh; Talman, Maj-Lis Møller; Kroman, Niels
2016-01-01
women aged 18 years or older, operated from 1999 to 2014, with resected benign or borderline PTs. Information on age, size of primary tumor and recurrence, histological grade, surgical treatment, margin size, and local recurrence were collected from the national Danish Pathology Register. RESULTS.......1-192). We identified 30 local recurrences, i.e., a recurrence rate of 6.3 %. Twenty-three recurrences had similar or lower histological grading than the primary tumor, one primary benign PT recurred as a tumor with unclear diagnosis, and one primary borderline PT recurred as malignant. The number...
Crowell, Sheila E; Beauchaine, Theodore P; Linehan, Marsha M
2009-05-01
Over the past several decades, research has focused increasingly on developmental precursors to psychological disorders that were previously assumed to emerge only in adulthood. This change in focus follows from the recognition that complex transactions between biological vulnerabilities and psychosocial risk factors shape emotional and behavioral development beginning at conception. To date, however, empirical research on the development of borderline personality is extremely limited. Indeed, in the decade since M. M. Linehan initially proposed a biosocial model of the development of borderline personality disorder, there have been few attempts to test the model among at-risk youth. In this review, diverse literatures are reviewed that can inform understanding of the ontogenesis of borderline pathology, and testable hypotheses are proposed to guide future research with at-risk children and adolescents. One probable pathway is identified that leads to borderline personality disorder; it begins with early vulnerability, expressed initially as impulsivity and followed by heightened emotional sensitivity. These vulnerabilities are potentiated across development by environmental risk factors that give rise to more extreme emotional, behavioral, and cognitive dysregulation. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Inpatient management of borderline personality disorder at Helen ...
African Journals Online (AJOL)
Inpatient management of borderline personality disorder at Helen Joseph Hospital, Johannesburg. ... South African Journal of Psychiatry ... to the acute inpatient psychiatric assessment unit at the Helen Joseph Hospital, in Johannesburg, over ...
Zimmerman, Mark; Ellison, William; Morgan, Theresa A; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy
2015-10-01
The morbidity associated with bipolar disorder is, in part, responsible for repeated calls for improved detection and recognition. No such commentary exists for the improved detection of borderline personality disorder. Clinical experience suggests that it is as disabling as bipolar disorder, but no study has directly compared the two disorders. To compare the levels of psychosocial morbidity in patients with bipolar disorder and borderline personality disorder. Patients were assessed with semi-structured interviews. We compared 307 patients with DSM-IV borderline personality disorder but without bipolar disorder and 236 patients with bipolar disorder but without borderline personality disorder. The patients with borderline personality disorder less frequently were college graduates, were diagnosed with more comorbid disorders, more frequently had a history of substance use disorder, reported more suicidal ideation at the time of the evaluation, more frequently had attempted suicide, reported poorer social functioning and were rated lower on the Global Assessment of Functioning. There was no difference between the two patient groups in history of admission to psychiatric hospital or time missed from work during the past 5 years. The level of psychosocial morbidity associated with borderline personality disorder was as great as (or greater than) that experienced by patients with bipolar disorder. From a public health perspective, efforts to improve the detection and treatment of borderline personality disorder might be as important as efforts to improve the recognition and treatment of bipolar disorder. © The Royal College of Psychiatrists 2015.
Beck, Emma; Sharp, Carla; Poulsen, Stig; Bo, Sune; Pedersen, Jesper; Simonsen, Erik
2017-01-01
Insecure attachment is a precursor and correlate of borderline personality disorder. According to the mentalization-based theory of borderline personality disorder, the presence of insecure attachment derails the development of the capacity to mentalize, potentially resulting in borderline pathology. While one prior study found support for this notion in adolescents, it neglected a focus on peer attachment. Separation from primary caregivers and formation of stronger bonds to peers are key developmental achievements during adolescence and peer attachment warrants attention as a separate concept. In a cross-sectional study, female outpatients (M age 15.78=, SD = 1.04) who fulfilled DSM-5 criteria for BPD ( N = 106) or met at least 4 BPD criteria ( N = 4) completed self-reports on attachment to parents and peers, mentalizing capacity (reflective function) and borderline personality features. Our findings suggest that in a simple mediational model, mentalizing capacity mediated the relation between attachment to peers and borderline features. In the case of attachment to parents, the mediational model was not significant. The current study is the first to evaluate this mediational model with parent and peer attachment as separate concepts and the first to do so in a sample of adolescents who meet full or sub-threshold criteria for borderline personality disorder. Findings incrementally support that mentalizing capacity and attachment insecurity, also in relation to peers, are important concepts in theoretical approaches to the development of borderline personality disorder in adolescence. Clinical implications are discussed.
Goodman, Marianne; Tomas, Irene Alvarez; Temes, Christina M; Fitzmaurice, Garrett M; Aguirre, Blaise A; Zanarini, Mary C
2017-08-01
Prevalence data on self-mutilation and suicide attempts for adolescent borderline personality disorder (BPD) are currently not available. The purpose of this paper was to determine the frequency and methods of two forms of physically self-destructive acts (i.e. self-mutilation and suicide attempts) reported by adolescent borderline inpatients in one of the largest samples to date and to compare these results with a similarly diagnosed and assessed group of adult borderline inpatients. A total of 104 adolescent inpatients with BPD and 290 adult inpatients with BPD were interviewed about their lifetime history of physically self-destructive acts. The overall rates of self-mutilation (about 90%) and suicide attempts (about 75%) were similar during index admission for both adolescent and adult borderline patients. However, adolescents reported significantly higher rates of extreme levels of lifetime self-mutilation (e.g. >25 and >50 episodes) and cutting in particular, as compared with adult BPD. In contrast, borderline adults were significantly more likely to report a history of numerous (five or more) suicide attempts than adolescents with BPD. Self-mutilation and suicide attempts among adolescent borderline patients are prevalent and serious. Taken together, these results suggest that extreme levels of self-mutilation distinguish adolescent BPD from adults with BPD. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.
[Transference Focused Psychotherapy for Borderline-Adolescents in a Day Clinic Treatment Program].
Krischer, Maya; Ponton-Rodriguez, Tamara; Gooran, Ghazal Rostami; Bender, Stephan
2017-07-01
Transference Focused Psychotherapy for Borderline-Adolescents in a Day Clinic Treatment Program This paper focuses on the concept of transference focused psychotherapy (TFP) modified for juvenile borderline patients. Adolescents with borderline developmental personality disorder (bpd) have an essential deficit in their personality structure that leads to oscillations in their self-esteem and in a "split" perception of the world. They suffer from a variety of symptoms and severe impairments on their own and their families' quality of life. Their fragmented perception of themselves and others make relationships almost unbearable for them. Relationships are mostly marked by severe anxiety of resentment and rejection. For these patients this causes intolerable trouble at school where every day conflicts take place. Self-mutilation and suicidal thoughts often seem the only way out. By now, there is an agreement that an early specialized assessment and treatment is necessary in order to stop the typical consequences of their self-mutilative and dysfunctional behavior. Still, in contrast to adult age, empirical evidence is missing which proves the effectiveness of treating adolescent borderline patients. In this paper we present a research project on the effectiveness of transference focused psychotherapy with adolescent borderline patients (TFP-A) in a day clinic setting, combining TFP with group skills training as known from dialectic behavior therapy (DBT). Furthermore, we give first results on analyzing the effectiveness of our day clinic treatment program based on TFP-A, focusing on improving core symptoms such as affective problems, aggressive behavior against self and others and interpersonal problems.
Rinne, Thomas; van den Brink, Wim; Wouters, Luuk; van Dyck, Richard
2002-01-01
Objective: Selective serotonin reuptake inhibitors (SSRIs) are recommended for treatment of affect lability, impulsivity, and aggression in patients with borderline personality disorder. This recommendation is based on positive findings in at least 10 open studies and one small double-blind study of
Nouwens, Peter J G; Lucas, Rosanne; Smulders, Nienke B M; Embregts, Petri J C M; van Nieuwenhuizen, Chijs
2017-07-17
Persons with mild intellectual disability or borderline intellectual functioning are often studied as a single group with similar characteristics. However, there are indications that differences exist within this population. Therefore, the aim of this study was to identify classes of persons with mild intellectual disability or borderline intellectual functioning and to examine whether these classes are related to individual and/or environmental characteristics. Latent class analysis was performed using file data of 250 eligible participants with a mean age of 26.1 (SD 13.8, range 3-70) years. Five distinct classes of persons with mild intellectual disability or borderline intellectual functioning were found. These classes significantly differed in individual and environmental characteristics. For example, persons with a mild intellectual disability experienced fewer problems than those with borderline intellectual disability. The identification of five classes implies that a differentiated approach is required towards persons with mild intellectual disability or borderline intellectual functioning.
Hecht, Kathryn F; Cicchetti, Dante; Rogosch, Fred A; Crick, Nicki R
2014-08-01
Child maltreatment has been established as a risk factor for borderline personality disorder (BPD), yet few studies consider how maltreatment influences the development of BPD features through childhood and adolescence. Subtype, developmental timing, and chronicity of child maltreatment were examined as factors in the development of borderline personality features in childhood. Children (M age = 11.30, SD = 0.94), including 314 maltreated and 285 nonmaltreated children from comparable low socioeconomic backgrounds, provided self-reports of developmentally salient borderline personality traits. Maltreated children had higher overall borderline feature scores, had higher scores on each individual subscale, and were more likely to be identified as at high risk for development of BPD through raised scores on all four subscales. Chronicity of maltreatment predicted higher overall borderline feature scores, and patterns of onset and recency of maltreatment significantly predicted whether a participant would meet criteria for the high-risk group. Implications of findings and recommendations for intervention are discussed.
Hecht, Kathryn F.; Cicchetti, Dante; Rogosch, Fred A.; Crick, Nicki
2014-01-01
Child maltreatment has been established as a risk factor for borderline personality disorder (BPD), yet few studies consider how maltreatment influences the development of BPD features through childhood and adolescence. Subtype, developmental timing and chronicity of child maltreatment were examined as factors in the development of borderline personality features in childhood. Children (M age = 11.30, SD = 0.94), including 314 maltreated and 285 nonmaltreated children from comparable low socioeconomic backgrounds, provided self-reports of developmentally salient borderline personality traits. Maltreated children had higher overall borderline feature scores, higher scores on each individual subscale and were more likely to be identified as at high risk for development of BPD through raised scores on all 4 subscales. Chronicity of maltreatment predicted higher overall borderline feature scores and patterns of onset and recency of maltreatment significantly predicted whether a participant would meet criteria for the high-risk group. Implications of findings and recommendations for intervention are discussed. PMID:25047300
S-100 protein in the diagnosis of tuberculoid borderline tuberculoidleprosy
International Nuclear Information System (INIS)
Khan, A.R.
1998-01-01
A definitive diagnosis of tuberculoid and borderline tuberculoid leprosyis based on a demonstration of either acid-fast bacilli or nerve elementswithin the granulomas. On routine hematoxylin and eosin stains, the nervefibers are not easily identifiable. In this study, we used S-100 protein tohighlight the nerve elements and to count their numbers in leprosy andnon-leprosy granulomas. Skin biopsy specimens from 15 cases oftuberculoid/borderline tuberculoid leprosy and 14 cases belonging to othergranulomatous disease of the skin were stained with S-100 protein. Thesurface area of all the biopsies was calculated and the numbers of nervebundles stained with S-100 protein were counted in each specimen. The nervebundles were 15 per cm2 in leprosy cases, and 9.2 per cm2 in non-leprosycases. In addition, the leprosy cases showed longer nerve twigs that wereperpendicularly oriented to the skin surface. Immunostaining with S-100facilitated detection of nerve elements in tuberculoid/borderline tuberculoidleprosy. Also, an increased number of nerve elements were found in leprosygranulomas when compared with non-leprosy granulomas (P=<0.05). (author)
Crowell, Sheila E.; Beauchaine, Theodore P.; Linehan, Marsha M.
2009-01-01
Over the past several decades, research has focused increasingly on developmental precursors to psychological disorders that were previously assumed to emerge only in adulthood. This change in focus follows from the recognition that complex transactions between biological vulnerabilities and psychosocial risk factors shape emotional and behavioral development beginning at conception. To date, however, empirical research on the development of borderline personality is extremely limited. Indeed, in the decade since M. M. Linehan initially proposed a biosocial model of the development of borderline personality disorder, there have been few attempts to test the model among at-risk youth. In this review, diverse literatures are reviewed that can inform understanding of the ontogenesis of borderline pathology, and testable hypotheses are proposed to guide future research with at-risk children and adolescents. One probable pathway is identified that leads to borderline personality disorder; it begins with early vulnerability, expressed initially as impulsivity and followed by heightened emotional sensitivity. These vulnerabilities are potentiated across development by environmental risk factors that give rise to more extreme emotional, behavioral, and cognitive dysregulation. PMID:19379027
Gestalt psychotherapy in the outpatient treatment of borderline ...
African Journals Online (AJOL)
): ... psychotic reactions as well as self-destructive behaviour could also be experienced. ... level graduate program, moved out of her parents' home and bought her own ... effectiveness of cognitive behavior therapy for borderline personality ...
Reynolds, Caleb J; Tragesser, Sarah L
2018-04-03
To determine whether core features of borderline personality disorder are associated with increased rates of being on disability benefits due to chronic pain conditions. A total of 147 patients currently in treatment for chronic pain at a multimodal chronic pain clinic. We tested for a concurrent relationship between borderline personality disorder features and employment status using self-report measures. Borderline personality disorder features were associated with increased likelihood of currently being on disability due to pain conditions (odds ratio [OR] = 23.13, 95% confidence interval [CI] = 1.68-318.73), on disability due to other conditions (OR = 33.65, 95% CI = 2.15-526.13), and unemployed (OR = 20.14, 95% CI = 1.38-294.93), even while controlling for pain severity and interference, depression, and trait anxiety. A follow-up analysis revealed that these associations were due to the negative relationships facet of borderline personality disorder features. Borderline personality disorder features, particularly negative relationships, are associated with increased rates of pain disability, general disability, and unemployment in a chronic pain sample. Future research should examine mechanisms by which the maladaptive interpersonal behaviors and cognitions of borderline personality disorder might result in worse long-term employment outcomes of chronic pain.
van der Meere, Jaap; van der Meer, Dirk-Jan; Borger, Norbert; Pirila, Silja
2008-01-01
This study was designed to investigate attention and impulse control in 21 boys with dual diagnoses of conduct disorder and borderline intelligence and in 19 boys with borderline intelligence only. Using the Continuous Performance Test A-not-X, it appeared that children with the dual diagnosis made
Directory of Open Access Journals (Sweden)
Morten eKaletsch
2014-11-01
Full Text Available Much recent research has shown that personality disorders are associated with an altered emotion perception. Whereas most of this research was conducted with stimuli such as faces, the present study examined possible differences in the perception of emotions expressed via body language and body movements. 30 patients with borderline personality disorder and 30 non-patients observed video scenes of emotional human interactions conveyed by point–light displays, rated the depicted valence, and judged their confidence in this rating. Patients with borderline personality disorder showed no altered emotion perception (i.e., no biased perception in either a negative or a positive direction. They did not perceive and evaluate depicted emotions as being more extreme than healthy controls. However, patients with borderline personality disorder showed less confidence in their perception of depicted emotions, especially when these were difficult to identify. The findings extend insights on altered emotion perception in persons with borderline personality disorder to include the field of body movements.
Risk of borderline ovarian tumors among women with benign ovarian tumors
DEFF Research Database (Denmark)
Guleria, Sonia; Jensen, Allan; Kjær, Susanne K
2018-01-01
tumors among women with a benign ovarian tumor. METHODS: This nationwide cohort study included all Danish women diagnosed with a benign ovarian tumor (n=139,466) during 1978-2012. The cohort was linked to the Danish Pathology Data Bank and standardized incidence ratios (SIR) with 95% confidence intervals...... (CI) were calculated. RESULTS: Women with benign ovarian tumors had increased risks for subsequent borderline ovarian tumors (SIR 1.62, 95% CI 1.43-1.82), and this applied to both serous (SIR 1.69, 95% CI 1.39-2.03) and mucinous (SIR 1.75, 95% CI 1.45-2.10) histotypes of borderline ovarian tumors....... The risk for borderline ovarian tumors was primarily increased for women diagnosed with a benign ovarian tumor before 40years of age. The risk remained increased up to 9years after a benign ovarian tumor diagnosis. Finally, the associations did not change markedly when analyzed for the different histotypes...
Self-Esteem and Anger in Borderline Patients With Self-Injury Behavior.
Almeida, Carla Maria; Horta, Maria Purificação
2018-04-01
Anger and low self-esteem characterize borderline individuals, yet little is known about their role and impact in the presence or absence of self-injury behavior. The present study aimed to investigate the impact of anger and self-esteem in borderline patients and whether these variables distinguish these patients with and without self-injury. Patients were recruited from a psychiatric service and were evaluated for self-esteem and anger. Additionally, impulsivity and symptoms were assessed. Two groups were compared, one with self-injurious behavior (n = 18) and another one without it (n = 23). Those who injure themselves seem to have a lower self-esteem (p < 0.001), yet the strengthening of self-esteem seems to have different outcomes, according to the presence or absence of self-injury. Anger and self-esteem seem to influence the severity of diagnosis, but only in patients who self-injure. Anger and self-esteem may influence borderline patients differently according to the presence or absence of self-injury.
Nelson, David A; Coyne, Sarah M; Swanson, Savannah M; Hart, Craig H; Olsen, Joseph A
2014-08-01
Crick, Murray-Close, and Woods (2005) encouraged the study of relational aggression as a developmental precursor to borderline personality features in children and adolescents. A longitudinal study is needed to more fully explore this association, to contrast potential associations with physical aggression, and to assess generalizability across various cultural contexts. In addition, parenting is of particular interest in the prediction of aggression or borderline personality disorder. Early aggression and parenting experiences may differ in their long-term prediction of aggression or borderline features, which may have important implications for early intervention. The currrent study incorporated a longitudinal sample of preschool children (84 boys, 84 girls) living in intact, two-parent biological households in Voronezh, Russia. Teachers provided ratings of children's relational and physical aggression in preschool. Mothers and fathers also self-reported their engagement in authoritative, authoritarian, permissive, and psychological controlling forms of parenting with their preschooler. A decade later, 70.8% of the original child participants consented to a follow-up study in which they completed self-reports of relational and physical aggression and borderline personality features. The multivariate results of this study showed that preschool relational aggression in girls predicted adolescent relational aggression. Preschool aversive parenting (i.e., authoritarian, permissive, and psychologically controlling forms) significantly predicted aggression and borderline features in adolescent females. For adolescent males, preschool authoritative parenting served as a protective factor against aggression and borderline features, whereas authoritarian parenting was a risk factor for later aggression.
Psychopathology in offspring of mothers with borderline personality disorder: a pilot study.
Weiss, M; Zelkowitz, P; Feldman, R B; Vogel, J; Heyman, M; Paris, J
1996-06-01
Children of mothers with borderline personality disorder (BPD) were hypothesized to be at greater risk for psychopathology, particularly impulse spectrum disorders, than children of mothers with other personality disorders. Twenty-one index children were compared with 23 children of mothers with a nonborderline personality disorder. Diagnoses were obtained using the Kiddie Schedule for Affective Disorders and Schizophrenia-Episodic Version (KSADS-E) and the Child Diagnostic Interview for BPD (CDIB), and functioning was rated with the Child Global Assessment Schedule (CGAS). Physical, sexual, and verbal abuse, as well as family violence and placements, were also assessed. The children of the borderline mothers, as compared with controls, had more psychiatric diagnoses, more impulse control disorders, a higher frequency of child BPD, and lower CGAS scores. There were no differences between the groups for trauma. The offspring of borderline mothers are at high risk for psychopathology.
Feliu-Soler, Albert; Pascual, Juan Carlos; Elices, Matilde; Martín-Blanco, Ana; Carmona, Cristina; Cebolla, Ausiàs; Simón, Vicente; Soler, Joaquim
2017-01-01
The aim of this randomized pilot study is to investigate the effects of a short training programme in loving-kindness and compassion meditation (LKM/CM) in patients with borderline personality disorder. Patients were allocated to LKM/CM or mindfulness continuation training (control group). Patients in the LKM/CM group showed greater changes in Acceptance compared with the control group. Remarkable changes in borderline symptomatology, self-criticism and self-kindness were also observed in the LKM/CM group. Mechanistic explanations and therapeutic implications of the findings are discussed. Three weeks of loving-kindness and compassion meditations increased acceptance of the present-moment experience in patients with borderline personality disorder. Significant improvements in the severity of borderline symptoms, self-criticism, mindfulness, acceptance and self-kindness were observed after the LKM/CM intervention. LKM/CM is a promising complementary strategy for inclusion in mindfulness-based interventions and Dialectical Behavioural Therapy for treating core symptoms in borderline personality disorder. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Schuppert, H. Marieke; Timmerman, Marieke E.; Bloo, Josephine; van Gemert, Tonny G.; Wiersema, Herman M.; Minderaa, Ruud B.; Emmelkamp, Paul M. G.; Nauta, Maaike H.
2012-01-01
Objective: To evaluate the effectiveness of Emotion Regulation Training (ERT), a 17-session weekly group training for adolescents with borderline personality disorder (BPD) symptoms. Method: One hundred nine adolescents with borderline traits (73% meeting the full criteria for BPD) were randomized to treatment as usual only (TAU) or ERT + TAU.…
Family Study of Borderline Personality Disorder and Its Sectors of Psychopathology
Gunderson, John G.; Zanarini, Mary C.; Choi-Kain, Lois W.; Mitchell, Karen S.; Jang, Kerry L.; Hudson, James I.
2011-01-01
Context The familiality of borderline personality disorder (BPD) and its sectors of psychopathology are incompletely understood. Objectives To assess the familial aggregation of BPD and its 4 major sectors (affective, interpersonal, behavioral, and cognitive) and test whether the relationship of the familial and nonfamilial associations among these sectors can be accounted for by a latent BPD construct. Design Family study, with direct interviews of probands and relatives. Setting A psychiatric hospital (McLean Hospital) and the Boston-area community. Participants A total of 368 probands (132 with BPD, 134 without BPD, and 102 with major depressive disorder) and 885 siblings and parents of probands. Main Assessments The Diagnostic Interview for DSM-IV Personality Disorders and the Revised Diagnostic Interview for Borderlines (DIB-R) were used to assess borderline psychopathology, and the Structured Clinical Interview for DSM-IV was used to assess major depressive disorder. Results Borderline personality disorder meeting both DSM-IV and DIB-R criteria showed substantial familial aggregation for BPD in individuals with a family member with BPD vs those without a family member with BPD, using proband-relative pairs (risk ratio, 2.9; 95% confidence interval, 1.5–5.5) as well as using all pairs of family members (3.9; 1.7–9.0). All 4 sectors of BPD psychopathology aggregated significantly in families, using both DSM-IV and DIB-R definitions (correlation of traits among all pairs of family members ranged from 0.07 to 0.27), with the affective and interpersonal sectors showing the highest levels; however, the level of familial aggregation of BPD was higher than that of the individual sectors. The relationship among the sectors was best explained by a common pathway model in which the sectors represent manifestations of a latent BPD construct. Conclusions Familial factors contribute to BPD and its sectors of psychopathology. Borderline personality disorder may arise
Zanarini, Mary C; Conkey, Lindsey C; Temes, Christina M; Fitzmaurice, Garrett M
2017-07-11
To determine if internet-based psychoeducation for borderline personality disorder is effective in reducing symptom severity and improving psychosocial functioning. Eighty women who met DSM-IV criteria for borderline personality disorder were randomly assigned either to the internet-based psychoeducation treatment group (n = 40) or to the internet-based control group with no psychoeducation (n = 40). Recruitment was conducted from July 2013 to March 2015. Subjects participated in 15 assessment periods that were divided into an acute phase (weeks 1-12) and a maintenance phase (months 6, 9, and 12). Main outcomes were assessed using the Zanarini Rating Scale for Borderline Personality Disorder. In the acute phase, women in the treatment group were found to have a significant decline in their scores on all 10 outcomes studied, while women in the control group had a significant decline on 7 of these outcomes. Two between-group differences were found to be significant-those in the treatment group reported a significantly greater decline in their impulsivity (z = -1.98, P = .048) and a significantly greater increase in their psychosocial functioning (z = -1.97, P = .049) than those in the control group. In the maintenance phase, those in the treatment group were found to have a significant decline in their scores on 9 of the 10 outcomes studied, while those in the control group had a significant decline in 3 of these outcomes. In terms of between-group differences, those in the treatment group reported a significantly greater decline in all 5 studied areas of borderline psychopathology: affective symptoms (z = -2.31, P = .021), cognitive symptoms (z = -3.20, P = .001), impulsivity (z = -2.44, P = .015), interpersonal difficulties (z = -2.15, P = .032), and overall borderline personality disorder symptoms (z = -2.11, P = .035). Taken together, these results suggest that internet-based psychoeducation is an effective form of early treatment for reducing the symptom
Zanarini, Mary C; Reichman, Charlotte A; Frankenburg, Frances R; Reich, D Bradford; Fitzmaurice, Garrett
2010-04-01
The purpose of this study was to describe the longitudinal course of eating disorders in patients with borderline personality disorder. The SCID I was administered to 290 borderline inpatients and 72 participants with other axis II disorders during their index admission and at five contiguous 2-year follow-up periods. The prevalence of anorexia, bulimia, and eating disorder not otherwise specified (EDNOS) declined significantly over time for those in both study groups but the prevalence of EDNOS remained significantly higher among borderline patients. While over 90% of borderline patients meeting criteria for anorexia, bulimia, or EDNOS at baseline experienced a stable remission by the time of the 10-year follow-up, diagnostic migration was common, particularly for those with anorexia or bulimia. In addition, both recurrences (52%) and new onsets (43%) of EDNOS were more common among borderline patients than recurrences and new onsets of anorexia (28% and 4%) and bulimia (29% and 11%). The results of this study suggest that the prognosis for both anorexia and bulimia in borderline patients is complicated, with remissions being stable but migrations to other eating disorders being common. The results also suggest that EDNOS may be the most prevalent and enduring of the eating disorders in these patients.
Philosophy and the Disciplines: The Borderlines | Minimah ...
African Journals Online (AJOL)
This work examines the borderlines of philosophy in relation to the central concern of other disciplines. As a preliminary step towards our examination, we attempt to uncover the specific nature of philosophy on the basis of its subject matter. We argue that while philosophy asks 'second order' questions about the totality of ...
Chabrol, Henri; Raynal, Patrick
2018-04-01
The co-occurrence of Autism Spectrum Disorder (ASD) and Borderline Personality Disorder (BPD) is not rare and has been linked to increased suicidality. Despite this significant comorbidity between ASD and BPD, no study had examined the co-occurrence of autistic traits and borderline personality disorder traits in the general population. The aim of the present study was to examine the co-occurrence of autistic and borderline traits in a non-clinical sample of young adults and its influence on the levels of suicidal ideation and depressive symptomatology. Participants were 474 college students who completed self-report questionnaires. Data were analysed using correlation and cluster analyses. Borderline personality traits and autistic traits were weakly correlated. However, cluster analysis yielded four groups: a low traits group, a borderline traits group, an autistic traits group, and a group characterized by high levels of both traits. Cluster analysis revealed that autistic and borderline traits can co-occur in a significant proportion of young adults. The high autistic and borderline traits group constituted 17% of the total sample and had higher level of suicidal ideation than the borderline traits group, despite similar levels of depressive symptoms. This result suggests that the higher suicidality observed in patients with comorbid ASD and BPD may extent to non-clinical individuals with high levels of co-occurrent autistic and borderline traits. Copyright © 2018 Elsevier Inc. All rights reserved.
Gruppemusikterapi med patienter med borderline-personlighedsforstyrrelse i dagbehandlingsregi
DEFF Research Database (Denmark)
Hannibal, Niels
2008-01-01
Denne artikel er første redegørelse for de erfaringer, som er gjort med gruppemusikterapi (GMT) for patienter med borderline-personlighedsforstyrrelse (BPF) i dagbehandlingsregi på Aalborg Psykiatriske Sygehus. Artiklen indeholder både konkrete anvisninger til aktiviteter og interventioner, liges...
Similarities and differences in borderline and organic personality disorder.
Mathiesen, Birgit B; Simonsen, Erik; Soegaard, Ulf; Kvist, Kajsa
2014-01-01
Previous research has shown that brain injury patients with Organic Personality Disorder (OPD) may display "borderline" traits due to prefrontal damage, and their personality structure may be unstable and close to a borderline personality organisation. They may have few general neuropsychological dysfunctions but specific executive deficits. Similar deficits have been found in patients with Borderline Personality Disorder (BPD). The objective of this study was to identify differences and similarities between the neuropsychological and personality profiles of BPD and OPD patients. Twenty BPD patients and 24 OPD patients were assessed with the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II), the Karolinska Psychodynamic Profile (KAPP), and a comprehensive neuropsychological test battery. Very few neuropsychological differences were found between the two patient groups. However, the verbal fluency, verbal intelligence, verbal memory, and immediate auditory memory/attention of the BPD patients were significantly poorer than the OPD patients'. The KAPP profiles of the BPD patients showed significantly poorer functioning in three areas: frustration tolerance, the body as a factor of self-esteem, and overall personality organisation. These results support our clinical experience and expectations concerning the severity of symptoms of both patient groups. We suggest considering in depth assessments of both neuropsychological and personality-related problems for each of these patients in order to inform treatment.
[Epistemic and historical elucidation of the borderline personality disorder].
Londoño Paredes, Diego Enrique
2015-01-01
The particularities of those that have been considered "hard cases" in the clinical field, and their relationship with personality disorders, are discussed together with their quintessential conceptual and diagnostic model: the borderline personalities. The aim of the study is to historically and epistemologically rebuild their origins within psychiatry and psychoanalysis. From a classical epistemological and historical study, a brief tour is made through the nineteenth century alienism and the postulate of "partial insanity". Next, a passage is spawned through the concepts that emerged from this postulate: "monomania" and "moral insanity", up to mid-century Kraepelin and the "fundamental states" of manic-depressive insanity as pathological constitutional forms or characters, and reaching the twentieth century with characterology and psychopathic personalities. Finally, psychoanalysis is analyzed as the main source of borderline personality disorders arising from the problems encountered in analytical treatments and the development of the notion of "character neurosis". Borderline personality disorders are the result of the conjunction of a number of factors, heirs of the notion of "partial insanity", of the fundamental states of manic-depression insanity, of characterology, of the idea of constitutions and pathological personalities, together with the emerging concerns of psychoanalysis in the early twentieth century. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Fulford, Daniel; Eisner, Lori R; Johnson, Sheri L
2015-06-30
Researchers and clinicians have long noted the overlap among features and high comorbidity of bipolar disorder and borderline personality disorder. The shared features of impulsivity and labile mood in both disorders make them challenging to distinguish. We tested the hypothesis that variables related to goal dysregulation would be uniquely related to risk for mania, while emotion-relevant impulsivity would be related to risk for both disorders. We administered a broad range of measures related to goal regulation traits and impulsivity to 214 undergraduates. Findings confirmed that risk for mania, but not for borderline personality disorder, was related to higher sensitivity to reward and intense pursuit of goals. In contrast, borderline personality disorder symptoms related more strongly than did mania risk with threat sensitivity and with impulsivity in the context of negative affect. Results highlight potential differences and commonalities in mania risk versus borderline personality disorder risk. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Dickens, Geoffrey L; Frogley, Catherine; Mason, Fiona; Anagnostakis, Katina; Picchioni, Marco M
2016-01-01
Clozapine is an atypical antipsychotic medicine which can cause significant side-effects. It is often prescribed off-license in severe cases of borderline personality disorder contrary to national treatment guidelines. Little is known about the experiences of those who take clozapine for borderline personality disorder. We explored the lived-experience of women in secure inpatient care who were prescribed clozapine for borderline personality disorder. Adult females ( N = 20) participated in audio-taped semi-structured interviews. Transcripts were subject to thematic analysis. The central themes related to evaluation, wellbeing, understanding and self-management; for many, their subjective wellbeing on clozapine was preferred to prior levels of functioning and symptomatology, sometimes profoundly so. The negative and potentially adverse effects of clozapine were explained as regrettable but relatively unimportant. When psychological interventions are, at least initially, ineffective then clozapine treatment is likely to be evaluated positively by a group of women with borderline personality disorder in secure care despite the potential disadvantages.
Directory of Open Access Journals (Sweden)
Anja eVaskinn
2015-08-01
Full Text Available Although borderline personality disorder and schizophrenia are notably different mental disorders, they share problems in social cognition – or understanding the feelings, intentions and thoughts of other people. To date no studies have directly compared the social cognitive abilities of individuals with these two disorders. In this study, the social cognitive subdomain theory of mind was investigated in females with borderline personality disorder (n = 25, females with schizophrenia (n = 25 and healthy females (n = 25. An ecologically valid video-based measure (Movie for the Assessment of Social Cognition was used. For the overall score, females with schizophrenia performed markedly below both healthy females and females with borderline personality disorder, whereas females with borderline personality disorder did not perform significantly different compared to the healthy control group. A statistically significant error type x group interaction effect indicated that the groups differed with respect to kind of errors. Whereas females with borderline personality disorder made mostly overmentalizing errors, females with schizophrenia in addition committed undermentalizing errors. Our study suggests different magnitude and pattern of social cognitive problems in borderline personality disorder and schizophrenia.
Findeklee, S; Lotz, L; Heusinger, K; Hoffmann, I; Dittrich, R; Beckmann, M W
2016-11-01
Borderline ovarian tumours are semimalignant tumours occurring unilaterally or bilaterally with a peak incidence among women of reproductive age. Since the affected women often wish to preserve fertility, particular precautions must be taken when counselling the patient and obtaining consent prior to planning an individual treatment. Options for preserving fertility include an organ-sparing surgical procedure and cryopreservation of oocytes and/or ovarian tissue. In this article, we report on a 25-year-old patient with a bilateral seromucinous borderline tumour who desired all fertility-preserving options. In order to perform the procedure without delay, we opted to perform luteal phase stimulation prior to oocyte retrieval. We conclude by discussing the current literature on the state of fertility preservation in the treatment of borderline ovarian tumours.
Borderline personality disorder and regularly drinking alcohol before sex.
Thompson, Ronald G; Eaton, Nicholas R; Hu, Mei-Chen; Hasin, Deborah S
2017-07-01
Drinking alcohol before sex increases the likelihood of engaging in unprotected intercourse, having multiple sexual partners and becoming infected with sexually transmitted infections. Borderline personality disorder (BPD), a complex psychiatric disorder characterised by pervasive instability in emotional regulation, self-image, interpersonal relationships and impulse control, is associated with substance use disorders and sexual risk behaviours. However, no study has examined the relationship between BPD and drinking alcohol before sex in the USA. This study examined the association between BPD and regularly drinking before sex in a nationally representative adult sample. Participants were 17 491 sexually active drinkers from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression models estimated effects of BPD diagnosis, specific borderline diagnostic criteria and BPD criterion count on the likelihood of regularly (mostly or always) drinking alcohol before sex, adjusted for controls. Borderline personality disorder diagnosis doubled the odds of regularly drinking before sex [adjusted odds ratio (AOR) = 2.26; confidence interval (CI) = 1.63, 3.14]. Of nine diagnostic criteria, impulsivity in areas that are self-damaging remained a significant predictor of regularly drinking before sex (AOR = 1.82; CI = 1.42, 2.35). The odds of regularly drinking before sex increased by 20% for each endorsed criterion (AOR = 1.20; CI = 1.14, 1.27) DISCUSSION AND CONCLUSIONS: This is the first study to examine the relationship between BPD and regularly drinking alcohol before sex in the USA. Substance misuse treatment should assess regularly drinking before sex, particularly among patients with BPD, and BPD treatment should assess risk at the intersection of impulsivity, sexual behaviour and substance use. [Thompson Jr RG, Eaton NR, Hu M-C, Hasin DS Borderline personality disorder and regularly drinking alcohol
Hawes, David J.; Helyer, Rebekah; Herlianto, Eugene C.; Willing, Jonah
2013-01-01
This study tested if children and adolescents with high levels of borderline personality features (BPF) exhibit the same shame-prone self-concept previously found to characterize adults with borderline personality disorder (Rusch et al., 2007). Self-concept was indexed using the Implicit Association Test, in a community sample of…
Trustworthiness Appraisal in Borderline Personality Disorder
Masland, Sara Rose
2016-01-01
Borderline personality (BPD) is a highly impairing illness with marked instability across multiple domains, including affect, interpersonal functioning, identity, and behavior. Within the past 15 years, researchers have sought to understand and characterize deficits in social cognition that might contribute to or arise from affective or interpersonal dysfunction. The purpose of this dissertation is to understand one aspect of impaired social cognition in BPD: biased trust processing. Individu...
Directory of Open Access Journals (Sweden)
Ali Mashhadi
2013-02-01
Full Text Available Background: Attention Deficit Hyperactivity Disorder (ADHD is a risk factor for Borderline Personality Disorder (BPD during adulthood. Studying the relationship between childhood ADHD disorder symptoms and depression and borderline personality disorder symptoms among students was the main aim of this study. Materials and Methods: A total of 291 students, who were studying in Shiraz and Tabriz universities inThe academic year of 2010-2011, were selected from three groups of Humanities, Basic Sciences, and Technical-Engineering Sciences using simple sampling method. They participated in the study through completing Wender Utah Rating Scale (WURS, Borderline Personality Scale (STB and Beck Depression Inventory (BDI-II. Pearsons correlation coefficient and multiple regression analysis were used to analyze the data. Results: The results showed that there is a significant positive relationship between childhood ADHD and borderline Personality Disorder (BPD in adulthood and childhood ADHD is able to predict BPD in adulthood (p<0.01. Similarly, the relationship between symptoms of childhood ADHD and depression was positive and significant (p<0.01. Conclusion: There is a relationship between symptoms of childhood ADHD, BPD and depression in students. It is recommended to pay due attention to the comorbidity disorders such as BPD and depression in the treatment of ADHD disorder.
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Ali Mohammadzadeh
2012-10-01
Full Text Available Background: There are models of the development of personality disorders which include individual differences in attachment relationships as causal factors contributed in explanation of these phenomena. The dimensional view of personality disorders represents these conditions as extreme variants of normal personality continua. This study investigated main and interactional effects of attachment styles and personality traits in relation to borderline characteristics. Materials and Methods: The current study was conducted in expo fact context. Randomly selected 603 participants (134 male 469 female from Tabriz Payam-e-Noor, Tarbait Moallem of Azarbaijan and Sarab Payam-e-Noor university students took part in this research. Participants answered to Borderline Personality Inventory (BPI, Eysenck Personality Questionnaire Revised, Short form (EPQ-RS and Adult Attachment Inventory (AAI. Data were analyzed using two way analysis of variance method.Results: Results indicate main effects of attachment styles and personality traits, so, individual with ambivalent insecure attachment experience more intensity of borderline traits than individual with avoidant insecure and secure attachments. Individual with high psychoticim and neuroticism traits experience more intensity of borderline characteristics than individual with extraversion personality traits. Also, there are no interactional effects of attachment styles and personality traits in relation to borderline characteristics. Conclusion: These findings reiterate contribution of childhood risk factors in developing borderline personality disorder, especially in children with emotionally vulnerability.
Cerebellar Cognitive Affective Syndrome Presented as Severe Borderline Personality Disorder
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Danilo Pesic
2014-01-01
Full Text Available An increasing number of findings confirm the significance of cerebellum in affecting regulation and early learning. Most consistent findings refer to association of congenital vermis anomalies with deficits in nonmotor functions of cerebellum. In this paper we presented a young woman who was treated since sixteen years of age for polysubstance abuse, affective instability, and self-harming who was later diagnosed with borderline personality disorder. Since the neurological and neuropsychological reports pointed to signs of cerebellar dysfunction and dysexecutive syndrome, we performed magnetic resonance imaging of brain which demonstrated partially developed vermis and rhombencephalosynapsis. These findings match the description of cerebellar cognitive affective syndrome and show an overlap with clinical manifestations of borderline personality disorder.
McMain, Shelley F; Links, Paul S; Gnam, William H; Guimond, Tim; Cardish, Robert J; Korman, Lorne; Streiner, David L
2009-12-01
The authors sought to evaluate the clinical efficacy of dialectical behavior therapy compared with general psychiatric management, including a combination of psychodynamically informed therapy and symptom-targeted medication management derived from specific recommendations in APA guidelines for borderline personality disorder. This was a single-blind trial in which 180 patients diagnosed with borderline personality disorder who had at least two suicidal or nonsuicidal self-injurious episodes in the past 5 years were randomly assigned to receive 1 year of dialectical behavior therapy or general psychiatric management. The primary outcome measures, assessed at baseline and every 4 months over the treatment period, were frequency and severity of suicidal and nonsuicidal self-harm episodes. Both groups showed improvement on the majority of clinical outcome measures after 1 year of treatment, including significant reductions in the frequency and severity of suicidal and nonsuicidal self-injurious episodes and significant improvements in most secondary clinical outcomes. Both groups had a reduction in general health care utilization, including emergency visits and psychiatric hospital days, as well as significant improvements in borderline personality disorder symptoms, symptom distress, depression, anger, and interpersonal functioning. No significant differences across any outcomes were found between groups. These results suggest that individuals with borderline personality disorder benefited equally from dialectical behavior therapy and a well-specified treatment delivered by psychiatrists with expertise in the treatment of borderline personality disorder.
Self-image and perception of mother and father in psychotic and borderline patients.
Armelius, K; Granberg
2000-02-01
Psychotic and borderline patients rated their self-image and their perception of their mother and father using the Structural Analysis of Social Behavior model (SASB). The borderline patients had more negative images of themselves and their parents, especially their fathers, than did the psychotic patients and the normal subjects, while the psychotic patients' ratings did not differ much from those of the normal subjects. The self-image was related to the images of both parents for borderline patients and normal subjects, while for the psychotic patients only the image of the mother was important for the self-image. In addition, the psychotic patients did not differentiate between the poles of control and autonomy in the introjected self-image. It was concluded that borderline patients are characterized by negative attachment, while psychotic patients are characterized by poor separation from the mother and poor differentiation between autonomy and control. The paper also discusses how this may influence the patients' relations to others. Psychotische und Borderline Patienten beurteilten ihr Selbstbild und ihre Wahrnehmung von Mutter und Vater mit Hilfe der strukturalen Analyse sozialen Verhaltens (SASB). Die Borderline Patienten hattten negativere Selbstbilder und Elternbilder (speziell Vaterbilder) als die psychotischen Patienten und gesunde Personen. Die Beurteilungen der psychotischen Patienten unterschieden sich dagegen nicht besonders von jenen Gesunder. Das Selbstbild stand in Beziehung zu beiden Elternbildern bei den Borderline Patienten und den Gesunden, während bei den psychotischen Patienten nur das Mutterbild für das Selbstbild bedeutsam war. Außerdem konnte bei den psychotischen Patienten nicht zwischen den Polen der Kontrolle und Autonomie bzgl. der introjizierten Selbstbilder differenziert werden. Aus den Ergebnissen wird gefolgert, dass Borderline Patienten durch eine negative Bindung charackterisiert sind, psychotische Patienten dagegen durch
C. Licht; M. Eikelenboom; prof Berno van Meijel; A.T. Beekman; dr Barbara Stringer; B. Koekkoek; A.J. Kerkhof; B.W. Penninx
2013-01-01
Background The presence of a comorbid borderline personality disorder (BPD) may be associated with an increase of suicidal behaviors in patients with depressive and anxiety disorders. The aim of this study is to examine the role of borderline personality traits on recurrent suicide
Buck, Kelly; Leonhardt, Bethany; George, Sunita; James, Alison; Vohs, Jenifer; Lysaker, Paul
2017-01-01
Abstract Background: Metacognition is a psychological function that includes a spectrum of mental activities. These activities involve thinking about thinking and range from more discrete acts, in which people recognize specific thoughts and feelings, to more synthetic acts in which an array of intentions, thoughts, feelings, and connections between events are integrated into larger complex representations. Recently, interest has arisen in the important role that metacognitive deficits may play in schizophrenia spectrum disorders. Research has found that many with schizophrenia experience compromised metacognitive capacity and the degree of impairment in metacognition has been linked to negative and disorganized symptoms, decrement in social functioning, and lower levels of subjective indicators of recovery. While metacognitive deficits have been broadly explored in schizophrenia, less is known about whether these deficits are similar or different than those found in other forms of serious mental illness. Methods: To explore this issue, we administered assessments of metacognition using the Metacognition Assessment Scale-Abbreviated, Alexithymia using the Toronto Alexithymia Scale and Social Cognition using the Bell Lysaker Emotion Recognition Scale to 65 adults with Schizophrenia, 34 adults with Borderline Personality Disorder (PD) and 32 adults with a Substance Use Disorder. We chose Borderline PD as our primary comparison because this group has also been found to have profound alterations in the ability to recognize and think about one’s own and others’ mental activities. We chose substance use disorder as a third psychiatric condition given that this is a common comorbidity of Borderline PD and Schizophrenia and because it has also been linked with deficits in the ability to reflect about mental states. Results: ANCOVA controlling for age revealed the Schizophrenia group had significant poorer overall metacognition compared to the other 2 groups while the
Sonographic evaluation of borderline hips in the newborn
International Nuclear Information System (INIS)
Rabassini, A.; Piovesan, L.; Rupeni, L.; Donadi, M.; Bacarini, L.; Gerardi, A.; Ortolani, M.
1991-01-01
Infant hips are classified, according to Graf, in 4 US types on the basis of the morphologic changes in both the cartilaginous and the bony roofs (type I, II, III, IV). Out of 6,000 examined hips, 170 (2.8%) were considered, which could be classified neither as type I (mature) nor as type II (delayed/immature ossification). These hips were called borderline hips. They exhibited some charecteristic US features: good bone modeling, rounded cotyle, and α angle 60 grades ±2. They were always observed during the first month of the patients' life. Anamnestic data were not specific (27.5% breech delivery, and 13% oligohydramnios); clinics sometimes overestimated tha actual anatomic development (64/170 cases with positivity of Ortolani's sign and/or restricted abduction; 25% of patients presented with no suspicious signs) Dynamic hip examination showed only physiological cranial deflection of the cartilaginous roof. Finally, borderline hips developed into type I hips in 99% of cases, within the third month of the patients' life
Stringer, Barbara; van Meijel, Berno; Eikelenboom, Merijn; Koekkoek, Bauke; Licht, Carmilla M. M.; Kerkhof, Ad J. F. M.; Penninx, Brenda W. J. H.; Beekman, Aartjan T. F.
2013-01-01
Background: The presence of a comorbid borderline personality disorder (BPD) may be associated with an increase of suicidal behaviors in patients with depressive and anxiety disorders. The aim of this study is to examine the role of borderline personality traits on recurrent suicide attempts.
Ross, Donald R; Favero, Marcus
2002-01-01
The experience of many patients with borderline personality is intense and kaleidoscopic. These qualities may be represented in film in ways that reflect and convey their essential features that are less readily captured in words. Quentin Tarantino has produced a trilogy of films that bring to light and to life the borderline experience. We use these movies to illustrate and discuss five key borderline themes: the fluid nature of drive derivatives, the discontinuous experience of time and space, the coniflicted search for an idealized parent, antisocial distortions of the superego, and the organizing and stabilizing function of a central romantic fantasy.
Borschmann, Rohan; Trevillion, Kylee; Henderson, R Claire; Rose, Diana; Szmukler, George; Moran, Paul
2014-06-01
Little is known about the crisis treatment preferences of people with borderline personality disorder. Clinicians may also question service users' ability to make considered decisions about their treatment when in crisis. Therefore, this qualitative study aimed to investigate crisis treatment preferences of a sample of community-dwelling adults with borderline personality disorder. Participants were 41 adults with borderline personality disorder who had created joint crisis plans during a randomized controlled trial. Data from all 41 joint crisis plans were analyzed iteratively via a thematic analysis framework. Participants gave clear statements in their crisis plans relating to the desire to recover from the crisis and to improve their social functioning. Key themes included the desire to be treated with dignity and respect and to receive emotional and practical support from clinicians. Many participants spoke of the importance of connecting with others during periods of crisis, but several reported a clear desire to be left alone during a future crisis. Other themes concerned preferences for specific treatment refusals during crises, including particular types of psychotropic medication and involuntary treatment. The variation of participants' preferences underscores the importance of developing individually tailored crisis plans for people with borderline personality disorder. The need to be treated with dignity and respect and to be given autonomy in decision making--also identified in global surveys of people with severe mental illness--is important to people with borderline personality disorder. Key messages for clinicians, service users, and policy makers, in addition to staff training issues, are discussed.
Sleep EEG findings in ICD-10 borderline personality disorder in Egypt.
Asaad, Tarek; Okasha, Tarek; Okasha, Ahmed
2002-09-01
Previous work has demonstrated that patients with borderline personality disorder show some similarities to patients with major depression, especially regarding their sleep profile. This study aimed at investigating such a hypothesis in an Egyptian sample, considering the possible influence of cultural differences. All night polysomnographic assessments were made for 20 ICD-10 diagnosed borderline patients (without co-morbid depression), in addition to 20 patients with major depression and 20 healthy matched controls. The two patient groups differed significantly from controls in their sleep profile, especially regarding sleep continuity measures, decreased SWS and REM sleep abnormalities. High similarity was found in EEG sleep profile of the two patient groups, though the changes were more robust in patients with depression. The small number of subjects precluded finer analyses of sleep microstructure by depressive symptoms. The great similarity in EEG sleep profile between borderline personality disorder patients and patients with major depression suggests a common biological origin for both conditions, with the difference being 'quantitative' rather than 'qualitative'. Our data are all the more compelling in that the presumed personality disturbance in the Egyptian culture manifests neurophysiologically as in the Western world.
Modelling borderline and mild dysplasia associated with HPV 6 and 11 infection.
Chapman, Ruth; Soldan, Kate; Jit, Mark
2011-04-05
Low risk HPV types 6/11 are responsible for some low-grade cytological abnormalities. Most economic analyses of HPV vaccination have estimated the additional benefit of HPV 6/11 protection by the quadrivalent vaccine, over the bivalent, based on reduction of genital warts but have not included reduction in repeat smears and colposcopies due to low-grade abnormalities. We investigate the contribution of HPV types 6/11 to abnormal smears and associated costs in England. The risk of borderline or mild dysplasia due to HPV 6/11 infection was estimated from a study of type-specific HPV DNA in cervical screening specimens collected throughout England. A Markov model representing 10 million women with HPV 6/11 or with no HPV infection from 24 to 64 years was developed to estimate the number of abnormal smears, subsequent repeat smears and colposcopies due to HPV 6/11 associated with borderline or mild dysplasia. Fitting was achieved by varying the force of infection, probability of borderline or mild dysplasia if HPV-uninfected or infected with HPV 6/11 and the duration of infection. The relative risks of borderline or mild dysplasia when infected with HPV 6/11 compared to not being HPV infected were 6.32 (95% credible interval 1.56-25.6) and 17.5 (1.02-300) respectively. Using best fitting parameters we find the costs incurred are between £170 and £195 per abnormal smear due to infection with HPV 6/11. In England, the impact of cytological abnormalities due to HPV 6/11 is relatively small, but not negligible. A vaccine that protects against HPV 6/11 infections could reduce costs associated with borderline and mild dysplasia, and associated colposcopies. These benefits should be considered when formulating immunisation policy, if possible. Smears and colposcopies in those uninfected with HPV far outnumber those in women infected with HPV 6/11. Copyright © 2011 Elsevier Ltd. All rights reserved.
Herpertz, Sabine C; Bertsch, Katja
2015-09-01
Borderline personality disorder is characterized by three domains of dysfunction: affect dysregulation, behavioral dyscontrol, and interpersonal hypersensitivity. Interpersonal hypersensitivity is associated with a (pre)attentive bias toward negative social information and, on the level of the brain, enhanced bottom-up emotion generation, while affect dysregulation results from abnormal top-down processes. Additionally, the problems of patients with borderline personality disorder in interpersonal functioning appear to be related to alterations in the (social) reward and empathy networks. There is increasing evidence that the oxytocinergic system may be involved in these domains of dysfunction and may thus contribute to borderline psychopathology and even open new avenues for targeted pharmacotherapeutic approaches. From studies in healthy and clinical subjects (including first studies with borderline personality disorder patients), the authors provide a conceptual framework for future research in borderline personality disorder that is based on oxytocinergic modulation of the following biobehavioral mechanisms: 1) the brain salience network favoring adaptive social approach behavior, 2) the affect regulation circuit normalizing top-down processes, 3) the mesolimbic circuit improving social reward experiences, and 4) modulating brain regions involved in cognitive and emotional empathy. In addition, preliminary data point to interactions between the oxytocin and cannabinoid system, with implications for pain processing. These mechanisms, which the authors believe to be modulated by oxytocin, may not be specific for borderline personality disorder but rather may be common to a host of psychiatric disorders in which disturbed parent-infant attachment is a major etiological factor.
Mosiołek, Anna; Gierus, Jacek; Koweszko, Tytus; Szulc, Agata
2018-02-28
The purpose of the study was to examine the relation between cognitive functioning in people with borderline personality disorder and their overall functioning level, as well as psychopathology intensification specific for this type of disorders. 64 patients aged 18-55 (M = 30.09) with borderline personality disorder (emotionally unstable personality - borderline type in the ICD-10) were examined. The study used: demographic-descriptive questionnaire, SCID II, Borderline Symptom Checlist-23, and Global Assessment of Functioning (GAF). For cognitive assessment, The Rey Auditory Verbal Learning Test, The Rey-Osterrieth Complex Figure test, TMTA, TMTB, verbal fluency test, Stroop test and Frontal Assessment Battery (FAB) were used. The average GAF score in the sample was M =43.65. Significant differences between the comorbidity group and non-comorbidity group were observed with respect to the GAF scores (Mann-Whitney U = 300.500, p = 0.008) as well as a number of significant (p borderline personality disorder. The obtained data seem to suggest that the cognitive functions affect the overall functioning only in patients with psychiatric co-morbidity. In people without psychiatric co-morbidity there is a relationship of cognitive functions only with certain aspects of psychopathology specific to BPD.
[The problems in dealing with the incest experiences of borderline patients].
Dulz, B; Schreyer, D
1997-11-01
Sexual and/or physical abuse can be found in large numbers in the history of severely disturbed borderline patients. The treatment of experiences of incest can induce new symptoms as well as reinforce still existing symptoms. Thus the free-floating anxiety, which is connected with the anxiety of impending doom in early childhood, can be reduced. During in-patient treatment the extent of free-floating anxiety of borderline patients can be reduced by the holding function of the therapeutic team. Reduction of the other symptoms can take place only subsequent to this. A therapy geared to the reduction of singular symptoms might be less successful.
Different aspects of emotional intelligence of borderline personality disorder
Peter, Mathell; Arntz, Arnoud R; Klimstra, T.A.; Vingerhoets, A.J.J.M.
2018-01-01
Objectives: The present study investigated deficiencies in different components of emotional intelligence in borderline personality disorder (BPD). Method: The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and the Emotional Quotient Inventory (EQ-i) were used to assess EI dimensions. BPD
Sempertegui Vallejo, G.A.; Karreman, A.; Arntz, A.; Bekker, M.H.J.
2013-01-01
Borderline personality disorder is a serious psychiatric disorder for which the effectiveness of the current pharmacotherapeutical and psychotherapeutic approaches has shown to be limited. In the last decades, schema therapy has increased in popularity as a treatment of borderline personality
Lysaker, Paul H; George, Sunita; Chaudoin-Patzoldt, Kelly A; Pec, Ondrej; Bob, Petr; Leonhardt, Bethany L; Vohs, Jenifer L; James, Alison V; Wickett, Amanda; Buck, Kelly D; Dimaggio, Giancarlo
2017-11-01
Deficits in the ability to recognize and think about mental states are broadly understood to be a root cause of dysfunction in Borderline Personality Disorder (PD). This study compared the magnitude of those deficits relative to other forms of serious mental illness or psychiatric conditions. Assessments were performed using the metacognition assessment scale-abbreviated (MAS-A), emotion recognition using the Bell Lysaker Emotion Recognition Test and alexithymia using the Toronto Alexithymia Scale among adults with schizophrenia (n = 65), Borderline PD (n = 34) and Substance Use disorder without psychosis or significant Borderline traits (n = 32). ANCOVA controlling for age revealed the Borderline PD group had significantly greater levels of metacognitive capacity on the MAS-A than the schizophrenia group and significantly lower levels of metacognitive capacity than the Substance Use group. Multiple comparisons revealed the Borderline PD group had significantly higher self-reflectivity and awareness of the other's mind than the schizophrenia group but lesser mastery and decentration on the MAS-A than substance use group, after controlling for self-report of psychopathology and overall number of PD traits. The Borderline PD and Schizophrenia group had significantly higher levels of alexithymia than the substance use group. No differences were found for emotion recognition. Results suggest metacognitive functioning is differentially affected in different mental disorders. Published by Elsevier B.V.
Pelvic inflammatory disease and risk of invasive ovarian cancer and ovarian borderline tumors
DEFF Research Database (Denmark)
Rasmussen, Christina B; Faber, Mette T; Jensen, Allan
2013-01-01
PURPOSE: The aim of the study was to examine the potential association between a history of pelvic inflammatory disease (PID) and risk of epithelial ovarian cancer or ovarian borderline tumors. METHODS: In a population-based case-control study in Denmark, we included 554 women with invasive ovarian...... cancer, 202 with ovarian borderline tumors, and 1,564 controls aged 35-79 years. The analyses were performed in multiple logistic regression models. RESULTS: We found a significantly increased risk of ovarian borderline tumors among women with a history of PID (OR = 1.50; 95% CI 1.......08-2.08) but no apparent association between PID and risk of invasive ovarian cancer (OR = 0.83; 95% CI 0.65-1.05). We found no effect of age at time of first PID or time since first PID on the risk for either condition. CONCLUSION: Our results suggest that a history of PID is associated with an increased risk of ovarian...
Directory of Open Access Journals (Sweden)
Takemoto Shuji
2012-05-01
Full Text Available Abstract Introduction Benign multicystic peritoneal mesothelioma is an extremely rare tumor that occurs mainly in women in their reproductive age. Its preoperative diagnosis and adequate treatment are quite difficult to attain. Case presentation Our patient was a 23-year-old Japanese woman who had a history of right oophorectomy and left ovarian cystectomy for an ovarian tumor at 20 years of age. The left ovarian tumor had been diagnosed on histology as a mucinous borderline tumor. Two years and nine months after the initial operation, multiple cysts were found in our patient. A laparotomy was performed and her uterus, left ovary, omentum and pelvic lymph nodes were removed due to suspicion of recurrence of the borderline tumor. A histological examination, however, revealed that the cysts were not a recurrence of the borderline tumor but rather benign multicystic peritoneal mesothelioma. There were no residual lesions and our patient was followed up with ultrasonography. She remains free from recurrence nine months after treatment. Conclusion We report a case of benign multicystic peritoneal mesothelioma mimicking recurrence of an ovarian borderline tumor. Benign multicystic peritoneal mesothelioma should be suspected when a multicystic lesion is present in the pelvis as in the case presented here, especially in patients with previous abdominal surgery.
Parenting of children with borderline to mild intellectual disability
Kleefman, Marijke
2015-01-01
Raising children with borderline to mild intellectual disability (BMID) may cause parenting stress, especially when the child with BMID has psychosocial problems. To improve support, it is important to have a better understanding of the effectiveness of interventions to reduce problems in raising
Merrett, Zalie; Rossell, Susan L; Castle, David J
2016-07-01
In clinical settings, there is substantial evidence both clinically and empirically to suggest that approximately 50% of individuals with borderline personality disorder experience auditory verbal hallucinations. However, there is limited research investigating the phenomenology of these voices. The aim of this study was to review and compare our current understanding of auditory verbal hallucinations in borderline personality disorder with auditory verbal hallucinations in patients with a psychotic disorder, to critically analyse existing studies investigating auditory verbal hallucinations in borderline personality disorder and to identify gaps in current knowledge, which will help direct future research. The literature was searched using the electronic database Scopus, PubMed and MEDLINE. Relevant studies were included if they were written in English, were empirical studies specifically addressing auditory verbal hallucinations and borderline personality disorder, were peer reviewed, used only adult humans and sample comprising borderline personality disorder as the primary diagnosis, and included a comparison group with a primary psychotic disorder such as schizophrenia. Our search strategy revealed a total of 16 articles investigating the phenomenology of auditory verbal hallucinations in borderline personality disorder. Some studies provided evidence to suggest that the voice experiences in borderline personality disorder are similar to those experienced by people with schizophrenia, for example, occur inside the head, and often involved persecutory voices. Other studies revealed some differences between schizophrenia and borderline personality disorder voice experiences, with the borderline personality disorder voices sounding more derogatory and self-critical in nature and the voice-hearers' response to the voices were more emotionally resistive. Furthermore, in one study, the schizophrenia group's voices resulted in more disruption in daily functioning
Borderline Personality Disorder in an Intermediate Psychological Therapies Service
Ryan, Seamus; Danquah, Adam N.; Berry, Katherine; Hopper, Mary
2017-01-01
The intermediate psychological therapies service is provided for individuals referred with common mental health problems within the primary care psychological therapies service, but whose difficulties are longstanding and/or complex. The prevalence of borderline personality disorder (BPD) in intermediate psychological therapy services has not been…
Facilitation of self-empowerment of women living with borderline ...
African Journals Online (AJOL)
Background: Borderline personality disorder is characterised by a pattern of instability in interpersonal relationships, self-image, affects and marked impulsivity. Objective: The objective is to define the central concept of “facilitation of self- empowerment”. Method: Analysis and synthesis reasoning methods as indicated by ...
Autonomic Impairment in Borderline Personality Disorder: A Laboratory Investigation
Weinberg, Anna; Klonsky, E. David; Hajcak, Greg
2009-01-01
Recent research suggests that emotional dysfunction in psychiatric disorders can be reflected in autonomic abnormalities. The present study examines sympathetic and parasympathetic autonomic nervous system activity in individuals with Borderline Personality Disorder (BPD) before, during, and following a social stressor task. Data were obtained…
Bloom, Jill Myerow; Woodward, Eva N; Susmaras, Teresa; Pantalone, David W
2012-09-01
Dialectical behavior therapy (DBT) is an empirically supported treatment for outpatients with borderline personality disorder. However, the utility of DBT strategies for inpatients with the disorder is unclear. This review summarizes and synthesizes findings from trials of DBT in inpatient settings. Multiple research databases were searched for articles published through June 2011 that reported on any implementation of DBT in an inpatient setting to address symptoms related to borderline personality disorder, including suicidal and self-injurious behavior. Eleven studies that reported pre- and posttreatment symptoms related to borderline personality disorder were evaluated. Studies indicated that many variations of standard DBT have been used in inpatient settings, including approaches that do not include phone consultation, that include group therapy only, and that vary in treatment duration (from two weeks to three months). Most studies reported reductions in suicidal ideation, self-injurious behaviors, and symptoms of depression and anxiety, whereas results for reducing anger and violent behaviors were mixed. Follow-up data indicated that symptom reduction was often maintained between one and 21 months posttreatment. On the basis of the evidence, the authors identify essential components of an inpatient DBT package and discuss its potential function as an "intensive orientation" to outpatient DBT services. There is considerable variation in the configuration and duration of DBT implementation for inpatients with borderline personality disorder. However, findings suggest that DBT may be effective in reducing symptoms related to borderline personality disorder in inpatient settings. Future research should standardize and systematically test inpatient DBT. (Psychiatric Services 63:881-888, 2012; doi: 10.1176/appi.ps.201100311).
Armenti, Nicholas A; Snead, Alexandra L; Babcock, Julia C
2018-02-01
Borderline and antisocial personality features relate to multiple externalizing behaviors, including intimate partner violence (IPV). However, not all individuals with borderline and antisocial traits perpetrate IPV. The strength of the personality-IPV link may be related to problematic substance use. We examined borderline and antisocial personality features, problematic substance use, and IPV in a community sample of couples. Positive relations between both borderline and antisocial features and IPV were stronger in conditions of high problematic alcohol use relative to low problematic alcohol use. Alcohol misuse may be an important factor to consider for IPV reduction in men with these personality features.
Interpersonal Precipitants and Suicide Attempts in Borderline Personality Disorder
Brodsky, Beth S.; Groves, Shelly A.; Oquendo, Maria A.; Mann, J. John; Stanley, Barbara
2006-01-01
Borderline personality disorder (BPD) is often characterized by multiple low lethality suicide attempts triggered by seemingly minor incidents, and less commonly by high lethality attempts that are attributed to impulsiveness or comorbid major depression. The relationships among life events, impulsiveness, and type of suicidal behavior has hardly…
Sex bias in classifying borderline and narcissistic personality disorder
Braamhorst, W.; Lobbestael, J.; Emons, W.H.M.; Arntz, A.; Witteman, C.L.M.; Bekker, M.H.J.
2015-01-01
This study investigated sex bias in the classification of borderline and narcissistic personality disorders. A sample of psychologists in training for a post-master degree (N = 180) read brief case histories (male or female version) and made DSM classification. To differentiate sex bias due to sex
Wolke, Dieter; Schreier, Andrea; Zanarini, Mary C.; Winsper, Catherine
2012-01-01
Background: Abuse by adults has been reported as a potent predictor of borderline personality disorder (BPD). Unclear is whether victimisation by peers increases the risk of borderline personality symptoms. Method: The Avon Longitudinal Study of Parents and Children (ALSPAC) prospective, longitudinal observation study of 6050 mothers and their…
Treloar, Amanda Jane Commons; Lewis, Andrew J.
2009-01-01
This paper reviews the history of the recognition of borderline personality disorder as a clinical disorder, followed by a review of the contemporary practice of diagnosing borderline personality disorder in psychiatric settings. Many researchers have cautioned against the conflation of difficult patients with the diagnostic category of borderline…
[Differential diagnosis between borderline personality disorder and bipolar disorder].
Herbst, Luis
2010-01-01
The relationship between bipolar disorder and borderline personality disorder remains controversial since in both conditions there are overlapping and similar symptomatic dimensions. Symptomatic dimensions suitable to subserve differential diagnosis are: mood, mood variability mode, and personal and family history. Characteristics of psychotic symptoms may also be useful in the differentiation. On the other hand, anxiety symptoms, neuropsychological profiles, neuro-imaging procedures and biomarkers seem not to contribute to differentiate between both diseases. The presentation of nonsuicidal self mutilation behavior can offer some differences between bipolar and borderline personality disorders, but both can coexist in clinical comorbid forms and do not significantly contribute to the differential diagnosis. Differential diagnosis is complicated by the fact that a low percentage of patients can experience comorbidity of both conditions. In this work we review all these issues, and particularly emphasize the importance of sitematically take into account the patient background, the course that follows his or her disorder, together with the outcome in response to medical decisions.
Fenning, Rachel M; Baker, Jason K; Baker, Bruce L; Crnic, Keith A
2014-06-01
A previous study suggested that mothers of 5-year-old children with borderline intellectual functioning displayed lower positive engagement with their children as compared with both mothers of typically developing children and mothers of children with significant developmental delays (Fenning, Baker, Baker, & Crnic, 2007). The current study integrated father data and followed these families over the subsequent 1-year period. Parent and child behavior were coded from naturalistic home observations at both waves. Results revealed that mothers of children with borderline intellectual functioning displayed a greater increase in negative-controlling parenting from child age 5 to 6 than did other mothers; fathers displayed more negative-controlling behavior in comparison to fathers of typically developing children. In addition, children with borderline intellectual functioning themselves exhibited a more significant escalation in difficult behavior than did typically developing children. Cross-lagged analyses for the sample as a whole indicated that maternal negative-controlling behavior predicted subsequent child difficulties, whereas negative paternal behavior was predicted by earlier child behavior. In conjunction with evidence from Fenning et al. (2007), these findings suggest a complex, dynamic, and systemic developmental pattern in the emotional behavior of families of children with borderline intellectual functioning. Implications and areas in need of additional research are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Dysfunctional Affect Regulation : in borderline personality disorder and somatoform disorder
van Dijke, A.
2011-01-01
The aim of this dissertation was to provide a systematic exploration of the nature and distribution of dysfunctional affect regulation, its associated phenomena, and retrospectively reported potentially traumatizing events in 475 patients diagnosed with borderline personality disorder (BPD),
Gratz, Kim L.; Latzman, Robert D.; Tull, Matthew T.; Reynolds, Elizabeth K.; Lejuez, C. W.
2011-01-01
Most of the extant literature on borderline personality disorder has focused on the course, consequences, and correlates of this disorder among adults. However, little is known about childhood borderline personality (BP) features, or the factors associated with the emergence of BP pathology in childhood. A greater understanding of childhood BP…
Directory of Open Access Journals (Sweden)
mozafar Ghaffari
2014-01-01
Full Text Available Background : Cognitive emotion regulation plays an immense role to control mental disorders. The aim of this research was to study the relationship between cognitive emotion regulation styles and impulsivity and students, borderline personality disorders. Materials and Methods: Statistical samples of this study included 200 students of Pyam-e-Noor university. Cognitive Emotion Regulation Questionnaire (CERQ, Barrat Impulsivity Scale (BIS and Borderline Personality Scale (STB have been used for data collection. The data was analyzed using Pearson correlation coefficient and multiple regression analysis. Results: Between variable of borderline personality disorder, and styles self-blame, rumination, catastrophizing and blaming others there was a positive correlation, but a negative relationship with acceptance, positive refocusing and positive reappraisal styles was observed (p>0.05. There was a positive relationship between variable of impulsivity with styles of self-blame, rumination, catastrophizing and blaming others, but had a negative relationship with acceptance, positive refocusing and positive reappraisal styles (p>0.05. The results of multi-variable correlation coefficient with Enter method indicated that cognitive emotion regulation styles play a role in explaining borderline personality disorder (R2= 0.646 and impulsivity (R2= 0.645. Conclusion: Training the effective strategies of cognitive emotion regulation should be considered as a part of the intervention in the treatment of impulsivity and borderline personality disorder.
Arbabi, Mohammad; Paast, Negin; Karim, Hamid Reza; Faghfori, Sara; Memari, Amir Hossein
2016-11-30
The aim of the present study was to determine whether patients with borderline personality disorder (BPD) show any neurological soft signs compared to healthy controls. Furthermore we sought to examine the role of common symptoms related to BPD, such as depression, anxiety or impulsivity, in association with neurological soft signs. Thirty patients with borderline personality disorder and thirty hospital-based controls were examined for neurological soft signs. The total score of neurological soft signs in BPD was significantly higher than controls. In terms of subscales, patients had higher scores in Sensory Integration and Motor Coordination and other neurological soft signs compared to control group. Multiple regression analysis showed that the impulsivity score was the best significant predictor of neurological soft signs in BPD. The increase of neurological soft signs in patients with BPD may address a non-focal neurological dysfunction in borderline personality disorder. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Bjørnholt, Sarah Marie; Kjaer, Susanne Krüger; Nielsen, Thor Schütt Svane; Jensen, Allan
2015-01-01
Do fertility drugs increase the risk for borderline ovarian tumours, overall and according to histological subtype? The use of any fertility drug did not increase the overall risk for borderline ovarian tumours, but an increased risk for serous borderline ovarian tumours was observed after the use of progesterone. Many epidemiological studies have addressed the connection between fertility drugs use and risk for ovarian cancer; most have found no strong association. Fewer studies have assessed the association between use of fertility drugs and risk for borderline ovarian tumours, and the results are inconsistent. A retrospective case-cohort study was designed with data from a cohort of 96 545 Danish women with fertility problems referred to all Danish fertility clinics in the period 1963-2006. All women were followed for first occurrence of a borderline ovarian tumour from the initial date of infertility evaluation until a date of migration, date of death or 31 December 2006, whichever occurred first. The median length of follow-up was 11.3 years. Included in the analyses were 142 women with borderline ovarian tumours (cases) and 1328 randomly selected sub-cohort members identified in the cohort during the follow-up through 2006. Cases were identified by linkage to the Danish Cancer Register and the Danish Register of Pathology by use of personal identification numbers. To obtain information on use of fertility drugs, hospital files and medical records of infertility-associated visits to all Danish fertility clinics were collected and supplemented with information from the Danish IVF register. We used case-cohort techniques to calculate rate ratios (RRs) and corresponding 95% confidence intervals (CIs) for borderline ovarian tumours, overall and according to histological subtype, associated with the use of any fertility drug or five specific groups of fertility drugs: clomiphene citrate, gonadotrophins (human menopausal gonadotrophins and follicle
Soler, Joaquim; Pascual, Juan Carlos; Campins, Josefa; Barrachina, Judith; Puigdemont, Dolors; Alvarez, Enrique; Pérez, Victor
2005-06-01
The aim of this study was to determine the efficacy and safety of dialectical behavior therapy plus olanzapine compared with dialectical behavior therapy plus placebo in patients with borderline personality disorder. Sixty patients with borderline personality disorder were included in a 12-week, double-blind, placebo-controlled study. All patients received dialectical behavior therapy and were randomly assigned to receive either olanzapine or placebo following a 1-month baseline period. Seventy percent of the patients completed the 4-month trial. Combined treatment showed an overall improvement in most symptoms studied in both groups. Olanzapine was associated with a statistically significant improvement over placebo in depression, anxiety, and impulsivity/aggressive behavior. The mean dose of olanzapine was 8.83 mg/day. A combined psychotherapeutic plus pharmacological approach appears to lower dropout rates and constitutes an effective treatment for borderline personality disorder.
Swann, Alan C; Lijffijt, Marijn; Lane, Scott D; Steinberg, Joel L; Moeller, F Gerard
2013-06-01
Interactions between characteristics of bipolar and Axis II cluster B disorders are clinically and diagnostically challenging. Characteristics associated with personality disorders may be dimensional aspects of bipolar disorder. We investigated relationships among antisocial personality disorder (ASPD) or borderline personality disorder symptoms, impulsivity, and course of illness in bipolar disorder. Subjects with bipolar disorder were recruited from the community. Diagnosis was by structured clinical interview for DSM-IV (SCID-I and -II), psychiatric symptom assessment by the change version of the schedule for affective disorders and schizophrenia (SADS-C), severity of Axis II symptoms by ASPD and borderline personality disorder SCID-II symptoms, and impulsivity by the Barratt impulsiveness scale (BIS-11). ASPD and borderline symptoms were not related to clinical state or affective symptoms. Borderline symptoms correlated with BIS-11 impulsivity scores, and predicted history of suicide attempts independently of the relationship to impulsivity. ASPD symptoms were more strongly related to course of illness, including early onset, frequent episodes, and substance-related disorders. These effects persisted after allowance for gender and substance-use disorder history. Personality disorder symptoms appear to be dimensional, trait-like characteristics of bipolar disorder. ASPD and Borderline symptoms are differentially related to impulsivity and course of illness. Copyright © 2012 Elsevier B.V. All rights reserved.
Swann, Alan C.; Lijffijt, Marijn; Lane, Scott D.; Steinberg, Joel L.; Moeller, F. Gerard
2012-01-01
Background Interactions between characteristics of bipolar and Axis II cluster B disorders are clinically and diagnostically challenging. Characteristics associated with personality disorders may be dimensional aspects of bipolar disorder. We investigated relationships among antisocial personality disorder (ASPD) or borderline personality disorder symptoms, impulsivity, and course of illness in bipolar disorder. Methods Subjects with bipolar disorder were recruited from the community. Diagnosis was by Structured Clinical Interview for DSM-IV (SCID-I and –II), psychiatric symptom assessment by the Change version of the Schedule for Affective Disorders and Schizophrenia (SADS-C), severity of axis II symptoms by ASPD and borderline personality disorder SCID-II symptoms, and impulsivity by the Barratt Impulsiveness Scale (BIS-11). Results ASPD and borderline symptoms were not related to clinical state or affective symptoms. Borderline symptoms correlated with BIS-11 impulsivity scores, and predicted history of suicide attempts independently of the relationship to impulsivity. ASPD symptoms were more strongly related to course of illness, including early onset, frequent episodes, and substance-related disorders. These effects persisted after allowance for gender and substance-use disorder history. Conclusions Personality disorder symptoms appear to be dimensional, trait-like characteristics of bipolar disorder. ASPD and Borderline symptoms are differentially related to impulsivity and course of illness. PMID:22835849
Keng, Shian-Ling; Wong, Yun Yi
2017-01-01
Background Linehan’s biosocial theory posits that parental invalidation during childhood plays a role in the development of borderline personality disorder symptoms later in life. However, little research has examined components of the biosocial model in an Asian context, and variables that may influence the relationship between childhood invalidation and borderline symptoms. Self-compassion is increasingly regarded as an adaptive way to regulate one’s emotions and to relate to oneself, and m...
Therapeutic self-disclosure with borderline patients.
Wilkinson, S M; Gabbard, G O
1993-01-01
The therapeutic use of countertransference disclosure as a means of highlighting the borderline patient's intrapsychic and interpersonal use of the therapist is discussed.Countertransference disclosure is narrowly defined as a form of clinical honesty that focuses on the therapist's experience of the patient in the here-and-now moment of the session. The effects of disclosure on transference exploration, neutrality, and patient revelations are explored through examination of detailed process notes of therapy sessions.Technical issues such as indirect versus direct disclosure and responses to direct questions are also addressed.
Zimmerman, Mark; Martinez, Jennifer H; Morgan, Theresa A; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy
2013-09-01
Because of the potential treatment implications, it is clinically important to distinguish between bipolar II depression and major depressive disorder with comorbid borderline personality disorder. The high frequency of diagnostic co-occurrence and resemblance of phenomenological features has led some authors to suggest that borderline personality disorder is part of the bipolar spectrum. Few studies have directly compared patients with bipolar disorder and borderline personality disorder. In the present study from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we compared these 2 groups of patients on demographic, clinical, and family history variables. From December 1995 to May 2012, 3,600 psychiatric patients presenting to the outpatient practice at Rhode Island Hospital (Providence, Rhode Island) were evaluated with semistructured diagnostic interviews for DSM-IV Axis I and Axis II disorders. The focus of the present study is the 206 patients with DSM-IV major depressive disorder and borderline personality disorder (MDD-BPD) and 62 patients with DSM-IV bipolar II depression without borderline personality disorder. The patients with MDD-BPD were significantly more often diagnosed with posttraumatic stress disorder (P depression had a significantly higher morbid risk for bipolar disorder in their first-degree relatives than the MDD-BPD patients (P depression and major depressive disorder with comorbid borderline personality disorder differed on a number of clinical and family history variables, thereby supporting the validity of this distinction. © Copyright 2013 Physicians Postgraduate Press, Inc.
International Nuclear Information System (INIS)
Kobayashi, Satoshi; Matsui, Osamu; Gabata, Toshifumi; Koda, Wataru; Minami, Tetsuya; Ryu, Yasuji; Kozaka, Kazuto; Kitao, Azusa
2012-01-01
Objectives: To analyze intranodular signal intensity pattern of hypovascular high-risk borderline lesions of HCC that illustrate multi-step hepatocarcinogenesis within the nodule on Gd–EOB–DTPA-enhanced MRI. Methods: A total of 73 nodules showing hypervascular foci in hypovascular high-risk borderline lesions identified by angiography-assisted CT were included in this study. The intranodular signal intensities of both the hypervascular foci and the hypovascular high-risk borderline lesions were evaluated on hepatobiliary-phase EOB-enhanced MRI obtained 20 min after intravenous injection of contrast media. Results: Among 59 hypervascular foci within hypointense hypovascular high-risk borderline lesions, 6 showed more hypointensity, 32 isointensity, and 21 hyperintensity compared to the surrounding hypointense, hypovascular portion of the nodules. Among 14 hypervascular foci within isointense hypovascular high-risk borderline lesions, 5 showed isointensity, and 9 hypointensity compared to the surrounding isointense hypovascular high-risk borderline lesions. No hypervascular foci showed hyperintensity compared to the surrounding isointense hypovascular high-risk borderline lesions. Conclusions: In most of the hypovascular high-risk borderline lesions containing hypervascular foci within the nodule, the signal intensity was decreased in hypervascular foci as compared with hypovascular high-risk borderline lesions and the surrounding background liver parenchyma. This supports the concept of signal intensity decrease during the dedifferentiation process in multistep hepatocarcinogenesis. However, around 30% of the nodules did not follow this rule, and hypervascular foci showed hyperintensity relative to the hypovascular high-risk borderline lesions.
Nouwens, P J G; Smulders, N B M; Embregts, P J C M; van Nieuwenhuizen, C
2017-12-01
Among persons with a mild intellectual disability or borderline intellectual functioning, differences in their characteristics imply that a differentiated approach is required to meet their needs. This retrospective study examined whether the history of support/treatment programs and the type of healthcare providers involved matched the specific support needs of persons with a mild intellectual disability or borderline intellectual functioning. Five (previously identified) profiles of persons with a mild intellectual disability or borderline intellectual functioning were used to investigate to what extent the support needs of this group had been met. For the 250 persons with mild intellectual disability or borderline intellectual functioning who matched these five profiles, data were collected retrospectively from their case files. Persons with mild intellectual disability or borderline intellectual functioning received a very similar amount and type of support/treatment programs. Differences between the profiles were found for non-verbal therapy, residential treatment and contacts with social work. Regarding the type of healthcare providers involved, differences between the profiles emerged for specialised intellectual disability services, youth services and specialised addiction services. The support programs for a heterogeneous population of persons with mild intellectual disability or borderline intellectual functioning seem to be suboptimal, indicating that more differentiation is required in the services offered to these individuals. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Kalpakci, Allison; Venta, Amanda; Sharp, Carla
2014-01-01
Central to most theories of borderline personality disorder (BPD) is the notion that the family environment interacts with genetically-based vulnerabilities to influence the development of BPD, with particular attention given to risk conferred by conflictual familial relations. However, the extent to which family conflict may relate to the development of BPD via related interpersonal beliefs is currently unknown. This study sought to test the hypothesis that the concurrent relation between conflictual family relations and borderline features in female college students is explained by beliefs associated with real or perceived unmet interpersonal needs (captured by Joiner's [2005] Interpersonal Psychological Theory, specifically thwarted belongingness and perceived burdensomeness). The sample included 267 female undergraduates ages 18-25 years (M = 20.86; SD = 1.80). Level of borderline personality features, unmet interpersonal needs, and family conflict were assessed. Bivariate analyses revealed significant relations between both thwarted belongingness and perceived burdensomeness, conflictual family relations, and borderline features. Multivariate analyses revealed that thwarted belongingness and perceived burdensomeness both mediated the relation between family conflict and borderline personality features, thus supporting a multiple mediation model. This cross-sectional study is a preliminary step towards confirming the broad theoretical hypothesis that conflictual family relations relate to beliefs about thwarted belongingness and perceived burdensomeness, which, in turn, relate to borderline personality pathology. Limitations and areas of future research are discussed.
Inhibition errors in borderline personality disorder with psychotic-like symptoms.
Grootens, K.P.; Luijtelaar, E.L.J.M. van; Buitelaar, J.K.; Laan, A. van der; Hummelen, J.W.; Verkes, R.J.
2008-01-01
BACKGROUND: The aim of this study was to examine whether patients with borderline personality disorder (BPD) have deficits in cognitive inhibition as measured with an anti-saccade eye task similar to patients with schizophrenia (Sz). Furthermore, we investigated whether these inhibition errors were
Borderline Personality Disorder: A Dysregulation of the Endogenous Opioid System?
Bandelow, Borwin; Schmahl, Christian; Falkai, Peter; Wedekind, Dirk
2010-01-01
The neurobiology of borderline personality disorder (BPD) remains unclear. Dysfunctions of several neurobiological systems, including serotoninergic, dopaminergic, and other neurotransmitter systems, have been discussed. Here we present a theory that alterations in the sensitivity of opioid receptors or the availability of endogenous opioids…
Facilitation of self-empowerment of women living with borderline ...
African Journals Online (AJOL)
N. Ntshingila
work it was discovered that borderline personality disorder patients had a ... parts of my past that I don't like and I understand a lot of things like why I do things that I ... in the now and experience a bit of positivity in me” Participant# 1. “My life is ...
Epidemiologic and molecular characteristics of borderline and malignant epithelial ovarian tumors
Bastos, Eugenia Maria Chaves De Moraes
Data from the Cancer and Steroid Hormone Study, a multicenter, population-based, case-control study were used to identify risk factors for epithelial ovarian cancer according to tumor behavior, histologic types, as well as p53 expression. Cases were women between 20 to 54 years old diagnosed with epithelial ovarian cancer from 1980 to 1982. Controls were women selected by random digit dialing. Tumor samples were analyzed for p53 overexpression using immunohistochemistry. Case-case and case-control conditional logistic regression models matched on age and diagnosing centers were used to calculate odds ratios (OR's) and 95% confidence intervals (CI's) for borderline, malignant, mucinous, and nonmucinous tumors, and p53 positive and p53 negative cases. The OR's for high number of lifetime ovulatory cycles (376-533 compared with less than 234) were 3.1 (95% CI 1.6-6.1) for malignant and 1.4 (95% CI 0.5-3.7) for borderline cases. The high number of ovulatory cycles was also a strong risk factor among nonmucinous cases. OR's for current and recent ex-smokers compared with never smokers were 2.8 (95% CI 1.7-4.8) for mucinous and 0.9 (95% CI 0.7-1.1) for nonmucinous types. Infertility showed a positive association with borderline ovarian cancer. Family history of ovarian or breast cancer was positively associated with malignant and nonmucinous cases. Parity had an inverse association with malignant ovarian cancer cases. When cases were subdivided by p53 results, the OR for tobacco smoking and p53 positive ovarian cancer was elevated for mucinous (OR = 3.9; 95% CI 0.8-18) at localized stage. Alcohol use showed a positive association with p53 positive malignant cases at advanced stage (OR = 2.0; 95% CI 1.2-3.2) and with p53 positive nonmucinous cases at advanced stage (OR = 2.1; 95% CI 1.2-3.4). A positive association between high number of ovulatory cycles and p53 positive malignant cases was observed in cases with localized stage (OR = 6.6; 95% CI 1.0-45) and advanced
Major Clinical Impact of Platinum-Based Chemotherapy in a Patient with a Borderline Ovarian Cancer
Directory of Open Access Journals (Sweden)
Jian Chen
2009-09-01
Full Text Available A patient with extensive and painful chest wall involvement from a metastatic borderline cancer of the ovary was treated with a carboplatin plus paclitaxel chemotherapy regimen. She achieved a rather dramatic improvement of pain control, a significant biochemical response with 75% reduction of the CA-125 antigen level, but only limited radiographic tumor regression. This experience emphasizes the potential clinical utility of platinum-based cytotoxic chemotherapy in the setting of symptomatic advanced borderline ovarian cancer.
Directory of Open Access Journals (Sweden)
Lúcia Buchalla Bagarelli
2004-02-01
Full Text Available OBJETIVO: realizar estudo molecular (hibridização in situ de pacientes com lesões intra-epiteliais do colo uterino, visando investigar a freqüência e o estado físico do papilomavírus humano (HPV. MÉTODOS: cortes histológicos de biopsias do colo uterino de 84 pacientes foram avaliados pela hibridização in situ, com sonda de amplo espectro, que permite identificação dos HPVs dos tipos 6, 11, 16, 18, 31, 33, 35, 39, 42, 45 e 56, e com sondas específicas para HPV dos tipos 6, 11, 16, 18, 31 e 33. Os padrões físicos de marcação do DNA dos HPV encontrados foram: epissomal, quando todo o núcleo ficou corado pela biotina (marrom; integrado, onde se visualizaram um ou dois pontos marrons no núcleo hibridizado, ou misto, com a associação dos dois padrões anteriores. Das 84 pacientes avaliadas, 31 (36,9% tinham lesões intra-epiteliais de baixo grau (LIE-BG e 53 (63,1% tinham lesões intra-epiteliais de alto grau (LIE-AG ao exame histológico. Para a análise estatística foi empregado o teste exato de Fisher. RESULTADOS: do total dos casos, 46 (54,7% foram positivos para DNA de HPV pela sonda de amplo espectro. Na tipagem dos vírus, o HPV-16 foi mais freqüente nas LIE-AG, com 12 casos - 22,6% (pPURPOSE: to carry out a molecular study (in situ hybridization on patients who present intraepithelial lesions of the uterine cervix, and to assess the frequency and the physical state of the human papillomavirus (HPV. METHODS: histological sections of biopsies of the uterine cervix from 84 patients were evaluated by in situ hybridization, with a broad-spectrum probe, which allows the identification of the HPV types 6, 11, 16, 18, 31, 33, 35, 39, 42, 45, and 56 and with specific probes for HPV types 6, 11, 16, 18, 31, and 33. The physical patterns of HPV DNA found were: episomal, when the entire nucleus stains with biotin (brown; integrated - one or two brown points in the hybridized nucleus, or mixed, associating both patterns. Of the 84
Integrating Early Intervention for Borderline Personality Disorder and Mood Disorders.
Chanen, Andrew M; Berk, Michael; Thompson, Katherine
2016-01-01
Borderline personality disorder (BPD) has been demonstrated to be a reliable and valid construct in young people (adolescents and young adults). Both borderline- and mood-related psychopathology become clinically apparent from puberty through to young adulthood, frequently co-occur, can reinforce one another, and can be difficult to differentiate clinically. This Gordian knot of overlapping clinical features, common risk factors, and precursors to both BPD and mood disorders complicates clinical assessment, prevention, and treatment. Regardless of whether an individual crosses an arbitrary diagnostic threshold, a considerable proportion of young people with borderline- and mood-related psychopathology will develop significant and persistent functional, vocational, and interpersonal impairment and disability during this critical risk and developmental period. There is a clear need for early intervention, but spurious diagnostic certainty risks stigma, misapplication of diagnostic labels, inappropriate treatment, and unfavorable outcomes. This article aims to integrate early intervention for BPD and mood disorders in the clinical context of developmental and phenomenological change and evolution. "Clinical staging," similar to disease staging in general medicine, is presented as a pragmatic, heuristic, and trans-diagnostic framework to guide prevention and intervention. It acknowledges that the early stages of these disorders cannot be disentangled sufficiently to allow for disorder-specific preventive measures and early interventions. Clinical staging defines an individual's location along the continuum of the evolving temporal course of a disorder. Such staging aids differentiation of early or milder clinical phenomena from those that accompany illness progression and chronicity, and suggests the application of appropriate and proportionate intervention strategies.
Outcalt, Jared; Dimaggio, Giancarlo; Popolo, Raffaele; Buck, Kelly; Chaudoin-Patzoldt, Kelly A; Kukla, Marina; Olesek, Kyle L; Lysaker, Paul H
2016-01-01
Borderline personality disorder traits have been observed to be linked with both insecure attachment styles as well as deficits in mentalizing and metacognition. Less is known, however, about how attachment style does or does not interact with deficits in mentalizing and metacognition to create, sustain, or influence levels of borderline personality disorder traits. In this study, we examined the hypothesis that metacognitive mastery, which is the ability to use knowledge about mental states of self and others to cope with distress and solve social problems, moderates the relationship of anxious attachment style with the severity of borderline personality disorder traits. Concurrent assessments were gathered of metacognitive mastery using the Metacognitive Assessment Scale Abbreviated, anxious attachment style using the Experiences of in Close Relationships Scale, and borderline personality disorder traits using the Structured Clinical Interview for DSM-IV Axis II Disorders. Participants were 59 adults in an early phase of recovery from substance use disorders in a residential setting. Multiple regression revealed that metacognitive mastery moderated the relationship of anxious attachment style with the number of borderline personality disorder traits. A median split of the anxious attachment and metacognitive mastery scores was performed yielding 4 groups. An analysis of covariance revealed that participants with higher levels of anxious attachment and poorer metacognitive mastery had more borderline personality disorder traits did than the other groups after controlling for levels of psychopathology. Insecure attachment may be associated with higher number of borderline personality disorder traits in the presence of deficits in metacognitive mastery. Patients with substance use and borderline personality disorder traits may benefit from treatment which addresses metacognitive mastery. Published by Elsevier Inc.
Borderline personality disorder and comorbid addiction: epidemiology and treatment.
Kienast, Thorsten; Stoffers, Jutta; Bermpohl, Felix; Lieb, Klaus
2014-04-18
Borderline personality disorder (BPD) affects 2.7% of adults. About 78% of adults with BPD also develop a substance-related disorder or addiction at some time in their lives. These persons are more impulsive and clinically less stable than BPD patients without substance dependency. They display suicidal behavior to a greater extent, drop out of treatment more often, and have shorter abstinence phases. The combination of borderline personality disorder with addiction requires a special therapeutic approach. This review is based on a selective literature search about the treatment of patients with BPD and addiction, with particular attention to Cochrane Reviews and randomized controlled trials (RCT). The available evidence is scant. In two RCTs, Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD) was found to improve patients' overall functional level (standardized mean difference, 1.07-1.78) and to increase the number of abstinence days (effect strength [ES], 1.03) and negative urine samples (ES, 0.75). Dual focus schema therapy (DFST) was evaluated in three RCTs. Because of methodological problems, however, no useful quantitative comparison across trials is possible. In one RCT, dynamic deconstructive psychotherapy (DDP) was found to have only a moderate, statistically insignificant effect. Only a single study provides data about potentially helpful drug therapy over the intermediate term. Patients with borderline personality disorder and comorbid addiction should be treated as early as possible for both conditions in a thematically hierarchical manner. There is no evidence for any restriction on drug therapy to prevent recurrent addiction in these patients. The psychotherapeutic techniques that can be used (despite the currently inadequate evidence base) include DBT-SUD, DFST, and DDP. These patients need qualified expert counseling in choosing a suitable type of psychotherapy. Specific treatment is available in only a few places, and the relevant
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Bertrand Kaeffer
2010-03-01
Full Text Available Exfoliated epithelial cells represent valuable source of information on the physiopathological state of the mucosa. However, the interpretation of data obtained from exfoliated cells is complicated by the conditions of isolation as well as the health of the subject. Exfoliation is either: a a natural loss of body cells implying a molecular signal related to the turnover of terminally differentiated cells and to the progressive mobilization of proliferative as well as stem cells or b the result of manual exfoliation by applying mechanical constraints like scraping. Depending on the methodology of isolation, exfoliated epithelial cells are believed to be either in apoptosis or in anoïkis. Most studies are using microscopic examination to demonstrate the presence of typical cells along with measurements on a limited number of biomarkers. Only few studies using proteomics or transcriptomics are available and they open discussion about tissue references and normalization. The main advantage of measures realized on exfoliated epithelial cells is that they are strictly non-invasive and open the possibility to evaluate maturation of gastric and intestinal tissues in long-term experiments performed on the same animal or in translational research on samples recovered from preterm infants.Células epiteliais exfoliadas são uma fonte de informação valiosa sobre o estado fisiológico da mucosa. Contudo, a interpretação dos dados obtidos de células exfoliadas é complicado pelas condições de isolamento e da saúde do sujeito. A exfoliação é: a uma perda natural de células implicando um sinal molecular relacionado ao turnover terminal de células diferenciadas e à progressiva mobilização de células proliferativas e de células tronco ou b o resultado de aplicação de fatores mecânicos como raspagem. Dependendo do método de islolamento, acredita-se que podem estar em apoptose ou em anoikis. A maior parte dos estudos tem utilizado exame
Use of dialectical behavior therapy in borderline personality disorder: a view from residency.
Sharma, Binali; Dunlop, Boadie W; Ninan, Philip T; Bradley, Rebekah
2007-01-01
The authors describe the use of dialectical behavior therapy (DBT) in treating borderline personality disorder during psychiatry residency, and assess the status of DBT education within psychiatry residencies in the United States. The authors present a patient with borderline personality disorder treated by a resident using DBT, along with perspectives from the resident's supervisors. Additionally, self-report surveys inquiring about the attitudes and experiences of residency directors and PGY-4 residents regarding DBT were sent to program directors with available e-mail addresses on FREIDA online. The DBT method employed by the resident had to be modified to fit the constraints of a residency program. The patient in therapy had a tumultuous course, ultimately resulting in the discontinuation of treatment. Survey results suggested an underemphasis on the education and use of DBT during residency, though the strength of this conclusion is limited by the small proportion of surveys returned. Achieving the efficacy of DBT-based treatment of borderline personality disorder reported in the literature in the setting of a residency program is challenging. Greater exposure to DBT during residency may increase residents' skills in using the technique and the likelihood that they will use it after residency.
Hudziak, J J; Boffeli, T J; Kreisman, J J; Battaglia, M M; Stanger, C; Guze, S B; Kriesman, J J
1996-12-01
The criteria for borderline personality disorder seem to select patients with very high rates of Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders. This study was undertaken to determine whether systematic assessment of patients with borderline personality disorder would reveal characteristic features of that condition which would distinguish it from these other disorders. Eighty-seven white female patients (75 in St. Louis and 12 in Milan, Italy) who had borderline personality disorder according to both the DSM-III-R criteria and the Revised Diagnostic Interview for Borderlines were further examined with the DSM-III-R Checklist and the Perley-Guze Hysteria Checklist to determine their patterns of psychiatric comorbidity. Every patient had at least one additional DSM diagnosis. Patients in St. Louis and Milan averaged five and four additional diagnoses, respectively. Eighty-four percent of the patients in St. Louis met criteria for either somatization disorder, Briquet's syndrome, antisocial personality disorder, or substance abuse disorders. Patterns of comorbidity for panic (51%), generalized anxiety disorder (55%), and major depression (87%) in St. Louis were consistent with those in other studies. The data indicate that the boundaries for the borderline condition are not specific and identify a high percentage of patients with these other disorders. Furthermore, the comorbidity profiles closely resemble the psychiatric profiles of patients with these disorders. If the borderline syndrome is meant to include all of these disorders, its usefulness as a diagnosis is limited. Until the fundamental features of borderline personality disorder that distinguish it from the others are identified, it is recommended that clinicians carefully assess patients for these other diagnoses. Efforts should be made to change the borderline personality disorder criteria by shifting away from overlap with the
Dependent personality features in a complex case of borderline personality disorder.
Nirestean, Tudor; Lukacs, Emese; Nirestean, Aurel; Gabos Grecu, Iosif
2016-11-01
Borderline personality disorder is a complex disease model as it encompasses a diversity of pathological personality traits and psychopathological symptoms. It is not surprising, therefore, that it is often manifested by personality disorders across all three clusters and accompanied by other mental (Axis I) disorders. This melange makes both psychological treatment and pharmacotherapy especially challenging, and this paper describes the case of a particularly complex case of a 33-year-old Romanian patient, who has a history of severe deprivation in childhood, mood and substance use disorder in association with borderline pathology. In the course of treatment from many sources and interventions, it has become clear that dependence is a key component of the pathology and has been rewarded with a degree of success in management. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
2013-01-01
Background Screening scales for bipolar disorder including the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) have been plagued by high false positive rates confounded by presence of borderline personality disorder. This study examined the accuracy of these scales for detecting bipolar disorder among patients referred for eating disorders and explored the possibility of simultaneous assessment of co-morbid borderline personality disorder. Methods Participants were 78 consecutive female patients who were referred for evaluation of an eating disorder. All participants completed the mood and eating disorder sections of the SCID-I/P and the borderline personality disorder section of the SCID-II, in addition to the MDQ and BSDS. Predictive validity of the MDQ and BSDS was evaluated by Receiver Operating Characteristic analysis of the Area Under the Curve (AUC). Results Fifteen (19%) and twelve (15%) patients fulfilled criteria for bipolar II disorder and borderline personality disorder, respectively. The AUCs for bipolar II disorder were 0.78 (MDQ) and 0.78 (BDSD), and the AUCs for borderline personality disorder were 0.75 (MDQ) and 0.79 (BSDS). Conclusions Among patients being evaluated for eating disorders, the MDQ and BSDS show promise as screening questionnaires for both bipolar disorder and borderline personality disorder. PMID:23443034
Left ventricular mass in borderline hypertension assessed by echo cardiography
International Nuclear Information System (INIS)
Mezzasalma, L.; Ghione, S.; Palonebo, C.
1989-01-01
The relationship between clinical measurement of blood pressure (BP) and left ventricular hypertrophy in arterial hypertension appears to be weak in most studies. On the contrary, stronger correlations with target organ damage in general, and left ventricular hypertrophy in particular, have been reported for blood pressure measurements obtained by ambulatory monitoring; this finding may indicate a possible role for blood pressure response to naturally occurring stresses in determining left ventricular hypertrophy. Aim of this study was to investigate, in 18 patients with borderline arterial hypertension, the relationships between echocardiographically assessed left ventricular mass and, respectively, casual BP and BP responses to some standardized stress tests. Only three patients had a diastolic wall thickness of the interventricular septum and of the posterior wall ≥1.2 cm and none had a pathologically increased left ventricular mass index. The following statistically significant correlations were found: casual diastolic BP vs. left ventricular mass index (r=0.53, p<0.02), systolic BP response to bicycle exercise test vs. left ventricular mass index (r=0.55, p<0.05). Multiple regression analysis showed that almost fifty percent of the variability of left ventricular mass index could be predicted by these two BP measurements. These findings suggest that besides the chronically increased afterload, also the transient hypertensive responses to naturally occuring physical stresses may have a role in determining the extent of cardiac structural changes in borderline hypertensive patients. In addition, they indicate a direct relation between left ventricular mass and blood pressure levels also in borderline hypertension, as previously shown for established hypertension, despite the fact that left ventricular hypertrophy represents only an occasional finding in early stages of hypertension
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Varga Albert
2011-06-01
Full Text Available Abstract Background the clinical decision making could be difficult in patients with borderline lesions (visually assessed stenosis severity of 30 to 50% of the left main coronary artery (LM. The aim of the study was to evaluate the relationship between transthoracic Doppler (TTDE peak diastolic flow velocity (PDV and intravascular ultrasound (IVUS measurements in the assessment of angiographically borderline LM lesions. Methods 27 patients (mean age 64 ± 8 years, 21 males with borderline LM stenosis referred for IVUS examination were included in the study. We performed standard IVUS with minimal lumen area (MLA and plaque burden (PB measurement and routine quantitative coronary angiography (QCA with diameter stenosis (%DS and area stenosis (%AS assessment in all. During TTDE, resting PDV was measured in the LM. Results interpretable Doppler signal could be obtained in 24 patients (88% feasibility; therefore these patients entered the final analysis. MLA was 7.1 ± 2.7 mm2. TTDE measured PDV correlated significantly with IVUS-derived MLA (r = -0.46, p 2 LM stenosis. Conclusion In angiographically borderline LM disease, resting PDV from transthoracic echocardiography is increased in presence of increased plaque burden by IVUS. TTDE evaluation might be a useful adjunct to other invasive and non-invasive methods in the assessment of borderline LM lesions. Further, large scale studies are needed to establish the exact cut-off value of PDV for routine clinical application.
Real-World Effectiveness of Clozapine for Borderline Personality Disorder
DEFF Research Database (Denmark)
Rohde, Christopher; Polcwiartek, Christoffer; Correll, Christoph U
2017-01-01
While some second-generation antipsychotics have shown efficacy on patients with borderline personality disorder (BPD), limited data exist regarding the effect of clozapine. Thus, we aimed to investigate the effects of clozapine on naturalistic outcomes in BPD patients with a 2-year mirror-image ....... The number of patients with intentional self-harm or overdose decreased significantly from 189 to 114 individuals (p
Zanarini, Mary C; Temes, Christina M; Ivey, Alexandra M; Cohn, Danielle M; Conkey, Lindsey C; Frankenburg, Frances R; Fitzmaurice, Garrett M
2017-06-01
This study had two aims. The first was to assess and compare various types of aggressive behavior toward others reported by borderline patients and axis II comparison subjects over time. The second was to determine the best baseline and time-varying predictors of aggressive behavior in these borderline patients. At baseline, a series of interviews and self-report measures were administered to 290 borderline patients and 72 axis II comparison subjects. Measures assessing aggression toward others, axis I and II disorders as well as adult adversity were re-administered every two years over the course of ten years. It was found that borderline patients reported significantly higher rates of verbal, emotional, and physical aggression toward others than comparison subjects but the rates of these forms of aggression toward others declined significantly for those in both study groups. Multivariate analyses indicated that the strongest predictors of adult aggression towards others were severity of adult adversity and a substance use disorder. Taken together, these results suggest that borderline patients commonly report aggression toward others but that this aggression declines significantly over time. These results also suggest that this aggression toward others is most strongly associated with adult experiences of adversity and concurrent substance abuse. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
Romero-Martínez, Ángel; Lila, Marisol; Moya-Albiol, Luis
2016-01-01
Antisocial, borderline, and narcissistic personality traits have been described as characteristics of intimate partner violence (IPV) perpetrators. Furthermore, deficits in cognitive empathy and impairments in emotional decoding processes may at least partially explain conduct disorders and social dysfunction in general. However, previous research has not explored potential associations between empathy deficits and the aforementioned traits or whether they are reflected in recidivism in IPV perpetrators. Accordingly, the main aim of this study was to explore associations between empathy deficits, antisocial, borderline, and narcissistic traits and the risk of recidivism in this population. The sample consisted of 144 IPV perpetrators (mean age = 41 years). High antisocial and borderline personality traits in this sample were associated with a high risk of recidivism, these relationships being moderated by poor empathy skills. Moreover, in IPV perpetrators with both antisocial and borderline personality traits, the risk of recidivism was higher than in those with only one of these traits. In contrast, narcissistic traits were unrelated to the risk of recidivism and impairments in empathy. The results of our study highlight the importance of empathy deficits and may help professionals to develop specific intervention programs focusing on improving empathy skills in antisocial and borderline IPV perpetrators.
Cicchetti, Dante; Rogosch, Fred A.; Hecht, Kathryn F.; Crick, Nicki R; Hetzel, Susan
2014-01-01
In this investigation, gene-environment-gender interaction effects in predicting child borderline personality disorder symptomatology among maltreated and nonmaltreated low-income children (N = 1,051) were examined. In the context of a summer research camp, adult-peer-, and self-report assessments of borderline precursor indicators were obtained, as well as child self-report on the Borderline Personality Features Scale-Children. Genetic variants of the OXTR genotype and the FKPB5 CATT haplotype were investigated. Children who self-reported high levels of borderline personality symptomatology were differentiated by adults, peers, and additional self-report on indicators of emotional instability, conflictual relationships with peers and adults, preoccupied attachment, and indicators of self-harm and suicidal ideation. Maltreated children also were more likely to evince many of these difficulties relative to nonmaltreated children. In a series of ANCOVAs, controlling for age and ancestrally informative markers, indicated significant maltreatment X gene X gender three-way interactions. Consideration of the maltreatment parameters of subtype, onset, and recency expanded understanding of variation among maltreated children. The three-way interaction effects demonstrated differential patterns among girls and boys. Among girls, the gene-environment interaction was more consistent with a diathesis-stress model, whereas among boys a differential-sensitivity interaction effect was indicated. Moreover, the genetic variants associated with greater risk for higher borderline symptomatology, dependent on maltreatment experiences, were opposite in girls compared to boys. The findings have important implications for understanding variability in early predictors of borderline personality pathology. PMID:25047302
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I. D. Spirina
2017-02-01
Full Text Available The objective of this study is to evaluate the mutual influence of pain syndrome and borderline psychiatric disorders depending on its intensity and tolerability in patients with coxarthrosis who need endoprosthetics. 76 patients with coxarthrosis aged from 25 to 68 who were hospitalized in the Department of Endoprosthetics at Mechnikov Regional Clinical Hospital in Dnipro City in the period from November 2015 to September 2016 were observed. For diagnosis of psychopathological disorders, and for evaluation of the effectiveness of therapeutic interventions, the following methods were used in our research: clinical and psychopathological (technique SCL-90-R, Tаylor anxiety scale, study of the type of attitude to the disease (LOBI, Dembo-Rubinstein self-esteem scale, Leonhard-Schmieschek questionnaire for assessment of accentuation of personality traits, the Luscher 8-colour test and the Toronto alexithymia scale (TAS. Severity of pain syndrome was assessed using a visual analogue scale of pain (VAS. Forms of borderline mental disorders were diagnosed in 51 patients with coxarthrosis, such as depressive disorder (F 32 – 19 (24.8%, neurasthenia (F 48 – 12 (16.2, anxiety and phobic disorders (F 40–41 – 14 (18.1%, and personality disorders (F 60.5, F 60.6, F 60.7 – 6 (7.6%. In 25 (33.3% patients clinically-defined forms of mental disorders were identified. Leading syndromes in these disorders were depression – 19 (24.8% patients, anxiety and phobic – 15 (20.0%, asthenic – 10 (12.4%, hypochondriacal – 7 (9.5% patients. According to the results of the correlation analysis, a close correlation between the severity of pain syndrome and borderline mental disorders (r = 0.779 was established for patients in the preoperative stage. The average level of pain syndrome on the VAS scale in patients with borderline mental disorders was twice as high as in patients without these disorders (63.4 vs. 32.4 points, but it does not depend on the
Development and Validation of the Minnesota Borderline Personality Disorder Scale
Bornovalova, Marina A.; Hicks, Brian M.; Patrick, Christopher J.; Iacono, William G.; McGue, Matt
2011-01-01
Although large epidemiological data sets can inform research on the etiology and development of borderline personality disorder (BPD), they rarely include BPD measures. In some cases, however, proxy measures can be constructed using instruments already in these data sets. In this study, the authors developed and validated a self-report measure of…
Maturation in patients with borderline personality disorder.
Levallius, Johanna; Rydén, Göran; Norring, Claes
2015-08-30
Patients with borderline personality disorder have a characteristic and extreme personality associated with psychopathology. The aim was to investigate personality change in relation to suicidality following treatment. 21 patients were assessed before and after psychotherapy on personality (NEO PI-R) and suicidality (SUAS). At follow-up, Neuroticism and Conscientiousness normalized along with six lower-order facets; Depression, Impulsiveness, Competence, Achievement Striving, Self-Discipline and Deliberation. Thirteen patients showed a positive personality development paralleled by a lesser degree of suicidality. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Penson, Brittany N; Ruchensky, Jared R; Morey, Leslie C; Edens, John F
2016-11-01
A substantial amount of research has examined the developmental trajectory of antisocial behavior and, in particular, the relationship between antisocial behavior and maladaptive personality traits. However, research typically has not controlled for previous behavior (e.g., past violence) when examining the utility of personality measures, such as self-report scales of antisocial and borderline traits, in predicting future behavior (e.g., subsequent violence). Examination of the potential interactive effects of measures of both antisocial and borderline traits also is relatively rare in longitudinal research predicting adverse outcomes. The current study utilizes a large sample of youthful offenders ( N = 1,354) from the Pathways to Desistance project to examine the separate effects of the Personality Assessment Inventory Antisocial Features (ANT) and Borderline Features (BOR) scales in predicting future offending behavior as well as trends in other negative outcomes (e.g., substance abuse, violence, employment difficulties) over a 1-year follow-up period. In addition, an ANT × BOR interaction term was created to explore the predictive effects of secondary psychopathy. ANT and BOR both explained unique variance in the prediction of various negative outcomes even after controlling for past indicators of those same behaviors during the preceding year.
Kleindienst, Nikolaus; Limberger, Matthias F; Ebner-Priemer, Ulrich W; Keibel-Mauchnik, Jana; Dyer, Anne; Berger, Mathias; Schmahl, Christian; Bohus, Martin
2011-08-01
A substantial proportion of Borderline Personality Disorder (BPD) patients respond by a marked decrease of psychopathology when treated with Dialectical Behavioral Therapy (DBT). To further enhance the rate of DBT-response, it is useful to identify characteristics related to unsatisfactory response. As DBT relies on emotional learning, we explored whether dissociation-which is known to interfere with learning- predicts poor response to DBT. Fifty-seven Borderline Personality Disorder (BPD) patients (DSM-IV) were prospectively observed during a three-month inpatient DBT program. Pre-post improvements in general psychopathology (SCL-90-R) were predicted from baseline scores of the Dissociative Experiences Scale (DES) by regression models accounting for baseline psychopathology. High DES-scores were related to poor pre-post improvement (β = -0.017 ± 0.006, p = 0.008). The data yielded no evidence that some facets of dissociation are more important in predicting DBT-response than others. The results suggest that dissociation in borderline-patients should be closely monitored and targeted during DBT. At this stage, research on treatment of dissociation (e.g., specific skills training) is warranted.
Simplified validation of borderline hits of database searches
Thomas, Henrik; Shevchenko, Andrej
2008-01-01
Along with unequivocal hits produced by matching multiple MS/MS spectra to database sequences, LC-MS/MS analysis often yields a large number of hits of borderline statistical confidence. To simplify their validation, we propose to use rapid de novo interpretation of all acquired MS/MS spectra and, with the help of a simple software tool, display the candidate sequences together with each database search hit. We demonstrate that comparing hit database sequences and independent de novo interpre...
Cristea, Ioana A; Gentili, Claudio; Cotet, Carmen D; Palomba, Daniela; Barbui, Corrado; Cuijpers, Pim
2017-04-01
Borderline personality disorder (BPD) is a debilitating condition, but several psychotherapies are considered effective. To conduct an updated systematic review and meta-analysis of randomized clinical trials to assess the efficacy of psychotherapies for BPD populations. Search terms were combined for borderline personality and randomized trials in PubMed, PsycINFO, EMBASE, and the Cochrane Central Register of Controlled Trials (from database inception to November 2015), as well as the reference lists of earlier meta-analyses. Included were randomized clinical trials of adults with diagnosed BPD randomized to psychotherapy exclusively or to a control intervention. Study selection differentiated stand-alone designs (in which an independent psychotherapy was compared with control interventions) from add-on designs (in which an experimental intervention added to usual treatment was compared with usual treatment alone). Data extraction coded characteristics of trials, participants, and interventions and assessed risk of bias using 4 domains of the Cochrane Collaboration Risk of Bias tool (independent extraction by 2 assessors). Outcomes were pooled using a random-effects model. Subgroup and meta-regression analyses were conducted. Standardized mean differences (Hedges g) were calculated using all outcomes reported in the trials for borderline symptoms, self-harm, suicide, health service use, and general psychopathology at posttest and follow-up. Differential treatment retention at posttest was analyzed, reporting odds ratios. Thirty-three trials (2256 participants) were included. For borderline-relevant outcomes combined (symptoms, self-harm, and suicide) at posttest, the investigated psychotherapies were moderately more effective than control interventions in stand-alone designs (g = 0.32; 95% CI, 0.14-0.51) and add-on designs (g = 0.40; 95% CI, 0.15-0.65). Results were similar for other outcomes, including stand-alone designs: self-harm (g = 0.32; 95% CI
Joyce, Peter R; Light, Katrina J; Rowe, Sarah L; Cloninger, C Robert; Kennedy, Martin A
2010-03-01
Self-mutilation has traditionally been associated with borderline personality disorder, and seldom examined separately from suicide attempts. Clinical experience suggests that self-mutilation is common in bipolar disorder. A family study was conducted on the molecular genetics of depression and personality, in which the proband had been treated for depression. All probands and parents or siblings were interviewed with a structured interview and completed the Temperament and Character Inventory. Fourteen per cent of subjects interviewed reported a history of self-mutilation, mostly by wrist cutting. Self-mutilation was more common in bipolar I disorder subjects then in any other diagnostic groups. In multiple logistic regression self-mutilation was predicted by mood disorder diagnosis and harm avoidance, but not by borderline personality disorder. Furthermore, the relatives of non-bipolar depressed probands with self-mutilation had higher rates of bipolar I or II disorder and higher rates of self-mutilation. Sixteen per cent of subjects reported suicide attempts and these were most common in those with bipolar I disorder and in those with borderline personality disorder. On multiple logistic regression, however, only mood disorder diagnosis and harm avoidance predicted suicide attempts. Suicide attempts, unlike self-mutilation, were not familial. Self-mutilation and suicide attempts are only partially overlapping behaviours, although both are predicted by mood disorder diagnosis and harm avoidance. Self-mutilation has a particularly strong association with bipolar disorder. Clinicians need to think of bipolar disorder, not borderline personality disorder, when assessing an individual who has a history of self-mutilation.
Brief Treatment for Borderline and Narcissistic Couples: Working the Reenactment Spiral.
Clark, Steven
1997-01-01
Develops a brief, psychoanalytically informed treatment model for borderline and narcissistic couples. Advantages and disadvantages as well as treatment principles of brief treatment for this population are explored. Phases of treatment are reviewed with an emphasis on process and interventions. Explores managing the spiraling escalation of affect…
Huprich, Steven K; Zimmerman, Mark; Chelminski, Iwona
2006-01-01
Several studies have found that 3 personality disorders (PDs) tend to share moderate rates of comorbidity with depressive PD: avoidant, borderline, and obsessive-compulsive. This study sought to evaluate the diagnostic criteria of each disorder in an effort to understand where areas of overlap may occur and to modify criteria sets where reasonable to reduce any degree of overlap. One thousand two hundred psychiatric outpatients were interviewed with the Structured Interview for DSM-IV Personality Disorders. The highest degree of comorbidity was observed between avoidant PD and depressive PD. Logistic regression analyses indicated that 2 criteria-avoidant criterion 5 and depressive criterion 2-could be removed from the diagnostic criteria sets and reduce the rates of overlap by as much as 15%. A factor analysis of the criteria of all 4 PDs indicated that there is a common clustering of many of the symptoms of avoidant, borderline, depressive, and obsessive-compulsive PDs and that borderline symptoms tend to cluster together most consistently. Avoidant and obsessive-compulsive personality symptoms clustered in ways that may reflect a problem of how to engage with others, suggestive of an approach-avoidance conflict. Depressive PD symptoms clustered in a way suggestive of problems with anger that is directed toward oneself and others. The factor analysis results suggest that an organization of symptoms around themes of conflict may provide useful ways of understanding the personality patterns of these 4 disorders.
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Álvaro P. Pinto
2005-04-01
Full Text Available Entre a rotina de biópsias e produtos cirúrgicos provenientes do colo uterino, um número significativo de lesões intra-epiteliais escamosas (LIE pode causar dificuldade quanto a caracterização e graduação histológica. Tais lesões têm sido identificadas e descritas isoladamente por artigos científicos como variantes histológicas de LIE cervicais. São elas a metaplasia papilar imatura atípica (MPIA e as variantes de neoplasia intra-epitelial cervical graus II/III: queratinizante, com padrão metaplásico imaturo de crescimento e escamomucinosa. Neste artigo são exemplificados quatro casos representativos das entidades citadas acima, provenientes das rotinas do Programa de Prevenção do Câncer Ginecológico do Estado do Paraná e de um laboratório privado especializado em patologia ginecológica de Curitiba, o Laboratório de Citopatologia e Anatomia Patológica Annalab. Os principais critérios diagnósticos são descritos, assim como a correlação citológica e molecular relacionada à presença e à localização do ácido nucleico viral (papilomavírus humano [HPV] nas lesões.In routine basis, among biopsies and surgical specimens derived from uterine cervix, a significant number of squamous intraepithelial lesions (SIL may be difficult to diagnose and grade. Some of these lesions were identified, isolated and reported in scientific articles as histological variants of SIL. They are: metaplastic papillary immature atypia (MPIA and the following grade II/III cervical intraepithelial neoplasia variants: keratinized, immature metaplastic-like proliferation and mucin-producing. In this article four cases representative of these variants are described. They were retrieved from the routines of a large scale gynecological cancer screening program and a private laboratory specialized on gynecological pathology, both from Paraná State, Brazil. The main histological criteria for diagnosis are described, as well cytological and
de la Rosa, Iris; Oquendo, María A; García, Gemma; Stanley, Barbara; González-Pinto, Ana; Liu, Shang-Min; Blanco, Carlos
To examine whether bipolar disorder and borderline personality disorder represent 2 different disorders or alternative manifestations of the same disorder. The data were collected between January 1, 2004, and December 31, 2005. The analyses were conducted between December 21 and December 27, 2010. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed on 25 symptoms assessing depression, mania, and borderline personality disorder from the National Epidemiologic Survey on Alcohol and Related Conditions, a large nationally representative sample of the US adult population (N = 34,653). DSM-IV criteria were used for diagnosis of bipolar disorder and borderline personality disorder. A 3-factor solution provided an excellent fit in both the EFA (root mean square error of approximation [RMSEA] = 0.017, comparative fix index [CFI] = 0.997) and the CFA (RMSEA = 0.024, CFI = 0.993). Factor 1 (Borderline Personality Disorder) loaded on all 9 borderline personality disorder symptoms, factor 2 (Depression) loaded on 8 symptoms of depression, and factor 3 (Mania) loaded on 7 symptoms of mania plus the psychomotor agitation item of the depression section. The correlations between the Borderline Personality Disorder and Depression factors (r = 0.328) and between the Borderline Personality Disorder and Mania factors (r = 0.394) were lower than the correlation between Depression and Mania factors (r = 0.538). A model with 3 positively correlated factors provided an excellent fit for the latent structure of borderline personality disorder and bipolar disorder symptoms. The pattern of pairwise correlations between the 3 factors is consistent with the clinical presentation of 2 syndromes (depression and mania) that can be characterized as a unitary psychiatric entity (bipolar disorder) and a third syndrome (borderline personality disorder) that is often comorbid with bipolar disorder. The findings converge in suggesting that bipolar disorder and
Brand, Bethany L; Lanius, Ruth A
2014-01-01
Emotion dysregulation is a core feature of chronic complex dissociative disorders (DD), as it is for borderline personality disorder (BPD). Chronic complex DD include dissociative identity disorder (DID) and the most common form of dissociative disorder not otherwise specified (DDNOS, type 1), now known as Other Specified Dissociative Disorders (OSDD, type 1). BPD is a common comorbid disorder with DD, although preliminary research indicates the disorders have some distinguishing features as well as considerable overlap. This article focuses on the epidemiology, clinical presentation, psychological profile, treatment, and neurobiology of chronic complex DD with emphasis placed on the role of emotion dysregulation in each of these areas. Trauma experts conceptualize borderline symptoms as often being trauma based, as are chronic complex DD. We review the preliminary research that compares DD to BPD in the hopes that this will stimulate additional comparative research.
Ghiasi, Hamed; Mohammadi, Abolalfazl; Zarrinfar, Pouria
2016-10-01
Objective: Borderline personality disorder is one of the most complex and prevalent personality disorders. Many variables have so far been studied in relation to this disorder. This study aimed to investigate the role of emotion regulation, attachment styles, and theory of mind in predicting the traits of borderline personality disorder. Method: In this study, 85 patients with borderline personality disorder were selected using convenience sampling method. To measure the desired variables, the questionnaires of Gross emotion regulation, Collins and Read attachment styles, and Baron Cohen's Reading Mind from Eyes Test were applied. The data were analyzed using multivariate stepwise regression technique. Results: Emotion regulation, attachment styles, and theory of mind predicted 41.2% of the variance criterion altogether; among which, the shares of emotion regulation, attachment styles and theory of mind to the distribution of the traits of borderline personality disorder were 27.5%, 9.8%, and 3.9%, respectively. Conclusion : The results of the study revealed that emotion regulation, attachment styles, and theory of mind are important variables in predicting the traits of borderline personality disorder and that these variables can be well applied for both the treatment and identification of this disorder.
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Hamed Ghiasi
2016-12-01
Full Text Available Objective: Borderline personality disorder is one of the most complex and prevalent personality disorders. Many variables have so far been studied in relation to this disorder. This study aimed to investigate the role of emotion regulation, attachment styles, and theory of mind in predicting the traits of borderline personality disorder.Method: In this study, 85 patients with borderline personality disorder were selected using convenience sampling method. To measure the desired variables, the questionnaires of Gross emotion regulation, Collins and Read attachment styles, and Baron Cohen's Reading Mind from Eyes Test were applied. The data were analyzed using multivariate stepwise regression technique.Results: Emotion regulation, attachment styles, and theory of mind predicted 41.2% of the variance criterion altogether; among which, the shares of emotion regulation, attachment styles and theory of mind to the distribution of the traits of borderline personality disorder were 27.5%, 9.8%, and 3.9%, respectively.Conclusion: The results of the study revealed that emotion regulation, attachment styles, and theory of mind are important variables in predicting the traits of borderline personality disorder and that these variables can be well applied for both the treatment and identification of this disorder.
Anja eVaskinn; Anja eVaskinn; Bjørnar T. eAntonsen; Bjørnar T. eAntonsen; Ragnhild A. eFretland; Isabel eDziobek; Kjetil eSundet; Kjetil eSundet; Theresa eWilberg
2015-01-01
Although borderline personality disorder and schizophrenia are notably different mental disorders, they share problems in social cognition – or understanding the feelings, intentions and thoughts of other people. To date no studies have directly compared the social cognitive abilities of individuals with these two disorders. In this study, the social cognitive subdomain theory of mind was investigated in females with borderline personality disorder (n = 25), females with schizophrenia (n = 25...
Borderline personality disorder and unmet needs.
Grambal, Ales; Prasko, Jan; Ociskova, Marie; Slepecky, Milos; Kotianova, Antonia; Sedlackova, Zuzana; Zatkova, Marta; Kasalova, Petra; Kamaradova, Dana
2017-08-01
Borderline personality disorder (BPD) is a disabling psychiatric condition with a chronic and challenging course. BPD is reflected as a disorder of self-regulation" and is associated with both psychological vulnerabilities and social relations that fail to support basic emotional needs. The objective of the paper is to provide the up-to-date data on the unmet needs of BPD patients and their families. A computerized search of the literature printed between January 1990 and May 2017 was conducted in PubMed, and additional papers were extracted using keywords "borderline personality disorder,"needs," "pharmacotherapy," "psychotherapy," "CBT," and "family" in various combinations. According to the eligibility criteria, 57 articles were chosen. Secondary articles from the reference lists of primarily identified papers have been selected for the eligibility and added to the first list (N=151). The results were divided into three categories: the needs connected with (1) the symptom control; (2) the treatment; (3) the quality of life. The needs connected with symptoms were described issues such as emotional needs, social interactions, self-harm, parasuicide, suicidality, comorbidity, mentalization, identity disturbance, moreover, barriers to treatment. The needs connected with the treatment described are focused on needs for early diagnosis, early intervention, holding environment, therapeutic relation, assertive community treatment, destigmatization, hospitalization, and primary care. The needs connected with the quality of life involve family needs, physical health, spiritual needs, advocacy needs, and needs for the separation-individuation. The part focused on implications for the treatment presented several treatment approaches, focusing mostly on the their basics and efficacy. Observing the patients' needs may be essential to the treatment of the individuals suffering from BPD. However, many needs remain unmet in the areas linked to medical, personal, and social
Ben-Porath, Denise D; Wisniewski, Lucene; Warren, Mark
2009-01-01
Studies have reported conflicting findings regarding the impact on treatment for eating disorder patients comorbidly diagnosed with borderline personality disorder. The current investigation sought to investigate whether individuals diagnosed with an eating disorder vs. those comorbidly diagnosed with an eating disorder and borderline personality disorder differ on measures of eating disorders symptoms and/or general distress over the course of treatment. In light of the success of DBT in treating individuals diagnosed with borderline personality disorder, a group known to have considerable difficulties in regulating affect, the current study also sought to examine whether these two groups would differ on expectancies to regulate affect over the course of DBT-informed treatment. Results indicated that while a comorbid diagnosis of borderline personality disorder did not impact eating disorder treatment outcomes, those comorbidly diagnosed did present overall with higher levels of general distress and psychological disturbance. With respect to affect regulation, results indicated that at the beginning of treatment, eating disordered individuals who carried a comorbid diagnosis of BPD were significantly less able to regulate affect than patients without a comorbid borderline diagnosis. However, at the end of treatment there was no statistically significant difference between the two groups. The role of affect regulation in treating eating disordered individuals with a comorbid borderline personality disorder diagnosis is discussed.
Working memory development in children with mild to borderline intellectual disabilities
Van der Molen, M. J.; Henry, L. A.; Van Luit, J. E H
2014-01-01
Background: The purpose of the current cross-sectional study was to examine the developmental progression in working memory (WM) between the ages of 9 and 16 years in a large sample of children with mild to borderline intellectual disabilities (MBID). Baddeley's influential WM model was used as a
Linguistic Factors Associated with Self-Inflicted Injury in Borderline Personality Disorder
Birdwell, Benjamin Park
2009-01-01
The present study builds on previous research, which demonstrated higher levels of depressive and interpersonal conflict language in first-person narrative accounts of nonsuicidal self-injury (NSSI) and suicide attempt (SA) in borderline personality disorder. The present study was designed to examine the semantic similarity of time-sequences…
The relationship between borderline personality disorder and bipolar disorder
Zimmerman, Mark; Morgan, Theresa A.
2013-01-01
It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We reviewed the most studied question on the relationship between BPD and bipolar disorder: their diagnostic concordance. Across studies, approximately 10% of patients with BPD had bi...
Implicit Self-Esteem in Borderline Personality and Depersonalization Disorder
Hedrick, Alexis N.; Berlin, Heather A.
2012-01-01
Self-identity is disrupted in people with borderline personality disorder (BPD) and depersonalization disorder (DPD), fluctuating with sudden shifts in affect in BPD and experienced as detached in DPD. Measures of implicit self-esteem, free from conscious control and presentation biases, may highlight how such disruptions of self-concept differentially affect these two populations on an unconscious level. We examined implicit self-esteem using the Implicit Association Test, along with measure...
Borderline features are associated with inaccurate trait self-estimations
Morey, Leslie C
2014-01-01
Background Many treatments for Borderline Personality Disorder (BPD) are based upon the hypothesis that gross distortion in perceptions and attributions related to self and others represent a core mechanism for the enduring difficulties displayed by such patients. However, available experimental evidence of such distortions provides equivocal results, with some studies suggesting that BPD is related to inaccuracy in such perceptions and others indicative of enhanced accuracy in some judgments...
Um caso de transtorno de personalidade borderline atendido em psicoterapia dinâmica breve
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Cunha Paulo Jannuzzi
2001-01-01
Full Text Available Trata-se de um caso de Transtorno de Personalidade Borderline, encaminhado para a área de Psicoterapia Dinâmica Breve (PDB do Centro de Psicologia Aplicada da UNESP - Bauru/SP. O foco delimitado consistiu em trabalhar as características depressivas do paciente, buscando ajudá-lo a elaborar o luto pela perda de sua mãe. A análise deste caso veio corroborar a hipótese de que pacientes com transtorno de personalidade borderline também podem ser beneficiados com a PDB. A peculiaridade desta modalidade de atendimento está relacionada ao estabelecimento de objetivos terapêuticos (foco condizentes com as reais possibilidades e limites de cada paciente.
International Nuclear Information System (INIS)
Ohkuma, Hiroki; Tanaka, Masahiko; Suzuki, Shigeharu; Kondoh, Izumi
2000-01-01
Chronic hydrocephalus after aneurysmal subarachnoid haemorrhage (SAH) is easily diagnosed in most cases. However, the diagnosis is sometimes difficult in borderline cases, in which (a) pathognomonic clinical deterioration due to hydrocephalus is masked by the neurological deficits caused in the acute stage of SAH and (b) ventricular enlargement is not so marked on CT scan. The purpose of this study was to investigate whether or not iodine-123 labelled N-isopropyl-p-iodoamphetamine ( 123 I-IMP) single-photon emission tomography (SPET) is of value for the early diagnosis of borderline chronic hydrocephalus after SAH. Fifteen patients who met the criteria of borderline chronic hydrocephalus were selected for the study, and underwent a shunt operation. The patients were divided into a shunt-effective group and a shunt-ineffective group according to neurological improvement after the shunt operation. 123 I-IMP SPET was performed in the acute stage of SAH, within 1 week before the shunt operation, and 2 weeks after the shunt operation. Regional cerebral blood flow was estimated by the 123 I-IMP autoradiographic method. Pre-shunting periventricular low-perfusion areas showed statistically significant differences between the two groups (P 123 I-IMP SPET can be used for both the early diagnosis of borderline chronic hydrocephalus after SAH and the prediction of shunt effectiveness. (orig.)
Elmquist, JoAnna; Shorey, Ryan C; Anderson, Scott; Stuart, Gregory L
2016-10-01
Extant literature has documented a significant relationship between borderline symptoms and substance use disorders. As supported in past work, there is a significant theoretical relationship between borderline symptoms and compulsive sexual behaviors because both disorders share common underlying behaviors and traits. There is no known research that has examined the empirical relationship between borderline symptoms and compulsive sexual behaviors in a population with substance use disorders. To fill this important gap in the literature, this relationship was examined in the current study. Medical records from 120 women admitted to a private, residential treatment program for substance use disorders were reviewed for the current study. Hierarchical multiple regression analysis demonstrated that borderline symptoms were significantly associated with compulsive sexual behaviors after controlling for alcohol use and problems, drug use and problems, age, and positive impression management. Results from this study provide potentially important research and clinical implications, which could ultimately aid treatment and reduce relapse. However, continued research is needed to further examine the relationship between symptoms and compulsive sexual behaviors. © 2016 Wiley Periodicals, Inc.
Bernard, Larry C
2013-08-01
Two studies investigate relationships between individual differences in motivation and borderline personality disorder, psychopathy, and maladjustment. Participants completed the Brief Assessment of Individual Motives 1--Revised, a measure of 15 putative evolved motives (i.e., "traits of action"). In Study 1, N = 147 adult participants also completed the Borderline Personality Questionnaire and Self-Report Psychopathy III Questionnaire (SRP III). In Study 2, N = 135 college age participants also completed the SRP III and the Counseling Center Assessment of Psychological Symptoms-62. Regression analyses suggested that individual differences in motivational traits account for moderate amounts of variance in measures of antisocial personality disorder, psychopathy, and maladjustment. They also suggested that lower motivation to engage in cooperative behaviors (e.g., sharing resources and forming coalitions) is related to impaired interpersonal relationships and maladjustment.
Attentional Bias for Emotional Stimuli in Borderline Personality Disorder : A Meta-Analysis
Kaiser, D.; Jacob, G.A.; Domes, G.; Arntz, A.
2016-01-01
Background: In borderline personality disorder (BPD), attentional bias (AB) to emotional stimuli may be a core component in disorder pathogenesis and maintenance. Sampling: 11 emotional Stroop task (EST) studies with 244 BPD patients, 255 nonpatients (NPs) and 95 clinical controls and 4 visual
Hughes, Amy E.; Crowell, Sheila E.; Uyeji, Lauren; Coan, James A.
2012-01-01
Theoretical and empirical research has linked poor emotion regulation abilities with dysfunctional frontolimbic circuitry. Consistent with this, research on borderline personality disorder (BPD) finds that frontolimbic dysfunction is a predominant neural substrate underlying the disorder. Emotion regulation is profoundly compromised in BPD.…
Vuijk, P. J.; Hartman, E.; Scherder, E.; Visscher, C.
2010-01-01
Background There is a relatively small body of research on the motor performance of children with mild intellectual disabilities (MID) and borderline intellectual functioning (BIF). Adequate levels of motor skills may contribute to lifelong enjoyment of physical activity, participation in sports and
Brandt, L M
1983-01-01
This chapter is an attempt to offer a model for therapeutic work with borderline patients that is based on the structure and content of the fairy tale. It views the fairy tale as both descriptive in its echoing of developmental struggles of childhood and integrative in providing a model for resolution of these conflicts. Clare's use of the fairy tale offers confirmation of theoretical notions which place the etiology of borderline pathology in early developmental failures and a clue to the therapeutic work with borderline patients. While the childhood route of the fairy tale may no longer be available to most, its subtle mirroring of the separation-individuation crisis and gradual, growthful steps toward integration of both the external and the internal worlds offer an exquisite model for the work of psychotherapy. "Once a king in Narnia , always a king in Narnia . But don't go trying to use the same route twice. . ." (Lewis 1950, p. 186).
Antisocial Traits as Modifiers of Treatment Response in Borderline Inpatients
CLARKIN, JOHN F.; HULL, JAMES; YEOMANS, FRANK; KAKUMA, TATSUYUKI; CANTOR, JENNIFER
1994-01-01
The relationship of antisocial traits to treatment response in 35 female inpatients with borderline personality disorder was studied. Antisocial traits were measured with the Personality Assessment Inventory. Treatment response was measured by weekly ratings on the Symptom Checklist-90—Revised over 25 weeks of hospitalization. Treatment course was found to be significantly associated with the level of antisocial behavior reported at admission.
Costantini, Giulio; De Panfilis, Chiara
2017-01-01
We argue that the series of traits characterizing Borderline Personality Disorder samples do not weigh equally. In this regard, we believe that network approaches employed recently in Personality and Psychopathology research to provide information about the differential relationships among symptoms would be useful to test our claim. To our knowledge, this approach has never been applied to personality disorders. We applied network analysis to the nine Borderline Personality Disorder traits to explore their relationships in two samples drawn from university students and clinical populations (N = 1317 and N = 96, respectively). We used the Fused Graphical Lasso, a technique that allows estimating networks from different populations separately while considering their similarities and differences. Moreover, we examined centrality indices to determine the relative importance of each symptom in each network. The general structure of the two networks was very similar in the two samples, although some differences were detected. Results indicate the centrality of mainly affective instability, identity, and effort to avoid abandonment aspects in Borderline Personality Disorder. Results are consistent with the new DSM Alternative Model for Personality Disorders. We discuss them in terms of implications for therapy. PMID:29040324
Van der Molen, M J; Van Luit, J E H; Van der Molen, M W; Klugkist, I; Jongmans, M J
2010-05-01
The goal of this study is to evaluate the effectiveness of a computerised working memory (WM) training on memory, response inhibition, fluid intelligence, scholastic abilities and the recall of stories in adolescents with mild to borderline intellectual disabilities attending special education. A total of 95 adolescents with mild to borderline intellectual disabilities were randomly assigned to either a training adaptive to each child's progress in WM, a non-adaptive WM training, or to a control group. Verbal short-term memory (STM) improved significantly from pre- to post-testing in the group who received the adaptive training compared with the control group. The beneficial effect on verbal STM was maintained at follow-up and other effects became clear at that time as well. Both the adaptive and non-adaptive WM training led to higher scores at follow-up than at post-intervention on visual STM, arithmetic and story recall compared with the control condition. In addition, the non-adaptive training group showed a significant increase in visuo-spatial WM capacity. The current study provides the first demonstration that WM can be effectively trained in adolescents with mild to borderline intellectual disabilities.
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Marcos Hirata Soares
2010-01-01
Full Text Available OBJETIVO: Este estudo objetivou revisar, na literatura, os critérios diagnósticos e as intervenções nos transtornos de personalidade do tipo Antissocial e Borderline. MÉTODOS: Uma pesquisa manual foi realizada no acervo bibliográfico particular do autor, selecionando-se 12 referências; outra pesquisa sistematizada foi desenvolvida no período de 1990 a 2008, no mês de janeiro de 2009, na Biblioteca Virtual em Saúde, selecionando-se 23 artigos. RESULTADOS: Os achados indicaram duas abordagens - uma que classifica como doença, mas que necessita de revisão dos critérios diagnósticos e avaliação e a segunda, que classifica como problemas morais. CONCLUSÃO: Independente da abordagem é necessário que o enfermeiro aprimore seu conhecimento e compreenda a dificuldade desse sujeito ao relacionar-se adequadamente com outras pessoas; assim, é de fundamental importância que os membros da equipe de saúde analisem seus sentimentos, atitudes e reações em relação ao comportamento do cliente, uma vez que a relação com esta clientela é considerada uma das mais complexas em saúde mental.OBJETIVO: Este estudio tuvo por objetivo revisar, en la literatura, los criterios diagnósticos y las intervenciones en los trastornos de personalidad del tipo Anti-social y Borderline. MÉTODOS: Se trata de una investigación manual que fue realizada en el acervo bibliográfico particular del autor, seleccionando 12 referencias; otra investigación sistematizada fue desarrollada en el período de 1990 a 2008, en el mes de enero de 2009, en la Biblioteca Virtual en Salud, seleccionándose 23 artículos. RESULTADOS: Los hallazgos indicaron dos abordajes - uno que los clasifica como enfermedad, pero que necesita de revisión de los criterios diagnósticos y de evaluación, y la segunda, que los clasifica como problemas morales. CONCLUSIÓN: Independientemente del abordaje es necesario que el enfermero perfeccione su conocimiento y comprenda la dificultad
Borderline personality disorder in cultural context: commentary on Paris.
Miller, S G
1996-01-01
Paris suggests that some cultures provide protective factors that can suppress the emergence of borderline personality disorder (BPD). Yet all cultures contain some individuals who perceive themselves as unable to meet what is expected of them, and the resultant distress is expressed through a variety of "ethnic" disorders such as susto or nervios. When viewed in this context, BPD is similar to these disorders, notably in the perceived sense of social failure, marginality and powerlessness.
What Works in the Treatment of Borderline Personality Disorder
Choi-Kain, Lois W.; Finch, Ellen F.; Masland, Sara R.; Jenkins, James A.; Unruh, Brandon T.
2017-01-01
Purpose of the Review This review summarizes advances in treatments for adults with borderline personality disorder (BPD) in the last 5?years. Recent Findings Evidence-based advances in the treatment of BPD include a delineation of generalist models of care in contrast to specialist treatments, identification of essential effective elements of dialectical behavioral therapy (DBT), and the adaptation of DBT treatment to manage post-traumatic stress disorder (PTSD) and BPD. Studies on pharmacol...
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Nahid Momeni Safarabad
2018-02-01
Full Text Available Objective: This study aimed at reporting the effect of the 3-phase model of eye movement desensitization and reprocessing in the treatment of a patient with borderline personality disorder.Method: A 33-year-old female, who met the DSM-IV-TR criteria for borderline personality disorder, received a 20-session therapy based on the 3-phase model of eye movement desensitization and reprocessing. Borderline Personality Disorder Checklist (BPD-Checklist, Dissociative Experience Scale (DES-II, Beck Depression Inventory-II-second edition (BDI-II, and Anxiety Inventory (BAI were filled out by the patient at all treatment phases and at the 3- month follow- up.Results: According to the obtained results, the patient’s pretest scores in all research tools were 161, 44, 37, and 38 for BPD-Checklist, DES-II, BDI-II, and BAI, respectively. After treatment, these scores decreased significantly (69, 14, 6 and 10 respectively. So, the patient exhibited improvement in borderline personality disorder, dissociative, depression and anxiety symptoms, which were maintained after the 3-month follow-up.Conclusion: The results supported the positive effect of phasic model of eye movement desensitization and reprocessing on borderline personality disorder.
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Huihui Yang
2018-04-01
Full Text Available The brief version of the Borderline Symptom List (BSL-23 is a self-rated scale developed from the initial 95-item version of Borderline Symptom List (BSL-95. The current study aimed to evaluate the psychometric properties of the Chinese version of the BSL-23. A total of 570 undergraduate students and 323 clinical patients completed the BSL-23, the borderline subscale of the Personality Diagnostic Questionnaire (PDQ-4+, the Center for Epidemiologic Studies Depression Scale (CES-D, the Barratt Impulsiveness Scale, 11th version (BIS-11, the Childhood Trauma Questionnaire (CTQ and the Attachment Style Questionnaire (ASQ. A Confirmatory Factor Analysis (CFA was conducted to test the one-factor structure of the BSL-23. Cronbach’s alpha, Omega coefficient, Split-Half coefficient, Mean Inter-Item Correlation (MIC and test-retest reliability were also measured. The correlations between the BSL-23 and other psychological variables were used to assess criterion-related validity and convergent validity. Participants who scored ≥ 5 on the borderline subscale of the PDQ-4+ were placed into the borderline personality disorder (BPD screening-positive group, while the others were placed into the screening-negative group. Independent sample t-tests were performed to examine the differences in BSL-23 scores between the BPD screening-positive group and the BPD screening-negative group. The CFA results supported the one-factor structure of the BSL-23 in both samples. The internal consistency was high both in the undergraduate sample (Cronbach’s α = 0.93, Omega = 0.95, Split-Half coefficient = 0.89, MIC = 0.38 and the clinical sample (Cronbach’s α = 0.97, Omega = 0.97, Split-Half coefficient = 0.96, MIC = 0.56. The test-retest reliability within 2 weeks was 0.62. The BSL-23 displayed moderate to high correlations with the PDQ-4+-Borderline subscale, the CES-D, the BIS-11, the CTQ and the ASQ (r = 0.35 – 0.70. In addition, the BSL-23 discriminated between
Yang, Huihui; Lei, Xiaoxia; Zhong, Mingtian; Zhou, Qi; Ling, Yu; Jungkunz, Martin; Yi, Jinyao
2018-01-01
The brief version of the Borderline Symptom List (BSL-23) is a self-rated scale developed from the initial 95-item version of Borderline Symptom List (BSL-95). The current study aimed to evaluate the psychometric properties of the Chinese version of the BSL-23. A total of 570 undergraduate students and 323 clinical patients completed the BSL-23, the borderline subscale of the Personality Diagnostic Questionnaire (PDQ-4+), the Center for Epidemiologic Studies Depression Scale (CES-D), the Barratt Impulsiveness Scale, 11th version (BIS-11), the Childhood Trauma Questionnaire (CTQ) and the Attachment Style Questionnaire (ASQ). A Confirmatory Factor Analysis (CFA) was conducted to test the one-factor structure of the BSL-23. Cronbach's alpha, Omega coefficient, Split-Half coefficient, Mean Inter-Item Correlation (M IC ) and test-retest reliability were also measured. The correlations between the BSL-23 and other psychological variables were used to assess criterion-related validity and convergent validity. Participants who scored ≥ 5 on the borderline subscale of the PDQ-4+ were placed into the borderline personality disorder (BPD) screening-positive group, while the others were placed into the screening-negative group. Independent sample t -tests were performed to examine the differences in BSL-23 scores between the BPD screening-positive group and the BPD screening-negative group. The CFA results supported the one-factor structure of the BSL-23 in both samples. The internal consistency was high both in the undergraduate sample (Cronbach's α = 0.93, Omega = 0.95, Split-Half coefficient = 0.89, M IC = 0.38) and the clinical sample (Cronbach's α = 0.97, Omega = 0.97, Split-Half coefficient = 0.96, M IC = 0.56). The test-retest reliability within 2 weeks was 0.62. The BSL-23 displayed moderate to high correlations with the PDQ-4+-Borderline subscale, the CES-D, the BIS-11, the CTQ and the ASQ ( r = 0.35 - 0.70). In addition, the BSL-23 discriminated between the BPD
Preventive Psychiatric Admission for Patients With Borderline Personality Disorder: A Pilot Study
Koekkoek, B.W.; Snoek, R. van der; Oosterwijk, K.; Meijel, B.K.G. van
2010-01-01
PURPOSE. The purpose of this study was to establish the preliminary effects of preventive psychiatric admission of patients with severe borderline personality disorder (BPD) on the rate of agreement over treatment, patient service use, and patient views on the intervention. DESIGN AND METHODS. A
Adolescent Disruptive Behavior and Borderline Personality Disorder Symptoms in Young Adult Men
Burke, Jeffrey D.; Stepp, Stephanie D.
2012-01-01
Very few studies have prospective information, especially regarding males, on the prediction of Borderline Personality Disorder (BPD) in adulthood from psychiatric disorders in childhood. Certain childhood disorders, however, have notably similar features in common with BPD. In particular, the affective dysfunction, hostility and interpersonal…
Stepp, Stephanie D.; Smith, Tiffany D.; Morse, Jennifer Q.; Hallquist, Michael N.; Pilkonis, Paul A.
2012-01-01
This study examined the prospective relationships among borderline personality disorder (BPD) symptoms, interpersonal problems, and types of aggressive behaviors (i.e., experiencing psychological and physical victimization and perpetrating psychological and physical aggression) in a psychiatric sample (N = 139) over the course of 2 years. We…
Observer-rated coping associated with borderline personality disorder: an exploratory study.
Kramer, Ueli
2014-01-01
Little is known about coping specificities, as operationalization of the concept of affect regulation, in borderline personality disorder (BPD). It is most important to take into account methodological criticisms addressed to the self-report questionnaire approach and to compare BPD coping specificities to the ones of neighbouring diagnostic categories, such as bipolar disorder (BD). The present exploratory study compared the coping profiles of N = 25 patients presenting BPD to those of N = 25 patients presenting BD and to those of N = 25 healthy controls. All participants underwent a clinical interview that was transcribed and rated using the Coping Patterns observer-rater system. Results partially confirmed study hypotheses and showed differences between BPD patients and healthy controls in all coping domains (competence, resources and autonomy), whereas the only coping domain presenting a BPD-specific lack of skills, compared with the BD patients, was autonomy, a set of coping strategies facing stress appraised as challenge. These coping processes were linked to general and BPD symptomatology. These results extend conclusions of earlier studies on affect regulation processes in BPD and bear important clinical implications, in the context of dialectical behavior therapy and other therapeutic approaches. Limitations of this exploratory study, such as the small sample size, are acknowledged. Coping can be reliably assessed in the narrative process in an non-structured interview frame. Patients with borderline personality disorder present with a specific lack of skills in affect regulation related to autonomy issues, compared to patients with bipolar disorder and healthy controls. Lack of skills in accommodation to distressing emotions in borderline personality disorder is related to symptom gravity and may be treated using radical acceptance strategies. Copyright © 2012 John Wiley & Sons, Ltd.
Working Memory Development in Children with Mild to Borderline Intellectual Disabilities
Van der Molen, M. J.; Henry, L. A.; Van Luit, J. E. H.
2014-01-01
Background: The purpose of the current cross-sectional study was to examine the developmental progression in working memory (WM) between the ages of 9 and 16 years in a large sample of children with mild to borderline intellectual disabilities (MBID). Baddeley's influential WM model was used as a theoretical framework. Furthermore, the…
Dickens, Geoffrey L; Lamont, Emma; Gray, Sarah
2016-07-01
To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses' attitudes have had limited success. Systematic, integrative literature review. Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses' attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Forty studies were included. Only one used direct observation of clinical practice. Nurses' knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals' and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Mental health nurses' responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working
Compulsive buying and borderline personality symptomatology.
Sansone, Randy A; Chang, Joy; Jewell, Bryan; Sellbom, Martin; Bidwell, Mark
2013-04-01
In this study, the authors investigated the relationship between compulsive buying and borderline personality disorder (BPD) symptomatology--two disorders possibly linked through impulsivity. Using a survey methodology in a cross-sectional consecutive sample of nonemergent female outpatients from an obstetrics/gynecology clinic, the authors assessed compulsive buying with the compulsive buying scale (CBS) and BPD symptomatology through the BPD scale of the personality diagnostic questionnaire-4 (PDQ-4) and the self-harm Inventory (SHI). In this sample, 8% of Caucasian women and 9% of African-American women scored positively for compulsive buying. The correlations between scores on the CBS and the PDQ-4 and SHI were 0.43 and 0.41, respectively-both statistically significant at the p buying and BPD, particularly among African-American women.
EEG Asymmetry in Borderline Personality Disorder and Depression Following Rejection
Beeney, Joseph E.; Levy, Kenneth N.; Gatzke-Kopp, Lisa M.; Hallquist, Michael N.
2013-01-01
Borderline personality disorder (BPD) and major depressive disorder (MDD) share numerous features including dysphoric affect, irritability, suicidality, and a heightened sensitivity to perceived interpersonal rejection. However, these disorders are associated with divergent profiles of reactivity to rejection; individuals with MDD are more likely to respond with withdrawal and isolation, and those with BPD appear to respond with increased approach behaviors and greater hostility. Potential me...
Hermens, M.L.M.; van Splunteren, P.T.; van den Bosch, A.; Verheul, R.
2011-01-01
Objective: This study determined the gap between actual care and optimal care (recommended in the clinical guideline) for patients with borderline personality disorder in the Netherlands. Factors that affected guideline implementation were identified. Methods: Ten specialized mental health
Beyond Borderline Personality Disorder: Dialectical Behavior Therapy in a College Counseling Center
Panepinto, Amberly R.; Uschold, Carissa C.; Olandese, Michelle; Linn, Braden K.
2015-01-01
The study investigated the efficacy of a dialectical behavior therapy (DBT) program with a general college counseling center population, not limited to students diagnosed with borderline personality disorder. A review of records of 64 students found that obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, paranoia,…
Rose, E.; Bramham, J.; Young, S.; Paliokostas, E.; Xenitidis, K.
2009-01-01
This study aimed to characterise the neuropsychological functioning of adults with comorbid attention deficit hyperactivity disorder (ADHD) and intellectual disability. Individuals with ADHD and mild-borderline range intelligence (N=59) and individuals with ADHD and normal intellectual functioning (N=95) were compared on attentional and response…
Brinkley, Dawn Y; Ackerman, Robert A; Ehrenreich, Samuel E; Underwood, Marion K
2017-05-01
This research examined adolescents' written text messages with sexual content to investigate how sexting relates to sexual activity and borderline personality features. Participants (N = 181, 85 girls) completed a measure of borderline personality features prior to 10 th grade and were subsequently given smartphones configured to capture the content of their text messages. Four days of text messaging were micro-coded for content related to sex. Following 12 th grade, participants reported on their sexual activity and again completed a measure of borderline personality features. Results showed that engaging in sexting at age 16 was associated with reporting an early sexual debut, having sexual intercourse experience, having multiple sex partners, and engaging in drug use in combination with sexual activity two years later. Girls engaging in sex talk were more likely to have had sexual intercourse by age 18. Text messaging about hypothetical sex in grade 10 also predicted borderline personality features at age 18. These findings suggest that sending text messages with sexual content poses risks for adolescents. Programs to prevent risky sexual activity and to promote psychological health could be enhanced by teaching adolescents to use digital communication responsibly.
Brinkley, Dawn Y.; Ackerman, Robert A.; Ehrenreich, Samuel E.; Underwood, Marion K.
2017-01-01
This research examined adolescents’ written text messages with sexual content to investigate how sexting relates to sexual activity and borderline personality features. Participants (N = 181, 85 girls) completed a measure of borderline personality features prior to 10th grade and were subsequently given smartphones configured to capture the content of their text messages. Four days of text messaging were micro-coded for content related to sex. Following 12th grade, participants reported on their sexual activity and again completed a measure of borderline personality features. Results showed that engaging in sexting at age 16 was associated with reporting an early sexual debut, having sexual intercourse experience, having multiple sex partners, and engaging in drug use in combination with sexual activity two years later. Girls engaging in sex talk were more likely to have had sexual intercourse by age 18. Text messaging about hypothetical sex in grade 10 also predicted borderline personality features at age 18. These findings suggest that sending text messages with sexual content poses risks for adolescents. Programs to prevent risky sexual activity and to promote psychological health could be enhanced by teaching adolescents to use digital communication responsibly. PMID:28824224
Parenting of children with borderline to mild intellectual disability
Kleefman, Marijke
2015-01-01
Raising children with borderline to mild intellectual disability (BMID) may cause parenting stress, especially when the child with BMID has psychosocial problems. To improve support, it is important to have a better understanding of the effectiveness of interventions to reduce problems in raising such children and of the problems these parents are dealing with. Therefore, the aim of this thesis was to assess the effectiveness of the parenting support program Stepping Stones Triple P (SSTP). F...
Sollberger, Daniel; Gremaud-Heitz, Daniela; Riemenschneider, Anke; Agarwalla, Puspa; Benecke, Cord; Schwald, Oliver; Küchenhoff, Joachim; Walter, Marc; Dammann, Gerhard
2015-01-01
Patients with borderline personality disorder (BPD) show various psychopathological symptoms and suffer especially from disturbance in their identity. The purpose of the study was to investigate changes-particularly in affective BPD symptoms and identity diffusion-during a structured, disorder-specific inpatient treatment (DST) that combined a psychodynamic transference-focused psychotherapy approach with modules of dialectical behavioural skills training. In a prospective, two-group comparison trial, 44 patients with BPD were assessed with questionnaires addressing identity diffusion and state, as well as trait affective psychopathology, before and after 12 weeks of inpatient treatment. Thirty-two patients received DST, whereas 12 patients were given inpatient treatment-as-usual (TAU). The patients were allocated in a non-random procedure for two groups, in order of admission and availability of treatment options in the DST unit. In the pre-post-comparison, the DST group showed a significant decrease in identity diffusion (p borderline symptomatology and in the personality structure feature of identity diffusion. This highlights the significance of a short-term specific inpatient therapy for BPD. A structured, disorder-specific inpatient treatment of patients diagnosed with borderline personality disorder (BPD) combined a psychodynamic transference-focused psychotherapy treatment approach (focusing on pathological features in personality organization, particularly on non-integrated images of self and others) with modules of dialectical behavioural skills training. This treatment is associated with a decrease in identity diffusion of these patients after 12 weeks of treatment. The treatment is also related to a significant decrease in borderline typical psychopathological symptoms such as depressive symptoms, as well as an improvement in state anger. The outcomes of this structured, disorder-specific inpatient treatment of severely ill BPD patients indicated
Adolescência e organização de personalidade borderline: caracterização dos vínculos afetivos
Directory of Open Access Journals (Sweden)
Aline Bedin Jordão
2010-12-01
Full Text Available A demanda clínica atual inclui um número significativo de pacientes borderlines. Esse estudo buscou realizar uma revisão de literatura abrangente e não sistemática sobre os vínculos afetivos de adolescentes com indicadores de personalidade borderline. Foram consultadas bases de dados nacionais e internacionais, privilegiando-se publicações a partir de 1995, no referencial psicanalítico. Os estudos encontrados foram discutidos em três grupos: adolescência e cultura contemporânea, características da organização borderline na adolescência e vínculos afetivos desses adolescentes. Discute-se a importância dos vínculos de apego inseguro, a questão da psicopatologia materna e o papel das experiências traumáticas na história de vida desses pacientes.
Fassino, Secondo; Amianto, Federico; Gastaldi, Filippo; Abbate-Daga, Giovanni; Brambilla, Francesca; Leombruni, Paolo
2009-01-30
Family environment is a pathogenic factor of borderline personality disorder (BPD). However, the personality traits of patients with BPD and their parents have never been assessed using the same instrument and then examined for relationships. In the present study, we explored the temperament and character traits of BPD patients and their parents to investigate possible interactions. In total, 56 patients with BPD and their parents were evaluated with the Temperament and Character Inventory (TCI) and compared with 53 control families. Discriminant and correlation analyses indicated that subjects with BPD displayed higher levels of novelty seeking, harm avoidance, and self-transcendence and lower levels of self-directedness than control subjects. Their fathers displayed higher levels of novelty seeking and lower levels of persistence and self-directedness, and their mothers displayed lower levels of self-directedness compared with levels in control parents. In BPD families, temperament and character traits displayed high levels of discriminatory power. Novelty seeking in offspring with borderline personality disorder was significantly correlated with their mothers' novelty seeking and their fathers' self-transcendence. Self-directedness in borderline offspring was significantly correlated with both their mothers' and fathers' novelty seeking, and their self-transcendence was significantly correlated with their mothers' novelty seeking and harm avoidance. The different correlational pattern for borderline and control families is discussed. Characteristic personality patterns were found in BPD offspring and in both parents. The relationship between personality traits of borderline offspring and those of their parents may be related to both genetic transmission and family dynamics. Ramifications for treatment are discussed.
Wieland, Jannelien; Kapitein-de Haan, Sara; Zitman, Frans G
2014-04-01
In the Netherlands, patients with borderline intellectual functioning are eligible for specialized mental health care. This offers the unique possibility to examine the mix of psychiatric disorders in patients who, in other countries, are treated in regular outpatient mental health care clinics. Our study sought to examine the rates of all main Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, Axis I psychiatric diagnoses in outpatients with borderline intellectual functioning of 2 specialized regional psychiatric outpatient departments and to compare these with rates of the same disorders in outpatients from regular mental health care (RMHC) and outpatients with mild intellectual disabilities (IDs). Our study was a cross-sectional, anonymized medical chart review. All participants were patients from the Dutch regional mental health care provider Rivierduinen. Diagnoses of patients with borderline intellectual functioning (borderline intellectual functioning group; n = 235) were compared with diagnoses of patients from RMHC (RMHC group; n = 1026) and patients with mild ID (mild ID group; n = 152). Compared with the RMHC group, psychotic and major depressive disorders were less common in the borderline intellectual functioning group, while posttraumatic stress disorder and V codes were more common. Compared with the mild ID group, psychotic disorders were significantly less common. Mental health problems in people with borderline intellectual functioning may not be well addressed in general psychiatry, or by standard psychiatry for patients with ID. Specific attention to this group in clinical practice and research may be warranted lest they fall between 2 stools.
Duijvenbode, N. van; Didden, H.C.M.; Nagel, J.E.L. van der; Korzilius, H.P.L.M.; Engels, R.C.M.E.
2018-01-01
We examined cognitive deficits in problematic drinkers with and without mild to borderline intellectual disability (MBID). Problematic drinkers were expected to show a significantly lower estimated performance IQ (PIQ), but not a lower estimated verbal IQ (VIQ), compared to light drinkers.
Weinstein, Yana; Gleason, Marci E. J.; Oltmanns, Thomas F.
2012-01-01
We examined the relationship between personality pathology and the frequency of self-reported psychological and physical partner aggression in a community sample of 872 adults aged 55–64. Previous research suggests that antisocial and borderline personality disorder (PD) symptoms are associated with partner aggression. Controlling for gender, education, alcohol dependence, and other personality pathology, we found that borderline PD symptoms, which include abandonment fears, unstable identity, and affective instability, were significantly related to the frequency of self-reported aggression towards one’s partner. This relationship was observed regardless of whether the participant’s personality was described by a clinical interviewer, the participant themselves, or an informant chosen by the participant. Further, the relationship between borderline PD symptoms and self-reported partner aggression was moderated by gender such that women were driving the association. Conversely, antisocial PD symptoms, which include deceitfulness, irresponsibility, disregard for rules, and lack of remorse did not significantly account for variance in self-reported partner aggression. PMID:22732005
Weinstein, Yana; Gleason, Marci E J; Oltmanns, Thomas F
2012-08-01
We examined the relationship between personality pathology and the frequency of self-reported psychological and physical partner aggression in a community sample of 872 adults aged 55-64. Previous research suggests that antisocial and borderline personality disorder (PD) symptoms are associated with partner aggression. Controlling for gender, education, alcohol dependence, and other personality pathology, we found that borderline PD symptoms, which include abandonment fears, unstable identity, and affective instability, were significantly related to the frequency of self-reported aggression toward one's partner. This relationship was observed regardless of whether the participant's personality was described by a clinical interviewer, the participant themselves, or an informant chosen by the participant. Further, the relationship between borderline PD symptoms and self-reported partner aggression was moderated by gender such that women were driving the association. Conversely, antisocial PD symptoms, which include deceitfulness, irresponsibility, disregard for rules, and lack of remorse did not significantly account for variance in self-reported partner aggression. PsycINFO Database Record (c) 2012 APA, all rights reserved.
Vuijk, P. J.; Hartman, E.; Scherder, E.; Visscher, C.
2010-01-01
Background: There is a relatively small body of research on the motor performance of children with mild intellectual disabilities (MID) and borderline intellectual functioning (BIF). Adequate levels of motor skills may contribute to lifelong enjoyment of physical activity, participation in sports and healthy lifestyles. The present study compares…
[Integrative approach in the psychotherapy of borderline personality disorder].
Kuritárné Szabó, Ildikó
2012-01-01
In the last 20 years six psychotherapy methods have been developed specifically for borderline personality disorder. Solid RCT evidences suggests the efficacy of all the methods. Roughly equivalent improvement was obtained from the different types of psychotherapies. Today we have reached a new phase of the borderline "psychotherapy boom", the integrative approach. According to the integrative treatment advocates we should not choose among these effective treatments but we can incorporate in the therapy all the components that work. The integrative approach uses general factors common to all effective therapies, combined with specific treatment techniques taken from different therapies in order to treat the given patient's psychopathology. These common factors are: coherent framework; attention to strategies for building strong positive alliance and maintaining patient motivation; creating a safe and structured therapeutic environment; clear treatment frame; transparency of the goals and roles; focus upon presenting problems; higher level therapeutic activity; here-and-now focus; and facilitating self-reflection. Treatment focuses on change while maintaining a validating and supportive stance. General strategies can be supplemented by more specific techniques such as cognitive-behavioral interventions for reducing maladaptive behavior, training for developing emotion regulation skills and interpersonal skills coming from dialectical behavior therapy. Methods drawn from psychodynamic approaches can be used for the modification of underlying interpersonal cognitive-emotional schemas.
Sempértegui, Gabriela A; Karreman, Annemiek; Arntz, Arnoud; Bekker, Marrie H J
2013-04-01
Borderline personality disorder is a serious psychiatric disorder for which the effectiveness of the current pharmacotherapeutical and psychotherapeutic approaches has shown to be limited. In the last decades, schema therapy has increased in popularity as a treatment of borderline personality disorder; however, systematic evaluation of both effectiveness and empirical evidence for the theoretical background of the therapy is limited. This literature review comprehensively evaluates the current empirical status of schema therapy for borderline personality disorder. We first described the theoretical framework and reviewed its empirical foundations. Next, we examined the evidence regarding effectiveness and implementability. We found evidence for a considerable number of elements of Young's schema model; however, the strength of the results varies and there are also mixed results and some empirical blanks in the theory. The number of studies on effectiveness is small, but reviewed findings suggest that schema therapy is a promising treatment. In Western-European societies, the therapy could be readily implemented as a cost-effective strategy with positive economic consequences. Copyright © 2012 Elsevier Ltd. All rights reserved.
Dysfunctional Affect Regulation : in borderline personality disorder and somatoform disorder
van Dijke, A.
2011-01-01
The aim of this dissertation was to provide a systematic exploration of the nature and distribution of dysfunctional affect regulation, its associated phenomena, and retrospectively reported potentially traumatizing events in 475 patients diagnosed with borderline personality disorder (BPD), somatoform disorder (SoD), comorbid BPD+SoD, and a psychiatric comparison group (PC) to provide a baseline against which to compare the hypothesized elevations in dysfunctional self and affect regulation....
Directory of Open Access Journals (Sweden)
Tamara J Somers
2008-01-01
Full Text Available OBJECTIVE: There is limited information about how morbidly obese osteoarthritis (OA patients cope with the pain they experience. Pain catastrophizing is an important predictor of pain and adjustment in persons with persistent pain. This may be particularly relevant in the morbidly obese (body mass index [BMI] of 40 kg/m2 or greater OA population at risk for increased pain. The present study first examined whether borderline morbidly obese and morbidly obese OA patients report higher levels of pain catastrophizing than a sample of OA patients in the overweight and obese category (BMI between 25 kg/m2 and 34 kg/m2. Next, it examined how pain catastrophizing is related to important indexes of pain and adjustment in borderline morbidly obese and morbidly obese OA patients.
Navarro Haro, María Vicenta; Hoffman, Hunter G.; García Palacios, Azucena; Sampaio, Mariana; Alhalali, Wadee; Hall, Karyn; Linehan, Marsha
2016-01-01
Borderline personality disorder (BPD) is a severe mental disorder characterized by a dysfunctional pattern of affective instability, impulsivity, and disturbed interpersonal relationships. Dialectical Behavior Therapy (DBT®) is the most effective treatment for Borderline Personality Disorder, but demand for DBT® far exceeds existing clinical resources. Most patients with BPD never receive DBT®. Incorporating computer technology into the DBT® could help increase dissemination. Immersive Virtua...
Maria V Nararro-Haro; Hunter G. Hoffman; Hunter G. Hoffman; Hunter G. Hoffman; Azucena Garcia-Palacios; Azucena Garcia-Palacios; Mariana Sampaio; Wadee Alhalabi; Wadee Alhalabi; Karyn Hall; Marsha Linehan
2016-01-01
Borderline personality disorder (BPD) is a severe mental disorder characterized by a dysfunctional pattern of affective instability, impulsivity, and disturbed interpersonal relationships. Dialectical Behavior Therapy (DBT®) is the most effective treatment for Borderline Personality Disorder, but demand for DBT® far exceeds existing clinical resources. Most patients with BPD never receive DBT®. Incorporating computer technology into the DBT® could help increase dissemination. Immersive Vir...
Nararro-Haro, Maria V.; Hoffman, Hunter G.; Garcia-Palacios, Azucena; Sampaio, Mariana; Alhalabi, Wadee; Hall, Karyn; Linehan, Marsha
2016-01-01
Borderline personality disorder (BPD) is a severe mental disorder characterized by a dysfunctional pattern of affective instability, impulsivity, and disturbed interpersonal relationships. Dialectical Behavior Therapy (DBT®) is the most effective treatment for Borderline Personality Disorder, but demand for DBT® far exceeds existing clinical resources. Most patients with BPD never receive DBT®. Incorporating computer technology into the DBT® could help increase dissemination. Immersive Virtua...
A meta-analysis on the association between emotional awareness and borderline personality pathology
Derks, Youri P.M.J.; Westerhof, Gerben J.; Bohlmeijer, Ernst T.
2017-01-01
Theories on borderline personality pathology (BPP) suggest that characteristic emotional dysregulation is due to low levels of emotional awareness or alexithymia. This study is the first meta-analysis to systematically review and analyze the evidence. A systematic search of the literature was
A meta-analysis on the association between emotional awareness and borderline personality pathology.
Derks, Youri Petrus Marinus Johannes; Westerhof, Gerben Johan; Bohlmeijer, Ernst Thomas
2017-01-01
Theories on borderline personality pathology (BPP) suggest that characteristic emotional dysregulation is due to low levels of emotional awareness or alexithymia. This study is the first meta-analysis to systematically review and analyze the evidence. A systematic search of the literature was
Shorey, Ryan C.; Anderson, Scott; Stuart, Gregory L.
2014-01-01
Individuals with substance use disorders are more likely to have antisocial and borderline personality disorder than non-substance abusers. Recently, research has examined the relations between early maladaptive schemas and personality disorders, as early maladaptive schemas are believed to underlie personality disorders. However, there is a dearth of research on the relations between early maladaptive schemas and personality disorders among individuals seeking treatment for substance abuse. The current study examined the relations among early maladaptive schemas and antisocial and borderline personality within in a sample of men seeking substance abuse treatment (n = 98). Results demonstrated that early maladaptive schema domains were associated with antisocial and borderline personality symptoms. Implications of these findings for substance use treatment and research are discussed. PMID:23650153
International Nuclear Information System (INIS)
Matsumoto, Mariko; Hoshino, Tomoyuki; Kikura, Mikino; Kikawada, Keiko; Kikawada, Toru
2005-01-01
The objective of this study was to examine measurements of the vestibular aqueduct on axial CT figures and to examine the cases with borderline EVA. The width of the vestibular aqueduct was measured in two places, the midpoint of the duct and the external aperture in the posterior cranial fossa. Criteria was as follow: Enlargement; ≥1.5 mm at the midpoint, ≥2 mm at the aperture, Borderline; 1-1.4 mm at the midpoint, 1.5-1.9 mm at the aperture. Three hundred forty-five cases with CT scans of the temporal bones taken during July 2003 to June 2004 in the secondary ENT referral center. Those patients include sensorinearal, mixed or conductive deafness, vertigo, ear infections and other ear diseases. Enlarged vestibular aqueduct was found in 10 ears with sensorineural deafness (SD) and 2 ears without SD. Borderline measurements were found in 19 ears with SD and 33 ears without SD. The enlarged midpoint measurement was not seen in the cases without SD. More than 1.5 mm of the definition for the enlargement at the midpoint of the vestibular aqueduct seemed to be appropriate in the clinical situation. The measurement at the midpoint of the duct is more reliable than at the external aperture. The conductive component in EVA Syndrome with mixed hearing loss is present only at the lower frequencies (250, 500 Hz), not at the middle and higer frequencies. Long-term follow-up of hearing should be done in the borderline cases with check-up of PDS gene anomaly if necessary. (author)
Helpman, Limor; Yaniv, Assaf; Beiner, Mario E; Aviel-Ronen, Sarit; Perri, Tamar; Ben-Baruch, Gilad; Hogen Ben-David, Liat; Jakobson-Setton, Ariella; Korach, Jacob
2017-11-01
Borderline ovarian tumors are typically indolent neoplasms. Since many are diagnosed in younger women, fertility conservation is an important consideration and has been advocated based on retrospective data. The objective of this study was to identify features impacting on recurrence and survival in a series of borderline ovarian tumors, and to assess the safety of a fertility-sparing approach. A historical cohort study of consecutive borderline ovarian tumors cases treated at a single institution over 30 years (1981-2011). Data on surgical approach (fertility-sparing or otherwise), disease stage, CA125 levels, histological features, adjuvant treatment and follow-up data were collected. Recurrence and survival were assessed using the Kaplan-Meier method and associations with the variables of interest were evaluated using a multivariate Cox proportional hazards model. 213 patients were included. Of 132 women age 40 years and below at diagnosis, 112 (85%) had a fertility-sparing procedure and 60 (46%) had conservation of an involved ovary. Fifty patients (24%) developed recurrences; fertility preservation (hazard ratio = 2.57; 95% confidence interval 1.1-6; p = 0.029) and advanced stage (hazard ratio = 4.15; 95% confidence interval 2.3-7.6; p Fertility preservation was not associated with compromised survival. Borderline ovarian tumors carry a good prognosis overall. Fertility preservation is associated with a higher risk of disease relapse; however, as most relapses are localized and may be salvaged with surgical treatment, overall survival is not compromised. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.
Law, Mary Kate; Fleeson, William; Arnold, Elizabeth Mayfield; Furr, R Michael
2016-02-01
While emotional difficulties are highly implicated in borderline personality disorder (BPD), the dynamic relationships between emotions and BPD symptoms that occur in everyday life are unknown. The current paper examined the function of negative emotions as they relate to BPD symptoms in real time. Experience sampling methodology with 281 participants measured negative emotions and borderline symptoms, expressed as a spectrum of experiences, five times daily for two weeks. Overall, having a BDP diagnosis was associated with experiencing more negative emotions. Multilevel modeling supported positive concurrent relationships between negative emotions and BPD symptoms. Lagged models showed that even after 3 hours negative emotions and several symptoms continued to influence each other. Therefore, results indicated that negative emotions and BPD symptoms are intricately related; some evidenced long-lasting relationships. This research supports emotion-symptom contingencies within BPD and provides insight regarding the reactivity and functionality of negative emotions in borderline pathology.
Emotional Processing in Borderline Personality Disorder
Suvak, Michael K.; Sege, Christopher T.; Sloan, Denise M.; Shea, M. Tracie; Yen, Shirley; Litz, Brett T.
2014-01-01
This study examined whether individuals with borderline personality disorder (BPD) would exhibit augmented emotional responses to picture stimuli after being challenged with an ideographic interpersonal conflict script. Participants were 24 adults diagnosed with BPD, 23 adults diagnosed with obsessive compulsive personality disorder (OCPD), and 28 normal controls. Participants viewed emotionally evocative pictures before and after listening to the interpersonal script while a variety of physiological measures were recorded. Findings indicated that the interpersonal script was effective in eliciting enduring emotional responses from the BPD group relative to the control groups. However, despite the effectiveness of the interpersonal challenge task, there were no group differences in emotional responding to the affect eliciting stimuli. The findings underscore the complexities involved in examining emotional dysregulation in BPD in a laboratory setting. PMID:22449065
Nioche, A; Pham, T H; Ducro, C; de Beaurepaire, C; Chudzik, L; Courtois, R; Réveillère, C
2010-06-01
Recent clinical and empirical works are based on Cleckley's clinical observations in which psychopathy is viewed as a personality disorder, characterised by a lack of emotions, callousness, unreliability and superficiality. Hare operationalised Cleckley's concept of psychopathy by developing the Psychopathy Checklist-Revised composed of 20 items that load on two factors in majority: factor 1 (personality aspects of psychopathy) and factor 2 (behavioural manifestations), close to the antisocial personality disorder (DSM-IV criteria). Comorbidity is strong with antisocial personality disorder but also with histrionic, narcissistic and borderline disorders. As results of categorical studies relative to comorbidity suggest a strong comorbidity between psychopathy and other personality disorders, and particularly cluster B disorders (axis II, DSM-IV), this study assesses the relationships between psychopathy (dimensional approach) and personality disorders (categorical approach) and particularly with the borderline personality disorder. The aim of this study is also to underline the complementarity of categorical (SCID-II) and dimensional approaches (PCL-R), and the utility of the standardised clinical examination. We hypothesised positive associations between psychopathy and other personality disorders, mainly with the cluster B axis II (narcissistic, antisocial, histrionic, and borderline). Among those disorders, a particular link exists with the borderline personality disorder, considering that their association may attenuate the pathological level of the psychopathy. The sample included 80 male inmates from French prisons (age: M=31.48; SD=11.06). Each participant was evaluated with the PCL-R to assess the level of psychopathy and the SCID-II to assess the possible presence of personality disorders. The MINI and the WAIS-III were used to exclude respectively those who presented an axis I comorbidity (mood disorders and psychotic disorders established at the moment
The outpatient psychotherapy of the borderline patient.
Chessick, R D
1993-01-01
This paper discussed common problems in the outpatient psychotherapy of borderline patients, especially their rage, seductiveness, and abrupt negative shifts. The definition of "borderline" is not settled. Even DSM-III-R mixes it up with other personality disorders. There are no pathognomonic symptoms, no specific personality constellations, and no compelling evidence for a definitive stage in infant development when this disorder is fixed; all stages are involved, from faulty foundational to oedipal periods. It is a descriptive diagnosis and typical presentations of such patients are reviewed. In the psychotherapeutic approach, limits must be set first, but these must be flexible and reasonable. Medications are used rarely and with care. We attempt to form an alliance by (a) getting the patient to join us in a study of himself or herself, especially a study of when rage and maladaptive behavior emerges, and (b) providing a consistent and reasonable ambience. The ultimate aim is uncovering and interpreting when the patient is ready for it, more and more approximating psychoanalytic treatment as the patient's pathology permits. The special phenomena of the self-object (Kohut), transitional object (Modell), and disruptive extreme erotic or raging (Kernberg) transferences were reviewed, as well as the pitfalls of therapist anxiety and impatience in dealing with them. While archaic transferences predominate, we serve as an auxiliary microscopic ego and appeal to the rational adult part of the patient's ego in a phenomenological investigation. We interpret early only if we cannot get the patient to examine what has led to the explosions and when distortions or projection without insight continues to predominate. The dangers of early transference interpretations are discussed. Therapy is long, tedious, and requires the willingness to patiently catalyze the patient's resumed development and endure the periodic disruptions. Countertransference problems and what to do about
Psychobiology and treatment of borderline personality disorder.
Cloninger, C Robert
2002-04-01
Borderline personality disorder can be characterized in terms of a profile of abnormal deviations on multiple personality dimensions using the temperament and character inventory (TCI). Borderline patients show poor character development, including low TCI self-directedness (irresponsible, blaming) and low TCI cooperativeness (hostile, intolerant). Their temperament is explosive or unstable due to a combination of high TCI harm avoidance (anxious, shy), high TCI novelty seeking (impulsive, quick-tempered), and low reward dependence (cold, aloof). Consequently they are usually dysthymic with an admixture of anxiety and anger, and regulate their social problems and intense emotions in immature ways. Genetic and psychobiological studies have led to identification of biological correlates of each of the TCI dimensions of personality, including individual differences in regional brain activity, psychophysiological variables, neuroendocrine abnormalities and specific gene polymorphisms. Each dimension of personality involves complex non-linear interaction of multiple genetic and environmental factors and, in turn, each personality dimension interacts with the others in influencing the way an individual directs and adapts to his or her life experiences. Systematic clinical trials have shown that these personality variables predict the response to pharmacological and psychotherapeutic treatments. For example, high harm avoidance and low self-directedness predict slower response and more rapid relapse with both antidepressants and cognitive-behavioral therapy. Treatment with drugs and/or psychotherapy can be individually matched to the patient's profile of temperament and character traits, rather than treating a heterogeneous group of patients as if they had a discrete, homogeneous illness. Fundamental change in cognitive schemas depends on attention to all aspects of character, especially self-transcendence, which has previously been neglected in cognitive
Self-esteem in patients with borderline and avoidant personality disorders.
Lynum, L I; Wilberg, T; Karterud, S
2008-10-01
This study compared self-esteem in patients with avoidant personality disorder (APD) and borderline personality disorder (BPD). Patients diagnosed with one or more personality disorders answered the questionnaire Index of Self Esteem as part of a comprehensive evaluation within the setting of a treatment trial. Our hypotheses were that (1) both patients with APD and patients with BPD would report low levels of self-esteem, (2) patients with APD would report lower self-esteem than patients with BPD. We further expected that (3) patients with higher levels of depression would report lower levels of self-esteem, but that (4) both borderline and avoidant personality pathology would contribute to explained variance in self-esteem beyond what would be accounted for by depression. All of our hypotheses were supported. The results from our study showed a significant difference in self-esteem level between the two personality disorders, patients with APD reporting lower self-esteem than patients with BPD. Subjects with both disorders were measured to have self-esteem levels within the range that presumes clinical problems. Self-esteem represents an important quality of subjective experience of the self, and the study of self-esteem in PDs can offer new and important knowledge of PDs as self-pathology.
Burnout, Depression, and Borderline Personality: A 1,163-Participant Study
Bianchi, Renzo; Rolland, Jean-Pierre; Salgado, Jesús F.
2018-01-01
We examined the association of burnout with borderline personality (BP) traits in a study of 1,163 educational staff (80.9% women; mean age: 42.96). Because burnout has been found to overlap with depression, parallel analyses of burnout and depression were conducted. Burnout symptoms were assessed with the Shirom-Melamed Burnout Measure, depressive symptoms with the PHQ-9, and BP traits with the Borderline Personality Questionnaire. Burnout was found to be associated with BP traits, controlling for neuroticism and history of depressive disorders. In women, burnout was linked to both the “affective insecurity” and the “impulsiveness” component of BP. In men, only the link between burnout and “affective insecurity” reached statistical significance. Compared to participants with “low” BP scores, participants with “high” BP scores reported more burnout symptoms, depressive symptoms, neuroticism, and occupational stress and less satisfaction with life. Disattenuated correlations between burnout and depression were close to 1, among both women (0.91) and men (0.94). The patterns of association of burnout and depression with the main study variables were similar, pointing to overlapping nomological networks. Burnout symptoms were only partly attributed to work by our participants. Our findings suggest that burnout is associated with BP traits through burnout-depression overlap. PMID:29375447
Experiences of women living with borderline personality disorder
Directory of Open Access Journals (Sweden)
N. Ntshingila
2016-12-01
From the findings obtained by means of the interviews of women living with borderline personality disorder, it was evident that there were childhood experiences of living in an unsafe space, related to unhealthy family dynamics, boundary violations and educational challenges. They experienced chronic feelings of emptiness in their relationships with the self. They also presented with a pattern of unstable interpersonal relationships and compromised mental health, which was apparent through the early onset of mental problems, emotional upheaval, looking for emotional escape and having different trigger factors. Lastly, all these women yearned for facilitated mental health.
Combined group and individual schema therapy for borderline personality disorder: a pilot study
Dickhaut, V.; Arntz, A.
2014-01-01
Background and Objectives: Schema Therapy (ST) is a highly effective treatment for Borderline Personality Disorder (BPD). In a group format, delivery costs could be reduced and recovery processes catalyzed by specific use of group processes. As patients may also need individual attention, we piloted
Immunohistochemical localization of HE4 in benign, borderline, and malignant lesions of the ovary.
Georgakopoulos, Penelope; Mehmood, Saira; Akalin, Ali; Shroyer, Kenneth R
2012-11-01
Despite advances in the development of novel methods to improve treatment, ovarian carcinoma is still the leading cause of gynecologic cancer death in the United States and other industrialized nations. Improvements in the clinical outcome of ovarian cancer will be achieved if methods can be developed to enable the detection of these tumors at the earliest possible stage. Thus, it is critically important to identify and validate new biomarkers of ovarian cancer. HE4 expression was defined by immunohistochemical analysis of a wide range of benign, borderline, and malignant ovarian lesions, including serous, endometrioid, mucinous, and clear cell lesions of the ovary and in primary tubal carcinomas and the normal fallopian tube. At the cellular level, HE4 was highly expressed in malignant ovarian tumors and in a wide range of benign and borderline ovarian lesions. In addition, HE4 was highly expressed in primary fallopian tube carcinomas and benign fallopian tubal epithelial cells. These results support the conclusion that HE4 is widely expressed in most benign, borderline, and malignant lesions of the ovary and the fallopian tube. The detection of HE4 expression at high levels in some benign lesions and normal tissues suggests that HE4 could have limited specificity as a marker of ovarian or tubal carcinoma. Furthermore, the relatively weak expression that was observed in many ovarian carcinomas indicates that HE4 could fail to detect some cases of primary or recurrent disease.
Schuppert, H.M.; Albers, C.J.; Minderaa, R.B.; Emmelkamp, P.M.G.; Nauta, M.H.
2012-01-01
Background: A combination of multiple factors, including a strong genetic predisposition and environmental factors, are considered to contribute to the developmental pathways to borderline personality disorder (BPD). However, these factors have mostly been investigated retrospectively, and hardly in
Slotema, C. W.; Niemantsverdriet, Ellis; Blom, J. D.; van der Gaag, M.; Hoek, H. W.; Sommer, I. E. C.
Background: In patients with borderline personality disorder (BPD), about 22-50% experience auditory verbal hallucinations (AVH). However, the impact of these hallucinations on suicidal ideation, suicide attempts, crisis-service interventions, and hospital admissions is unknown. Methods: In a
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Jean Marc Guile
2016-09-01
Full Text Available Introduction: Chart review is a low-cost, but highly informative, method to describe symptoms, treatment and risk factors associated with Borderline Personality Disorder (BPD and to adapt screening and intervention to clinical reality. Previous chart review studies report more aggressiveness/anger and psychotic features in youths with BPD. They show that adverse family environment and parental psychopathology constitute important factors for BPD pathology. Objectives: To examine clinical characteristics of depressed BPD adolescents (12-17 years old outpatients according to gender and to explore variables which are associated with BPD traits. Methods: A retrospective chart review using the Child and Adolescent Version of the Retrospective Diagnostic Instrument for Borderlines was conducted on 30 depressed BPD adolescents with BPD traits and 28 non-BPD depressed patients without BPD traits. Participants who reached the C-DIB threshold for BPD were included in the BPD traits group. The Child and Adolescent Version of the Retrospective Diagnostic Interview for Borderlines was used to determine the presence of BPD. Comparisons analyses were performed using Pearson’s Chi-square test. Associated factors were determined using regression analyses. Results: BPD traits participants outpatients were characterised by higher family problems (parental psychopathology, parent disagreement/argument, parent-child relational problem, more aggressive symptoms, and higher rates of family intervention and hospitalisation. A number of familial factors (parental history of delinquency, substance use, or personality disorders, having siblings, parental disagreement/argument in boys were associated with BPD symptomatologytraits. Attention seeking and problematic functioning (does not adapt well to group activities were also associated with BPD traits. Discussion: Our study stresses the need to assess BPD traits in adolescent psychiatric evaluation, especially in
ONTOLOGICAL STANDARDIZATION FOR HISTORICAL MAP COLLECTIONS: STUDYING THE GREEK BORDERLINES OF 1881
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E. Gkadolou
2012-07-01
Full Text Available Historical maps deliver valuable historical information which is applicable in several domains while they document the spatiotemporal evolution of the geographical entities that are depicted therein. In order to use the historical cartographic information effectively, the maps' semantic documentation becomes a necessity for restoring any semantic ambiguities and structuring the relationship between historical and current geographical space. This paper examines cartographic ontologies as a proposed methodology and presents the first outcomes of the methodology applied for the historical map series «Carte de la nouvelle frontière Turco-Grecque» that sets the borderlines between Greece and Ottoman Empire in 1881. The map entities were modelled and compared to the current ones so as to record the changes in their spatial and thematic attributes and an ontology was developed in Protégé OWL Editor 3.4.4 for the attributes that thoroughly define a historical map and the digitised spatial entities. Special focus was given on the Greek borderline and the changes that it caused to other geographic entities.
Ontological Standardization for Historical Map Collections: Studying the Greek Borderlines of 1881
Gkadolou, E.; Tomai, E.; Stefanakis, E.; Kritikos, G.
2012-07-01
Historical maps deliver valuable historical information which is applicable in several domains while they document the spatiotemporal evolution of the geographical entities that are depicted therein. In order to use the historical cartographic information effectively, the maps' semantic documentation becomes a necessity for restoring any semantic ambiguities and structuring the relationship between historical and current geographical space. This paper examines cartographic ontologies as a proposed methodology and presents the first outcomes of the methodology applied for the historical map series «Carte de la nouvelle frontière Turco-Grecque» that sets the borderlines between Greece and Ottoman Empire in 1881. The map entities were modelled and compared to the current ones so as to record the changes in their spatial and thematic attributes and an ontology was developed in Protégé OWL Editor 3.4.4 for the attributes that thoroughly define a historical map and the digitised spatial entities. Special focus was given on the Greek borderline and the changes that it caused to other geographic entities.
Miskewicz, Kelly; Fleeson, William; Arnold, Elizabeth Mayfield; Law, Mary Kate; Mneimne, Malek; Furr, R. Michael
2015-01-01
This article tested a contingency-oriented perspective to examine the dynamic relationships between in-the-moment borderline personality disorder (BPD) symptom events and in-the-moment triggers. An experience sampling study with 282 adults, including 77 participants with BPD, obtained reports of situational triggers and BPD symptom events five times daily for two weeks. Triggers included being rejected, betrayed, abandoned, offended, disappointed, having one’s self-concept threatened, being in a boring situation, and being alone. BPD was associated with increased situational triggers. Multilevel models revealed significant within-person associations between situational triggers and BPD symptoms for the average participant in the study, with significant individual variance in the strength and direction of trigger-symptom contingencies. Most trigger-symptom contingencies were stronger for individuals with higher borderline symptomatology, suggesting that triggers are meaningfully related to BPD. These findings highlight possible proximal mechanisms that maintain BPD and help explain the course of a disorder often described as chaotic and unpredictable. PMID:26200848
De Panfilis, Chiara; Marchesi, Carlo; Cabrino, Chiara; Monici, Alberto; Politi, Virginia; Rossi, Matteo; Maggini, Carlo
2012-12-30
Despite obvious clinical need, factors underlying early treatment discontinuation among 'real world' borderline personality disorder (BPD) patients are still unknown. This study investigates individual characteristics that can predict early (Disorders, fourth edition (DSM-IV) Personality. Sociodemographic, clinical and personality variables potentially relevant for dropout were assessed for all participants at baseline. Early dropouts (n=54) were compared to continuers (n=108) on all measures. Logistic regression was then used to identify independent predictors of early dropout. A history of suicide attempts predicted early discontinuation, whereas the presence of an eating disorder and of avoidant personality features protected from early dropout. If confirmed, these findings may help clinicians operating in general psychiatric settings with estimating the risk of premature treatment discontinuation, and stress the need to specifically address suicidal behaviours in order to improve treatment retention among borderline outpatients. In this regard, implementing general psychiatric care with specialised, evidence-based psychotherapeutic interventions may be deemed necessary. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
The effect of dialectical behavior therapy skills use on borderline personality disorder features.
Stepp, Stephanie D; Epler, Amee J; Jahng, Seungmin; Trull, Timothy J
2008-12-01
We assessed the effect of DBT skills utilization on features of borderline personality disorder as measured by the Personality Assessment Inventory-Borderline Features Scale (PAI-BOR). Participants were outpatients (N = 27) enrolled in a dialectical behavior therapy (DBT) program in a university-affiliated community mental health clinic. Diary cards were collected each week to track self-reported skills use. At the beginning of each new skills training module, patients completed another PAI-BOR. Univariate and multilevel analyses indicated significant improvement on the total PAI-BOR score and on several PAI-BOR subscale scores. Results also revealed that overall DBT skills use increased significantly over time, as did individual skills related to mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. Multilevel modeling results indicated that overall skills use showed a significant effect on PAI-BOR total scores, Affective Instability scores, Identity Problems scores, and Negative Relationships scores, even after controlling for initial levels of distress and diary card compliance.
The Interpersonal Dimension of Borderline Personality Disorder: Toward a Neuropeptide Model
Stanley, Barbara; Siever, Larry J.
2009-01-01
Borderline personality disorder is characterized by affective instability, impulsivity, identity diffusion, and interpersonal dysfunction. Perceived rejection and loss often serve as triggers to impulsive, suicidal, and self-injurious behavior, affective reactivity, and angry outbursts, suggesting that the attachment and affiliative system may be implicated in the disorder. Neuropeptides, including the opioids, oxytocin, and vasopressin, serve a crucial role in the regulation of affiliative b...
Crawford, Mike J; Sanatinia, Rahil; Barrett, Barbara; Cunningham, Gillian; Dale, Oliver; Ganguli, Poushali; Lawrence-Smith, Geoff; Leeson, Verity; Lemonsky, Fenella; Lykomitrou, Georgia; Montgomery, Alan A; Morriss, Richard; Munjiza, Jasna; Paton, Carol; Skorodzien, Iwona; Singh, Vineet; Tan, Wei; Tyrer, Peter; Reilly, Joseph G
2018-04-06
The authors examined whether lamotrigine is a clinically effective and cost-effective treatment for people with borderline personality disorder. This was a multicenter, double-blind, placebo-controlled randomized trial. Between July 2013 and November 2016, the authors recruited 276 people age 18 or over who met diagnostic criteria for borderline personality disorder. Individuals with coexisting bipolar affective disorder or psychosis, those already taking a mood stabilizer, and women at risk of pregnancy were excluded. A web-based randomization service was used to allocate participants randomly in a 1:1 ratio to receive either an inert placebo or up to 400 mg/day of lamotrigine. The primary outcome measure was score on the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) at 52 weeks. Secondary outcome measures included depressive symptoms, deliberate self-harm, social functioning, health-related quality of life, resource use and costs, side effects of treatment, and adverse events. A total of 195 (70.6%) participants were followed up at 52 weeks, at which point 49 (36%) of those in the lamotrigine group and 58 (42%) of those in the placebo group were taking study medication. The mean ZAN-BPD score was 11.3 (SD=6.6) among those in the lamotrigine group and 11.5 (SD=7.7) among those in the placebo group (adjusted difference in means=0.1, 95% CI=-1.8, 2.0). There was no evidence of any differences in secondary outcomes. Costs of direct care were similar in the two groups. The results suggest that treating people with borderline personality disorder with lamotrigine is not a clinically effective or cost-effective use of resources.
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Farid Hoseini F
2008-12-01
Full Text Available "nBackground: The Temperament and Character Inventory (TCI efficiently diagnoses personality disorders, differentiating the individual subtypes. This research aimed to evaluate personality dimensions using the Cloninger TCI (TCI-125 in a group of people with borderline personality disorders at Ruzbeh Hospital, Tehran, Iran. "nMethods: In this descriptive cross-sectional study, 27 borderline personality patients were evaluated with a clinical interview based on the Diagnostic and Statistical Manual of Mental Disorders fourth edition text revision (DSM-ІV-TR and Structured Clinical Interview for DSM-ІV Axis IІ (SCIDII. Depression and anxiety scores of patients were assessed using the Beck Depression Inventory (BDI and Beck Anxiety Inventory (BAI questionnaires. Dimensions of temperament and character traits were assessed using the TCI-125. The findings were compared with parameters of the normal Iranian population. "nResults: Results showed higher scores for novelty seeking and harm avoidance and lower scores for self directedness, self transcendence and cooperativeness in borderline personality disorder patients. "nConclusion: The results of the Cloninger TCI in this study showed higher scores for novelty seeking and harm avoidance and lower scores for self directedness than those of the normal Iranian population. Scores for reward dependence fell within the range of the normal population. Lower scores for character factors, such as self directedness, cooperativeness and self transcendence, are usually associated with cluster B personality traits. Higher scores for novelty seeking and harm avoidance are usually characteristic of borderline personality disorder patients. In this study, there is the possibility that the small sample size or other factors, such as medication or substance abuse, might affect the study, resulting in normal scores for reward dependence.
Hessels, C.J.
2017-01-01
The expanding research on Borderline personality disorder (BPD) increasingly confirms continuity from adolescence to adulthood, in phenomenology, structure, stability, validity and morbidity. This has led to a more developmental perspective on BPD. The current thesis aims to contribute to the
Psychopharmacologic treatment of borderline personality disorder
Ripoll, Luis H.
2013-01-01
The best available evidence for psychopharmacologic treatment of borderline personality disorder (BPD) is outlined here. BPD is defined by disturbances in identity and interpersonal functioning, and patients report potential medication treatment targets such as impulsivity, aggression, transient psychotic and dissociative symptoms, and refractory affective instability Few randomized controlled trials of psychopharmacological treatments for BPD have been published recently, although multiple reviews have converged on the effectiveness of specific anticonvulsants, atypical antipsychotic agents, and omega-3 fatty acid supplementation. Stronger evidence exists for medication providing significant improvements in impulsive aggression than in affective or other interpersonal symptoms. Future research strategies will focus on the potential role of neuropeptide agents and medications with greater specificity for 2A serotonin receptors, as well as optimizing concomitant implementation of evidence-based psychotherapy and psychopharmacology, in order to improve BPD patients' overall functioning. PMID:24174895
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Sofia Marques
2017-04-01
Conclusion: In summary, the available studies support cognitive-behavioral psychological treatments as an efficacious intervention in borderline personality disorder. However, the existing scientific literature on this topic is still scarce and there is need for more studies, with higher methodological rigor, that should validate these results.
Amini, Mehdi; Pourshahbaz, Abbas; Mohammadkhani, Parvaneh; Khodaie Ardakani, Mohammad Reza; Lotfi, Mozhgan
2015-01-01
Background: Fundamental problems with Personality Disorders (PD) diagnostic system in the previous version of DSM, led to the revision of DSM. Therefore, a multidimensional system has been proposed for diagnosis of personality disorder features in DSM-5. In the dimensional approach of DSM-5, personality disorders diagnosis is based on levels of personality functioning (Criteria A) and personality trait domains (Criteria B). Objectives: The purpose of this study was firstly, to examine the DSM-5 levels of personality functioning in antisocial and borderline personality disorders, and second, to explore which levels of personality functioning in patients with antisocial and borderline personality disorders can better predicted severity than others. Patients and Methods: This study had a cross sectional design. The participants consisted of 252 individuals with antisocial (n = 122) and borderline personality disorders (n = 130). They were recruited from Tehran prisoners, and clinical psychology and psychiatry centers of Razi and Taleghani Hospitals, Tehran, Iran. The sample was selected based on judgmental sampling. The SCID-II-PQ, SCID-II and DSM-5 levels of personality functioning were used to diagnose and assess personality disorders. The data were analyzed by correlation and multiple regression analysis. All statistical analyses were performed using the SPSS 16 software. Results: Firstly, it was found that DSM-5 levels of personality functioning have a strong correlation with antisocial and borderline personality symptoms, specially intimacy and self-directedness (P antisocial personality disorder severity (P personality disorder severity, as well (P personality functioning are a significant predictor of personality disorders severity. The results partially confirm existing studies. PMID:26430521
Amini, Mehdi; Pourshahbaz, Abbas; Mohammadkhani, Parvaneh; Khodaie Ardakani, Mohammad Reza; Lotfi, Mozhgan
2015-08-01
Fundamental problems with Personality Disorders (PD) diagnostic system in the previous version of DSM, led to the revision of DSM. Therefore, a multidimensional system has been proposed for diagnosis of personality disorder features in DSM-5. In the dimensional approach of DSM-5, personality disorders diagnosis is based on levels of personality functioning (Criteria A) and personality trait domains (Criteria B). The purpose of this study was firstly, to examine the DSM-5 levels of personality functioning in antisocial and borderline personality disorders, and second, to explore which levels of personality functioning in patients with antisocial and borderline personality disorders can better predicted severity than others. This study had a cross sectional design. The participants consisted of 252 individuals with antisocial (n = 122) and borderline personality disorders (n = 130). They were recruited from Tehran prisoners, and clinical psychology and psychiatry centers of Razi and Taleghani Hospitals, Tehran, Iran. The sample was selected based on judgmental sampling. The SCID-II-PQ, SCID-II and DSM-5 levels of personality functioning were used to diagnose and assess personality disorders. The data were analyzed by correlation and multiple regression analysis. All statistical analyses were performed using the SPSS 16 software. Firstly, it was found that DSM-5 levels of personality functioning have a strong correlation with antisocial and borderline personality symptoms, specially intimacy and self-directedness (P antisocial personality disorder severity (P personality disorder severity, as well (P personality functioning are a significant predictor of personality disorders severity. The results partially confirm existing studies.
Borderline personality disorder: nursing interventions using dialectical behavioral therapy.
Osborne, Unda L; McComish, Judith Fry
2006-06-01
Psychotherapeutic treatment of people with borderline personality disorder (BPD) is one of the greatest challenges confronting mental health professionals today. Clients with BPD are often difficult for nurses to work with, perhaps due to a lack of understanding of the underlying dynamics of the disorder. This article describes effective treatment strategies for BPD with a central focus on dialectical behavioral therapy (DBT). In typical mental health settings, nurses can effectively implement interventions using the concepts of DBT to help people with BPD build effective coping strategies and skillful behavioral responses for improved quality of life.
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Orhan Gelişen
2006-08-01
We also review published case reports of borderline ovarian tumors following ovulation induction to update the medical literature about this rare yet serious condition may be encountered by physicians providing infertility treatment. A borderline ovarian neoplasm in polycystic ovaries should be considered if a patient develops unforeseen ovarian mass (es following ovulation induction.
Zanarini, Mary C; Barison, Leah K; Frankenburg, Frances R; Reich, D Bradford; Hudson, James I
2009-08-01
The purpose of this study was to assess the familial coaggregation of borderline personality disorder (BPD) with a full array of axis I disorders and four axis II disorders (antisocial personality disorder, histrionic personality disorder, narcissistic personality disorder, and sadistic personality disorder) in the first-degree relatives of borderline probands and axis II comparison subjects. Four hundred and forty-five inpatients were interviewed about familial psychopathology using the Revised Family History Questionnaire-a semistructured interview of demonstrated reliability. Of these 445 subjects, 341 met both DIB-R and DSM-III-R criteria for BPD and 104 met DSM-III-R criteria for another type of personality disorder (and neither criteria set for BPD). The psychopathology of 1,580 first-degree relatives of borderline probands and 472 relatives of axis II comparison subjects was assessed. Using structural models for familial coaggregation, it was found that BPD coaggregates with major depression, dysthymic disorder, bipolar I disorder, alcohol abuse/dependence, drug abuse/dependence, panic disorder, social phobia, obsessive-compulsive disorder, generalized anxiety disorder, posttraumatic stress disorder, somatoform pain disorder, and all four axis II disorders studied. Taken together, the results of this study suggest that common familial factors, particularly in the areas of affective disturbance and impulsivity, contribute to borderline personality disorder.
Shorey, Ryan C; Anderson, Scott; Stuart, Gregory L
2014-01-01
Individuals with substance use disorders are more likely to have antisocial and borderline personality disorder than non-substance abusers. Recently, research has examined the relations between early maladaptive schemas and personality disorders, as early maladaptive schemas are believed to underlie personality disorders. However, there is a dearth of research on the relations between early maladaptive schemas and personality disorders among individuals seeking treatment for substance abuse. The current study examined the relations among early maladaptive schemas and antisocial and borderline personality within in a sample of men seeking substance abuse treatment (n = 98). Results demonstrated that early maladaptive schema domains were associated with antisocial and borderline personality symptoms. Implications of these findings for substance use treatment and research are discussed. Antisocial (ASPD) and Borderline (BPD) personality disorder symptoms are prevalence among individuals seeking substance abuse treatment. Early maladaptive schemas are believed to underlie the development of ASPD and BPD symptoms, and are also prevalence among individuals seeking substance use treatment. Findings from the current study suggest that specific early maladaptive schema domains predict ASPD and BPD symptoms in a substance abuse treatment seeking sample of adult males. The treatment of ASPD and BPD among men seeking substance use treatment may want to focus on early maladaptive schemas. Copyright © 2013 John Wiley & Sons, Ltd.
Ollier, Laurence; Laffont, Catherine; Kechkekian, Aurore; Doglio, Alain; Giordanengo, Valérie
2008-12-01
Routine use of the automated chemiluminescent microparticle immunoassay Abbott ARCHITECT anti-HBc for diagnosis of hepatitis B is limited in case of borderline reactive sera with low signal close to the cut-off index. In order to determine the significance of anti-HBc detection when borderline reactivity occurs using the ARCHITECT anti-HBc assay, a comparative study was designed. 3540 serum samples collected over a 2-month period in the hospital of Nice were examined for markers of HBV infection (HBsAg, anti-HBs and anti-HBc). One hundred seven samples with sufficient volume and with borderline reactivity by the ARCHITECT assay were tested by two other anti-HBc assays, a microparticle enzyme immunoassay (MEIA, AxSYM Core, Abbott Laboratories, IL, USA) and an enzyme linked fluorescent assay (ELFA, VIDAS Anti-HBc Total II, bioMérieux, Lyon, France). Only 46 samples were confirmed by the AxSYM and the VIDAS assays. Additional serological information linked to patient history showed that the remaining samples (61) were false positives (11), had low titer of anti-HBc antibodies (13), or were inconclusive (37). This comparative study highlighted the existence of a grey zone around the cut-off index. Confirmative results through a different immunoassay are needed to confirm the diagnosis of HBV on borderline reactive sera using the ARCHITECT anti-HBc assay.
van Asselt-Goverts, A.E.; Embregts, P.J.C.M; Hendriks, A.H.C.
2018-01-01
Background: Little is known about the effectiveness of interventions aimed at enhancing the social networks of people with intellectual disabilities. This study explores the results of such an intervention. How did the clients with mild to borderline intellectual disabilities and their support
Inhibition of epidermal cell proliferation by borderline rays
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Born, W [Freiburg Univ.; Daikeler, G
1976-08-01
Treatment of guinea pig flanks with very soft x-rays (borderline rays) directly caused a partial block of epidermal DNA synthesis which had been determined by measuring the /sup 3/H-Tdr incorporation. Higher doses and repeated applications would undoubtedly cause lasting damage to the tissue. The enhanced epidermal DNA synthesis which is sometimes observed should not be misinterpreted as a sign of a directly biopositive utilisation of the quantum energy supplied. Rather, it is a secondary repair process following initial phases of depression. A reparative increase in DNA synthesis may also occur as a primary process if the radiation is almost completely absorbed above the germinative layer.
Gruppemusikterapi med patienter med borderline-personlighedsforstyrrelse i dagbehandlingsregi
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Niels Hannibal
2008-05-01
Full Text Available Denne artikel er første redegørelse for de erfaringer, som er gjort med gruppemusikterapi (GMT for patienter med borderline-personlighedsforstyrrelse (BPF i dagbehandlingsregi på Aalborg Psykiatriske Sygehus. Artiklen indeholder både konkrete anvisninger til aktiviteter og interventioner, ligesom den i et teoretisk perspektiv redegør for forskellige processer og reaktioner, der kan iagttages i behandlingen. Artiklen konkluderer, at GMT i sin nuværende form kan bidrage til udvikling af BPF-patienters evne til mentalisering og affektregulering, til opbygning af en gruppefølelse og fremme af interpersonel læring, ligesom GMT kan udvikle alliance til terapi generelt og GMT specifikt.
Frontal EEG asymmetry in borderline personality disorder is associated with alexithymia
Flasbeck, Vera; Popkirov, Stoyan; Brüne, Martin
2017-01-01
Background Frontal EEG asymmetry is a widely studied correlate of emotion processing and psychopathology. Recent research suggests that frontal EEG asymmetry during resting state is related to approach/withdrawal motivation and is also found in affective disorders such as major depressive disorder. Patients with borderline personality disorder (BPD) show aberrant behavior in relation to both approach and withdrawal motivation, which may arguably be associated with their difficulties in emotio...
Kliem, Sören; Kröger, Christoph; Kosfelder, Joachim
2010-12-01
At present, the most frequently investigated psychosocial intervention for borderline personality disorder (BPD) is dialectical behavior therapy (DBT). We conducted a meta-analysis to examine the efficacy and long-term effectiveness of DBT. Systematic bibliographic research was undertaken to find relevant literature from online databases (PubMed, PsycINFO, PsychSpider, Medline). We excluded studies in which patients with diagnoses other than BPD were treated, the treatment did not comprise all components specified in the DBT manual or in the suggestions for inpatient DBT programs, patients failed to be diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, and the intervention group comprised fewer than 10 patients. Using a mixed-effect hierarchical modeling approach, we calculated global effect sizes and effect sizes for suicidal and self-injurious behaviors. Calculations of postintervention global effect sizes were based on 16 studies. Of these, 8 were randomized controlled trials (RCTs), and 8 were neither randomized nor controlled (nRCT). The dropout rate was 27.3% pre- to posttreatment. A moderate global effect and a moderate effect size for suicidal and self-injurious behaviors were found, when including a moderator for RCTs with borderline-specific treatments. There was no evidence for the influence of other moderators (e.g., quality of studies, setting, duration of intervention). A small impairment was shown from posttreatment to follow-up, including 5 RCTs only. Future research should compare DBT with other active borderline-specific treatments that have also demonstrated their efficacy using several long-term follow-up assessment points. (c) 2010 APA, all rights reserved.
Howard, Rick; McCarthy, Lucy; Huband, Nick; Duggan, Conor
2013-07-01
Research suggests that a particular externalising phenotype, manifested in a developmental trajectory from severe childhood conduct disorder through early-onset substance abuse to adult antisocial/borderline personality disorder co-morbidity, may increase risk of antisocial behaviour in general and criminal recidivism in particular. This study aims to test the hypothesis that antisocial/borderline co-morbidity together with the triad of substance dependence, severe conduct disorder and borderline pathology would result in an increased risk of criminal recidivism. Fifty-three men who had been assessed and treated in a secure hospital unit were followed up after they had returned to the community. They were assessed for severity of the following: (i) antisocial personality disorder; (ii) borderline personality disorder; (iii) drug/alcohol dependence; and (iv) high Psychopathy Checklist Revised scores (factors 1 and 2). Patients with antisocial/borderline co-morbidity took significantly less time to re-offend compared with those without such co-morbidity. Both Psychopathy Checklist Revised factor 2 and the tripartite risk measure significantly predicted time to re-offence; the former largely accounted for the predictive accuracy of the latter. Risk of criminal recidivism can be adequately assessed without recourse to the pejorative term 'psychopath'. It is sufficient to assess the presence of the three elements of our risk measure: borderline and antisocial personality disorders in the context of drug/alcohol dependence and severe childhood conduct disorder. Practical implications of the study are as follows. (i) Sound assessment of personality, inclusive of a detailed history of childhood conduct disorder as well as adolescent and adult substance misuse, yields good enough information about risk of recidivism without recourse to the pejorative concept of 'psychopathy'. (ii) Given the high risk of alcohol-related violence in individuals with antisocial/borderline co
Koekkoek, B.; van Meijel, B.; Schene, A.; Hutschemaekers, G.
2009-01-01
The objective of this research was to assess the problems that professionals perceive in the community mental health care for patients with severe borderline personality disorder that do not fit into specialized therapy. A group of national experts (n = 8) participated in a four-phase
Distel, Marijn A; Carlier, Angela; Middeldorp, Christel M; Derom, Catherine A; Lubke, Gitta H; Boomsma, Dorret I
2011-12-01
Previous research has established the comorbidity of adult Attention-Deficit Hyperactivity Disorder (ADHD) with different personality disorders including Borderline Personality Disorder (BPD). The association between adult ADHD and BPD has primarily been investigated at the phenotypic level and not yet at the genetic level. The present study investigates the genetic and environmental contributions to the association between borderline personality traits (BPT) and ADHD symptoms in a sample of 7,233 twins and siblings (aged 18-90 years) registered with the Netherlands Twin Register and the East Flanders Prospective Twin Survey (EFPTS) . Participants completed the Conners' Adult ADHD Rating Scales (CAARS-S:SV) and the Personality Assessment Inventory-Borderline Features Scale (PAI-BOR). A bivariate genetic analysis was performed to determine the extent to which genetic and environmental factors influence variation in BPT and ADHD symptoms and the covariance between them. The heritability of BPT and ADHD symptoms was estimated at 45 and 36%, respectively. The remaining variance in BPT and ADHD symptoms was explained by unique environmental influences. The phenotypic correlation between BPT and ADHD symptoms was estimated at r = 0.59, and could be explained for 49% by genetic factors and 51% by environmental factors. The genetic and environmental correlations between BPT and ADHD symptoms were 0.72 and 0.51, respectively. The shared etiology between BPT and ADHD symptoms is thus a likely cause for the comorbidity of the two disorders. Copyright © 2011 Wiley-Liss, Inc.
Alireza Aghayousefi; Morteza Tarkhan; Tahereh Ghorbani
2015-01-01
Objective: This study aimed to examine the effect of dialectic behavior therapy on the reduction of impulsiveness in women with comorbidity of borderline personality disorders and substance abuse. Method: An experimental single system research design using multiple baselines was employed for this study. Based on the structured diagnostic interview and entry criteria, four participants among female patients with borderline personality disorders and substance abuse were selected via purposive s...
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M Nasiri
2017-05-01
Full Text Available BACKGROUND AND OBJECTIVE: Borderline personality disorder which constantly changes the mood, identity and interpersonal relationship is a mental disorder classified in category B. Besides, it leads to behaviors such as drug abuse, impulsive sex and suicide which make more difficult the treatment of these patients. The aim of this study was to report the recovery of a personality problem in a case with borderline personality disorder after the head trauma. CASE REPORT: The personality signs of a 28-year-old boy who had the full criteria of borderline personality disorder including drug abuse, impulsivity, mood instability, periods of anger and aggression were significantly decreased after hitting. Personality difference and improvement of patient were shown in MMPI test and MRI indicated the structural changes in his brain. He had no problem in 4-year-follow up. CONCLUSION: This report suggested the personality and behavioral changes after head trauma. MRI results indicated that the recovery is probably caused by the destruction area in the frontal lobe and the anterior temporal lobe (near the hippocampus. Thus the importance of neuropsychological factors should be considered in creating the diagnostic criteria.
Distel, M.A.; Carlier, A.; Middeldorp, C.M.; Derom, C.A.; Lubke, G.H.; Boomsma, D.I.
2011-01-01
Previous research has established the comorbidity of adult Attention-Deficit Hyperactivity Disorder (ADHD) with different personality disorders including Borderline Personality Disorder (BPD). The association between adult ADHD and BPD has primarily been investigated at the phenotypic level and not
Distel, Marijn A.; Carlier, Angela; Middeldorp, Christel M.; Derom, Catherine A.; Lubke, Gitta H.; Boomsma, Dorret I.
2011-01-01
Previous research has established the comorbidity of adult Attention-Deficit Hyperactivity Disorder (ADHD) with different personality disorders including Borderline Personality Disorder (BPD). The association between adult ADHD and BPD has primarily been investigated at the phenotypic level and not
Sauer, Christina; Sheppes, Gal; Lackner, Helmut Karl; Arens, Elisabeth A; Tarrasch, Ricardo; Barnow, Sven
2016-08-30
Emotion dysregulation is a core feature of borderline personality disorder (BPD). So far, many studies have tested the consequences of the implementation of certain emotion regulation (ER) strategies, but there have been no investigations about ER choices in BPD. Thus, the aim of this study was to investigate habitual ER choices by self-report questionnaires and experimentally by testing the preference to select between distraction and reappraisal when facing different emotional intensities (high vs. low) and contents (borderline-specific vs. unspecific negative) in patients with BPD (n=24) compared with clinical controls (patients with major depression, n=19) and a healthy control group (n=32). Additionally, heart rate (HR) responses were continuously assessed. Main results revealed that both patient groups showed maladaptive self-reported ER choice profiles compared with HC. We found, however, no differences between the groups in the choice of distraction and reappraisal on the behavioral level and in HR responses. In BPD, within-group analyses revealed a positive correlation between symptom severity and the preference for distraction under high-intensity borderline-specific stimuli. Our findings provide preliminary evidence of ER choices in BPD and show the robustness of the choice effect in patients with affective disorders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
van der Meere, Jacob; Börger, Norbert; Pirila, Silja
2012-01-01
The aim of the present study is to investigate visual orientation in hospitalized boys with severe early onset conduct disorder and borderline intellectual functioning. It is tested whether boys with the dual diagnosis have a stronger action-oriented response style to visual-cued go signals than the
Wetzelaer, P.; Farrell, J.; Evers, S.M.A.A.; Jacob, G.A.; Lee, C.W.; Brand, O.; van Breukelen, G.; Fassbinder, E.; Fretwell, H.; Harper, R.P.; Lavender, A.; Lockwood, G.; Malogiannis, I.A.; Schweiger, U.; Startup, H.; Stevenson, T.; Zarbock, G.; Arntz, A.
2014-01-01
Background: Borderline personality disorder (BPD) is a severe and highly prevalent mental disorder. Schema therapy (ST) has been found effective in the treatment of BPD and is commonly delivered through an individual format. A group format (group schema therapy, GST) has also been developed. GST has
Kliem, Soren; Kroger, Christoph; Kosfelder, Joachim
2010-01-01
Objective: At present, the most frequently investigated psychosocial intervention for borderline personality disorder (BPD) is dialectical behavior therapy (DBT). We conducted a meta-analysis to examine the efficacy and long-term effectiveness of DBT. Method: Systematic bibliographic research was undertaken to find relevant literature from online…
Buis, C. C. M.; van Leeuwen, F. E.; Mooij, T. M.; Burger, C. W.; Lambalk, Cornelis B.; Kortman, Marian; Laven, Joop S. E.; Jansen, Cees A. M.; Helmerhorst, Frans M.; Cohlen, Ben J.; Willemsen, Wim N. P.; Smeenk, Jesper M. J.; Simons, Arnold H. M.; van der Veen, Fulco; Evers, Johannes L. H.; van Dop, Peter A.; Macklon, Nicholas S.
2013-01-01
Is ovarian or extra-ovarian endometriosis associated with an increased risk of ovarian cancer and borderline ovarian tumours (BOT)? We found a 3- to 8-fold increased risk of ovarian tumours associated with endometriosis: the magnitude of the risk increase depended on the definition of endometriosis.
Memory and linguistic/executive functions of children with Borderline Intellectual Functioning
Água Dias, Andrea; Albuquerque, Cristina P.; Simões, Mário Rodrigues
2017-01-01
Children with Borderline Intellectual Functioning (BIF) have received little research attention and have been studied in conjunction with Intellectual and Developmental Disabilities. The present study intends to broaden the knowledge on BIF, by analyzing domains such as verbal memory and visual memory, as well as tasks that rely simultaneously on memory, executive functions and language. A cross-sectional, comparison study was carried out between a group of 40 children with BIF (mean age = 10...
Frontotemporal Dementia Complicated by Comorbid Borderline Personality Disorder: A Case Report
Salzbrenner, LCDR Stephen; Brown, Jaime; Hart, Gavin; Dettmer, Ens Jonathan; Williams, LT Raquel; Ormeno, LT Monica; O’Neal, LCDR Ethel; Shippy, LT Jennifer
2009-01-01
Frontotemporal dementia is the fourth most common cause of dementia in the United States and characteristically presents with an early decline in social conduct, impaired regulation of interpersonal conduct, emotional blunting, and general loss of insight, with relative preservation of memory. This a case of frontotemporal dementia in a 46-year-old woman who presented with existing diagnoses of borderline personality disorder and major depressive disorder. She had been repeatedly evaluated fo...
Rabie, A-Bakr M; Wong, Ricky W K; Min, G U
2008-01-01
To investigate the differences in morphological characteristics of borderline class III patients who had undergone camouflage orthodontic treatment or orthognathic surgery, and to compare the treatment effects between these two modalities. Cephalograms of 25 patients (13 orthodontic, 12 surgical) with class III malocclusion were analyzed. All had a pretreatment ANB angle greater than -5 masculine. Using discriminant analysis, only Holdaway angle was selected to differentiate patients in the pretreatment stage. Seventy-two per cent patients were correctly classified. In the orthodontic group, reverse overjet was corrected by retraction of the lower incisors and downward and backward rotation of the mandible. The surgical group was corrected by setback of the lower anterior dentoalveolus and uprighting of the lower incisors. No difference was found in posttreatment soft tissue measurements between the two groups. Twelve degree for the Holdaway angle can be a guideline in determining the treatment modalities for borderline class III patients, but the preferences of operators and patients are also important. (2) Both therapeutic options should highlight changes in the lower dentoalveolus and lower incisors. (3) Both treatment modalities can achieve satisfactory improvements to the people.
Does the concept of borderline personality features have clinical utility in childhood?
Hawes, David J
2014-01-01
Phenotypic features of borderline personality disorder may first emerge during childhood, alongside symptoms of common externalizing and internalizing disorders. Children with these borderline personality features (BPF) are, therefore, likely to come into contact with clinical services prior to adolescence. This raises the question of whether BPF may be clinically informative with respect to the formulation and treatment of childhood psychopathology. BPF in late childhood appear to be highly heritable, while also predicted by environmental risk factors that overlap with those related to both externalizing and internalizing disorders. These risk factors include hostile parenting, maternal insensitivity to infant attachment cues, and early peer victimization, thereby implicating both family and peer processes that play out across early development. Children with BPF appear to be further characterized by social-cognitive factors including social perspective coordination deficits, a shame-prone self-concept, and hypermentalizing, which may represent potential therapeutic targets. Clinical research into the implications of BPF for the treatment of childhood psychopathology is a current priority. It is proposed that the research designs that have contributed to recent evidence for the clinical utility of childhood psychopathic traits may likewise aid in understanding the potential clinical utility of BPF in children.
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Setareh Jani
2016-12-01
Full Text Available Introduction: Given the disruptive effects of personality disorders on personal and family life, it is essential to recognize their predisposing factors to understand them more accurately, and identify their preventive measures treatment facilitators. Therefore, the present study aimed to examine the relationship of severe personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders. Methods: The present descriptive-correlational study recruited patients with paranoid, borderline and schizotypal personality disorders presenting to psychiatry clinics in Ardabil using convenient sampling method. A total of 30 paranoid patients, 30 borderline patients and 20 schizotypal patients were selected by a psychiatrist through psychiatric examination, clinical interview and completing Millon Clinical Multiaxial Inventory (MCMI-III. The following instruments were used: MCMI- III and behavioral activation-inhibition system scale (BIS-BAS. The data were analyzed with Pearson’s correlation coefficient and stepwise regression. Results: BIS and BAS systems were both significant for predicting borderline and paranoid personality disorders, but only BIS was significant for predicting schizotypal personality disorder. Conclusion: These findings can help experts to have a better and more accurate understanding of personality disorders and use proper methods to predict the probability of these disorders and develop treatments.
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Jankowska Anna
2016-09-01
Full Text Available Psychological well-being is one of the greatest concerns in children and adolescents with Borderline Intellectual Functioning (BIF. Those youths are frequently exposed to stress and social inequality, and they are particularly prone to developing mental health issues which persist through adolescence and into adult life. The purpose of this article is to introduce a framework for promoting psychological resilience in children and adolescents with BIF. Three interrelated and complementary factors require professional attention and efforts to improve resilience in children with borderline intelligence: a protecting a child’s self-worth, b generating sources of social support, c training of adaptive coping skills. The significance of early diagnosis and continuous monitoring of a child’s development is also discussed. Children with BIF should be provided with internal (self-worth, coping skills and external (social support resources to enhance their resilience and ability to confront adversities, and to reduce the risk of mental health issues.
[Impulse control disorders in borderline and antisocial personality disorder].
Herpertz, S
2007-01-18
A borderline personality disorder is associated with highly impulsive acts that cannot be controlled by cognitive inhibition. In a psychopathic/antisocial personality disorder emotional inhibition of hostile acts is lacking. The patient has a high proclivity for risk-seeking, and is incapable of responding appropriately to punishment. In both disorders, the result is (auto)aggressive behavior. The family doctor must refer such patients to a specialist, when there is an acute danger of self-harm or when a grave functional limitation in the areas of work or interpersonal relationship has persisted over a long period of time.
Aaltonen, K I; Rosenström, T; Baryshnikov, I; Karpov, B; Melartin, T; Suominen, K; Heikkinen, M; Näätänen, P; Koivisto, M; Joffe, G; Isometsä, E
2017-07-01
Substantial evidence supports an association between childhood maltreatment and suicidal behaviour. However, few studies have examined factors mediating this relationship among patients with unipolar or bipolar mood disorders. Depressive disorder and bipolar disorder (ICD-10-DCR) patients (n=287) from the Helsinki University Psychiatric Consortium (HUPC) Study were surveyed on self-reported childhood experiences, current depressive symptoms, borderline personality disorder traits, and lifetime suicidal behaviour. Psychiatric records served to complement the information on suicide attempts. We examined by formal mediation analyses whether (1) the effect of childhood maltreatment on suicidal behaviour is mediated through borderline personality disorder traits and (2) the mediation effect differs between lifetime suicidal ideation and lifetime suicide attempts. The impact of childhood maltreatment in multivariate models on either lifetime suicidal ideation or lifetime suicide attempts showed comparable total effects. In formal mediation analyses, borderline personality disorder traits mediated all of the total effect of childhood maltreatment on lifetime suicide attempts, but only one fifth of the total effect on lifetime suicidal ideation. The mediation effect was stronger for lifetime suicide attempts than for lifetime suicidal ideation (P=0.002) and independent of current depressive symptoms. The mechanisms of the effect of childhood maltreatment on suicidal ideation versus suicide attempts may diverge among psychiatric patients with mood disorders. Borderline personality disorder traits may contribute to these mechanisms, although the influence appears considerably stronger for suicide attempts than for suicidal ideation. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Howard, Rick; Huband, Nick; Duggan, Conor
2012-05-01
This study tested the hypothesis that adult antisocial syndrome co-concurrent with borderline personality disorder (AAS + BPD) would be associated with greater conduct disorder (CD) severity than AAS alone. Sixty-nine personality disordered individuals exhibited a sufficient number of adult antisocial traits to meet DSM-IV criterion A for antisocial personality disorder (AsPD). These were subdivided into those who did (AAS + BPD) or did not (AAS alone) meet DSM-IV criteria for a BPD diagnosis. We then compared the 2 groups on CD symptoms and historical, clinical, and self-report measures. The mean number of CD criteria met and the total number of individual CD symptoms were significantly greater in the AAS + BPD group compared with the AAS alone group. The former also were more likely to be female, to have self-harmed, to show greater personality disorder comorbidity, and to self-report greater anger. The functional link between CD and adult antisocial symptoms appears to be mediated, or at least moderated, by co-occurring borderline pathology.
van der Molen, M.J.; van Luit, J.E.H.; van der Molen, M.W.; Klugkist, I.; Jongmans, M.J.
2010-01-01
Background: The goal of this study is to evaluate the effectiveness of a computerised working memory (WM) training on memory, response inhibition, fluid intelligence, scholastic abilities and the recall of stories in adolescents with mild to borderline intellectual disabilities attending special
Kutcher, S; Papatheodorou, G; Reiter, S; Gardner, D
1995-01-01
Borderline personality disorder is a significantly disabling disturbance often arising in adolescents or young adults. In the absence of demonstrated effective treatments in this population, this open prospective study evaluated the effect of low dose (3 mg per day) flupenthixol in 13 rigorously diagnosed adolescents with borderline personality disorder. Therapeutic outcome over eight weeks of treatment assessed across measures of impulsivity, depression/dysphoria, general psychopathology and global functioning showed significant improvement in all spheres. These findings suggest that low dose flupenthixol may have a role to play in the short-term treatment of this population. PMID:7703220
Hurtado, M M; Triviño, M; Arnedo, M; Roldán, G; Tudela, P
2016-12-30
This research explored the relationship between executive functions (working memory and reasoning subtests of the Wechsler Adult Intelligence Scale, Trail Making and Stroop tests, fluency and planning tasks, and Wisconsin Card Sorting Test) and emotional intelligence measured by the Mayer-Salovey-Caruso Emotional Intelligence Test in patients with schizophrenia or borderline personality disorder compared to a control group. As expected, both clinical groups performed worse than the control group in executive functions and emotional intelligence, although the impairment was greater in the borderline personality disorder group. Executive functions significantly correlated with social functioning. Results are discussed in relation to the brain circuits that mediate executive functions and emotional intelligence and the findings obtained with other models of social cognition. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Becker, Daniel F.; Añez, Luis Miguel; Paris, Manuel; Grilo, Carlos M.
2009-01-01
This study examined the factor structure of the DSM-IV criteria for borderline personality disorder (BPD) in Hispanic patients. Subjects were 130 monolingual Hispanic adults who had been admitted to a specialty outpatient clinic that provides psychiatric and substance abuse services to Spanish-speaking individuals. All were reliably assessed with the Spanish-Language Version of the Diagnostic Interview for DSM-IV Personality Disorders. After evaluating internal consistency of the BPD criterion set, an exploratory factor analysis was performed using principal axis factoring. Results suggested a unidimensional structure, and were consistent with similar studies of the DSM-IV criteria for BPD in non-Hispanic samples. These findings have implications for understanding borderline psychopathology in this population, and for the overall validity of the DSM-IV BPD construct. PMID:20472296
How Do Stress Exposure and Stress Regulation Relate to Borderline Personality Disorder?
Bourvis, Nadège; Aouidad, Aveline; Cabelguen, Clémence; Cohen, David; Xavier, Jean
2017-01-01
Borderline personality disorder (BPD) is a severe and frequent disorder characterized by a pervasive pattern of instability affecting impulse control, emotional regulation, cognitive processing, self-image and interpersonal relationships. Patients’ personal histories are often marked by stressful or traumatic experiences, either unique or repeated. Moreover, while clinical signs of the disorder include both chronic and acute features, acute features are mostly triggered by acute stressful sit...
Wlodarczyk, Julian; Lawn, Sharon
2017-01-01
Victimisation is a traumatic experience linked to development of Borderline personality disorder (BPD). However, there is limited research investigating the developmental journey prior to BPD diagnosis. School environments offer an opportunity for BPD prevention and early intervention. A survey with 19 Australian family carers of people with BPD…
A Borderline Ovarian Tumour in a Patient with Classic Bladder Exstrophy; a Case Report.
LENUS (Irish Health Repository)
Beauchamp, K
2018-02-01
A 37-year-old Romanian lady presented with a large pelvic mass, urosepsis and deteriorating renal function. She had undergone separation from her conjoined twin. Imaging revealed grossly abnormal anatomy and a suspicious pelvic mass. Examination was consistent with classic bladder exstrophy. Postoperative histology showed borderline ovarian tumour (BTO)
Jung, Saem; Lee, Sang-Hyun; Lee, Jong Ho
2015-01-01
Hypertriglyceridemia (HTG) is a risk factor for atherosclerotic cardiovascular disease (CVD). We investigated alterations in plasma metabolites associated with borderline-to-moderate HTG (triglycerides (TG) 150-500 mg/dL). Using UPLC-LTQ-Orbitrap mass spectrometry analysis, the metabolomics profiles of 111 non-diabetic and non-obese individuals with borderline-to-moderate HTG were compared with those of 111 age- and sex-matched controls with normotriglyceridemia (NTG, TG amides, including N-ethyldodecanamide (q = 2.9E-05), N-propyldodecanamide (q = 3.5E-05), palmitoleamide (q = 2.9E-06), and palmitic amide (q = 0.019). The metabolomic profiles of the HTG group also exhibited lower plasma levels of cis-4-octenedioic acid (qamides, and cis-4-octenedioic acid among non-diabetic and non-obese individuals with borderline-to-moderate HTG. These results provide novel insights into the metabolic alterations that occur in the early metabolic stages of HTG. This information may facilitate the design of early interventions to prevent disease progression. PMID:25856314
Abnormalities in cortical gray matter density in borderline personality disorder
Rossi, Roberta; Lanfredi, Mariangela; Pievani, Michela; Boccardi, Marina; Rasser, Paul E; Thompson, Paul M; Cavedo, Enrica; Cotelli, Maria; Rosini, Sandra; Beneduce, Rossella; Bignotti, Stefano; Magni, Laura R; Rillosi, Luciana; Magnaldi, Silvia; Cobelli, Milena; Rossi, Giuseppe; Frisoni, Giovanni B
2015-01-01
Background Borderline personality disorder (BPD) is a chronic condition with a strong impact on patients‘ affective,cognitive and social functioning. Neuroimaging techniques offer invaluable tools to understand the biological substrate of the disease. We aimed to investigate gray matter alterations over the whole cortex in a group of Borderline Personality Disorder (BPD) patients compared to healthy controls (HC). Methods Magnetic resonance-based cortical pattern matching was used to assess cortical gray matter density (GMD) in 26 BPD patients and in their age- and sex-matched HC (age: 38±11; females: 16, 61%). Results BPD patients showed widespread lower cortical GMD compared to HC (4% difference) with peaks of lower density located in the dorsal frontal cortex, in the orbitofrontal cortex, the anterior and posterior cingulate, the right parietal lobe, the temporal lobe (medial temporal cortex and fusiform gyrus) and in the visual cortex (p<0.005). Our BPD subjects displayed a symmetric distribution of anomalies in the dorsal aspect of the cortical mantle, but a wider involvement of the left hemisphere in the mesial aspect in terms of lower density. A few restricted regions of higher density were detected in the right hemisphere. All regions remained significant after correction for multiple comparisons via permutation testing. Conclusions BPD patients feature specific morphology of the cerebral structures involved in cognitive and emotional processing and social cognition/mentalization, consistent with clinical and functional data. PMID:25561291
van Nieuwenhuijzen, M.; Vriens, A.
2012-01-01
The purpose of this study was to examine the unique contributions of (social) cognitive skills such as inhibition, working memory, perspective taking, facial emotion recognition, and interpretation of situations to the variance in social information processing in children with mild to borderline
Borderline personality disorder and emotional intelligence.
Peter, Mathell; Schuurmans, Hanneke; Vingerhoets, Ad J J M; Smeets, Guus; Verkoeijen, Peter; Arntz, Arnoud
2013-02-01
The present study investigated emotional intelligence (EI) in borderline personality disorder (BPD). It was hypothesized that patients with BPD (n = 61) compared with patients with other personality disorders (PDs; n = 69) and nonpatients (n = 248) would show higher scores on the ability to perceive emotions and impairments in the ability to regulate emotions. EI was assessed with the Mayer-Salovey-Caruso Emotional Intelligence Test (Mayer, Salovey, and Caruso [New York: MHS, 2002]). As compared with the PD group and the nonpatient group, the patients with BPD displayed the anticipated deficits in their ability to understand, whereas no differences emerged with respect to their ability to perceive, use, and regulate emotions. In addition, a negative relationship was found between the severity of BPD and total EI score. However, this relationship disappeared when intelligence quotient was partialled out. These results suggest that BPD is associated with emotion understanding deficits, whereas temporary severity of BPD is associated with emotion regulation deficits.
van Asselt-Goverts, A. E.; Embregts, P. J. C. M.; Hendriks, A. H. C.
2018-01-01
Background: Little is known about the effectiveness of interventions aimed at enhancing the social networks of people with intellectual disabilities. This study explores the results of such an intervention. How did the clients with mild to borderline intellectual disabilities and their support workers evaluate the intervention? What did they learn…
Neiditch, Emily R.
2010-01-01
Borderline personality disorder (BPD) puts great stress on the family system as family members cope with difficult symptoms, accompanying stigma, and caregiver burden. However, development and research on family interventions for BPD lags behind that of other serious mental illnesses. The current study describes a sample of family members,…
Dickens, Geoffrey L; Lamont, Emma; Stirling, Fiona J
2018-06-01
There is increasing interest in the use of commercial movies in nursing education, or "cinenurducation". There is a need for educational interventions which target mental health nurses' attitudes towards people with borderline personality disorder. To investigate and evaluate the experience and effects of attendance at a screening of the movie Ida's Diary, a first-person account of living with borderline personality disorder. Mixed methods design comprising a within-subjects AB longitudinal survey, and a qualitative analysis of participant-generated data and researcher field notes from a World Café discussion group. One university in Scotland. N = 66 undergraduate and postgraduate mental health nursing and counselling students. Participants completed measures of cognitive and emotional attitudes towards, and knowledge about, people with borderline personality disorder before and after one of two film screenings. We conducted a World Café discussion group after the second screening. Resulting data were subject to a qualitative thematic analysis. Quantitative analysis revealed a five-factor cognitive and a single-factor emotional attitude structure. Cognitive-attitudinal items related to treatment deservingness and value of mixed treatment approaches improved across iterations. Total knowledge score did not change, but one item about borderline personality disorder as a precursor to schizophrenia received considerably more incorrect endorsement post-screening. Qualitative analysis revealed five themes: Facilitation and inhibition of learning; promotion but not satiation of appetite for knowledge; challenging existing understanding; prompting creativity and anxiety; and initiating thinking about the bigger picture. Participants found the film thought provoking; it increased their appetite for knowledge. Findings suggest that screening should be delivered in conjunction with more didactic information about borderline personality disorder. Copyright © 2018
Lang, R.B.; Didden, H.C.M.; Sigafoos, J.; Rispoli, M.; Regester, A.; Lancioni, G.E.
2009-01-01
We present the case of a 17-year-old girl with Asperger syndrome and borderline intellectual disability with a 5-year history of chronic skin-picking. Our intervention approach included an initial functional assessment to identify variables maintaining skin-picking, followed by evaluation of a
Ben-Porath, Denise D.
2004-01-01
Therapists often struggle with managing intersession contact with clients diagnosed with borderline personality disorder, particularly when dangerous and life-threatening symptoms are communicated (Gunderson, 1996). Difficulties have arisen, in part, because previous phone contacts with this population have failed to recognize the importance of…
Child-Parent Attachment Styles and Borderline Personality Disorder Relationship
Directory of Open Access Journals (Sweden)
Senija Tahirovic
2016-08-01
Full Text Available Many studies have focused on the attachment styles and their impact on human functioning and relationships (Bretherton, 1992. Some attachment styles have been associated with pathological way of human overall functioning, and it has already been observed that insecure attachment style in childhood may be associated with personality dysfunction (Brennan & Shaver, 1998. The purpose of this study is to investigate how people diagnosed with borderline personality disorder (BPD describe their attachment style to the primary caregivers from their memories from childhood. This study was conducted in Germany in an inpatient psychiatric clinic. Fifteen participants represented a convenience sample, of patients already diagnosed with BPD. For this study Adult Attachment Interview (AAI was used. The AAI is a semi-structured interview focusing on the early attachment experiences and their effects based on Attachment Theory.The results indicated that people diagnosed with BPD showed both preoccupied and dismissing child-parent attachment style,however it was the dismissing attachment style that dominated in our sample. The findings supported the hypothesis that participants who showed dismissing attachment style also used positive adjectives to describe the relationship with their primary caregiver, and those with the preoccupied attachment style used negative adjectives to describe the relationship with their primary caregiver. Even though, study was conducted with small number of participants, the study did provide evidence that there is a relationship between BPD and attachment styles in childhood. Threfore, the study offered contribution to the already existing knowledge and research findings regarding the influence of attachment style on BPD development. Keywords: Attachment, Personality disorder, Borderline Personality Disorder (BPD, child, childhood
Inpatient management of borderline personality disorder at Helen Joseph Hospital, Johannesburg
Directory of Open Access Journals (Sweden)
Laila Paruk
2016-06-01
Full Text Available Objective: The aim of this report was to establish a profile of patients with borderline personality disorder (BPD admitted to the acute inpatient psychiatric assessment unit at the Helen Joseph Hospital, in Johannesburg, over the course of 1 year. Methods: A retrospective record review was conducted to investigate the prevalence, demographics, reasons for admission, treatment, length of stay and follow-up of a group of inpatients during 2010 with a diagnosis of BPD, based on DSM-IV-TR diagnostic criteria, allocated on discharge. Results: Considering evidence retrospectively, the quality of the BPD diagnosis allocated appeared adequate. Statistical analysis revealed findings mainly in keeping with other reports, for example, that patients with BPD are above-average users of resources who make significantly more use of emergency services and that they generally do not adhere well to their scheduled outpatient follow-up arrangements. The longer average length of inpatient stay of this group with BPD, however, exceeded the typically brief period generally recommended for acute inpatient containment and emergency intervention. Conclusion: Implementation of targeted prevention and early intervention strategies, based on systematised programmes such as dialectical behavioural therapy and mentalisation based therapy, may be useful in addressing these problems experienced with integrating the in- and outpatient management of BPD. Keywords: Borderline personality; inpatient; acute
Hayakawa, Masaya
2009-01-01
The aim of this work was to examine a possible treatment for patients with borderline personality disorder who have wrist-cutting syndrome, a condition characterized by repeated, superficial wrist cutting in a non-suicidal fashion. Within the current healthcare system in Japan, the average amount of time a doctor can spend with a psychiatric outpatient is about 8 to 15 minutes. We, therefore, examined whether repeated 15-minute psychotherapy sessions to improve patient assertiveness would be effective for reducing wrist cutting and possibly other forms of self-mutilation. We treated 13 patients diagnosed with borderline personality disorder and wrist-cutting syndrome with assertiveness training during 15-minute, biweekly therapy sessions over a course of one to four years. At the conclusion of psychotherapeutic treatment, 69% of outpatients showed a statistically significant reduction in wrist-cutting behavior.
Patient-reported outcomes in borderline personality disorder
Hasler, Gregor; Hopwood, Christopher J.; Jacob, Gitta A.; Brändle, Laura S.; Schulte-Vels, Thomas
2014-01-01
Patient-reported outcome (PRO) refers to measures that emphasize the subjective view of patients about their health-related conditions and behaviors. Typically, PROs include self-report questionnaires and clinical interviews. Defining PROs for borderline personality disorder (BPD) is particularly challenging given the disorder's high symptomatic heterogeneity, high comorbidity with other psychiatric conditions, highly fluctuating symptoms, weak correlations between symptoms and functional outcomes, and lack of valid and reliable experimental measures to complement self-report data. Here, we provide an overview of currently used BPD outcome measures and discuss them from clinical, psychometric, experimental, and patient perspectives. In addition, we review the most promising leads to improve BPD PROs, including the DSM-5 Section III, the Recovery Approach, Ecological Momentary Assessments, and novel experimental measures of social functioning that are associated with functional and social outcomes. PMID:25152662
Bayes, Adam; Graham, Rebecca K; Parker, Gordon B; McCraw, Stacey
2018-06-01
Recent research indicates that borderline personality disorder (BPD) can be diagnostically differentiated from the bipolar disorders. However, no studies have attempted to differentiate participants with sub-threshold bipolar disorder or SubT BP (where hypomanic episodes last less than 4 days) from those with a BPD. In this study, participants were assigned a SubT BP, bipolar II disorder (BP II) or BPD diagnosis based on clinical assessment and DSM-IV criteria. Participants completed self-report measures and undertook a clinical interview which collected socio-demographic information, a mood history, family history, developmental history, treatment information, and assessed cognitive, emotional and behavioural functioning. Both bipolar groups, whether SubT BP or BP II, differed to the BPD group on a number of key variables (i.e. developmental trauma, depression correlates, borderline personality scores, self-harm and suicide attempts), and compared to each other, returned similar scores on nearly all key variables. Borderline risk scores resulted in comparable classification rates of 0.74 (for BPD vs BP II) and 0.82 (for BPD vs sub-threshold BP II). Study findings indicate that both SubT BP and BP II disorder can be differentiated from BPD on a set of refined clinical variables with comparable accuracy. Copyright © 2018 Elsevier B.V. All rights reserved.
Grilo, Carlos M.; Sanislow, Charles A.; Gunderson, John G.; Pagano, Maria E.; Yen, Shirley; Zanarini, Mary C.; Shea, Tracie M.; Skodol, Andrew E.; Stout, Robert L.; Morey, Leslie C.; McGlashan, Thomas H.
2004-01-01
The authors examined the stability of schizotypal (STPD), borderline (BPD), avoidant (AVPD) and obsessive-compulsive (OCPD) personality disorders (PDs) over 2 years of prospective multiwave follow-up. Six hundred thirty-three participants recruited at 4 collaborating sites who met criteria for 1 or more of the 4 PDs or for major depressive…
Bernardon, Stephanie; Pernice-Duca, Francesca
2012-01-01
Borderline personality disorder (BPD) presents a number of symptoms and adjustment issues for individuals, but it is also associated with a myriad of risks for the larger family system. A systemic perspective is crucial to comprehending the development of BPD. Promoting healthy relationships with one or more supportive adult enables the child to…
Bedics, Jamie D.; Atkins, David C.; Comtois, Katherine A.; Linehan, Marsha M.
2012-01-01
Objective: The present study explored the role of the therapeutic relationship and introject during the course of dialectical behavior therapy (DBT; Linehan, 1993) for the treatment of borderline personality disorder. Method: Women meeting "DSM-IV" criteria for borderline personality disorder (N = 101) were randomized to receive DBT or community…
Perugi, Giulio; Toni, Cristina; Travierso, Maria Chiara; Akiskal, Hagop S
2003-01-01
Recent data, including our own, indicate significant overlap between atypical depression and bipolar II. Furthermore, the affective fluctuations of patients with these disorders are difficult to separate, on clinical grounds, from cyclothymic temperamental and borderline personality disorders. The present analyses are part of an ongoing Pisa-San Diego investigation to examine whether interpersonal sensitivity, mood reactivity and cyclothymic mood swings constitute a common diathesis underlying the atypical depression-bipolar II-borderline personality constructs. We examined in a semi-structured format 107 consecutive patients who met criteria for major depressive episode with DSM-IV atypical features. Patients were further evaluated on the basis of the Atypical Depression Diagnostic Scale (ADDS), the Hopkins Symptoms Check-list (HSCL-90), and the Hamilton Rating Scale for Depression (HRSD), coupled with its modified form for reverse vegetative features as well as Axis I and SCID-II evaluated Axis II comorbidity, and cyclothymic dispositions ('APA Review', American Psychiatric Press, Washington DC, 1992). Seventy-eight percent of atypical depressives met criteria for bipolar spectrum-principally bipolar II-disorder. Forty-five patients who met the criteria for cyclothymic temperament, compared with the 62 who did not, were indistinguishable on demographic, familial and clinical features, but were significantly higher in lifetime comorbidity for panic disorder with agoraphobia, alcohol abuse, bulimia nervosa, as well as borderline and dependent personality disorders. Cyclothymic atypical depressives also scored higher on the ADDS items of maximum reactivity of mood, interpersonal sensitivity, functional impairment, avoidance of relationships, other rejection avoidance, and on the interpersonal sensitivity, phobic anxiety, paranoid ideation and psychoticism of the HSCL-90 factors. The total number of cyclothymic traits was significantly correlated with 'maximum
Childhood Precursors of Adult Borderline Personality Disorder Features: A Longitudinal Study.
Cramer, Phebe
2016-07-01
This study identifies childhood personality traits that are precursors of adult Borderline Personality Disorder (BPD) features. In a longitudinal study, childhood personality traits were assessed at age 11 (N = 100) using the California Child Q-set (CCQ: Block and Block, 1980). A number of these Q-items were found to be significantly correlated (p personality dimensions: Impulsivity and Nonconformity/Aggression. The findings thus provide evidence that childhood personality traits predict adult BPD features. Identifying such childhood precursors provides an opportunity for early intervention.
Tumor Filóides Borderline: Relato de caso
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MARINA PIRASSOL TEPEDINO
2016-12-01
Full Text Available O presente artigo tem o objetivo de narrar o caso de uma jovem de 24 anos, que teve quadro de Tumor Filóides do tipo borderline, evidenciado durante cirurgia de excisão de fibroadenoma, e diagnosticado por exame histopatológico da lesão, sendo futuramente reabordado com nova cirurgia. O Tumor Filóides é uma neoplasia fibroepitelial incomum da mama, representando de 0,3 a 0,9% de todos os tumores primários daquele órgão. É comumente vista entre pacientes com 40-50 anos. Sendo mais raro ainda sua apresentação em jovens. Por fim este artigo apresenta breve revisão de literatura, mostrando que a conduta utilizada no caso foi correta.
Douma, J.C.H.; Dekker, M.C.; de Ruiter, K.P.; Verhulst, F.C.; Koot, H.M.
2006-01-01
OBJECTIVE: To study the help-seeking process of parents for emotional or behavioral problems in their child with borderline to moderate intellectual disabilities. METHOD: In 2003, in a special education-based sample of 522 youths (ages 10-18years, response = 77.9%), we studied the parents'
Duijvenbode, N. van; Didden, H.C.M.; Voogd, H.F.J.M.; Korzilius, H.P.L.M.; Engels, R.C.M.E.
2012-01-01
The primary aim of the present pilot study was to examine cognitive biases in individuals with mild to borderline ID and alcohol use-related problems. Participants (N = 57) performed the approach avoidance task, picture rating task and visual dot probe task, which was combined with eye-tracking
van Alebeek, A.; van der Heijden, P.T.; Hessels, C.; Thong, Melissa; van Aken, M.A.G.
2017-01-01
One of the most common personality disorders among adolescents and young adults is the Borderline Personality Disorder (BPD). The objective of current study was to assess three questionnaires that can reliably screen for BPD in adolescents and young adults (N = 53): the McLean Screening Instrument
The development of an attachment-based treatment program for borderline personality disorder.
Bateman, Anthony W; Fonagy, Peter
2003-01-01
The treatment of borderline personality disorder (BPD) remains controversial. The authors have developed an evidence-based treatment program rooted in attachment theory that integrates research on constitutional factors with environmental influences. BPD is conceived of as a disorder in the self-structure brought about through environmentally induced distortion of psychological functioning, which decouples key mental processes necessary for interpersonal and social function. The primary mental function involved is mentalization, which is enfeebled by an absence of contingent and marked mirroring during development. Treatment strategies target mentalization in order to foster the development of stable internal representations, to aid the formation of a coherent sense of self, and to enable to borderline patient to form more secure relationships in which motivations of self and other are better understood. Destabilization of the self leads to emotional volatility, so treatment also needs to focus on identification and appropriate expression of affect. This article describes some of the techniques used to enhance mentalization within the context of group and individual psychotherapy. Targeting of current symptomatology and behavior is insufficient. Therapists need to retain their own ability to mentalize, maintain mental closeness, focus on current mental states, and avoid excessive use of conflict interpretation and metaphor while paying careful attention to the use of transference and countertransference.
Nouwens, P.J.G.; Lucas, R.; Smulders, N.B.M.; Embregts, P.J.C.M.; van Nieuwenhuizen, Ch.
2017-01-01
Background Persons with mild intellectual disability or borderline intellectual functioning are often studied as a single group with similar characteristics. However, there are indications that differences exist within this population. Therefore, the aim of this study was to identify classes of
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Alireza Aghayousefi
2015-09-01
Full Text Available Objective: This study aimed to examine the effect of dialectic behavior therapy on the reduction of impulsiveness in women with comorbidity of borderline personality disorders and substance abuse. Method: An experimental single system research design using multiple baselines was employed for this study. Based on the structured diagnostic interview and entry criteria, four participants among female patients with borderline personality disorders and substance abuse were selected via purposive sampling method. All four subjects received twelve dialectic behavior therapy sessions. Then, Impulsiveness Bart Scale (IBS was used to measure impulsiveness. Results: Dialectic behavior therapy led to the significant reduction of impulsiveness scores in women with borderline personality disorders and substance abuse. Graphs pertaining to the effectiveness and effect size indicate a significant decrease in participants’ impulsiveness. Conclusion: Dialectic behavior therapy interventions can contribute to the decrease of impulsiveness and bring about desired practical implications in the treatment and prevention of substance abuse.
Dammann, Gerhard; Riemenschneider, Anke; Walter, Marc; Sollberger, Daniel; Küchenhoff, Joachim; Gündel, Harald; Clarkin, John F; Gremaud-Heitz, Daniela J
Borderline personality disorder (BPD) is a very common illness; interpersonal problems are one of the core features. The purpose of this study was to investigate the changes in interpersonal problems after transference-focused psychotherapy (TFP)-based disorder-specific treatment and to explore whether the severity of interpersonal problems could serve as a predictor for other variables. A sample of 37 inpatients with BPD was assessed with the Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID I and II) and had to complete a questionnaire including the Inventory of Interpersonal Problems (IIP-C), Inventory of Personality Organization (IPO), Beck Depression Inventory (BDI), Spielberger State and Trait Inventory (STAI), Spielberger State and Trait Anger Inventory (STAXI), and Symptom Checklist-90 (SCL-90-R). After 12 weeks of TFP-based disorder-specific treatment, the patients repeated the same questionnaire; 7 patients had to be excluded from the study, and thus calculations were conducted with 30 patients. After treatment, the patients showed a significant decrease in the IIP total item score and all 8 subscales except the domineering, intrusive, and cold scales. The IIP total item baseline score was correlated with borderline symptomatic and psychopathology [e.g. anxiety, Global Severity Index (GSI)] after 12 weeks as well as with most IIP postsubscales. Although interpersonal problems are considered one of the more stable features of BPD, our results showed a significant improvement after 12 weeks of TFP-based disorder-specific inpatient treatment, especially in the total score and the subscales on the friendly submissive level. The severity of interpersonal problems at baseline was connected to outcome values of other borderline features as well as general psychiatric complaints. It therefore seems important to consider the treatment of interpersonal problems in therapy to be of greater significance. © 2016 S. Karger AG, Basel.
Diamond, Diana; Levy, Kenneth N; Clarkin, John F; Fischer-Kern, Melitta; Cain, Nicole M; Doering, Stephan; Hörz, Susanne; Buchheim, Anna
2014-10-01
We investigated attachment representations and the capacity for mentalization in a sample of adult female borderline patients with and without comorbid narcissistic personality disorder (NPD). Participants were 22 borderline patients diagnosed with comorbid NPD (NPD/BPD) and 129 BPD patients without NPD (BPD) from 2 randomized clinical trials. Attachment and mentalization were assessed on the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1996). Results showed that as expected, compared with the BPD group, the NPD/BPD group was significantly more likely to be categorized as either dismissing or cannot classify on the AAI, whereas the BPD group was more likely to be classified as either preoccupied or unresolved for loss and abuse than was the NPD/BPD group. Both groups of patients scored low on mentalizing, and there were no significant differences between the groups, indicating that both NPD/BPD and BPD individuals showed deficits in this capacity. The clinical implications of the group differences in AAI classification are discussed with a focus on how understanding the attachment representations of NPD/BPD patients helps to illuminate their complex, contradictory mental states. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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José Álvaro Pereira Gomes
2009-04-01
Full Text Available Paciente apresentou falência de transplante de limbo e conjuntiva de doador vivo alógeno no olho direito após ceratoconjuntivite epidêmica. Após alguns meses, foi submetida a transplante de células-tronco epiteliais límbicas alógenas cultivadas ex vivo sobre membrana amniótica (primeiro caso no Brasil, tendo evoluído com epitelização total da córnea e melhora da acuidade visual. Após o 3º mês da cirurgia, iniciou-se neovascularização superficial periférica com piora da transparência corneana. A visão manteve-se 0,1 após um ano de cirurgia.Case report of a patient who developed failure of an allogenic living related conjunctival limbal transplantation in the right eye after an episode of epidemic keratoconjunctivitis. After a few months, she underwent transplantation of allogenic limbal epithelial stem cells cultivated ex vivo on amniotic membrane (first case in Brazil. The patient evolved with total corneal epithelialization and improvement of the visual acuity. Three months after the surgery, peripheral superficial neovascularization with worsening of the corneal transparency was observed. The vision remained 0.1 after one year of the transplantation.
Van der Molen, M. J.; Van Luit, J. E. H.; Van der Molen, M. W.; Klugkist, I.; Jongmans, M. J.
2010-01-01
Background: The goal of this study is to evaluate the effectiveness of a computerised working memory (WM) training on memory, response inhibition, fluid intelligence, scholastic abilities and the recall of stories in adolescents with mild to borderline intellectual disabilities attending special education. Method: A total of 95 adolescents with…
van Nieuwenhuijzen, M.; Vriens, A.
2012-01-01
The purpose of this study was to examine the unique contributions of (social) cognitive skills such as inhibition, working memory, perspective taking, facial emotion recognition, and interpretation of situations to the variance in social information processing in children with mild to borderline intellectual disabilities. Respondents were 79…
Tene, O; Har-Even, A; Dahan, E; Babokshin, Y; Reuveni, I; Ponarovsky, B; Rosman, V; Gluzman, L
2011-01-01
Clinical dilemma: A 20-year-old female patient, diagnosed as suffering from borderline personality disorder, is referred to your clinic. Her disorder is characterized by unstable personal relationships, impulsivity, suicidal behavior, emotional instability and pan-anxiety. After initiation of pharmacological treatment which you have chosen, you meet with her parents who ask you which is better for their daughter dynamic-analytic psychotherapy or dialectical behavioral therapy.
Bohus, M; Schmahl, C; Herpertz, S C; Lieb, K; Berger, M; Roepke, S; Heinz, A; Gallinat, J; Lyssenko, L
2016-07-01
Borderline personality disorders (BPD) are severe mental diseases which place high pressure on the psychiatric healthcare system. Nowadays, well-tested, disorder-specific treatment concepts are available also for inpatient treatment in Germany. These show very good and long-term improvements in the psychopathology as well as posttreatment social participation; however, prerequisites for the implementation of these evidence-based inpatient psychotherapy programs are well-trained treatment teams and appropriate financing of resource expenditure. The aim was to formulate a definition of normative needs for treatment duration and intensity for a guideline-conform, empirically proven and effective inpatient treatment of borderline personality disorder as well as the derived personnel requirements in comparison to the currently available resources within the framework of the Psychiatry Personnel Act (Psych-PV). The resource requirements were established based on evaluated hospital ward models, the recommendations of the S2 guidelines and the criteria of specialist societies and compared with the personnel stipulations according to the Psych-PV. The results for a normatively established treatment program showed a pronounced deficit in the financing of the evaluated resource requirements, even when the stipulations laid down in the Psych-PV were implemented to 100 %. Disorder-specific inpatient treatment programs for borderline personality disorder have been scientifically proven to be highly effective; however, resource analyses show that the personnel requirements necessary for effective implementation of these programs are much higher than those allocated by the funding according to the Pysch-PV. The current underfunding leads to inadequate treatment outcomes with high readmission rates and as a result high direct and indirect costs of illness.
Sauer, Shannon E.; Baer, Ruth A.
2010-01-01
Linehan's biosocial theory suggests that borderline personality disorder (BPD) results from a transaction of two childhood precursors: emotional vulnerability and an invalidating environment. Until recently, few empirical studies have explored relationships between these theoretical precursors and symptoms of the disorder. Psychometrically sound…
Distel, M.A.; Middeldorp, C.M.; Trull, T.J.; Derom, C.A.; Willemsen, G.; Boomsma, D.I.
2011-01-01
Background Traumatic life events are generally more common in patients with borderline personality disorder (BPD) than in non-patients or patients with other personality disorders. This study investigates whether exposure to life events moderates the genetic architecture of BPD features. As the
Lobbestael, J.; Arntz, A.
2015-01-01
Background: One of the core postulated features of borderline personality disorder (BPD) is extreme emotional reactivity to a wide array of evocative stimuli. Findings from previous experimental research however are mixed, and some theories suggest specificity of hyper emotional responses, as being
Dijk, F.E. van; Schellekens, A.F.A.; Broek, P.J.A. van den; Kan, C.C.; Verkes, R.J.; Buitelaar, J.K.
2014-01-01
This study examined whether cognitive measures of response inhibition derived from the AX-CPT are able to differentiate between adult attention deficit/hyperactivity disorder (ADHD), borderline personality disorder (BPD), and healthy controls (HC). Current DSM-IV-TR symptoms of ADHD and BPD were
Croes, S; Beisser, P S; Terporten, P H; Neef, C; Deurenberg, R H; Stobberingh, E E
Since it is unknown whether β-lactam antimicrobial agents can be used effectively against borderline oxacillin-resistant Staphylococcus aureus (BORSA) with oxacillin MICs ≥4 mg/L, the in vitro bactericidal activity and pharmacodynamic effect of oxacillin against clinical BORSA isolates was
Marques, Sofia; Barrocas, Daniel; Rijo, Daniel
2017-01-01
Introduction: Borderline personality disorder is the most common personality disorder, with a global prevalence rate between 1.6% and 6%. It is characterized by affective disturbance and impulsivity, which lead to a high number of self-harm behaviors and great amount of health services use. International guidelines recommend psychotherapy as the primary treatment for borderline personality disorder. This paper reviews evidence about the effects and efficacy of cognitive-behavioral oriented ps...
Rasmussen, Christina B.; Kjaer, Susanne K.; Albieri, Vanna; Bandera, Elisa V.; Doherty, Jennifer A.; Høgdall, Estrid; Webb, Penelope M.; Jordan, Susan J.; Rossing, Mary Anne; Wicklund, Kristine G.; Goodman, Marc T.; Modugno, Francesmary; Moysich, Kirsten B.; Ness, Roberta B.; Edwards, Robert P.; Schildkraut, Joellen M.; Berchuck, Andrew; Olson, Sara H.; Kiemeney, Lambertus A.; Massuger, Leon F. A. G.; Narod, Steven A.; Phelan, Catherine M.; Anton-Culver, Hoda; Ziogas, Argyrios; Wu, Anna H.; Pearce, Celeste L.; Risch, Harvey A.; Jensen, Allan
2017-01-01
Inflammation has been implicated in ovarian carcinogenesis. However, studies investigating the association between pelvic inflammatory disease (PID) and ovarian cancer risk are few and inconsistent. We investigated the association between PID and the risk of epithelial ovarian cancer according to tumor behavior and histotype. We pooled data from 13 case-control studies, conducted between 1989 and 2009, from the Ovarian Cancer Association Consortium (OCAC), including 9,162 women with ovarian cancers, 2,354 women with borderline tumors, and 14,736 control participants. Study-specific odds ratios were estimated and subsequently combined into a pooled odds ratio using a random-effects model. A history of PID was associated with an increased risk of borderline tumors (pooled odds ratio (pOR) = 1.32, 95% confidence interval (CI): 1.10, 1.58). Women with at least 2 episodes of PID had a 2-fold increased risk of borderline tumors (pOR = 2.14, 95% CI: 1.08, 4.24). No association was observed between PID and ovarian cancer risk overall (pOR = 0.99, 95% CI: 0.83, 1.19); however, a statistically nonsignificantly increased risk of low-grade serous tumors (pOR = 1.48, 95% CI: 0.92, 2.38) was noted. In conclusion, PID was associated with an increased risk of borderline ovarian tumors, particularly among women who had had multiple episodes of PID. Although our results indicated a histotype-specific association with PID, the association of PID with ovarian cancer risk is still somewhat uncertain and requires further investigation. PMID:27941069
Lindenboim, Noam; Comtois, Katherine Anne; Linehan, Marsha M.
2007-01-01
Dialectical Behavior Therapy (DBT) is an evidence-based practice for borderline personality disorder (BPD) and suicidal behavior that has been replicated with a variety of populations. Patients' practice of behavioral skills taught in the group skills training component of DBT may be partly responsible for the positive treatment outcomes according…
Stepp, Stephanie D.
2012-01-01
Recognizable symptoms and features of borderline personality disorder (BPD) appear during adolescence. However, there has been resistance to diagnose or research this disorder prior to adulthood because of clinical lore that BPD is a long-standing illness and that personality traits are not stable until adulthood. This has resulted in little…
Pos, Alberta E; Greenberg, Leslie S
2012-02-01
Emotion-focused therapy (EFT) is an empirically supported treatment that may have potential as a stage-two treatment for borderline personality disorder (BPD). Specific aspects of BPD--the tendency to experience fluctuating self-states; weakness in meta-cognitive or reflective functioning; and the tendency for self-states to be organized by presently occurring interpersonal processes--present challenges to applying some EFT interventions with this population. In particular, even within a highly attuned, validating and accepting empathic relationship, clients with BPD may have difficulty with the usual manualizations of chair work interventions. This is because these interventions often employ polarization and intensification of experience in order to activate adaptive alternate emotional resources and self organizations. For the client with borderline personality disorder, these interventions may be counter-productive, emotionally dysregulating and disorganizing. EFT chair work, however, also has the potential to provide structure to the borderline clients experience of self, to stimulate metacognitive awareness, provide an alive experience of the process of polarization, attenuate emotional activation, and increase the experience of self-coherence. This article describes the development of stepwise approximations of EFT two-chair intervention for self-critical splits. It outlines potential stages of two-chair work as well as intervention principles important for productive chair work with this population. The EFT change principles of awareness, expression regulation, reflection, transformation, and corrective experience still centrally apply. However, several additional strategies are discussed to scaffold clients' capacity to both experience and regulate emotion.
Social cognition in borderline personality disorder
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Stefan eRoepke
2013-01-01
Full Text Available Many typical symptoms of borderline personality disorder (BPD occur within interpersonal contexts, suggesting that BPD is characterized by aberrant social cognition. While research consistently shows that BPD patients have biases in mental state attribution (e.g., evaluate others as malevolent, the research focusing on accuracy in inferring mental states (i.e., cognitive empathy is less consistent. For complex and ecologically valid tasks in particular, emerging evidence suggests that individuals with BPD have impairments in the attribution of emotions, thoughts, and intentions of others (e.g., Preißler et al., 2010. A history of childhood trauma and co-morbid PTSD seem to be strong additional predictors for cognitive empathy deficits. Together with reduced emotional empathy and aberrant sending of social signals (e.g., expression of mixed and hard-to-read emotions, the deficits in attribution might contribute to behavioral problems in BPD. Given the importance of social cognition on the part of both the sender and the recipient in maintaining interpersonal relationships and therapeutic alliance, these impairments deserve more attention.
UNDERWOOD, MARION K.; BERON, KURT J.; ROSEN, LISA H.
2011-01-01
This investigation examined the relation between developmental trajectories jointly estimated for social and physical aggression and adjustment problems at age 14. Teachers provided ratings of children's social and physical aggression in Grades 3, 4, 5, 6, and 7 for a sample of 255 children (131 girls, 21% African American, 52% European American, 21% Mexican American). Participants, parents, and teachers completed measures of the adolescent's adjustment to assess internalizing symptoms, rule-breaking behaviors, and borderline and narcissistic personality features. Results showed that membership in a high and rising trajectory group predicted rule-breaking behaviors and borderline personality features. Membership in a high desister group predicted internalizing symptoms, rule-breaking behaviors, and borderline and narcissistic personality features. The findings suggest that although low levels of social and physical aggression may not bode poorly for adjustment, individuals engaging in high levels of social and physical aggression in middle childhood may be at greatest risk for adolescent psychopathology, whether they increase or desist in their aggression through early adolescence. PMID:21532919
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M GannadiFarnood
2014-12-01
Full Text Available Objective: This research was an attempt to predict the tendency of people having borderline personality traits to smoking, drinking alcohol, and taking psychoactive drugs based on emotional dysregulation and child abuse. Method: This study employed a correlation method which is categorized in descriptive category. A sample including 600 male and female bachelor students of Tabriz University was selected by cluster sampling. Then, high risk behaviors scale, Emotional dysregulation Scale, Child abuse scale, and borderline personality scale (STB were distributed among this group. Findings: Stepwise multiple regression analysis suggested that emotional dysregulation and child abuse significantly predicted varying degrees of smoking, drug, and alcohol usage. Conclusion: The research findings suggest the basic role of initial biological vulnerability in terms of emotional regulation (dysregulation and invalidating family environment (child abuse in the prediction of catching the disorder of borderline personality traits and producing high riskbehaviorssuch as alcohol drink and drug usage.
Schuppert, H.M.; Albers, C.J.; Minderaa, R.B.; Emmelkamp, P.M.G.; Nauta, M.H.
2015-01-01
The development of borderline personality disorder (BPD) has been associated with parenting styles and parental psychopathology. Only a few studies have examined current parental rearing styles and parental psychopathology in relationship to BPD symptoms in adolescents. Moreover, parenting stress
Schuppert, H. Marieke; Albers, Casper J.; Minderaa, Ruud B.; Emmelkamp, Paulus; Nauta, Maaike H.
The development of borderline personality disorder (BPD) has been associated with parenting styles and parental psychopathology. Only a few studies have examined current parental rearing styles and parental psychopathology in relationship to BPD symptoms in adolescents. Moreover, parenting stress
Rizvi, Shireen L.; Linehan, Marsha M.
2005-01-01
This study sought to pilot test a short-term intervention for maladaptive shame in borderline personality disorder (BPD) based on the skill of "opposite action" from dialectical behavior therapy. Five women with BPD were treated with the intervention using a single-subject, multiple-baseline design. Results indicate that, although state ratings of…
Spinhoven, Philip; Giesen-Bloo, Josephine; van Dyck, Richard; Kooiman, Kees; Arntz, Arnoud
2007-01-01
This study investigated the quality and development of the therapeutic alliance as a mediator of change in schema-focused therapy (SFT) and transference-focused psychotherapy (TFP) for borderline personality disorder. Seventy-eight patients were randomly allocated to 3 years of biweekly SFT or TFP. Scores of both therapists and patients for the…
Muehlenkamp, Jennifer J.; Ertelt, Troy W.; Miller, Alec L.; Claes, Laurence
2011-01-01
Background: There is little research on how specific borderline personality disorder (BPD) symptoms relate to suicide attempts or suicide and non-suicidal self-injury (NSSI) within adolescent populations, which is important to know given the recent proposal of an NSSI disorder. Even less well known is whether specific BPD symptoms distinguish NSSI…
Conceptual Changes to the Definition of Borderline Personality Disorder Proposed for DSM-5
Samuel, Douglas B.; Widiger, Thomas A.; Pilkonis, Paul A.; Miller, Joshua D.; Lynam, Donald R.; Ball, Samuel A.
2011-01-01
The Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Personality and Personality Disorders Work Group proposed the elimination of diagnostic criterion sets in favor of a prototype matching system that defines personality disorders using narrative descriptions. Although some research supports this general approach, no empirical studies have yet examined the specific definitions proposed for DSM–5. Given the wide interest in borderline personality disorder (BPD), it is crucial to d...
[Role of the family in the development of borderline personality disorder].
Gagnon, P
1993-11-01
The role of family in the development of borderline personality disorder is examined with an emphasis on dimensions of family functioning. A synthesis of theoretical concepts implicating such factors, derived mostly from psychoanalysis, is proposed with an emphasis on separation-individuation, early frustrations, regression to recognition memory, oscillations in attachment and social influences. Empirical studies are reviewed. Affective neglect and parental overprotection are often cited, although dysfunctional behaviour control may have a regulatory effect on these factors and a crucial impact on psychic reality of the patient recalling his childhood.
Emotional Processes in Borderline Personality Disorder: An Update for Clinical Practice
Dixon-Gordon, Katherine L.; Peters, Jessica R.; Fertuck, Eric A.; Yen, Shirley
2016-01-01
Despite prior assumptions about poor prognosis, the surge in research on borderline personality disorder (BPD) over the past several decades shows that it is treatable and can have a good prognosis. Prominent theories of BPD highlight the importance of emotional dysfunction as core to this disorder. However, recent empirical research suggests a more nuanced view of emotional dysfunction in BPD. This research is reviewed in the present article, with a view towards how these laboratory-based findings can influence clinical work with individuals suffering from BPD. PMID:29527105
Linehan, Marsha M; McDavid, Joshua D; Brown, Milton Z; Sayrs, Jennifer H R; Gallop, Robert J
2008-06-01
This double-blind study examined whether olanzapine augments the efficacy of dialectical behavior therapy (DBT) in reducing anger and hostility in borderline personality disorder patients. Twenty-four women with borderline personality disorder (DSM-IV criteria) and high levels of irritability and anger received 6 months of DBT. Subjects were randomly assigned to receive either low-dose olanzapine or placebo and were assessed with standardized measures in a double-blind manner. The study was conducted from September 2000 to December 2002. Intent-to-treat analyses indicated that both treatment conditions resulted in significant improvement in irritability, aggression, depression, and self-inflicted injury (p borderline personality disorder. Effect sizes were moderate to large, with the small sample size likely limiting the ability to detect significant results. Overall, there were large and consistent reductions in irritability, aggression, depression, and self-injury for both groups of subjects receiving DBT.
van der Molen, M.J.
2010-01-01
The validity of Baddeley's working memory model within the typically developing population, was tested. However, it is not clear if this model also holds in children and adolescents with mild to, borderline intellectual disabilities (ID; IQ score 55-85). The main purpose of this study was therefore,
van Zutphen, Linda; Siep, Nicolette; Jacob, Gitta A; Goebel, R.; Arntz, Arnoud
Emotional sensitivity, emotion regulation and impulsivity are fundamental topics in research of borderline personality disorder (BPD). Studies using fMRI examining the neural correlates concerning these topics is growing and has just begun understanding the underlying neural correlates in BPD.
Borderline Personality Disorder and Oxytocin: Review of Clinical Trials and Future Directions.
Amad, Ali; Thomas, Pierre; Perez-Rodriguez, M Mercedes
2015-01-01
Borderline personality disorder (BPD) is a common mental disorder characterized by a pervasive pattern of emotional Borderline personality disorder (BPD) is a common mental disorder characterized by a pervasive pattern of emotional lability, impulsivity, interpersonal difficulties, identity disturbances, and disturbed cognition. Traditional pharmacotherapies are effective in treating some of these core symptoms but have only modest effects on the domain of interpersonal dysfunction of BPD. Thus there is a need to develop new, neurobiologically informed pharmacological treatments for BPD. This review focuses on the potential use of intranasal oxytocin (OXT), which has key roles in the regulation of complex social cognition and behaviors, to target symptoms of interpersonal dysfunction in BPD. Surprisingly, despite promising data on the prosocial effects of OXT, only 5 trials in BPD have been published to date. These trials show mixed results with on one hand, a decrease of emotional responses to stress and on the other hand, some "paradoxical" reactions with worsened interpersonal anxiety and decreased cooperative behavior. These mixed results are interpreted according to different theoretical models and also in light of some methodological limitations. Further studies are needed to understand the effect of OXT in patients with BPD and ongoing clinical trials will provide some answers to remaining questions on the use of OXT in BPD. Recommendations for future studies are also proposed in this review.
Blagov, Pavel S; Westen, Drew
2008-11-01
After the introduction of histrionic personality disorder (HPD), nosologists struggled to reduce its overlap with borderline personality disorder and other PDs. We studied the coherence of HPD in adults and adolescents as part of 2 larger studies. Clinicians described a random patient with personality pathology using rigorous psychometrics, including the SWAP-II (a Q-sort that captures personality and its pathology in adults) in study 1 and the SWAP-II-A (the adolescent version) in study 2. Using DSM-IV-based measures, we identified patients who met HPD criteria with varying degrees of diagnostic confidence. Central tendencies in the SWAP-II and SWAP-II-A profiles revealed that both the most descriptive and most distinctive features of the patients included some features of HPD but also many features of borderline personality disorder. Q-factor analyses of the SWAP data yielded 3 types of patients in each of the 2 samples. The HPD diagnosis may not be sufficiently coherent or valid.
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Simić I.
2013-01-01
Full Text Available Despite the wide usage of exercise ECG tests and Duke Treadmill Score (DTS in clinical practice, no comparison between this scoring system and Fractional Flow Reserve (FFR has yet been made, particularly in cases of angiographically verified borderline lesions. Thirty patients with single coronary lesions and angiographically assessed borderline stenosis (between 30-70% and previously calculated intermediate values of DTS between -10 to +4 were examined using FFR. Adequate specificity and sensitivity (0.769 and 0.556, respectively were in a more narrow range of -0.5 to -10. Sex and age did not have an influence on the DTS values. There was a correlation between the values of FFR and age (r=0.395, p=0.031 and between angiographic assessment of stenosis and quantitative coronary angiography (QCA (r=0.648, p<0.0001. In the study population, a decision on revascularization could not be based solely on angiographic or QCA assessment of the artery or on the values of DTS.
Goodwin, Jean M.
2005-01-01
This brief review traces the evolution of clinical understanding about borderline syndromes during the last three decades of the 20th century. The focus shifted from descriptive phenomenology in the 1970s to documenting linkages with childhood trauma in the 1980s. In the 1990s, effective and teachable techniques for emotional containment in these…
Hypersensitivity in borderline personality disorder during mindreading.
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Carina Frick
Full Text Available BACKGROUND: One of the core symptoms of borderline personality disorder (BPD is the instability in interpersonal relationships. This might be related to existent differences in mindreading between BPD patients and healthy individuals. METHODS: We examined the behavioural and neurophysiological (fMRI responses of BPD patients and healthy controls (HC during performance of the 'Reading the Mind in the Eyes' test (RMET. RESULTS: Mental state discrimination was significantly better and faster for affective eye gazes in BPD patients than in HC. At the neurophysiological level, this was manifested in a stronger activation of the amygdala and greater activity of the medial frontal gyrus, the left temporal pole and the middle temporal gyrus during affective eye gazes. In contrast, HC subjects showed a greater activation in the insula and the superior temporal gyri. CONCLUSION: These findings indicate that BPD patients are highly vigilant to social stimuli, maybe because they resonate intuitively with mental states of others.
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Olga N. Tucker
2008-01-01
Full Text Available Synchronous major vessel resection during pancreaticoduodenectomy (PD for borderline resectable pancreatic adenocarcinoma remains controversial. In the 1970s, regional pancreatectomy advocated by Fortner was associated with unacceptably high morbidity and mortality rates, with no impact on long-term survival. With the establishment of a multidisciplinary approach, improvements in preoperative staging techniques, surgical expertise, and perioperative care reduced mortality rates and improved 5-year-survival rates are now achieved following resection in high-volume centres. Perioperative morbidity and mortality following PD with portal vein resection are comparable to standard PD, with reported 5-year-survival rates of up to 17%. Segmental resection and reconstruction of the common hepatic artery/proper hepatic artery (CHA/PHA can be performed to achieve an R0 resection in selected patients with limited involvement of the CHA/PHA at the origin of the gastroduodenal artery (GDA. PD with concomitant major vessel resection for borderline resectable tumours should be performed when a margin-negative resection is anticipated at high-volume centres with expertise in complex pancreatic surgery. Where an incomplete (R1 or R2 resection is likely neoadjuvant treatment with systemic chemotherapy followed by chemoradiation as part of a clinical trial should be offered to all patients.
Palomares, Nerea; McMaster, Antonia; Díaz-Marsá, Marina; de la Vega, Irene; Montes, Ana; Carrasco, José Luis
2016-11-01
Current literature suggests that personality disorder comorbidity negatively contributes to both the severity and prognosis of other disorders; however, little literature has been devoted to its influence on borderline personality disorder (BPD). The objective of the present work is to study comorbidity with other personality disorders in a severe clinical sample of patients with BPD, and its relationship with global functionality. A sample of 65 patients with severe borderline personality disorder was included in the study. Clinical and functionality measures were applied in order to study comorbidity of BPD with other disorders and its relationship with functionality. Associations with other comorbid PDs were analyzed with t-tests and linear correlations. Most patients (87%) presented comorbidity with other PDs. Almost half of the sample (42%) presented more than two PDs, and cluster A (paranoid) and C (obsessive and avoidant) PD were more frequent than cluster B (histrionic and antisocial). Only the presence of avoidant PD predicted a worse functional outcome in the long term (U Mann Withney ppersonality disorder might negatively predict for prognosis.
Van Veen, M M; Karsten, J; Lancel, M
2017-01-01
Studies investigating sleep and personality disorders consistently demonstrate a relation between personality disorders characterized by behavioral disinhibition and/or emotional dysregulation (traditionally termed cluster B personality disorders) and poor sleep. This finding is in line with previous studies associating insomnia with impulsive behavior, since this is a core characteristic of both antisocial and borderline personality disorder. The current study investigates a group (n = 112) of forensic psychiatric inpatients with antisocial or borderline personality disorder or traits thereof. Subjective sleep characteristics and impulsivity were assessed with the Pittsburgh Sleep Quality Index, the Sleep Diagnosis List, and the Barratt Impulsiveness Scale, respectively. More than half of the patients (53.6%) report poor sleep quality and 22.3% appears to suffer from severe chronic insomnia. Both poor sleep quality and chronic insomnia are significantly associated with self-reported impulsivity, in particular with attentional impulsiveness. This association was not significantly influenced by comorbid disorders. Actively treating sleep problems in these patients may not only improve sleep quality, mental health, and physical well-being, but may also have impact on impulsivity-related health risks by increasing self-control.
Donges, Uta-Susan; Dukalski, Bibiana; Kersting, Anette; Suslow, Thomas
2015-01-01
Instability of affects and interpersonal relations are important features of borderline personality disorder (BPD). Interpersonal problems of individuals suffering from BPD might develop based on abnormalities in the processing of facial affects and high sensitivity to negative affective expressions. The aims of the present study were to examine automatic evaluative shifts and latencies as a function of masked facial affects in patients with BPD compared to healthy individuals. As BPD comorbidity rates for mental and personality disorders are high, we investigated also the relationships of affective processing characteristics with specific borderline symptoms and comorbidity. Twenty-nine women with BPD and 38 healthy women participated in the study. The majority of patients suffered from additional Axis I disorders and/or additional personality disorders. In the priming experiment, angry, happy, neutral, or no facial expression was briefly presented (for 33 ms) and masked by neutral faces that had to be evaluated. Evaluative decisions and response latencies were registered. Borderline-typical symptomatology was assessed with the Borderline Symptom List. In the total sample, valence-congruent evaluative shifts and delays of evaluative decision due to facial affect were observed. No between-group differences were obtained for evaluative decisions and latencies. The presence of comorbid anxiety disorders was found to be positively correlated with evaluative shifting owing to masked happy primes, regardless of baseline-neutral or no facial expression condition. The presence of comorbid depressive disorder, paranoid personality disorder, and symptoms of social isolation and self-aggression were significantly correlated with response delay due to masked angry faces, regardless of baseline. In the present affective priming study, no abnormalities in the automatic recognition and processing of facial affects were observed in BPD patients compared to healthy individuals
Directory of Open Access Journals (Sweden)
Sybilla Blasczyk-Schiep
2016-01-01
Full Text Available Background The aim of this research is to determine the level of emotion regulation, studied through the method of variable action orientation vs. state and its relationship with depressiveness and dimension of the reasons for living and self-harming behaviour of patients with borderline personality disorder. Participants and procedure The research studied 61 patients diagnosed with an emotionally unstable personality of borderline type. The research used the Polish adaptation of tests to measure the action vs. state orientation (SSI-K, the self-harming behaviour (SHI, depression (BDI and the reasons for living vs. suicidal tendency (RFL-I. Results In people with borderline personality disorder, the level of emotion regulation (action vs. state orientation, reasons for living and depression are predictors of self-harming behaviour. The experience of a depressive episode or lack thereof does not have a relationship with the increase of self-harming. Analysis of the interaction between variables showed that the reasons for living and the action orientation after failure are related to the reduction of self-harming behaviour in all subjects. In depressed people, state orientation is associated with an increase in the action orientation with decreased self-destructive behaviours. Conclusions High levels of reasons for living in interaction with the action orientation have a negative relationship with the self-harming behaviour of patients diagnosed with borderline personality disorder. Among those subjects, depressive patients, a statistically lower level of self-harm is related to the action orientation. These results suggest that therapeutic treatment is important to activate both reasons for living as well as action orientation as effective dimensions in preventing self-harming.
Serum CA 125, carcinoembryonic antigen, and CA 19-9 as tumor markers in borderline ovarian tumors
Engelen, MJA; de Bruijn, HWA; Hollema, H; ten Koor, KA; Willemse, PHB; Aalders, JG; van der Zee, AGJ
Objectives. The goals of this study were to analyze preoperative serum levels of CA 125, carcinoembryonic antigen (CEA), and CA 19-9 in patients with borderline ovarian tumors and to investigate if routine assessment of these markers in follow-up may lead to earlier detection of recurrence. Methods.
Draper, Matthew R.; Faulkner, Ginger E.
2009-01-01
This case study examines the dynamics and challenges associated with counseling a client experiencing borderline personality disorder in the small college institutional context. The work of counseling centers at small private institutions has been relatively unexplored in the extant college counseling literature. To help fill this gap, the current…
Hoțoiu, Maria; Tavella, Federico; Treur, Jan
2018-01-01
This paper presents a computational network model for a person with a Borderline Personality Disorder. It was designed according to a Network-Oriented Modeling approach as a temporal-causal network based on neuropsychological background knowledge. Some example simulations are discussed. The model
Harned, Melanie S; Jackson, Safia C; Comtois, Katherine A; Linehan, Marsha M
2010-08-01
This study examined the efficacy of dialectical behavior therapy (DBT) in reducing behaviors commonly used as exclusion criteria for posttraumatic stress disorder (PTSD) treatment. The sample included 51 suicidal and/or self-injuring women with borderline personality disorder (BPD), 26 (51%) of whom met criteria for PTSD. BPD clients with and without PTSD were equally likely to eliminate the exclusionary behaviors during 1 year of DBT. By posttreatment, 50-68% of the BPD clients with PTSD would have been suitable candidates for PTSD treatment. Borderline personality disorder clients with PTSD who began treatment with a greater number of recent suicide attempts and more severe PTSD were significantly less likely to become eligible for PTSD treatment.
Monika Marszał; Dominika Górska
2015-01-01
Background The aim of this study was to broaden the understanding of the emotional difficulties of borderline personality organization (BPO) by reference to a meta-ability named ‘orientation on the internal world’, here conceptualized as mentalization and mindfulness, in the framework of object relation theory. It was assumed that it is not mentalization “in itself”, but mainly its regulatory function, that is important for BPO. Participants and procedure The clinical and ...
2014-01-01
Background Severe borderline personality disorder is associated with a very high psychosocial and economic burden. Current treatment guidelines suggest that several manualized treatments, including day hospital Mentalization-Based Treatment (MBT-DH), are effective in these patients. However, only two randomized controlled trials have compared manualized MBT-DH with treatment as usual. Given the relative paucity of data supporting the efficacy and cost-effectiveness of MBT-DH, the possible influence of researcher allegiance in one of the trials, and potential problems with the generalization of findings to mental health systems in other countries, this multi-site randomized trial aims to investigate the efficacy and cost-effectiveness of manualized MBT-DH compared to manualized specialist treatment as usual in The Netherlands. Methods/design The trial is being conducted at two sites in The Netherlands. Patients with a DSM-IV-TR diagnosis of borderline personality disorder and a score of ≥ 20 on the Borderline Personality Disorder Severity Index were randomly allocated to MBT-DH or treatment as usual. The MBT-DH program consists of a maximum of 18 months’ intensive treatment, followed by a maximum of 18 months of maintenance therapy. Specialist treatment as usual is provided by the City Crisis Service in Amsterdam, a service that specializes in treating patients with personality disorders, offering manualized, non-MBT interventions including family interventions, Linehan training, social skills training, and pharmacotherapy, without a maximum time limit. Patients are assessed at baseline and subsequently every 6 months up to 36 months after the start of treatment. The primary outcome measure is the frequency and severity of manifestations of borderline personality disorder as assessed by the Borderline Personality Disorder Severity Index. Secondary outcome measures include parasuicidal behaviour, symptomatic distress, social and interpersonal functioning
Laurenssen, Elisabeth M P; Westra, Dieuwertje; Kikkert, Martijn J; Noom, Marc J; Eeren, Hester V; van Broekhuyzen, Anna J; Peen, Jaap; Luyten, Patrick; Busschbach, Jan J V; Dekker, Jack J M
2014-05-22
Severe borderline personality disorder is associated with a very high psychosocial and economic burden. Current treatment guidelines suggest that several manualized treatments, including day hospital Mentalization-Based Treatment (MBT-DH), are effective in these patients. However, only two randomized controlled trials have compared manualized MBT-DH with treatment as usual. Given the relative paucity of data supporting the efficacy and cost-effectiveness of MBT-DH, the possible influence of researcher allegiance in one of the trials, and potential problems with the generalization of findings to mental health systems in other countries, this multi-site randomized trial aims to investigate the efficacy and cost-effectiveness of manualized MBT-DH compared to manualized specialist treatment as usual in The Netherlands. The trial is being conducted at two sites in The Netherlands. Patients with a DSM-IV-TR diagnosis of borderline personality disorder and a score of ≥ 20 on the Borderline Personality Disorder Severity Index were randomly allocated to MBT-DH or treatment as usual. The MBT-DH program consists of a maximum of 18 months' intensive treatment, followed by a maximum of 18 months of maintenance therapy. Specialist treatment as usual is provided by the City Crisis Service in Amsterdam, a service that specializes in treating patients with personality disorders, offering manualized, non-MBT interventions including family interventions, Linehan training, social skills training, and pharmacotherapy, without a maximum time limit. Patients are assessed at baseline and subsequently every 6 months up to 36 months after the start of treatment. The primary outcome measure is the frequency and severity of manifestations of borderline personality disorder as assessed by the Borderline Personality Disorder Severity Index. Secondary outcome measures include parasuicidal behaviour, symptomatic distress, social and interpersonal functioning, personality functioning
Gungor, Tayfun; Altinkaya, S Ozlem; Akbay, Serap; Bilge, Umit; Mollamahmutoglu, Leyla
2010-03-01
Cystic tumors of ovary, whether benign, borderline, or malignant may be associated with mural nodule of various types, including sarcomas, sarcoma-like mural nodules (SLMN), and foci of anaplastic carcinoma. Cases of serous borderline ovarian tumor with mural nodules of mixed type are very rare. A 54-year-old woman referred with abdominal swelling. Imaging studies revealed a huge mass localized in pelvis and lower abdomen and grade 1-2 left renal hydronephrosis. Preoperative Ca-125 was 798 U/ml. In exploratory laparotomy there was a 16 cm mass adherent to lateral abdominal wall and intestines. Adhesiolysis and de-bulking surgery were performed including bilateral pelvic, para-aortic lymphadenectomy, appendectomy and omentectomy. Left ureter was found to be dilated because of the infiltration of distal part by the tumor, so distal ureteral resection and neoureterocystostomy were performed. Final pathology revealed borderline serous ovarian tumor with mural nodules which were consisted of SLMNs, multiple and sharply demarcated from the adjacent tumor, and sarcomatous nodules showing infiltrative appearance in metastatic regions. Mural nodules showed a positive reaction for vimentin and SMA but were negative for cytokeratin and also necrosis, hemorrhage, and 10-15 mitoses in 10 high power fields were noted. She had postoperative chemotherapy and follow-up is going on without metastases in her first year. The existence of sarcomatous nodules combined with the SLMN necessitates a careful histologic analysis for treatment and the determination of prognosis. However, too few cases of mixed type mural nodules have been published to warrant a conclusion regarding their prognosis.
Mistry, Sumit; Zammit, Stanley; Price, Valentina-Escott; Jones, Hannah J; Smith, Daniel J
2017-10-15
There is limited understanding of the symptomatic development of bipolar disorder from childhood to early adulthood. We assessed whether borderline personality disorder traits, ADHD, and emotional, behavioural and social difficulties during childhood were associated with hypomania assessed in young adulthood. We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), to examine associations between measures of childhood psychopathology and lifetime hypomanic features assessed at age 22-23 years using the Hypomania Checklist-32 (HCL-32; n = 3372). We also conducted a factor analysis of the HCL to identify latent constructs underlying hypomania, and the extent to which childhood psychopathology was associated with these. We identified two factors of the HCL corresponding to energy/mood and risk-taking/irritability. There was evidence of association between childhood borderline personality disorder traits and both hypomania factors, with evidence that the association was stronger with the risk-taking/irritability factor. All individual borderline traits, with the exception of fear of abandonment, were associated with hypomania. There was also evidence of association between most other measures of childhood psychopathology (ADHD, hyperactivity, conduct problems, peer relationship problems and reduced prosocial behaviour) and the risk-taking/irritability factor, but much less consistent evidence of association with the energy/mood factor. The HCL cannot diagnose bipolar disorder and may be subject to reporting bias. A broad range of childhood psychopathologies may represent early markers of risk for hypomania. Further studies are required to understand the mechanisms underlying these associations, and to inform earlier detection of bipolar disorder. Copyright © 2017 Elsevier B.V. All rights reserved.
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Tuhkanen, Hanna; Soini, Ylermi; Kosma, Veli-Matti; Anttila, Maarit; Sironen, Reijo; Hämäläinen, Kirsi; Kukkonen, Laura; Virtanen, Ismo; Mannermaa, Arto
2009-01-01
Transcription factor Snail1 has a central role in induction of epithelial-mesenchymal transition (EMT). The aim of the present study was to elucidate the expression of Snail1 protein during epithelial ovarian tumourigenesis and to study the association of Snail1 expression with clinicopathological factors and prognosis. Epithelial and stromal fibroblast-like fusiform cells of 14 normal ovarian samples, 21 benign, 24 borderline and 74 malignant epithelial ovarian tumours were studied for Snail1 protein using immunohistochemistry. Nuclei of surface peritoneal cells of normal ovaries (n = 14) were regarded as negative for Snail1. Nuclear expression of Snail1 protein in epithelial ovarian tumours was increased during tumour progression from precursor lesions into carcinomas both in epithelial (p = 0.006) and stromal cells (p = 0.007). Nuclei of benign tumours (n = 21) were negative for Snail1. In borderline tumours (n = 24) occasional positive epithelial cells were found in 2 (8%) samples and in 3 (13%) samples stromal cells were focally positive for Snail1. In carcinomas (n = 74) focal Snail1 staining in epithelial cells was present in 17 (23%) tumours, and in stromal cells in 18 (24%) tumours. Nuclear expression of Snail1 in epithelial or stromal cells was not associated with clinicopathological factors or prognosis. Nuclear Snail1 expression seems to be related to tumour progression, and expression in borderline tumours indicates a role for Snail1 in early epithelial ovarian tumour development. Snail1 also appears to function more generally in tissue remodelling as positive staining was demonstrated in stromal cells
Wong, H M; Chow, L Y
2011-06-01
Borderline personality disorder is an important but under-recognised clinical entity, for which there are only a few available diagnostic instruments in the Chinese language. None has been tested for its psychometric properties in the Cantonese-speaking population in Hong Kong. The present study aimed to assess the validity of the Chinese version of the Borderline Personality Disorder subscale of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders Axis II Personality Disorders (SCID-II) in Cantonese-speaking Hong Kong Chinese. A convenience sampling method was used. The subjects were seen by a multidisciplinary clinical team, who arrived at a best-estimate diagnosis and then by application of the SCID-II rater using the Chinese version of the Borderline Personality Disorder subscale. The study was carried out at the psychiatric clinic of the Prince of Wales Hospital in Hong Kong. A total of 87 patients of Chinese ethnicity aged 18 to 64 years who attended the clinic in April 2007 were recruited. The aforementioned patient parameters were used to examine the internal consistency, best-estimate clinical diagnosis-SCID diagnosis agreement, sensitivity, and specificity of the Chinese version of the subscale. The Borderline Personality Disorder subscale (Chinese version) of SCID-II had an internal consistency of 0.82 (Cronbach's alpha coefficient), best-estimate clinical diagnosis-SCID diagnosis agreement of 0.82 (kappa), sensitivity of 0.92, and specificity of 0.94. The Borderline Personality Disorder subscale (Chinese version) of the SCID-II rater had reasonable validity when applied to Cantonese-speaking Chinese subjects in Hong Kong.
Dream analysis in the psychodynamic psychotherapy of borderline patients.
Stone, Michael H
2012-06-01
Despite Freud's dictum that dreams are the royal road to the unconscious, the use of dream analysis by therapists working with Borderline Personality Disorder and other severe psychiatric conditions has in the past two decades has fallen into a state of decline, if not outright neglect. The reasons why are not altogether clear, though some have said that the growing popularity of ego psychology and other movements in the domain of psychoanalysis have perhaps pushed dream analysis to one side. To me this marginalization seems unjustified. I hope to demonstrate in this article the enduring utility of dream analysis in working with the more severely disordered patients, with the aim of revivifying its application--and its efficacy--in our work with such patients.
Schuiringa, H.D.
2014-01-01
Children with mild to borderline intellectual disabilities (MBID; IQ between 55 and 85 with problems in adaptive functioning) have been found to show higher rates of emotional and externalizing behavior problems and their externalizing behavior problems tend to persist over time, more so than those
DEFF Research Database (Denmark)
Andreasson, Kate; Krogh, Jesper; Wenneberg, Christina
2016-01-01
were: severity of borderline symptoms, depressive symptoms, hopelessness, suicide ideation, and self-esteem. RESULTS: At 28 weeks, the number of participants with new self-harm in the DBT group was 21 of 57 (36.8%) versus 12 of 51 (23.5%) in the CAMS treatment (OR: 1.90; 95% CI: 0.80-4.40; P = .14......BACKGROUND: Many psychological treatments have shown effect on reducing self-harm in adults with borderline personality disorder. There is a need of brief psychotherapeutical treatment alternative for suicide prevention in specialized outpatient clinics. METHODS/DESIGN: The DiaS trial was designed...... as a pragmatic single-center, two-armed, parallel-group observer-blinded, randomized clinical superiority trial. The participants had at least two criteria from the borderline personality disorder diagnosis and a recent suicide attempt (within a month). The participants were offered 16 weeks of dialectical...
Características neuropsicológicas de alunos com funcionamento intelectual borderline
Dias, Andrea Baptista Água
2016-01-01
Dissertação de mestrado em Temas de Psicologia do Desenvolvimento, apresentada à Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra. Os Slow Learners são alunos com Funcionamento Intelectual Borderline (FIB) que frequentemente se debatem para acompanhar as exigências académicas. O presente estudo teve como objetivo contribuir para aumentar o conhecimento em relação a estes alunos, tendo-se realizado um estudo empírico comparativo e correlacional, com uma ...
Directory of Open Access Journals (Sweden)
Sheila E. Crowell
2016-11-01
Full Text Available Borderline personality disorder (BPD is a complex psychiatric diagnosis characterized by dysregulated behaviors, emotions, cognitions, and interpersonal relationships. In recent years, developmental psychopathologists have sought to identify early origins of BPD, with the ultimate goal of developing and providing effective preventative interventions for those at highest risk. In addition to heritable biological sensitivities, many scholars assert that environmental and interpersonal risk factors contribute to the emergence and maintenance of key borderline traits. Nonetheless, many BPD researchers examine only affected individuals, neglecting the family, peer, couple, and other dynamic contextual forces that impinge upon individual-level behavior. In the past decade, however, theoretical and empirical research has increasingly explored the interpersonal causes, correlates, and consequences of BPD. Such work has resulted in novel research and clinical theories intended to better understand and improve interpersonal dynamics among those with borderline traits. A major objective for the field is to better characterize how interpersonal dynamics affect (and are affected by the behaviors, emotions, and thoughts of vulnerable individuals to either reduce or heighten risk for BPD.
Staff perceptions of borderline personality disorder and recovery: A Q-sort method approach.
Dean, Rebecca; Siddiqui, Sara; Beesley, Frank; Fox, John; Berry, Katherine
2018-04-16
This study was the first to explore how staff that work with people diagnosed with borderline personality disorder (BPD) perceive recovery in this client group. These views are important because of the crucial role that staff play in the care of people with BPD, and the challenges that staff experience with these clients. A Q methodology design was used, containing 58 statements about recovery. Twenty-nine mental health staff sorted recovery statements according to perceived importance to recovery in BPD. There were two different viewpoints about recovery in BPD. A medically oriented group viewed coping with symptoms and behaviours specific to BPD as being most important to recovery, whereas participants who were more well-being oriented viewed achieving overall well-being that was universally valued regardless of diagnosis as more important. Both groups reported that engaging in socially valued activities such as work and education was not an important aspect of recovery and that people with BPD could be considered to have recovered despite continued impairments in everyday functioning. Staff perceptions of recovery in BPD can differ, which poses risks for consistent team working, a particularly important issue in this client group due to the relational difficulties associated with the diagnosis. Multidisciplinary teams working with people diagnosed with BPD therefore need to find a forum to promote a shared understanding of each patient's needs and support plans. We advocate that team formulation is a promising approach to achieve more consistent ways of working within teams. Findings Multidisciplinary teams working with people with borderline personality disorder should use team formulations to create a shared understanding of individual patient's needs and goals for recovery, so they can deliver a consistent approach to care. Recovery questionnaires should be used to develop an understanding of a patient's individual recovery goals. Limitations Opportunity
Witt, S.H.; Streit, F.; Jungkunz, M; Frank, J.; Awasthi, S; Reinbold, C S; Treutlein, J.; Degenhardt, F.; Forstner, A. J.; Heilmann-Heimbach, S.; Dietl, L; Schwarze, C E; Schendel, D.J.; Strohmaier, J.; Abdellaoui, A; Adolfsson, R; Air, T M; Akil, H.; Lopezz de Alda, M.; Alliey-Rodriguez, N; Andreassen, O. A.; Babadjanova, G; Bass, N.J.; Bauer, M.; Baune, Bernard T; Bellivier, F.; Bergen, S. E.; Bethell, A.; Biernacka, J.M.; Blackwood, D H R; Boks, Marco P; Boomsma, D I; Børglum, Anders D; Borrmann-Hassenbach, M; Brennan, P.; Budde, M.; Buttenschøn, H N; Byrne, Enda M; Cervantes, P; Clarke, T.K.; Craddock, N.; Cruceanu, C; Curtis, D.; de Geus, E J C; Fischer, S B; Hottenga, J-J; Middeldorp, C M; Milaneschi, Y; Penninx, B W J H; Willemsen, G
2017-01-01
Borderline personality disorder (BOR) is determined by environmental and genetic factors, and characterized by affective instability and impulsivity, diagnostic symptoms also observed in manic phases of bipolar disorder (BIP). Up to 20% of BIP patients show comorbidity with BOR. This report
International Nuclear Information System (INIS)
Yeo, Dong Myung; Rha, Sung Eun; Byun, Jae Young; Lee, Ahwon; Kim, Mee Ran
2013-01-01
We report MR imaging findings of a rare case of endocervical mucinous borderline tumor (MBT) involving the cul-de-sac and left fallopian tube arising from extensive pelvic endometriosis with pathologic correlation in a 35-year-old woman presented with vague pelvic pain. Endocervical MBT is a type of endometriosis-associated carcinoma. Imaging findings of endocervical MBT are unilocular or oligolocular cystic lesions with enhancing mural nodules, which are different from those of the more common intestinal type MBT.
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Yeo, Dong Myung; Rha, Sung Eun; Byun, Jae Young; Lee, Ahwon; Kim, Mee Ran [Seoul St. Mary' s Hospital, The Catholic University of Korea, Seoul (Korea, Republic of)
2013-12-15
We report MR imaging findings of a rare case of endocervical mucinous borderline tumor (MBT) involving the cul-de-sac and left fallopian tube arising from extensive pelvic endometriosis with pathologic correlation in a 35-year-old woman presented with vague pelvic pain. Endocervical MBT is a type of endometriosis-associated carcinoma. Imaging findings of endocervical MBT are unilocular or oligolocular cystic lesions with enhancing mural nodules, which are different from those of the more common intestinal type MBT.
Chanen, Andrew; Jackson, Henry; Cotton, Sue M; Gleeson, John; Davey, Christopher G; Betts, Jennifer; Reid, Sophie; Thompson, Katherine; McCutcheon, Louise
2015-10-21
Borderline personality disorder is a severe mental disorder that usually has its onset in youth, but its diagnosis and treatment are often delayed. Psychosocial 'early intervention' is effective in improving symptoms and behaviours, but no trial has studied adaptive functioning as a primary outcome, even though this remains the major persistent impairment in this patient group. Also, the degree of complexity of treatment and requirements for implementation in mainstream health services are unclear. The primary aim of this trial is to evaluate the effectiveness of three forms of early intervention for borderline personality disorder in terms of adaptive functioning. Each treatment is defined by combining either a specialised or a general service delivery model with either an individual psychotherapy or a control psychotherapy condition. The study is a parallel-group, single-blind, randomised controlled trial, which has randomised permuted blocking, stratified by depression score, sex and age. The treatments are: (1) the specialised Helping Young People Early service model plus up to 16 sessions of individual cognitive analytic therapy; (2) the Helping Young People Early service plus up to 16 sessions of a control psychotherapy condition known as 'befriending'; (3) a general youth mental health care model plus up to 16 sessions of befriending. Participants will comprise 135 help-seeking youth aged 15-25 years with borderline personality disorder. After baseline assessment, staff blind to the study design and treatment group allocation will conduct assessments at 3, 6, 12 and 18 months. At the 12-month primary endpoint, the primary outcome is adaptive functioning (measures of social adjustment and interpersonal problems); secondary outcomes include measures of client satisfaction, borderline personality disorder features, depression and substance use. The results of this trial will help to clarify the comparative effectiveness of a specialised early intervention
Taubner, Svenja; Volkert, Jana; Gablonski, Thorsten-Christian; Rossouw, Trudie
2017-07-01
Mentalization-Based Treatment for Adolescents with Borderline Personality Disorder - Concept and Efficacy In recent years, the concept of mentalization has become increasingly important in practice and research. It describes the imaginative ability to understand human behavior in terms of mental states. Mentalization is a central component to understand the etiology and to treat patients with borderline personality disorder (BPD). Both adult and adolescent patients with BPD have limited mentalization abilities, which can be reliably assessed using the Reflective Functioning Scale. Mentalization-Based Treatment (MBT) was originally developed as an integrative approach for the treatment of adult patients with BPD. It is a manualized psychotherapy with psychodynamic roots with the aim to increase mentalizing abilities of patients. Since then, MBT has been further developed for other mental disorders as well as for the treatment of different age groups. One of these developments is MBT for Adolescents (MBT-A). MBT-A includes both individual as well as family sessions and the average duration of therapy is about twelve months. MBT-A can be applied in inpatient and outpatient settings and aims to improve mentalizing abilities in emotionally important relationships and the whole family system. First studies have found evidence for the efficacy of MBT-A. A randomized controlled trial (RCT) is currently being carried out to evaluate the efficacy of MBT-A for adolescents with conduct disorder. However, further evidence for efficacy and further conceptual development is needed.
Schuppert, H Marieke; Albers, Casper J; Minderaa, Ruud B; Emmelkamp, Paul M G; Nauta, Maaike H
2015-06-01
The development of borderline personality disorder (BPD) has been associated with parenting styles and parental psychopathology. Only a few studies have examined current parental rearing styles and parental psychopathology in relationship to BPD symptoms in adolescents. Moreover, parenting stress has not been examined in this group. The current study examined 101 adolescents (14-19 years old) with BPD symptoms and their mothers. Assessments were made on severity of BPD symptoms, youth-perceived maternal rearing styles, and psychopathology and parenting stress in mothers. Multiple regression analyses were used to examine potential predictors of borderline severity. No correlation was found between severity of BPD symptoms in adolescents and parenting stress. Only youth-perceived maternal overprotection was significantly related to BPD severity. The combination of perceived maternal rejection with cluster B traits in mothers was significantly related to BPD severity in adolescents. This study provides a contribution to the disentanglement of the developmental pathways that lead to BPD.
Leppänen, V; Hakko, H; Sintonen, H; Lindeman, S
2016-02-01
The implementation of effective psychotherapies in community mental health care is challenging. This study aimed to create a well-structured and easily applicable treatment model for patients with severe borderline personality disorder (BPD). We integrated a schema therapy based psycho-educational group into an available individual therapy. Two groups were formed: (1) community treatment by experts (CTBE) patients (n = 24) receiving new treatment and (2) treatment as usual (TAU) patients (n = 47). Changes in symptoms were measured by Borderline Personality Disorder Severity Index-IV interview and quality of life by the 15D health-related quality of life questionnaire. After 1 year the CTBE patients showed a significant reduction in a wider range of BPD symptoms and better quality of life than TAU patients. The results of this study are encouraging. A well-structured treatment model was successfully implemented into community mental health care with improved patient adherence to treatment and superior treatment outcomes compared to TAU patients.
Subtypes of borderline personality disorder patients: a cluster-analytic approach.
Smits, Maaike L; Feenstra, Dine J; Bales, Dawn L; de Vos, Jasmijn; Lucas, Zwaan; Verheul, Roel; Luyten, Patrick
2017-01-01
The borderline personality disorder (BPD) population is notably heterogeneous, and this has potentially important implications for intervention. Identifying distinct subtypes of patients may represent a first step in identifying which treatments work best for which individuals. A cluster-analysis on dimensional personality disorder (PD) features, as assessed with the SCID-II, was performed on a sample of carefully screened BPD patients ( N = 187) referred for mentalization-based treatment. The optimal cluster solution was determined using multiple indices of fit. The validity of the clusters was explored by investigating their relationship with borderline pathology, symptom severity, interpersonal problems, quality of life, personality functioning, attachment, and trauma history, in addition to demographic and clinical features. A three-cluster solution was retained, which identified three clusters of BPD patients with distinct profiles. The largest cluster ( n = 145) consisted of patients characterized by "core BPD" features, without marked elevations on other PD dimensions. A second "Extravert/externalizing" cluster of patients ( n = 27) was characterized by high levels of histrionic, narcissistic, and antisocial features. A third, smaller "Schizotypal/paranoid" cluster ( n = 15) consisted of patients with marked schizotypal and paranoid features. Patients in these clusters showed theoretically meaningful differences in terms of demographic and clinical features. Three meaningful subtypes of BPD patients were identified with distinct profiles. Differences were small, even when controlling for severity of PD pathology, suggesting a strong common factor underlying BPD. These results may represent a stepping stone toward research with larger samples aimed at replicating the findings and investigating differential trajectories of change, treatment outcomes, and treatment approaches for these subtypes. The study was retrospectively registered 16 April 2010
Bernanke, Joel; McCommon, Benjamin
2018-01-01
Given many competing demands, psychotherapy training to competency is difficult during psychiatric residency. Good Psychiatric Management for borderline personality disorder (GPM) offers an evidence-based, simplified, psychodynamically informed framework for the outpatient management of patients with borderline personality disorder, one of the most challenging disorders psychiatric residents must learn to treat. In this article, we provide an overview of GPM, and show that training in GPM meets a requirement for training in supportive psychotherapy; builds on psychodynamic psychotherapy training; and applies to other severe personality disorders, especially narcissistic personality disorder. We describe the interpersonal hypersensitivity model used in GPM as a straightforward way for clinicians to collaborate with patients in organizing approaches to psychoeducation, treatment goals, case management, use of multiple treatment modalities, and safety. A modification of the interpersonal hypersensitivity model that includes intra-personal hypersensitivity can be used to address narcissistic problems often present in borderline personality disorder. We argue that these features make GPM ideally suited for psychiatry residents in treating their most challenging patients, provide clinical examples to illustrate these points, and report the key lessons learned by a psychiatry resident after a year of GPM supervision.
Borderline features are associated with inaccurate trait self-estimations.
Morey, Leslie C
2014-01-01
Many treatments for Borderline Personality Disorder (BPD) are based upon the hypothesis that gross distortion in perceptions and attributions related to self and others represent a core mechanism for the enduring difficulties displayed by such patients. However, available experimental evidence of such distortions provides equivocal results, with some studies suggesting that BPD is related to inaccuracy in such perceptions and others indicative of enhanced accuracy in some judgments. The current study uses a novel methodology to explore whether individuals with BPD features are less accurate in estimating their levels of universal personality characteristics as compared to community norms. One hundred and four students received course instruction on the Five Factor Model of personality, and then were asked to estimate their levels of these five traits relative to community norms. They then completed the NEO-Five Factor Inventory and the Personality Assessment Inventory-Borderline Features scale (PAI-BOR). Accuracy of estimates was calculated by computing squared differences between self-estimated trait levels and norm-referenced standardized scores in the NEO-FFI. There was a moderately strong relationship between PAI-BOR score and inaccuracy of trait level estimates. In particular, high BOR individuals dramatically overestimated their levels of Agreeableness and Conscientiousness, estimating themselves to be slightly above average on each of these characteristics but actually scoring well below average on both. The accuracy of estimates of levels of Neuroticism were unrelated to BOR scores, despite the fact that BOR scores were highly correlated with Neuroticism. These findings support the hypothesis that a key feature of BPD involves marked perceptual distortions of various aspects of self in relationship to others. However, the results also indicate that this is not a global perceptual deficit, as high BOR scorers accurately estimated that their emotional
van der Molen, Mariet J.
2010-01-01
The validity of Baddeley's working memory model within the typically developing population, was tested. However, it is not clear if this model also holds in children and adolescents with mild to, borderline intellectual disabilities (ID; IQ score 55-85). The main purpose of this study was therefore, to explore the model's validity in this…
The Borderline Syndrome Index: a validation study using the personality assessment schedule.
Marlowe, M J; O'Neill-Byrne, K; Lowe-Ponsford, F; Watson, J P
1996-01-01
This study examines the validity and screening properties of the Borderline Syndrome Index--BSI (developed in the USA) for categories of the Personality Assessment Schedule--PAS (developed in the UK). Patients were recruited by case control sampling. Chance corrected agreement between instruments and screening properties of the BSI were calculated. The BSI proved a moderately sensitive but non-specific screen. Questionnaire scores were highly correlated with symptom measures. The results do not support the validity of the BSI or its use as a screening instrument. BSI scores may be distorted by current symptoms.
A Meta-analysis on the Association Between Emotional Awareness and Borderline Personality Pathology.
Derks, Youri P M J; Westerhof, Gerben J; Bohlmeijer, Ernst T
2017-06-01
Theories on borderline personality pathology (BPP) suggest that characteristic emotional dysregulation is due to low levels of emotional awareness or alexithymia. This study is the first meta-analysis to systematically review and analyze the evidence. A systematic search of the literature was performed using PsycInfo, Web of Science/MEDLINE, and Scopus. The term "borderline personality disorder" was searched for in conjunction with "emotional awareness," "emotional self-awareness," "emotion recognition," "alexithymia," "emotional processing," "emotional granularity," "emotional intelligence," or "emotion regulation." All references in the included studies were reviewed for additional relevant articles. Thirty-nine studies were then evaluated in a random effects meta-analysis to assess the association between BPP and emotional awareness. An overall moderate positive association between BPP and emotional awareness was significant (r = 0.359; 95% CI [0.283, 0.431]; Z = 8.678; p emotional awareness and those using alexithymia instruments. The strongest associations with regard to aspects of alexithymia were found for difficulties in identifying and describing emotions rather than externally oriented thinking. The results corroborate a moderate relationship between low emotional awareness and BPP. However, the mono-method self-report used in almost all studies is found problematic and precludes drawing definite conclusions. Since leading psychotherapeutic treatments strongly focus on increasing emotional awareness, future research should address this issue and further examine to what extent low levels of emotional awareness, particularly alexithymia, can be treated.
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Patrícia Helena Vaz Tanesi
2007-04-01
Full Text Available Adesão é um comportamento complexo, envolve desde pequenas recusas ao tratamento até o uso inadequado dos serviços de saúde e abandono do tratamento. O presente trabalho é um estudo qualitativo com seis pacientes com transtorno de personalidade borderline sobre adesão ao tratamento, utilizando análise qualitativa em entrevista aberta, questionário psicossocial, classificação diagnóstica pela SCID I e II e acompanhamento clínico. Os resultados mostraram que impulsividade, manipulação, dissociação afetiva, tentativa de suicídio, tendência à regressão e agressividade dificultaram ou impossibilitaram a adesão ao tratamento. Concluímos que os casos que abandonaram o tratamento colocaram a equipe em uma situação de impotência e apelo para estratégias sociais como forma de manejo da situação. É levantada a hipótese de que familiares saudáveis podem ser importantes para a adesão ao tratamento. Nos casos que não abandonaram o acompanhamento, a não-adesão se manifestou como ataques ao vínculo, ataques a melhora, e agressividade voltada à equipe e à instituição.Compliance is a complex behavior, ranging from minor instances of treatment refusal to the inappropriate use of health services or even treatment abandonment. The study comprises a qualitative analysis of six patients with borderline personality disorder submitted to an open interview, a psychosocial questionnaire, a diagnostic classification through SCDI I and II and a clinical follow-up. Six behaviors made treatment compliance either difficult or impossible: impulsivity, manipulation, affective dissociation, attempted suicide, tendency to regression, and aggression. The participants who abandoned the treatment made the health team impotent, requiring social strategies to manage the situation. We hypothesized that healthy families are of great importance for compliance to treatment. For the cases in which treatment was not abandoned, non-compliance was
Zanarini, Mary C; Temes, Christina M; Magni, Laura R; Fitzmaurice, Garrett M; Aguirre, Blaise A; Goodman, Marianne
2017-08-01
The validity of borderline personality disorder (BPD) in children and adolescents has not been studied in a rigorous manner reflecting the criteria of Robins and Guze first detailed in 1970. This paper and the others in this series address some aspects of this multifaceted validation paradigm, which requires that a disorder has a known clinical presentation, can be delimited from other disorders, 'runs' in families, and something of its aetiology, treatment response and course is known. Three groups of subjects were studied: 104 adolescent inpatients meeting the Revised Diagnostic Interview for Borderlines and DSM-IV criteria for BPD, 60 psychiatrically healthy adolescents and 290 adult inpatients meeting the Revised Diagnostic Interview for Borderlines and DSM-III-R criteria for BPD. Adolescents with BPD had significantly higher prevalence rates of 22 of the 24 symptoms studied than psychiatrically healthy adolescents. Only rates of serious treatment regressions and countertransference problems failed to reach the Bonferroni-corrected level of 0.002. Adolescents and adults with BPD had only four symptomatic differences that reached this level of significance, with adolescents with BPD reporting significantly lower levels of quasi-psychotic thought, dependency/masochism, devaluation/manipulation/sadism and countertransference problems than adults with BPD. Taken together, the results of this study suggest that adolescents report BPD as severe as that reported by adults. They also suggest that BPD in adolescents is not a tumultuous phase of normal adolescence. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.
Eaton, Danice K; McKnight-Eily, Lela R; Lowry, Richard; Perry, Geraldine S; Presley-Cantrell, Letitia; Croft, Janet B
2010-04-01
We describe the prevalence of insufficient, borderline, and optimal sleep hours among U.S. high school students on an average school night. Most students (68.9%) reported insufficient sleep, whereas few (7.6%) reported optimal sleep. The prevalence of insufficient sleep was highest among female and black students, and students in grades 11 and 12. Published by Elsevier Inc.
Schuiringa, Hilde; Van Nieuwenhuijzen, Maroesjka; Orobio De Castro, Bram; Lochman, John E.; Matthys, Walter
2017-01-01
This study evaluated the effectiveness of Standing Strong Together (SST), a combined group based parent and child intervention for externalizing behavior in 9–16 year-old children with mild to borderline intellectual disabilities (MBID). Children with externalizing behavior and MBID (IQ from 55 to
Herbort, Maike C.; Soch, Joram; W?stenberg, Torsten; Krauel, Kerstin; Pujara, Maia; Koenigs, Michael; Gallinat, J?rgen; Walter, Henrik; Roepke, Stefan; Schott, Bj?rn H.
2016-01-01
Patients with borderline personality disorder (BPD) frequently exhibit impulsive behavior, and self-reported impulsivity is typically higher in BPD patients when compared to healthy controls. Previous functional neuroimaging studies have suggested a link between impulsivity, the ventral striatal response to reward anticipation, and prediction errors. Here we investigated the striatal neural response to monetary gain and loss anticipation and their relationship with impulsivity in 21 female BP...
Whalley, Heather C; Nickson, Thomas; Pope, Merrick; Nicol, Katie; Romaniuk, Liana; Bastin, Mark E; Semple, Scott I; McIntosh, Andrew M; Hall, Jeremy
2015-01-01
BACKGROUND: \\ud \\ud Borderline personality disorder (BPD) is a severe psychiatric disorder involving a range of symptoms including marked affective instability and disturbances in interpersonal interactions. Neuroimaging studies are beginning to provide evidence of altered processing in fronto-limbic network deficits in the disorder, however, few studies directly examine structural connections within this circuitry together with their relation to proposed causative processes and clinical feat...
Amini, Mehdi; Pourshahbaz, Abbas; Mohammadkhani, Parvaneh; Ardakani, Mohammad-Reza Khodaie; Lotfi, Mozhgan
2014-12-01
The goal of this study was to examine the construct validity of the diagnostic and statistical manual of mental disorder-5 (DSM-5) conceptual model of antisocial and borderline personality disorders (PDs). More specifically, the aim was to determine whether the DSM-5 five-factor structure of pathological personality trait domains replicated in an independently collected sample that differs culturally from the derivation sample. This study was on a sample of 346 individuals with antisocial (n = 122) and borderline PD (n = 130), and nonclinical subjects (n = 94). Participants randomly selected from prisoners, out-patient, and in-patient clients. Participants were recruited from Tehran prisoners, and clinical psychology and psychiatry clinics of Razi and Taleghani Hospital, Tehran, Iran. The SCID-II-PQ, SCID-II, DSM-5 Personality Trait Rating Form (Clinician's PTRF) were used to diagnosis of PD and to assessment of pathological traits. The data were analyzed by exploratory factor analysis. Factor analysis revealed a 5-factor solution for DSM-5 personality traits. Results showed that DSM-5 has adequate construct validity in Iranian sample with antisocial and borderline PDs. Factors similar in number with the other studies, but different in the content. Exploratory factor analysis revealed five homogeneous components of antisocial and borderline PDs. That may represent personality, behavioral, and affective features central to the disorder. Furthermore, the present study helps understand the adequacy of DSM-5 dimensional approach to evaluation of personality pathology, specifically on Iranian sample.
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Mehdi Amini
2014-01-01
Full Text Available Background: The goal of this study was to examine the construct validity of the diagnostic and statistical manual of mental disorder-5 (DSM-5 conceptual model of antisocial and borderline personality disorders (PDs. More specifically, the aim was to determine whether the DSM-5 five-factor structure of pathological personality trait domains replicated in an independently collected sample that differs culturally from the derivation sample. Methods: This study was on a sample of 346 individuals with antisocial (n = 122 and borderline PD (n = 130, and nonclinical subjects (n = 94. Participants randomly selected from prisoners, out-patient, and in-patient clients . Participants were recruited from Tehran prisoners, and clinical psychology and psychiatry clinics of Razi and Taleghani Hospital, Tehran, Iran. The SCID-II-PQ, SCID-II, DSM-5 Personality Trait Rating Form (Clinician′s PTRF were used to diagnosis of PD and to assessment of pathological traits. The data were analyzed by exploratory factor analysis. Results: Factor analysis revealed a 5-factor solution for DSM-5 personality traits. Results showed that DSM-5 has adequate construct validity in Iranian sample with antisocial and borderline PDs. Factors similar in number with the other studies, but different in the content. Conclusions: Exploratory factor analysis revealed five homogeneous components of antisocial and borderline PDs. That may represent personality, behavioral, and affective features central to the disorder. Furthermore, the present study helps understand the adequacy of DSM-5 dimensional approach to evaluation of personality pathology, specifically on Iranian sample.
Schuiringa, Hilde; van Nieuwenhuijzen, Maroesjka; Orobio de Castro, Bram; Matthys, Walter
2015-01-01
This cross-sectional study examined the association between parenting behavior, the parent-child relationship, and externalizing child behavior in families of children with mild to borderline intellectual disabilities (MBID). The families of a child with MBID and accompanying externalizing behavior
Luteijn, I.; Didden, H.C.M.; Nagel, J.E.L. van der
2017-01-01
Knowledge regarding substance-related problems and offending behavior in individuals with mild intellectual disability or borderline intellectual functioning (MBID; IQ 50-85) has increased over the last years, but is still limited. The present study examined differences in prevalence and clinical
Waltz, Jennifer; Dimeff, Linda A.; Koerner, Kelly; Linehan, Marsha M.; Taylor, Laura; Miller, Christopher
2009-01-01
This study tested the feasibility of using a psychoeducational video recording to teach a behavioral skill from the Dialectical Behavior Therapy (DBT; Linehan, 1993a, 1993b) skills training program to individuals meeting criteria for borderline personality disorder. A video presenting a DBT emotion-regulation skill was developed and the extent to…
Morton, Jane; Snowdon, Sharon; Gopold, Michelle; Guymer, Elise
2012-01-01
A pilot study of a brief group-based Acceptance and Commitment Therapy (ACT) intervention (12 two-hour sessions) was conducted with clients of public mental health services meeting four or more criteria for borderline personality disorder (BPD). Participants were randomly assigned to receive the ACT group intervention in addition to their current…
Carr, Steven; Francis, Andrew
2009-01-01
The present study sought to determine if cognitive beliefs and schemas mediated the relationship between retrospectively reported childhood events and adult borderline personality disorder (BPD) symptoms in a non-clinical sample. One hundred and seventy-eight non-clinical participants completed questionnaires measuring BPD symptoms, core beliefs,…
Assessment of dysfunctional beliefs in borderline personality disorder.
Butler, Andrew C; Brown, Gregory K; Beck, Aaron T; Grisham, Jessica R
2002-10-01
This study had two aims: to test the hypothesis that borderline personality disorder (BPD) patients hold numerous dysfunctional beliefs associated with a variety of Axis II disorders, and to construct a BPD belief scale which captures these beliefs. Beliefs were measured using the Personality Belief Questionnaire (PBQ) which is designed to assess beliefs associated with various personality disorders, although not specifically BPD. Eighty-four BPD patients and 204 patients with other personality disorders (OPD) were randomly split into two study samples. Fourteen PBQ items were found to discriminate BPD from OPD patients in both samples. These items came from the PBQ Dependent, Paranoid, Avoidant, and Histrionic scales and reflect themes of dependency, helplessness, distrust, fears of rejection/abandonment/losing emotional control, and extreme attention-seeking behavior. A BPD beliefs scale constructed from these items showed good internal consistency and diagnostic validity among the 288 study patients. The scale may be used to assist in diagnosis and cognitive therapy of BPD.
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Cíntia Tereza Lima Ferraro
2011-08-01
Full Text Available Os papilomavírus humanos (HPVs pertencem à família Papillomaviridae e seu ciclo de vida é diretamente ligado à diferenciação das células epiteliais do hospedeiro. Possuem seis genes que se expressam precocemente e dois genes que se expressam tardiamente, sendo denominados respectivamente E (early e L (late. O ácido desoxirribonucleico (DNA viral dentro da célula do hospedeiro pode assumir duas formas: epissomal e integrada. O HPV tem como alvo as células basais de epitélios escamosos, em particular da área genital, onde está associado ao carcinoma da cérvice uterina. Na boca, o HPV está associado a papiloma escamoso oral, condiloma acuminado, verruga vulgar e hiperplasia epitelial focal. Entretanto, seu papel na carcinogênese oral é ainda controverso, sendo também identificado como agente etiológico de alguns carcinomas de células escamosas de cabeça e pescoço. A infecção pelo HPV pode agir sinergicamente com agentes carcinogênicos, como o tabaco e o álcool. Pelo menos 150 subtipos diferentes de HPV já foram identificados, sendo que 25 têm sido detectados em lesões orais. Considerando a relevância do tema para a melhor compreensão da infecção oral pelo HPV, o objetivo desta atualização é rever os aspectos relevantes da biologia do HPV, com ênfase na relação HPV-ceratinócitos, e a importância dos dados clínicos e histopatológicos na definição diagnóstica das lesões orais possivelmente associadas ao HPV.Papillomaviruses belong to the family Papillomaviridae and their life cycle is directly linked to the differentiation of host epithelial cells. They have six genes that are expressed earlier and two genes that are expressed later in their life cycle, named respectively E (early and L (late. Host cell viral DNA can take two forms: episomal and integrated. The human papillomavirus (HPV targets the basal cells of squamous epithelia, particularly from the genital area, which is associated with uterine
Copeptin levels and blood lipid profile in borderline patients with or without self-mutilation
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Sevda Korkmaz
2016-10-01
Full Text Available Purpose: Self-mutilation, known as self-harming behaviour of an individual without the intention of suicide, is commonly observed in individuals with borderline personality disorder. The objective of this study is to compare copeptin levels that are known to be related to aggressive behaviour and blood lipid profiles in borderline patients with and without self-mutilation. Methods: Twenty patients with self-mutilation [SM(+] and 20 patients without self-mutilation [SM(−] between the ages of 18 and 49, diagnosed with borderline personality disorder based on DSM-IV-TR(8 diagnostic criteria and attended to by Fırat University Psychiatry Polyclinic, participated in the study. Socio-demographic and clinical data form, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale (HAMA and Barrat Impulsivity Scale (BIS were applied to all participants. Copeptin levels and plasma lipid levels were studied in the blood samples taken from the participants. Results: Mean copeptin level found in SM(+ group (37.54 ± 18.8 ng/mL was statistically significantly higher than SM(− group (18.53 ± 16.6 ng/mL (p = 0.002. A negative correlation was found between mean copeptin and mean total cholesterol levels (r = −0.436; p = 0.005, and between copeptin and low-density lipoprotein cholesterol (LDL levels (r = −0.403; p = 0.01 in both SM(+ and SM(− patient groups. HAMA mean score for SM(+ group was found as 36.45 ± 13.2, and for SM(− group, it was found as 35.7 ± 12.9. There was a statistically significant difference between the depression points achieved by the two groups (p = 0.046. BIS total points average for SM(+ group was determined as 71 ± 9.71, whereas it was determined as 66.8 ± 7.92 in SM(− group. There was no statistically significant difference between the groups based on anxiety points. Barrat planning, Barrat motor and Barrat attention points for SM(+ group were higher than the SM(− group. However, the difference was not
Fox, Emily; Krawczyk, Kirsten; Staniford, Jessica; Dickens, Geoffrey L
2015-11-01
Previous studies about the effectiveness of Dialectical Behaviour Therapy for the treatment of Borderline Personality Disorder have had promising results. However, no previous studies have examined its effectiveness when delivered in low secure inpatient services for women. To evaluate clinical outcomes during and after a 1-year period of admission within a low secure unit for women offering a Dialectical Behaviour Therapy programme. A naturalistic, within subjects study of clinical data collected as part of routine practice was conducted. Participants were 18 consecutively admitted women who met the diagnostic criteria for Borderline Personality Disorder and had completed at least 1 year of treatment. Measures covered: risk behaviours; self-reported symptoms of Borderline Personality Disorder, and current mood and symptom experience; staff reports of clinical problems, needs and social functioning. Scores were compared between admission and at 6 months and 1 year. There was a statistically significant improvement on all 13 measures over the year's treatment. Most improvement was demonstrated between admission and 6 months. Engagement in1-year's treatment was associated with significant reduction in risk behaviours and both staff-rated and self-rated outcome measures. Some significant questions remain about which elements of the programme are most effective but the results are encouraging.
International Nuclear Information System (INIS)
Bazyl'chik, S. V.
1993-01-01
Spread of the border-line neuro psychic disturbances in children and teenagers aged 10-16 living in the districts contaminated with radionuclides was studied. A marked increase of psychic disturbances, particularly in girls, attributed to the growth of neurotic and neurosis-like disorders as compared with the control group was revealed. Asthenic type disorders prevailed in derangement structure. 7 refs., 1 tab
Psychotherapy for Borderline Personality Disorder: Progress and Remaining Challenges.
Links, Paul S; Shah, Ravi; Eynan, Rahel
2017-03-01
The main purpose of this review was to critically evaluate the literature on psychotherapies for borderline personality disorder (BPD) published over the past 5 years to identify the progress with remaining challenges and to determine priority areas for future research. A systematic review of the literature over the last 5 years was undertaken. The review yielded 184 relevant abstracts, and after applying inclusion criteria, 16 articles were fully reviewed based on the articles' implications for future research and/or clinical practice. Our review indicated that patients with various severities benefited from psychotherapy; more intensive therapies were not significantly superior to less intensive therapies; enhancing emotion regulation processes and fostering more coherent self-identity were important mechanisms of change; therapies had been extended to patients with BPD and posttraumatic stress disorder; and more research was needed to be directed at functional outcomes.
Ouabain-binding and 86rubidium-uptake in lymphocytes of normal and borderline hypertensive subjects
DEFF Research Database (Denmark)
Nielsen, J R; Pedersen, K E; Johansen, Torben
1983-01-01
activity were studied in lymphocytes of nine borderline hypertensives (27 (20-36) years) and nine controls (28 (20-36) years). Maximum 3H-ouabain binding and 86Rb-uptake were taken as measures of the number of pump sites and cation pump activity, respectively. The median number of sodium/potassium pump...... to increased cation pump activity in lymphocytes of BH subjects in vitro may be interpreted as an adaptive change possibly induced by a circulating natriuretic substance....
Jansen, B.R.J.; Lange, E.; van der Molen, M.J.
2013-01-01
Adolescents with mild to borderline intellectual disability (MBID) often complete schooling without mastering basic math skills, even though basic math is essential for math-related challenges in everyday life. Limited attention to cognitive skills and low executive functioning (EF) may cause this
Tingting Xu; Kathryn R. Cullen; Bryon Mueller; Mindy W. Schreiner; Kelvin O. Lim; S. Charles Schulz; Keshab K. Parhi
2016-01-01
Borderline personality disorder (BPD) is associated with symptoms such as affect dysregulation, impaired sense of self, and self-harm behaviors. Neuroimaging research on BPD has revealed structural and functional abnormalities in specific brain regions and connections. However, little is known about the topological organizations of brain networks in BPD. We collected resting-state functional magnetic resonance imaging (fMRI) data from 20 patients with BPD and 10 healthy controls, and construc...
Scheidell, Joy D; Lejuez, Carl W; Golin, Carol E; Hobbs, Marcia M; Wohl, David A; Adimora, Adaora A; Khan, Maria R
2016-05-01
Sexually transmitted infections (STI)/HIV rates are disproportionately high among men involved in the criminal justice system. Mental health disorders, including personality disorders, are also elevated among inmates. Borderline personality disorder (BPD) may be an important risk factor for STI/HIV, yet remains relatively understudied, particularly among inmates. We used baseline data from Project DISRUPT, a cohort study of African American men being released from prison in North Carolina who were in heterosexual relationships at prison entry (n=189), to assess their STI/HIV risk in the 6 months before incarceration and BPD symptoms focused on emotional lability and relationship dysfunction. We created a continuous BPD symptom severity score and a dichotomous BPD indicator split at the top quartile of the score (BPD-TQ) to examine associations between BPD and STI/HIV outcomes using logistic regression. We also examined associations between individual symptoms and outcomes. After adjustment for sociodemographics and antisocial personality disorder, BPD-TQ was associated with sexual risk behaviors including multiple partnerships (adjusted odds ratio, 2.58; 95% confidence interval, 1.24-5.36) and sex with nonmonogamous partners (adjusted odds ratio, 2.54; 95% confidence interval, 1.17-5.51). Prevalence of previous STI (47.5% vs. 29.6%) and prevalent chlamydial infection (6.9% vs. 3.1%) seemed higher in those in BPD-TQ, although the associations were not statistically significant. Associations were similar to those with the continuous score. Borderline personality disorder symptoms most associated with STI/HIV risk were abandonment worry, mood swings, and shifts in opinions. Borderline personality disorder is strongly associated with STI/HIV risk in this sample. Researchers should further evaluate the relationship between STI/HIV and BPD, in addition to mood disorders.
Yamashita, Kunihiko; Shinoda, Shinsuke; Hagiwara, Saori; Itagaki, Hiroshi
2014-02-01
We developed a new local lymph node assay (LLNA) that includes the elicitation phase termed LLNA:DAE for discrimination of borderline-positive chemicals as classified by the LLNA modified by Daicel based on ATP content (LLNA:DA) and for cross-sensitization testing. Although the LLNA:DA method could help identify skin sensitizers, some skin irritants classified as non-sensitizers by the LLNA were classified as borderline positive. In addition, the evaluation for the cross-sensitization potential between chemicals was impossible. In the LLNA:DAE procedure, test group of mice received four applications of chemicals on the dorsum of the right ear for induction and one application on the dorsum of the left ear for elicitation. Control group of mice received one chemical application on the dorsum of the left ear. We evaluated the sensitizing potential by comparing the weights of the lymph nodes from the left ears between the two groups. The results of using the LLNA:DAE method to examine 24 chemicals, which contained borderline-positive chemicals, were consistent with those from the LLNA method, except for nickel chloride (NiCl2). Two chemical pairs, 2,4-dinitrochlorobenzene (DNCB) with 2,4-dinitrofluorobenzene (DNFB) and hydroquinone (HQ) with p-benzoquinone (p-BQ), showed clear cross-sensitization with each other, while another chemical pair, DNFB with hexylcinnamic aldehyde (HCA) did not. Taken together, our results suggest that the LLNA:DAE method is useful for discriminating borderline-positive chemicals and for determining chemical cross-sensitization.
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Belghis Rovshan
2014-04-01
Full Text Available Background and Aim: Discourse-based interventions were studied less in speech therapy. This study aimed to investigate the effects of discourse-based intervention on language disabilities in school-aged children with borderline intelligence quotient (IQ.Methods: In an experimental study, 33 students at the age of 6-13 years with borderline intelligence quotient (17 students for intervention and 16 students for control group were selected with available sampling. The intervention lasted 14 sessions (every session: 45 minutes that focused on the structure and content of discourse. Personal narrative was elicited with explanation of the same topic (go to a trip for pre- and post-test.Results: Mean scores of intelligence quotient, age and education had no difference between the two groups. The intervention caused the increase of compound sentences (p=0.038, types of cohesive conjunctions (p=0.003, and related information (p=0.008 and decrease of ungrammatical sentences (p=0.031.Conclusion: Our findings indicate that participation in the intervention program has a clinically significant effect on the participants' abilities to produce personal narrative.
Fecundação in vitro de ovócitos bovinos com sêmen submetido a diferentes diluidores
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Coelho Lia de Alencar
2000-01-01
Full Text Available O objetivo deste trabalho foi avaliar a influência do diluidor do sêmen no desenvolvimento in vitro de ovócitos bovinos após a maturação e fecundação in vitro. Ejaculado de um reprodutor foi fracionado e submetido a três diluidores: Lactose/gema de ovo (LG, Citrato/gema de ovo (CG e Tris/gema de ovo (TG. Amostras deste material foram envasadas, congeladas e estocadas em N² e, posteriormente, descongeladas; a fração móvel foi separada por gradiente descontínuo de Percoll. A concentração espermática foi ajustada para 10 x 10(6/mL e a capacitação espermática, induzida com 10 µg/mL de heparina. Após 24 horas de cultura para maturação in vitro, os ovócitos, aspirados de folículos ovarianos, foram inseminados com sêmen diluído em meio TALP e, após 48 horas de cultura, os zigotos foram transferidos para gotas de meio TCM 199, com 5% de soro fetal bovino, 5% de soro de vaca em estro e suspensão de células epiteliais do oviduto bovino, cobertas com óleo de silicone, e mantidos em cultura por nove dias. Todas as culturas foram realizadas a 38,5ºC em atmosfera com 5% de CO2. Os dados foram analisados pelo teste do qui-quadrado e houve diferença com relação à taxa de clivagem (TC, sendo as médias de 66,0; 69,3; e 54,4% para LG, CG e TG, respectivamente. Não houve diferença entre tratamentos com relação às taxas de mórulas/blastocistos ou de eclosão. O diluidor do sêmen não teve efeito sobre o desenvolvimento in vitro de embriões bovinos, embora a TC tenha sido afetada.
Steuwe, Carolin; Berg, Michaela; Driessen, Martin; Beblo, Thomas
2017-01-01
This study focused on the predictors of therapy dropout in a naturalistic sample of patients with borderline pathology receiving dialectical behavior therapy (DBT) in an inpatient setting. We assumed that the change of the therapist between DBT-briefing and start of DBT-treatment as well as comorbid posttraumatic stress disorder (PTSD) and childhood trauma history were associated with elevated dropout. Eighty-nine participants with borderline pathology (≥ 3 borderline personality disorder criteria) receiving an inpatient DBT program completed a quality assurance questionnaire set assessing demographic information and pretreatment psychopathology during the days of their inpatient stay. Beyond that, changes of therapists were documented. The predictor analyses were investigated with generalized estimating equations. The dropout rate was 24.7%. A change of therapist between DBT-briefing and treatment as well as high childhood emotional abuse was associated with premature termination of treatment. Higher values of physical neglect during childhood were associated with a protective effect on treatment dropout. Surprisingly, this was also true for comorbid PTSD. This study supports the importance of therapy process variables as predictors of therapy dropout in borderline pathology. A change of therapist between DBT-briefing and treatment was associated with an increased vulnerability for dropping out of treatment and should therefore be avoided if possible. Against our hypotheses, a comorbid PTSD was even protective with regard to DBT dropout. Therefore, this severely suffering patient group should not be rejected from treatment assuming them to be too unstable for psychotherapy. However, results need to be replicated. ClinicalTrials.gov Identifier: NCT03018639, retrospectively registered on January 9, 2017.
Van den Broeck, Kris; Reza, Jasmin; Nelis, Sabine; Claes, Laurence; Pieters, Guido; Raes, Filip
2014-01-01
Recent findings show that (previously) depressed and traumatised patients, compared to controls, make more frequently use of an observer perspective (as set against a field perspective) when retrieving memories. Because patients with borderline personality disorder (BPD) often report mood disturbances and past traumatic experiences, it would be plausible to expect that these patients too would retrieve higher proportions of observer memories. Therefore, and given the phenotypical variance of BPD, we examined whether vantage perspective during recall is associated with one or more BPD symptom clusters. A community sample consisting of 148 volunteers (66 males) completed the Autobiographical Memory Test, the Borderline Syndrome Index, and the Depression Scale of the Depression Anxiety Stress Scales. Interpersonal and anxious-neurotic BPD features were associated with higher proportions of observer memories. The proportion of observer memories was not associated with the total number of BPD symptoms. Nevertheless, our data suggest the existence of substantial connections between perspective taking during recall on the one hand and interpersonal difficulties and anxious-neurotic symptoms on the other hand, especially following cues that tap into domains that are highly discrepant towards one's actual self-concept.
Shaib, Walid L; Ip, Andrew; Cardona, Kenneth; Alese, Olatunji B; Maithel, Shishir K; Kooby, David; Landry, Jerome; El-Rayes, Bassel F
2016-02-01
Adenocarcinoma of the pancreas remains a highly lethal disease, with less than 5% survival at 5 years. Borderline resectable pancreatic cancer (BRPC) and locally advanced unresectable pancreatic cancer (LAPC) account for approximately 30% of newly diagnosed cases of PC. The objective of BRPC therapy is to downstage the tumor to allow resection; the objective of LAPC therapy is to control disease and improve survival. There is no consensus on the definitions of BRPC and LAPC, which leads to major limitations in designing clinical trials and evaluating their results. A multimodality approach is always needed to ensure proper utilization and timing of chemotherapy, radiation, and surgery in the management of this disease. Combination chemotherapy regimens (5-fluorouracil, leucovorin, irinotecan, oxaliplatin, and gemcitabine [FOLFIRINOX] and gemcitabine/nab-paclitaxel) have improved overall survival in metastatic disease. The role of combination chemotherapy regimens in BRPC and LAPC is an area of active investigation. There is no consensus on the dose, modality, and role of radiation therapy in the treatment of BRPC and LAPC. This article reviews the literature and highlights the areas of controversy regarding management of BRPC and LAPC. Pancreatic cancer is one of the worst cancers with regard to survival, even at early stages of the disease. This review evaluates all the evidence for the stages in which the cancer is not primarily resectable with surgery, known as borderline resectable or locally advanced unresectable. Recently, advancements in radiation techniques and use of better combination chemotherapies have improved survival and tolerance. There is no consensus on description of stages or treatment sequences (chemotherapy, chemoradiation, radiation), nor on the best chemotherapy regimen. The evidence behind the treatment paradigm for these stages of pancreatic cancer is summarized. ©AlphaMed Press.
Vega, Daniel; Torrubia, Rafael; Soto, Àngel; Ribas, Joan; Soler, Joaquim; Pascual, Juan Carlos; Rodríguez-Fornells, Antoni; Marco-Pallarés, Josep
2017-10-01
Non-suicidal self-injury (NSSI) is highly prevalent during late adolescence and young adulthood. There is some evidence of a link between NSSI and Borderline Personality Disorder (BPD), but little is known about the association between BPD traits and the various functions that maintain NSSI. The main purpose of this study was to explore the association between borderline personality traits and NSSI functions in a sample of college students. We also compared NSSI functions in college students who engaged in NSSI to those in an age-matched sample of BPD patients. This study included a total of 238 college students and 36 BPD patients. Participants were asked to complete a number of clinical measures. In the non-clinical sample, BPD features were more pronounced in the presence of NSSI, and we observed a differential relationship between NSSI functions and psychopathological BPD-traits. The NSSI clinical variables most strongly associated with BPD were frequency, variety of methods and severity, but not age of onset. Our results provide new information on the relationship between BPD and NSSI in young adults, and could be used to improve the early detection of vulnerable BPD-individuals and in planning NSSI treatment. Copyright © 2017 Elsevier B.V. All rights reserved.
Van den Broeck, Kris; Pieters, Guido; Claes, Laurence; Berens, Ann; Raes, Filip
2016-11-01
Overgeneral memory (OGM), the tendency to retrieve categories of events from autobiographical memory instead of single events, is found to be a reliable predictor for future mood disturbances and post-traumatic symptom severity. Patients with borderline personality disorder (BPD) often report co-morbid episodes of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). Therefore, we investigated whether OGM would predict depression severity and (post-traumatic) stress symptoms in BPD patients. At admission (N = 54) and at six-month follow-up (N ≥ 31), BPD patients completed the Structured Clinical Interview for DSM-IV Disorders, the Assessment of DSM-IV Personality Disorders, the Autobiographical Memory Test, the Beck Depression Inventory-2nd edition (BDI-II), and the Impact of Event Scale. OGM at baseline predicted (a) higher levels of depressive symptoms at follow-up and (b) more intrusions related to a stressful event over and above baseline levels of borderline symptoms, depressive symptoms, and intrusions, respectively. No association was found between memory specificity and event-related avoidance at follow-up. Despite previous findings suggesting that OGM in BPD is less robust than in MDD and PTSD, our results suggest that memory specificity in BPD patients may have some relevance for the course of depressive and stress symptomatology in BPD.
Paret, Christian; Hoesterey, Steffen; Kleindienst, Nikolaus; Schmahl, Christian
2016-10-30
Those with borderline personality disorder (BPD) display altered evaluations regarding reward and punishment compared to others. The processing of rewards is basal for operant conditioning. However, studies addressing operant conditioning in BPD patients are rare. In the current study, an operant conditioning task combining learning acquisition and reversal was used. BPD patients and matched healthy controls (HCs) were exposed to aversive and neutral stimuli to assess the influence of emotion on learning. Picture content, dissociation, aversive tension and symptom severity were rated. Error rates were measured. Results showed no group interactions between aversive versus neutral scenes. The higher emotional arousal, dissociation and tension, the worse the acquisition, but not reversal, scores were for BPD patients. Scores from the Borderline Symptom List were associated with more errors in the reversal, but not the acquisition phase. The results are preliminary evidence for impaired acquisition learning due to increased emotional arousal, dissociation and tension in BPD patients. A failure to process punishment in the reversal phase was associated with symptom severity and may be related to neuropsychological dysfunctioning involving the ventromedial prefrontal cortex. Conclusions are limited due to the correlational study design and the small sample size. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Staerk, Laila; Wang, Biqi; Preis, Sarah R; Larson, Martin G; Lubitz, Steven A; Ellinor, Patrick T; McManus, David D; Ko, Darae; Weng, Lu-Chen; Lunetta, Kathryn L; Frost, Lars; Benjamin, Emelia J
2018-01-01
Abstract Objective To examine the association between risk factor burdens—categorized as optimal, borderline, or elevated—and the lifetime risk of atrial fibrillation. Design Community based cohort study. Setting Longitudinal data from the Framingham Heart Study. Participants Individuals free of atrial fibrillation at index ages 55, 65, and 75 years were assessed. Smoking, alcohol consumption, body mass index, blood pressure, diabetes, and history of heart failure or myocardial infarction were assessed as being optimal (that is, all risk factors were optimal), borderline (presence of borderline risk factors and absence of any elevated risk factor), or elevated (presence of at least one elevated risk factor) at index age. Main outcome measure Lifetime risk of atrial fibrillation at index age up to 95 years, accounting for the competing risk of death. Results At index age 55 years, the study sample comprised 5338 participants (2531 (47.4%) men). In this group, 247 (4.6%) had an optimal risk profile, 1415 (26.5%) had a borderline risk profile, and 3676 (68.9%) an elevated risk profile. The prevalence of elevated risk factors increased gradually when the index ages rose. For index age of 55 years, the lifetime risk of atrial fibrillation was 37.0% (95% confidence interval 34.3% to 39.6%). The lifetime risk of atrial fibrillation was 23.4% (12.8% to 34.5%) with an optimal risk profile, 33.4% (27.9% to 38.9%) with a borderline risk profile, and 38.4% (35.5% to 41.4%) with an elevated risk profile. Overall, participants with at least one elevated risk factor were associated with at least 37.8% lifetime risk of atrial fibrillation. The gradient in lifetime risk across risk factor burden was similar at index ages 65 and 75 years. Conclusions Regardless of index ages at 55, 65, or 75 years, an optimal risk factor profile was associated with a lifetime risk of atrial fibrillation of about one in five; this risk rose to more than one in three in individuals with at least
Salcedo,Mila de Moura Behar Pontremoli; Silveira,Gustavo Py Gomes da; Zettler,Cláudio Galeano
2008-01-01
OBJETIVO: demonstrar a expressão de biomarcadores, detectados por técnicas de imunohistoquímica, em tecidos sadios, lesões pré-neoplásicas e neoplásicas do colo do útero. MÉTODOS: para avaliação da reatividade imunohistoquímica de tecidos do colo do útero ao p16 e ao herpes simples vírus tipo 2 (HSV-2), foram avaliadas 187 amostras de lesões intra-epiteliais de baixo grau (LIE-BG) e lesões intra-epiteliais de alto grau (LIE-AG) e carcinoma do colo do útero, e comparadas com grupo de pacientes...
The Pathogenesis and Treatment of Emotion Dysregulation in Borderline Personality Disorder
Directory of Open Access Journals (Sweden)
Andreas Laddis
2015-01-01
Full Text Available Uncontrollable emotional lability and impulsivity are a paramount phenomenon of Borderline Personality Disorder (BPD. This paper aims to review theories that entertain emotion dysregulation as the core deficit of BPD and a key factor in the etiology of BPD, in order, then, to propose the author’s own theory, which arguably transcends certain limitations of the earlier ones. The author asserts that his psychodynamic theory explains the symptoms of BPD more thoroughly and it inspires a more parsimonious interpretation of brain imaging findings. In closing, the author draws implications of the proposed theory for clinical practice. He reports an efficacy study for treatment of emotion dysregulation based on that theory.
Dalbudak, Ercan; Evren, Cuneyt; Aldemir, Secil; Evren, Bilge
2014-11-30
The aim of this study was to investigate the relationship of Internet addiction (IA) risk with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students. A total of 271 Turkish university students participated in this study. The students were assessed through the Internet Addiction Scale (IAS), the Borderline Personality Inventory (BPI), the Dissociative Experiences Scale (DES), the Childhood Trauma Questionnaire (CTQ-28), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The rates of students were 19.9% (n=54) in the high IA risk group, 38.7% (n=105) in the mild IA risk group and 41.3% (n=112) in the group without IA risk. Correlation analyses revealed that the severity of IA risk was related with BPI, DES, emotional abuse, CTQ-28, depression and anxiety scores. Univariate covariance analysis (ANCOVA) indicated that the severity of borderline personality features, emotional abuse, depression and anxiety symptoms were the predictors of IAS score, while gender had no effect on IAS score. Among childhood trauma types, emotional abuse seems to be the main predictor of IA risk severity. Borderline personality features predicted the severity of IA risk together with emotional abuse, depression and anxiety symptoms among Turkish university students. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
The neuropsychological correlates of borderline personality disorder and suicidal behaviour.
LeGris, Jeannette; van Reekum, Rob
2006-03-01
In subjects with borderline personality disorder (BPD), compared with subjects who attempted suicide, to review neuropsychological (NP) function that may predispose to suicidal behaviour along a continuum of high and low lethality. We undertook electronic searches of MEDLINE, PsycINFO, EMBASE, Biosos Reviews, and Cinhal. The searches were restricted to English-language publications from 1985 onward. The search terms borderline personality disorder, suicide, suicide attempt, self-harm behaviour, neuropsychological, executive function (EF), neurocognitive, and neuropsychological function produced 29 neuropsychology studies involving BPD and 7 neuropsychology studies of suicide attempters, regardless of psychiatric diagnosis. Of the BPD studies, 83% found NP impairment in one or more cognitive domains, irrespective of depression, involving specific or generalized deficits linked to the dorsolateral prefrontal and orbitofrontal regions. The functions most frequently reported (in 71% to 86% of BPD studies) are response-inhibitory processes affecting executive function performance that requires speeded attention and visuomotor skills. Decision making and visual memory impairment are also most frequently affected; 60% to 67% of BPD studies report attentional impairment, verbal memory impairment, and visuospatial organizational impairment. Least affected processes in BPD appear to involve spatial working memory, planning, and possibly, IQ. The similarities in NP deficits found in BPD and suicide-attempt studies involve decision making and Trails performances. BPD studies, however, reflect more frequent impairment on the Stroop Test and Wisconsin Card Sort Test performance than the suicide-attempt studies, whereas verbal fluency appears to be more frequently impaired in those attempting suicide. Impaired EF and disinhibitory processes, as indicated by verbal fluency, Trails, and Stroop performance, primarily associated with dorsolateral prefrontal cortical regions may
Nouwens, P J G; Smulders, N B M; Embregts, P J C M; van Nieuwenhuizen, C
2017-01-01
Background: Among persons with a mild intellectual disability or borderline intellectual functioning, differences in their characteristics imply that a differentiated approach is required to meet their needs. This retrospective study examined whether the history of support/treatment programs and the
Dijk, F.E. van; Lappenschaar, M.; Kan, C.C.; Verkes, R.J.; Buitelaar, J.K.
2012-01-01
OBJECTIVE: There is substantial symptomatic overlap between attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) in adults, but the nature of the relationship between these disorders needs further clarification. The role of temperament and character traits in the
van Nieuwenhuijzen, M.; de Castro, B. Orobio; van Aken, M. A. G.; Matthys, W.
A growing interest exists in mechanisms involved in behaviour problems in children with mild intellectual disabilities and borderline intelligence (MID/BI). Social problem solving difficulties have been found to be an explanatory mechanism for aggressive behaviour in these children. However,
Subtyping borderline personality disorder by suicidal behavior.
Soloff, Paul H; Chiappetta, Laurel
2012-06-01
Course and outcome of Borderline Personality Disorder (BPD) are favorable for the vast majority of patients; however, up to 10% die by suicide. This discrepancy begs the question of whether there is a high lethality subtype in BPD, defined by recurrent suicidal behavior and increasing attempt lethality over time. In a prospective, longitudinal study, we sought predictors of high lethality among repeat attempters, and defined clinical subtypes by applying trajectory analysis to consecutive lethality scores. Criteria-defined subjects with BPD were assessed using standardized instruments and followed longitudinally. Suicidal behavior was assessed on the Columbia Suicide History, Lethality Rating Scale, and Suicide Intent Scale. Variables discriminating single and repeat attempters were entered into logistic regression models to define predictors of high and low lethality attempts. Trajectory analysis using three attempt and five attempt models identified discrete patterns of Lethality Rating Scale scores. A high lethality trajectory was associated with inpatient recruitment, and poor psychosocial function, a low lethality trajectory with greater Negativism, Substance Use Disorders, Histrionic and/or Narcissistic PD co-morbidity. Illness severity, older age, and poor psychosocial function are characteristics of a poor prognosis subtype related to suicidal behavior.
Duijvenbode, N. van; Didden, H.C.M.; Hazel, T. van den; Engels, R.C.M.E.
2016-01-01
Objective: To investigate the reliability and validity of a Wechsler Abbreviated Scale of Intelligence-based Wechsler Adult Intelligence Scale - third edition (WAIS-III) short form (SF) in a sample of individuals with mild to borderline intellectual disability (MBID) (N=117; M-IQ=71.34; SDIQ=8.00,
Gallé, F; Cirella, A; Salzano, A M; Onofrio, V Di; Belfiore, P; Liguori, G
2017-12-01
Personality disorders are frequently associated with eating disorders in obese patients and may negatively affect weight loss and maintenance after bariatric surgery. This non-randomized study aimed to assess the effects of different psychotherapeutic interventions on weight loss in a sample of patients with borderline personality disorder who underwent laparoscopic gastric bypass or laparoscopic adjustable gastric banding. A total of 153 bariatric patients meeting borderline personality disorder criteria were chosen voluntarily and consecutively to undergo an interpersonal individual treatment (n = 50), a dialectical behavioral group treatment (n = 50), or treatment as usual (n = 53) for a year after surgery. Their body mass index was measured before and at the end of each treatment. A total of 12 patients (7.8%) dropped out of the study. Significantly higher body mass index reductions were registered in both experimental groups (-14.2 and -9.4 kg/m 2 , respectively) compared with the treatment as usual group (-2.1 kg/m 2 ; p borderline personality disorder. A randomized controlled trial is needed to confirm these preliminary findings.
Pain perception in self-injurious patients with borderline personality disorder.
Russ, M J; Roth, S D; Lerman, A; Kakuma, T; Harrison, K; Shindledecker, R D; Hull, J; Mattis, S
1992-09-15
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.