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Borderline personality disorders

Jayashri Kulkarni, Natalie Thomas, Abdul-Rahman Hudaib, Emorfia Gavrilidis, Jasmin Grigg, Raelene Tan, Jacinta Cheng, Amelia Arnold, Caroline Gurvich
BACKGROUND: Borderline personality disorder (BPD) is a complex, severe and highly stigmatised psychiatric illness. Several lines of evidence highlight the causal link between chronic stress, glucocorticoid response to stress and glutamatergic overactivity as a key event in the pathophysiology of BPD. Therefore, molecular mechanisms capable of regulating glutamate excitotoxicity represent novel and potentially promising treatment targets. Memantine-HCl is a voltage-dependent N-methyl-D-aspartate (NMDA) receptor 'channel blocker' that selectively blocks pathological glutamate overactivity...
March 16, 2018: CNS Drugs
John Gunderson, Sara Masland, Lois Choi-Kain
Borderline personality disorder (BPD) has moved from being an untreatable disorder to a disorder with multiple evidence-based psychotherapies. When a second generation of research showed that less intensive, easier-to-learn therapies could be nearly as effective, they offered an approach that would be responsive to the persisting unmet needs of these patients. This paper describes good psychiatric management (GPM), a once-weekly, generalist model that medicalizes the disorder, emphasizes psychoeducation, and focuses on social adaptation...
January 5, 2018: Current Opinion in Psychology
Stoyan Popkirov, Vera Flasbeck, Uwe Schlegel, Georg Juckel, Martin Brüne
Previous studies have suggested that alexithymia may be related to impairments in automatic emotion processing. While it is well established that alexithymia is highly prevalent in individuals with borderline personality disorder (BPD), it is unknown whether this is reflected by an altered automatic processing of emotional stimuli. In the present study we investigated visually evoked event-related potentials using neutral and negative images from the International Affective Pictures System in 26 BPD patients and 26 healthy controls...
March 6, 2018: Psychiatry Research
Katja Wingenfeld, Lucia Dettenborn, Clemens Kirschbaum, Wei Gao, Christian Otte, Stefan Roepke
Endocannabinoids are involved in depressive and anxious symptoms and might play a role in stress-associated psychiatric disorders. While alterations in the endogenous cannabinoid system have been repeatedly found in patients with posttraumatic stress disorder (PTSD), this system has been mostly neglected in borderline personality disorder (BPD). However, there is first evidence for elevated serum levels of the endocannabinoids arachidonylethanolamide (AEA) and 2-arachidonyl-sn-glycerol (2-AG) in BPD patients compared to healthy controls and PTSD patients...
March 16, 2018: Stress: the International Journal on the Biology of Stress
Stoyan Popkirov, Vera Flasbeck, Uwe Schlegel, Georg Juckel, Martin Brüne
Frontal EEG asymmetry (FEA) has been studied as both state and trait parameter in emotion regulation and affective disorders. Its significance in borderline personality disorder (BPD) remains largely unknown. Twenty-six BPD patients and 26 healthy controls underwent EEG before and after mood induction using aversive images. A slight but significant shift from left- to right-sided asymmetry over prefrontal electrodes occurred across all subjects. In BPD baseline FEA over F7 and F8 correlated significantly with childhood trauma and functional neurological "conversion" symptoms as assessed by respective questionnaires...
March 15, 2018: Journal of Trauma & Dissociation
Niko Flink, Kirsi Honkalampi, Soili M Lehto, Virpi Leppänen, Heimo Viinamäki, Sari Lindeman
Borderline personality disorder (BPD) and chronic depression (CD) are common and challenging mental disorders. Maladaptive cognitive schemas have been proposed to increase vulnerability to both disorders. In order to elucidate the role of maladaptive cognitive schemas in BPD and CD, this study compared psychiatric outpatients with BPD (N = 30) and CD (N = 30) in terms of early maladaptive schemas (EMSs). The groups were compared using the Young Schema Questionnaire short form-extended (YSQ-S2-extended) and the 15D health status questionnaire...
March 14, 2018: Clinical Psychology & Psychotherapy
Katja Bertsch, Karen Hillmann, Sabine C Herpertz
One of the core symptoms of borderline personality disorder (BPD) is emotion dysregulation, which comprises emotion sensitivity, heightened and labile negative affect, deficient appropriate regulation strategies, and a surplus of maladaptive regulation strategies. Although earlier studies provided some evidence for threat hypersensitivity in terms of a negatively biased perception of other people ("negativity bias") and deficits in the recognition of full-blown anger, i.e., higher error rates and slower reaction times, researchers have only recently started studying effects of interindividual differences (e...
March 14, 2018: Psychopathology
Gordon Parker, Stacey McCraw, Adam Bayes
OBJECTIVES: To determine if differing developmental factors show specificity to differing manifestations of borderline personality disorder (BPD). METHODS: A clinical sample of 73 females diagnosed with BPD undertook a psychiatrist interview and completed self-report questionnaires, including the semi-structured Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV) assessing for BPD status. A set of negative and potentially traumatic developmental factors were included in the assessment...
March 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Lillian H Krantz, Shelley McMain, Janice R Kuo
The current research tested whether four dimensions of mindfulness - acceptance without judgment, observing, describing and acting with awareness - predicted frequency of nonsuicidal self-injury (NSSI) and mediate the relationship with NSSI outcomes during 20-weeks of Dialectical Behaviour Therapy (DBT) skills training for borderline personality disorder (BPD). Eighty-four self-harming individuals with BPD were randomized to either DBT skills training or to a waitlist control group. A series of regressions revealed no relationship between dimensions of mindfulness and NSSI at baseline...
March 1, 2018: Behaviour Research and Therapy
George Fein, Mathew Price, Valerie A Cardenas
Borderline personality disorder (BPD) is often a complicating comorbid factor in alcohol use disorders and substance use disorders. Previous work showed that abstinent alcoholics endorsed lifetime and current symptoms of most of the BPD criteria at much higher rates than controls, with much higher symptom counts for short-term abstinent alcoholic (STAA) women than men, which is consistent with such symptoms negatively affecting female alcoholics' ability to maintain abstinence. Because prior work has also shown that treatment-naïve alcoholics (TNA) are not the same as treated alcoholics observed earlier in their alcohol dependence, but rather are a different population with potentially lower psychiatric comorbidity, in this study we compared BPD symptom criteria between TNA samples of comparable age to the control and STAA samples, including both men and women and individuals dependent on alcohol only or with lifetime dependence on both alcohol and drugs...
October 31, 2017: Alcohol
Tsung-Jen Lin, Huei-Chen Ko, Jo Yung-Wei Wu, Tian Po Oei, Hsien-Yuan Lane, Chung-Hey Chen
OBJECTIVES: Effectiveness of the condensed Dialectical Behavior Therapy Skills Training Group (DBTSTG) was compared to the Cognitive Therapy Group (CTG) in reducing depression and suicide reattempt, and modifying emotion regulation strategies among those with borderline personality disorder (BPD). METHODS: Eighty-two depressed BPD college students with a suicidal history within the past six-months were randomly allocated to DBTSTG or CTG. RESULTS: Both groups had similar reductions in suicide reattempts and depression after the intervention and 6-month follow-ups...
March 12, 2018: Archives of Suicide Research: Official Journal of the International Academy for Suicide Research
Johanna Hepp, Sean P Lane, Andrea M Wycoff, Ryan W Carpenter, Timothy J Trull
Affective instability and interpersonal stress are key features of borderline personality disorder (BPD). They were shown to covary in the daily lives of patients in a recent ambulatory assessment study (Hepp et al., 2017) that observed comparatively larger positive associations between interpersonal stressors and negative affect in individuals with BPD than those with depressive disorders. The present study sought to replicate these findings, collecting data on hostility, sadness, fear, and rejection or disagreement events from 56 BPD and 60 community control participants for 21 days, 6 times a day...
February 2018: Journal of Abnormal Psychology
A Noteboom, L M Dil, H L Van
BACKGROUND: Borderline personality disorder (bpd) seems to have a progressive course, starting during adolescence. It's prevalence peaks during early adulthood, after which it declines. The symptom profile changes during its course. Consequently, a personalised approach based on staging and profiling appears suitable for bpd. AIM: To describe a useful model for clinical staging and profiling of bpd. METHOD: A literature analysis, reviewing the evidence of clinical stages and risk factors...
2018: Tijdschrift Voor Psychiatrie
Maria V Navarro-Haro, Melanie S Harned, Kathryn E Korslund, Anthony DuBose, Tianying Chen, André Ivanoff, Marsha M Linehan
Dialectical behavior therapy (DBT) is an evidence-based treatment for borderline personality disorder. The DBT Intensive Training™ is widely used to train community clinicians to deliver DBT, but little is known about its effectiveness. This study prospectively evaluated predictors of adoption and reach of DBT among 52 community teams (212 clinicians) after DBT Intensive Training™. Pre-post training questionnaires were completed by trainees and a follow-up survey by team leaders approximately 8 months later...
March 5, 2018: Community Mental Health Journal
Katharina Kolbeck, Steffen Moritz, Julia Bierbrodt, Christina Andreou
Ongoing research is shifting towards a dimensional understanding of borderline personality disorder (BPD). Aim of this study was to identify personality profiles in BPD that are predictive of self-destructive behaviors. Personality traits were assessed (n = 130) according to the five-factor model of personality (i.e., Neuroticism, Extraversion, Openness to Experience, Agreeableness, Conscientiousness) and an additional factor called Risk Preference. Self-destructive behavior parameters such as non-suicidal self-injury (NSSI) and other borderline typical dyscontrolled behaviors (e...
March 5, 2018: Journal of Personality Disorders
Dana B Borkum, Frances R Frankenburg, Garrett M Fitzmaurice, Argyro Athanasiadi, Christina M Temes, D Bradford Reich, Mary C Zanarini
The current study assesses time-to-cessation of individual therapy for patients with borderline personality disorder (BPD) and comparison subjects with other personality disorders (OPD) after 16 years of prospective follow-up. It also details the multivariate factors that predict this outcome for those with BPD. At baseline, 290 patients met criteria for BPD and 72 met criteria for OPD. Individuals with BPD had a significantly slower time-to-cessation of individual therapy than OPD comparison subjects. Seven baseline variables were found to be significant multivariate predictors of a slower time-to-cessation of individual therapy: older age, being white, severity of childhood neglect, history of a mood disorder, an IQ less than 90, poor vocational record prior to index admission, and higher level of trait neuroticism...
March 5, 2018: Journal of Personality Disorders
Lene Halling Hastrup, Mickey T Kongerslev, Erik Simonsen
Earlier studies report that although people with borderline personality disorder (BPD) experience symptom reduction in the long term, they continue to have difficulties in work recovery. This nationwide 9-year register-based study (N = 67,075) investigated the long-term labor-market attachment of all individuals diagnosed with BPD during first admission to Danish mental health services in comparison with other psychiatric disorders. Controlling for baseline characteristics and co-occurring secondary psychiatric diagnoses, the BPD group had 32% lower odds (OR = 0...
March 5, 2018: Journal of Personality Disorders
Brin F S Grenyer, Rachel C Bailey, Kate L Lewis, Michael Matthias, Toni Garretty, Annemaree Bickerton
Carers of persons with borderline personality disorder (BPD) experience high burden. Treatment guidelines advocate involving carers in comprehensive therapy approaches. This study is a randomized controlled trial of group psychoeducation, compared to waitlist. Group psychoeducation involved 6-8 carers per group and focused on improving relationship patterns between carers and relatives with BPD, psychoeducation about the disorder, peer support and self-care, and skills to reduce burden. Carers were randomized into intervention (N = 33) or waitlist (N = 35)...
March 5, 2018: Journal of Personality Disorders
Liliana Dell'Osso, Ivan Mirko Cremone, Barbara Carpita, Andrea Fagiolini, Gabriele Massimetti, Letizia Bossini, Antonio Vita, Stefano Barlati, Claudia Carmassi, Camilla Gesi
BACKGROUND: Despite discrete autism-related dimensions, such as deficits in communication, empathy and mentalizing are likely to affect the development of personality and despite they actually frequently occur in borderline patients, no research has so far investigated the relationship between autistic traits and Borderline Personality Disorder (BPD). The objective of this study is to investigate the clinical significance of autistic traits in subjects with BPD. METHODS: The sample included 50 patients with a clinical diagnosis of BPD and 69 healthy controls...
January 5, 2018: Comprehensive Psychiatry
Lauren Harris, Iwona Chelminski, Kristy Dalrymple, Theresa Morgan, Mark Zimmerman
BACKGROUND: Suicidal behavior has been associated with maladaptive strategies for emotion regulation; however, limited research has explored this association after controlling for diagnosis. This study aims to explore this connection across diagnoses. We hypothesized that patients who reported greater difficulty with emotion regulation would be more likely to have made suicide attempts. METHOD: Participants included 1046 psychiatric outpatients. Diagnoses and information about suicide history were determined using semi-structured interviews...
February 21, 2018: Journal of Affective Disorders
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