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Denning DM, Newlands RT, Gonzales A, Benuto LT. Borderline Personality Disorder Symptoms in a Community Sample of Sexually and Gender Diverse Adults. J Pers Disord 2022; 36:701-716. [PMID: 36454158 DOI: 10.1521/pedi.2022.36.6.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The current study aimed to identify borderline personality disorder (BPD) symptom disparities in sexually and/or gender diverse adults, determine if BPD symptoms vary across sexual orientation and gender identity, and identify factors related to BPD symptoms in this population. A sample of 218 sexually and gender diverse adults completed measures for BPD symptoms and trauma/stressors. Results suggest that sexually and/or gender diverse adults scored higher on six of the nine diagnostic criteria for BPD and were likely to have a probable BPD diagnosis, although these disparities were not observed across groups. Factors such as age, abuse and neglect and stigmatizing events were associated with more BPD symptoms, although the relationship between stigma and BPD symptoms did not remain when controlling for other factors. Results suggest that sexual orientation and gender identity are important factors when investigating BPD, and stigma may in part account for this disparity, although future research is needed.
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Affiliation(s)
- Dominic M Denning
- Department of Psychology, University of Nevada, Reno.,Department of Psychiatry, University of California, San Diego
| | | | - Arianna Gonzales
- Department of Psychology, University of Nevada, Reno.,Department of Psychology, California State University, Sacramento
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2
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The relationship between borderline personality features and affective responses to altering emotional context. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-01077-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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3
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Dixon-Gordon KL, Turner BJ, Haliczer LA, Gratz KL, Tull MT, Chapman AL. Self-injury motives: A person-centered examination. Suicide Life Threat Behav 2022; 52:812-827. [PMID: 35362639 DOI: 10.1111/sltb.12865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 01/04/2022] [Accepted: 02/19/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION People report multiple motives for nonsuicidal self-injury (NSSI), but few studies have examined how these motives relate to one another. This study identified person-centered classes of NSSI motives, their NSSI and psychopathological correlates, and their utility in predicting future NSSI across two samples. METHODS Participants were adolescents and young adults (aged 15-35) with recent NSSI recruited from online forums (n = 155, Sample 1) or the community (n = 127, Sample 2). Participants completed measures of NSSI, emotion regulation difficulties, borderline personality disorder (BPD), depression, and reported on their NSSI over 12 months. RESULTS Latent profile analyses yielded five classes in each sample: low interpersonal, self-punishment/interpersonal, moderate intra/interpersonal, high intra/interpersonal, and mainly interpersonal motives. Classes were not associated with lifetime NSSI characteristics, but highly motivated participants reported more severe depression and BPD symptoms, and greater emotion dysregulation than low-motivated participants. Those in the mainly interpersonal (Sample 1) and self-punishment/interpersonal (Sample 2) motives classes reported greater NSSI frequency during follow-up. CONCLUSIONS This study identified five classes of NSSI motives. Participants who report multiple motives for NSSI may be more clinically severe, whereas those who report strong desires to communicate with others or punish themselves may be at the highest risk for more frequent NSSI over time.
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Affiliation(s)
- Katherine L Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Lauren A Haliczer
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Alexander L Chapman
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
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4
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Cavicchioli M, Maffei C. Rumination as a widespread emotion-based cognitive vulnerability in borderline personality disorder: A meta-analytic review. J Clin Psychol 2021; 78:989-1008. [PMID: 34816435 DOI: 10.1002/jclp.23281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/28/2021] [Accepted: 11/12/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The current quantitative review aims at comprehensively clarifying the role of rumination in borderline personality disorder (BPD) considering its relevance for several clinical models of the disorder. METHOD This meta-analysis included 29 independent studies assessing different forms of rumination-general tendency to engage in ruminative thinking patterns and four types of emotion-based rumination among both nonclinical subjects reporting BPD features and patients with BPD. Furthermore, the study tested whether rumination could be considered a widespread emotion-based cognitive vulnerability in BPD. RESULTS Meta-analytic procedures were based on 46 r coefficients that showed large pooled effect sizes for all forms of rumination. With the exception of interpersonal rumination, the remaining forms of rumination were equally involved in BPD features. CONCLUSIONS Rumination should be considered a widespread emotion-based cognitive vulnerability in BPD. Future studies should provide longitudinal and contextual-based evaluations of rumination among treatment-seeking individuals with BPD.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
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5
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Pistorello J, Jobes DA, Gallop R, Compton SN, Locey NS, Au JS, Noose SK, Walloch JC, Johnson J, Young M, Dickens Y, Chatham P, Jeffcoat T. A Randomized Controlled Trial of the Collaborative Assessment and Management of Suicidality (CAMS) Versus Treatment as Usual (TAU) for Suicidal College Students. Arch Suicide Res 2021; 25:765-789. [PMID: 32275480 PMCID: PMC7585690 DOI: 10.1080/13811118.2020.1749742] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This randomized controlled trial compared the Collaborative Assessment and Management of Suicidality (CAMS) and Treatment as Usual (TAU) for suicidal college students within a feasibility trial. Sixty-two suicidal college students were randomized to CAMS (n = 33) or TAU (n = 29). We hypothesized that those receiving CAMS would show more improvement in suicide-related measures, and effects would be moderated by borderline personality disorder (BPD), prior suicide attempts, and age. Both treatment groups showed improvements in all outcome variables; CAMS had a significantly higher impact on depression and suicidal ideation when measured weekly during care and was more likely than TAU to decrease hopelessness among students with fewer BPD features, no suicide attempt history, and older age. Conversely, TAU did better for students with BPD features and history of multiple suicide attempts.
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6
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Wright AJ. Deliberate Context-Driven Conceptualization in Psychological Assessment. J Pers Assess 2021; 104:700-709. [PMID: 34227917 DOI: 10.1080/00223891.2021.1942024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Clinical formulation and case conceptualization in clinical psychological assessment typically organize a client's presenting problems within a psychological framework and narrative that explains the cluster of symptoms, etiological and maintenance factors, and explaining both how and why a client is struggling or suffering. However, many of the most commonly used models of case conceptualization, as well as the preponderance of tests and measures used in psychological assessment, minimize or ignore the impacts of contextual factors, including dominant culture's expectations for normative behavior and the client's history of trauma and adverse and negative events. This paper presents a rationale and model for encouraging psychologists conducting clinical psychological assessment to be deliberate in first considering contextual factors in case conceptualization before relying entirely on primarily intrapsychic models. While contextual conceptualizations will not always replace (or join) intrapsychic models of case formulation, being deliberate and explicit about at least considering them is an important way to mitigate some of psychologists' biases and has the potential to situate a narrative of client difficulties in a way that takes at least some of the burden off the client.
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7
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Dixon-Gordon KL, Fitzpatrick S, Haliczer LA. Emotion regulation and borderline personality features in daily life: The role of social context. J Affect Disord 2021; 282:677-685. [PMID: 33445091 DOI: 10.1016/j.jad.2020.12.125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/27/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Borderline personality disorder (BPD) is associated with emotional dysfunction and interpersonal sensitivity. Yet, little work has characterized how BPD features predicts emotional reactivity and emotion regulation behaviors in response to interpersonal stress relative to other forms of stress. METHODS Participants were 152 university students who completed baseline measures of BPD features and complied with two-week daily diary procedures assessing daily emotion regulation strategy use in response to social and non-social stressors. RESULTS Generalized estimating equations revealed that BPD features predicted greater negative and positive emotions in response to daily stressors, and interacted with type of stressor in predicting urges and behaviors. Elevated BPD features was associated with greater urges for dysfunctional emotion regulatory behaviors and fewer functional emotion regulatory behaviors to a greater extent in response to social (versus non-social) stressors. LIMITATIONS This study was limited by its focus on past-day retrospective recall. Further, the student sample limits the generalizability of these findings. CONCLUSIONS These findings suggest that individuals with elevated BPD features may have less functional emotion regulation in social contexts.
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Affiliation(s)
- Katherine L Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, 135 Hicks Way, Amherst, MA 01002, USA.
| | | | - Lauren A Haliczer
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, 135 Hicks Way, Amherst, MA 01002, USA
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8
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Spitzen TL, Tull MT, Baer MM, Dixon-Gordon KL, Chapman AL, Gratz KL. Predicting engagement in nonsuicidal self-injury (NSSI) over the course of 12 months: the roles of borderline personality disorder pathology and emotional consequences of NSSI. J Affect Disord 2020; 277:631-639. [PMID: 32905915 DOI: 10.1016/j.jad.2020.08.049] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 06/06/2020] [Accepted: 08/20/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Despite theories that negative reinforcement in the form of relief from negative emotions maintains nonsuicidal self-injury (NSSI), no studies have examined the extent to which specific emotional consequences of NSSI predict the maintenance of NSSI over time or explain the greater risk for NSSI found among individuals with borderline personality disorder (BPD) pathology. This study examined whether specific emotional consequences of NSSI relate to the continuance of NSSI behavior over a 12-month period and explain the relation of baseline BPD pathology to future NSSI. METHODS Participants with a history of recent repeated NSSI (N = 84) completed baseline measures of BPD pathology, NSSI, and the emotional antecedents and consequences of NSSI, including self-conscious emotions, undifferentiated negative affect, anger, emptiness, sadness, and anxiety; follow-up data on NSSI were collected every three months for one year. RESULTS Of the emotional consequences of NSSI examined here, only self-conscious emotions significantly predicted the presence and frequency of NSSI during the 12-month follow-up period. Likewise, whereas BPD pathology was not directly associated with later NSSI, both overall BPD pathology and the specific BPD feature of identity problems were indirectly related to the presence of 12-month NSSI through the greater frequency of post-NSSI self-conscious emotions. LIMITATIONS Emotional consequences of NSSI were assessed using a retrospective self-report measure. Only frequency, and not intensity, of emotions before and after NSSI were assessed. CONCLUSIONS Results suggest a distinct role of post-NSSI self-conscious emotions in the maintenance of NSSI among individuals with and without BPD pathology.
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Affiliation(s)
- Tara L Spitzen
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Margaret M Baer
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | | | | | - Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, OH, USA.
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9
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Babinski DE, Castagna PJ, Waschbusch DA. Preliminary Investigation of the Psychometric Properties of the Parent Version of the Borderline Personality Features Scale for Children (BPFS-P). J Pers Assess 2020; 103:602-612. [PMID: 33124913 DOI: 10.1080/00223891.2020.1835934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
There is growing evidence that features of borderline personality disorder (BPD) emerge in childhood and present long-term risk for the development of BPD. Thus, valid and reliable assessments of BPD features in childhood are needed. This study examined the psychometric properties of the parent version of the Borderline Personality Features Scale for Children (BPFS-P) in a large, representative sample (N = 1,050; 51.5% male; Mage = 8.42, SD = 2.31; Agerange = 5 to 12 years). The factor structure of the BPFS-P was examined, and measurement invariance was tested across child age and sex as well as caregiver informant sex. Additionally, the unique contribution of the identified factors of the BPFS-P to overall impairment and need for treatment beyond co-occurring dimensions of additional psychopathology was examined. A one factor structure was identified, which demonstrated measurement invariance across child sex and age as well as caregiver informant sex. BPD features measured with the BPFS-P contributed unique variance to explaining overall impairment and need for treatment. These findings point to the potential of the BPFS-P to break new ground in identifying youth at risk for BPD.
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Affiliation(s)
- Dara E Babinski
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA
| | | | - Daniel A Waschbusch
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA
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10
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Genetic and Environmental Causes of Individual Differences in Borderline Personality Disorder Features and Loneliness are Partially Shared. Twin Res Hum Genet 2020; 23:214-220. [PMID: 32885774 DOI: 10.1017/thg.2020.62] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Loneliness is related to mental and somatic health outcomes, including borderline personality disorder. Here, we analyze the sources of variation that are responsible for the relationship between borderline personality features (including four dimensions, affective instability, identity disturbance, negative relationships, self-harm and a total score) and loneliness. Using genetically informative data from two large nonclinical samples of adult twin pairs from Australia and the Netherlands (N = 11,329), we estimate the phenotypic, genetic and environmental correlations between self-reported borderline personality features and loneliness. Individual differences in borderline personality and loneliness were best explained by additive genetic factors with heritability estimates h2 = 41% for the borderline personality total score and h2 = 36% for loneliness, with the remaining variation explained by environmental influences that were not shared by twins from the same pair. Genetic and environmental factors influencing borderline personality (total score and four subscales separately) were also partial causes of loneliness. The correlation between loneliness and the borderline personality total score was rph = .51. The genetic correlation was estimated at rg = .64 and the environmental correlation at re = .40. Our study suggests common etiological factors in loneliness and borderline personality features.
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11
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Bortolla R, Cavicchioli M, Fossati A, Maffei C. Emotional Reactivity in Borderline Personality Disorder: Theoretical Considerations Based on a Meta-Analytic Review of Laboratory Studies. J Pers Disord 2020; 34:64-87. [PMID: 30355020 DOI: 10.1521/pedi_2018_32_382] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Emotional hyperreactivity (Linehan, 1993) is the most investigated construct in borderline personality disorder (BPD). However, experimental studies revealed mixed results on the topic. Our main objective is to comprehensively summarize the results on emotional reactivity in BPD compared to healthy controls (HCs), using a meta-analytic approach, considering different emotional response systems (physiology, behavior, self-report). We included 31 experimental studies (1,675 subjects). We observed null to small effect sizes for several physiological and behavioral outcomes. Conversely, BPD subjects revealed a moderate to large difference in valence attributed to emotional stimuli and a small difference in self-reported arousal. Significant differences in pooled effect sizes were found between self-report and physiological outcomes. Several sources of heterogeneity were explored. In general, the hyperreactivity hypothesis was not supported. Additional dysfunctional processes should be taken into consideration to understand BPD emotional responsiveness.
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Affiliation(s)
| | | | | | - Cesare Maffei
- Vita-Salute San Raffaele University, Milan, Italy.,San Raffaele Hospital, Milan
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12
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Waugh MH, McClain CM, Mariotti EC, Mulay AL, DeVore EN, Lenger KA, Russell AN, Florimbio AR, Lewis KC, Ridenour JM, Beevers LG. Comparative Content Analysis of Self-Report Scales for Level of Personality Functioning. J Pers Assess 2020; 103:161-173. [PMID: 31917602 DOI: 10.1080/00223891.2019.1705464] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Content validity analyses of eight self-report instruments for assessing severity of personality disorder (PD), also known as Level of Personality Functioning (LPF), were conducted using the conceptual scheme of the Alternative Model for Personality Disorders (AMPD; APA, 2013). The item contents of these eight inventories were characterized for the LPF constructs of Identity (ID), Self-Direction (SD), Empathy (EM), and Intimacy (IN) along with the pathological personality trait domains of Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. Severity of pathology (SV) reflected in item content was also rated. Raters demonstrated robust agreement for AMPD and SV constructs across instruments. Similarity between instrument AMPD construct profiles was quantified by intraclass correlations (ICC). Results showed the instruments were generally similar in AMPD-construct coverage, but some important differences emerged. The subscales of the instruments also were characterized for the degree to which they reflect the four LPF (ID, SD, EM, IN) domain constructs. Collectively, these content validity comparisons clarify the equivalence of instruments for AMPD constructs and the relative proportions of construct coverage within instrument subscales. These results can inform future research with LPF self-report instruments and guide clinicians in selecting an LPF-related instrument for use in practice.
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Affiliation(s)
- Mark H Waugh
- Oak Ridge National Laboratory.,University of Tennessee, Knoxville
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13
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Koster N, Hopwood CJ, Goodman M, Zanarini MC. Correlates between Five-Factor Model traits and the Revised Diagnostic Interview for Borderlines dimensions in an adolescent clinical sample. Personal Ment Health 2019; 13:197-204. [PMID: 31287247 PMCID: PMC6899891 DOI: 10.1002/pmh.1459] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/29/2019] [Accepted: 05/28/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Extensive evidence supports the association between Five-Factor Model (FFM) traits involving high neuroticism, low agreeableness and low conscientiousness and borderline personality disorder (BPD) characteristics, particularly among adults in community samples. However, studies supporting this link in adolescent samples are relatively limited, and few studies have examined the links between FFM traits and specific dimensions of BPD, such as those distinguished by the Revised Diagnostic Interview for Borderlines (DIB-R). In this study, we examined associations between FFM traits and BPD characteristics in a group of clinical and non-clinical adolescents. METHOD We evaluated the correlations between the FFM personality traits, as measured by the NEO-Five-Factor Inventory and BPD characteristics as measured by the DIB-R in a sample of adolescents (N = 162). RESULTS Consistent with previous research, BPD dimensions were highly associated with high neuroticism, low conscientiousness, low agreeableness and to a somewhat lesser extent with low extraversion. Specificity of associations between FFM traits and DIB-R section scores was limited, in part because of strong intercorrelations among DIB-R scores. DISCUSSION These results imply that evidence about trait-BPD associations in adult samples generalizes well to adolescents. Clinical implications of these findings are discussed.
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Affiliation(s)
- Nagila Koster
- Centre for Adolescent PsychiatryReinier van Arkel's‐HertogenboschThe Netherlands
- Developmental PsychologyUtrecht UniversityUtrechtThe Netherlands
| | | | - Marianne Goodman
- James J. Peters Veterans Affairs Medical CenterBronxNYUSA
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Mary C. Zanarini
- Laboratory for the Study of Adult DevelopmentMcLean HospitalBelmontMAUSA
- Department of PsychiatryHarvard Medical SchoolBostonMAUSA
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14
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Keng SL, Lee CSL, Eisenlohr-Moul TA. Effects of brief daily mindfulness practice on affective outcomes and correlates in a high BPD trait sample. Psychiatry Res 2019; 280:112485. [PMID: 31408773 DOI: 10.1016/j.psychres.2019.112485] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/14/2019] [Accepted: 07/14/2019] [Indexed: 10/26/2022]
Abstract
Borderline personality disorder (BPD) is a psychological disorder characterized by dysregulation across multiple domains. While selected mindfulness-based interventions are effective in addressing symptoms of BPD, less is known regarding the effects of engaging in brief mindfulness practices on affective correlates of BPD. The present study investigated the effects of engaging in brief, daily mindfulness practice in a sample of young adults with elevated BPD symptoms. Ninety-two participants were recruited and randomly assigned to 2 weeks of daily mindfulness meditation or relaxation practice (active control), or to a no-practice control condition. Participants completed measures assessing depression, anxiety, stress, shame, difficulties with emotion regulation, trait mindfulness, and self-compassion before and after the practice period. Compared to the no-practice control condition, mindfulness practice resulted in significant improvements in trait mindfulness and self-compassion, whereas relaxation practice led to reductions in emotion regulation difficulties. No significant differences were found on any of the other outcomes between the mindfulness and relaxation conditions. The findings suggest that while both mindfulness and relaxation-based practices are effective in targeting selected transdiagnostic processes associated with BPD, more intensive interventions may be required for the practices to induce changes at the level of psychological symptoms.
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15
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López-Pérez B, McCagh J. How do I want to feel? The link between emotion goals and difficulties in emotion regulation in borderline personality disorder. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2019; 59:96-114. [PMID: 31553067 DOI: 10.1111/bjc.12235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 08/21/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Appropriate contextualized emotion goals (i.e., desired emotional endpoints that facilitate goal attainment) are fundamental to emotion regulation, as they may determine the direction of regulation efforts. Given that difficulties in emotion regulation are prevalent in borderline personality disorder (BPD), we explored whether BPD traits (Study 1) and BPD diagnosis (Study 2) presented specific contextualized emotion goals, and whether these emotion goals may be linked to difficulties in emotion regulation. METHODS In Study 1, 358 individuals were recruited via Amazon Mechanical Turk and assessed on the presence of borderline traits, emotion regulation ability, and general and contextualized emotion goals. In Study 2, these measures were employed in a sample of 35 people with BPD and 35 matched controls who were also assessed on their current mood state and screened for Axis I and II disorders of the DSM-IV. RESULTS Study 1 showed that emotion dysregulation was positively predicted by borderline traits and contextualized emotion goals that impair goal attainment (i.e., greater preference for anger for collaboration and happiness for confrontation). Findings of Study 2 also showed that a higher preference for happiness for confrontation was linked to higher emotion dysregulation in both individuals with BPD and controls. Furthermore, individuals with BPD reported a lower preference for happiness for collaboration than controls. CONCLUSIONS These results support the importance of looking at emotion goals and its link with emotion dysregulation. Interventions targeting maladaptive contextualized goals may represent an important therapeutic window to enhance emotion regulation. PRACTITIONER POINTS Clinical implications BPD individuals' emotion regulation is linked to maladaptive emotion goals. Helping people at risk to manipulate their emotion goals to be more context sensitive may enhance well-being and serve as a therapeutic tool in practice. Limitations The present research only considered the context of collaboration and confrontation, but other contexts more relevant for individuals with BPD (i.e., self-harm situations) might provide valuable information about their difficulties in emotion regulation. To study contextualized emotion goals in clinical populations, longitudinal rather than cross-sectional designs should be considered.
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Affiliation(s)
| | - Jane McCagh
- Department of Psychology, Liverpool Hope University, UK
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16
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Bullis JR, Boettcher H, Sauer‐Zavala S, Farchione TJ, Barlow DH. What is an emotional disorder? A transdiagnostic mechanistic definition with implications for assessment, treatment, and prevention. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2019. [DOI: 10.1111/cpsp.12278] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Jacqueline R. Bullis
- Center for Anxiety and Related Disorders Boston University Boston Massachusetts
- Division of Depression and Anxiety Disorders Harvard Medical School McLean Hospital Belmont Massachusetts
| | - Hannah Boettcher
- Center for Anxiety and Related Disorders Boston University Boston Massachusetts
| | | | - Todd J. Farchione
- Center for Anxiety and Related Disorders Boston University Boston Massachusetts
| | - David H. Barlow
- Center for Anxiety and Related Disorders Boston University Boston Massachusetts
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17
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Hughes CD, Rizvi SL. Biases in Affective Forecasting and Recall as a Function of Borderline Personality Disorder Features. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2019. [DOI: 10.1521/jscp.2019.38.3.200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: The ability to predict emotional experiences, “affective forecasting,” is an essential factor in individuals' decision-making processes. Research has shown that, generally, individuals are inaccurate in their affective forecasts/recollections, and that certain psychological disorders may be related to individual differences in these inaccuracies, or biases. Understanding the role of affective biases in disorders characterized by emotion dysregulation, like Borderline Personality Disorder (BPD), may provide important information regarding the sources of said dysregulation. The present study aimed to identify specific or unique patterns in affective forecasting/recall biases as a function of BPD features. Method: Using a sample of undergraduates (n = 185), we compared predicted and recalled affective states with actual affect following a sadness-evoking film clip. We predicted that higher levels of BPD features would be associated with greater affective forecasting and recall biases. Results: Results indicated that BPD features predicted a specific pattern of forecasting and recall biases regarding the clip. Counter to our hypotheses, as BPD features increased, forecasts/recollections of their affective states following the sadness-evoking film clip were more accurate (less biased). Discussion: Results indicate that BPD features may be related to a specific pattern of bias with negative affective states and warrant further study. Furthermore, this study provides evidence that disorder-specific patterns of forecasting/recall bias can be studied with a laboratory-based paradigm.
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18
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Vest NA, Murphy KT, Tragesser SL. Borderline personality disorder features and drinking, cannabis, and prescription opioid motives: Differential associations across substance and sex. Addict Behav 2018; 87:46-54. [PMID: 29945027 DOI: 10.1016/j.addbeh.2018.06.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Drinking motives have shown meaningful associations with borderline personality disorder (BPD) features. However, it is unknown whether other common substances of abuse (namely cannabis and prescription opioids) have the same associations with BPD features. In the present study, we tested associations between BPD features and motives across three substances: alcohol, cannabis, and prescription opioids. The purpose of the study was to determine whether BPD showed similar patterns of associations across drugs, or whether some substances serve particular functions for individuals with BPD features, and whether this also varies by sex in a college student sample. METHOD Five-hundred ninety-four college students completed online questionnaires measuring demographics, borderline personality disorder features, substance use, and substance specific motives for alcohol, cannabis, and prescription opioid use. RESULTS BPD was most strongly associated with coping motives across all substances. For both alcohol and cannabis, this was true for both males and females, along with conformity motives. For prescription opioids, coping, social, enhancement, and pain motives were only significantly related to BPD features for females. When compared statistically, it was found that the associations with coping drinking motives and opioid pain motives were higher among females. CONCLUSIONS This pattern of results suggests that negatively reinforcing motives (coping and conformity) play a similar functional role in borderline personality and substance use disorder pathology for alcohol and cannabis, but for prescription opioids the negative reinforcement motives (coping and pain) were only evident in females.
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Dixon-Gordon KL, Berghoff CR, McDermott MJ. Borderline Personality Disorder Symptoms and Pain in College Students: The Role of Emotional Suppression. J Pers Disord 2018; 32:277-288. [PMID: 28604278 DOI: 10.1521/pedi_2017_31_300] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Borderline personality disorder (BPD) is associated with higher rates of pain conditions and greater pain impairment. Past research implicates emotional suppression in acute pain tolerance; thus, emotional suppression may contribute to pain interference among those with high BPD features. Participants were 89 university students who completed measures of BPD features, and complied with 2-week daily diary procedures assessing suppression of emotional thoughts associated with social and nonsocial stressors, distress, pain severity, and interference. Multilevel models revealed a BPD × Suppression × Distress interaction, such that suppression in response to social (but not nonsocial) stressors in the context of high distress was related to pain interference when controlling for pain severity among those with high, but not low, BPD features. These findings suggest. that suppression of emotionally relevant thoughts in response to high distress may contribute to the functional impairment from pain among those with high BPD symptoms.
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Affiliation(s)
- Katherine L Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Christopher R Berghoff
- Department of Psychiatry and Human Behavior, University of Mississippi, Medical Center, Jackson, Mississippi
| | - Michael J McDermott
- Department of Psychology, University of Louisiana, Lafayette, Lafayette, Louisiana
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20
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Abstract
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.
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Difficulties in Interpersonal Emotion Regulation: Initial Development and Validation of a Self-Report Measure. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2018. [DOI: 10.1007/s10862-018-9647-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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22
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Elzy M, Karver M. Behaviour vs. perception: An investigation into the components of emotional invalidation. Personal Ment Health 2018; 12:59-72. [PMID: 29218840 DOI: 10.1002/pmh.1403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 09/17/2017] [Accepted: 09/19/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND The negative effects of emotionally invalidating environments are theorized by the biosocial theory of borderline personality disorder to be vast and severe. However, findings from studies on the impact of emotional invalidation (EI) vary, perhaps due to different operational definitions of EI. The current investigation seeks to explore the relationship between the objective behavioural observations of EI and recipient's subjective perceptions of experiencing these behaviours. METHOD First, 58 participants watched scripted interactions between a confederate and a mock participant and identified the presence of invalidating and/or neutral behaviours. Next, 92 participants engaged in one-on-one interactions with a confederate utilizing the same scripted interactions observed by the first set of participants. RESULTS While the first set of participants identified invalidating behaviours accurately and consistently, the participants who experienced the behaviours demonstrated more variability in their perceptions of the behaviours as emotionally invalidating. CONCLUSION These preliminary findings demonstrate that the objective existence of emotionally invalidating behaviours are likely not the same as the experienced perception of EI across individuals, highlighting the need to examine how EI is operationally defined and measured. Future research should examine what individual characteristics may play a role in perceiving behaviours as emotionally invalidating. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Meredith Elzy
- Psychology, University of South Carolina Aiken, 471 University Parkway, Aiken, South Carolina, USA
| | - Marc Karver
- Psychology, University of South Florida, Tampa, Florida, USA
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Effects of brief mindfulness and loving-kindness meditation inductions on emotional and behavioral responses to social rejection among individuals with high borderline personality traits. Behav Res Ther 2018; 100:44-53. [DOI: 10.1016/j.brat.2017.11.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/10/2017] [Accepted: 11/20/2017] [Indexed: 11/20/2022]
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Ammerman BA, Olino TM, Coccaro EF, McCloskey MS. Predicting Nonsuicidal Self-Injury in Borderline Personality Disorder Using Ecological Momentary Assessment. J Pers Disord 2017; 31:844-855. [PMID: 28072044 DOI: 10.1521/pedi_2017_31_278] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Borderline personality disorder (BPD) is a highly comorbid disorder, and these comorbidities increase the impairment associated with BPD. For example, depression, which occurs in the majority of individuals with BPD, increases the likelihood of an individual with BPD to engage in nonsuicidal self-injury (NSSI). Little research, however, has investigated potential mechanisms of NSSI engagement in this population. The current study aimed to fill this gap by examining momentary experiences, levels of distress tolerance, and NSSI among 51 individuals meeting current diagnostic criteria for BPD and a comorbid depressive disorder. Using data from an ecological momentary assessment across 7 days, it was found that daily urges to hurt oneself and impulsive urges, but not daily negative affect or aggressive urges, predicted NSSI occurrence. Furthermore, low levels of distress tolerance was a stronger predictor of NSSI behavior than daily experiences. These findings have important implications with regard to state versus trait dispositions in NSSI engagement among those with BPD and depression.
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Jardin C, Sharp C, Garey L, Vanwoerden S, Crist N, Elhai JD, Zvolensky MJ. Compelled to Risk: Does Sexual Compulsivity Explain the Connection Between Borderline Personality Disorder Features and Number of Sexual Partners? J Pers Disord 2017; 31:738-752. [PMID: 28072043 DOI: 10.1521/pedi_2017_31_277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Having more sexual partners increases the likelihood of new HIV infections among women. Women with more borderline personality disorder (BPD) features have been known to have greater numbers of sexual partners. However, the mechanisms linking BPD features with more sexual partners remain to be clarified. Sexual compulsivity (lack of control, increased distress over sexual behavior) may be one such explanatory factor, as it overlaps with BPD features (e.g., impulsivity, negative affectivity). The present study examined whether sexual compulsivity explained the relation of BPD features with number of sexual partners among a diverse sample of college females (N = 1,326). Results demonstrated a significant indirect effect of BPD features via sexual compulsivity on number of sexual partners. These findings support the relation between BPD features and sexual compulsivity and suggest sexual compulsivity as a target in the promotion of the sexual health of women with BPD who demonstrate risky sexual practices.
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Affiliation(s)
- Charles Jardin
- Department of Psychology, University of Houston, Houston, Texas
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, Texas.,Adolescent Treatment Program, The Menninger Clinic, Houston, Texas
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, Texas
| | | | - Nic Crist
- Department of Psychology, University of Houston, Houston, Texas
| | - Jon D Elhai
- Department of Psychology and Department of Psychiatry, University of Toledo, Toledo, Ohio
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas.,Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas
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Kolla NJ, Meyer J, Sanches M, Charbonneau J. Monoamine Oxidase-A Genetic Variants and Childhood Abuse Predict Impulsiveness in Borderline Personality Disorder. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2017; 15:343-351. [PMID: 29073746 PMCID: PMC5678484 DOI: 10.9758/cpn.2017.15.4.343] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/10/2017] [Accepted: 03/30/2017] [Indexed: 01/01/2023]
Abstract
Objective Impulsivity is a core feature of borderline personality disorder (BPD) and antisocial personality disorder (ASPD) that likely arises from combined genetic and environmental influences. The interaction of the low activity variant of the monoamine oxidase-A (MAOA-L) gene and early childhood adversity has been shown to predict aggression in clinical and non-clinical populations. Although impulsivity is a risk factor for aggression in BPD and ASPD, little research has investigated potential gene-environment (G×E) influences impacting its expression in these conditions. Moreover, G×E interactions may differ by diagnosis. Methods Full factorial analysis of variance was employed to investigate the influence of monoamine oxidase-A (MAO-A) genotype, childhood abuse, and diagnosis on Barratt Impulsiveness Scale-11 (BIS-11) scores in 61 individuals: 20 subjects with BPD, 18 subjects with ASPD, and 23 healthy controls. Results A group×genotype×abuse interaction was present (F(2,49)=4.4, p=0.018), such that the interaction of MAOA-L and childhood abuse predicted greater BIS-11 motor impulsiveness in BPD. Additionally, BPD subjects reported higher BIS-11 attentional impulsiveness versus ASPD participants (t(1,36)=2.3, p=0.025). Conclusion These preliminary results suggest that MAOA-L may modulate the impact of childhood abuse on impulsivity in BPD. Results additionally indicate that impulsiveness may be expressed differently in BPD and ASPD.
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Affiliation(s)
- Nathan J Kolla
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Western Ontario, London, ON, Canada
| | - Jeffrey Meyer
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Marcos Sanches
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - James Charbonneau
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
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Keng SL, Tan JX. Effects of brief mindful breathing and loving-kindness meditation on shame and social problem solving abilities among individuals with high borderline personality traits. Behav Res Ther 2017; 97:43-51. [DOI: 10.1016/j.brat.2017.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 07/06/2017] [Accepted: 07/07/2017] [Indexed: 11/16/2022]
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Conway CC, Hipwell AE, Stepp SD. Seven-Year Course of Borderline Personality Disorder Features: Borderline Pathology Is as Unstable as Depression during Adolescence. Clin Psychol Sci 2017; 5:742-749. [PMID: 28920008 DOI: 10.1177/2167702617691546] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Borderline personality disorder (PD) historically is construed as an unremitting condition with poor prognosis. The present study takes a new approach to examining stability and change in borderline PD by explaining symptom expression in terms of an unchanging foundation-termed borderline proneness-on one hand, and transitory influences on the other. We monitored borderline PD symptoms annually in a large sample of high-risk adolescent girls (N = 2,450) from ages 14 to 20. Trait-state-occasion modeling revealed that just over half (52-57%) of borderline PD symptom variation was attributable to fixed borderline proneness, whereas the remainder was subject to change across yearly measurement occasions. This degree of stability was no larger than the corresponding estimate for depression, a condition known for its variable course. Our results indicate that, contrary to its reputation, borderline pathology is not set in stone, and it fluctuates in response to situational influences.
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Affiliation(s)
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA
| | - Stephanie D Stepp
- Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA
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Characteristics of Repetitive Thought Associated with Borderline Personality Features: A Multimodal Investigation of Ruminative Content and Style. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017; 39:456-466. [PMID: 28983149 DOI: 10.1007/s10862-017-9594-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Increased ruminative style of thought has been well documented in borderline personality disorder (BPD); however, less is known about how the content of rumination relates to domains of BPD features. Relationships between forms of rumination and BPD features were examined in an undergraduate sample with a wide range of BPD features. Participants completed self-report measures of rumination and a free-writing task about their repetitive thought. Rumination on specific themes, including anger rumination, depressive brooding, rumination on interpersonal situations, anxious rumination, and stress-reactive rumination were significantly associated with most BPD features after controlling for general rumination. Coded writing samples suggested that BPD features are associated with repetitive thought that is negative in valence, difficult to control, prolonged, unhelpful, and unresolved. Although rumination is often described as a form of self-focused attention, BPD relationship difficulties were correlated with greater other-focus in the writing samples, which may reflect more interpersonal themes. Across both self-reports and the writing task, the BPD feature of self-destructive behavior was associated specifically with anger and hostility, suggesting this content may play a particularly important role in fueling impulsive behavior. These findings suggest that both the style and the content of repetitive thought may play a role in BPD features.
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Somma A, Fossati A, Terrinoni A, Williams R, Ardizzone I, Fantini F, Borroni S, Krueger RF, Markon KE, Ferrara M. Reliability and clinical usefulness of the personality inventory for DSM-5 in clinically referred adolescents: A preliminary report in a sample of Italian inpatients. Compr Psychiatry 2016; 70:141-51. [PMID: 27624434 DOI: 10.1016/j.comppsych.2016.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 07/15/2016] [Accepted: 07/16/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The DSM-5 Alternative Model of Personality Disorders (AMPD) provides the opportunity to integrate the needed developmental perspective in the assessment of personality pathology. Based on this model, Krueger and colleagues (2012) developed the Personality Inventory for DSM-5 (PID-5), which operationalizes the proposed DSM-5 traits. METHODS Eighty-five consecutively admitted Italian adolescent inpatients were administered the Italian translation of the PID-5, in order to obtain preliminary data on PID-5 reliability and clinical usefulness in clinically referred adolescents. RESULTS With the possible exception of the PID-5 Suspiciousness scale, all other PID-5 scales evidenced adequate internal consistency reliability (i.e., Cronbach's α values of at least .70, most being greater than .80). Our data seemed to yield at least partial support for the construct validity of the PID-5 scales also in clinical adolescents, at least in terms of patterns of associations with dimensionally assessed DSM-5 Section II PDs that were also included in the DSM-5 AMPD (excluding Antisocial PD because of the participants' minor age). Finally, our data suggested that the clinical usefulness of the PID-5 in adolescent inpatients may extend beyond PDs to profiling adolescents at risk for life-threatening suicide attempts. In particular, PID-5 Depressivity, Anhedonia, and Submissiveness trait scales were significantly associated with adolescents' history of life-threatening suicide attempts, even after controlling for a number of other variables, including mood disorder diagnosis. DISCUSSION As a whole, our study may provide interesting, albeit preliminary data as to the clinical usefulness of PID-5 in the assessment of adolescent inpatients.
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Affiliation(s)
- Antonella Somma
- Department of Human Studies, LUMSA University, Rome, Italy, and San Raffaele Hospital, Milan, Italy
| | - Andrea Fossati
- Department of Human Studies, LUMSA University, Rome, Italy, and San Raffaele Hospital, Milan, Italy.
| | - Arianna Terrinoni
- Department of Pediatrics and Child and Adolescent Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Riccardo Williams
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Ignazio Ardizzone
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Fiorella Fantini
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Serena Borroni
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, U.S.A
| | | | - Mauro Ferrara
- Department of Pediatrics and Child and Adolescent Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy
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Fernandez E, Johnson SL. Anger in psychological disorders: Prevalence, presentation, etiology and prognostic implications. Clin Psychol Rev 2016; 46:124-35. [DOI: 10.1016/j.cpr.2016.04.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 12/14/2015] [Accepted: 04/25/2016] [Indexed: 01/21/2023]
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32
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Shorey RC, Elmquist J, Wolford-Clevenger C, Gawrysiak MJ, Anderson S, Stuart GL. The relationship between dispositional mindfulness, borderline personality features, and suicidal ideation in a sample of women in residential substance use treatment. Psychiatry Res 2016; 238:122-128. [PMID: 27086221 PMCID: PMC4834542 DOI: 10.1016/j.psychres.2016.02.040] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 12/28/2015] [Accepted: 02/16/2016] [Indexed: 11/27/2022]
Abstract
Borderline personality disorder (BPD), which is characterized by unstable moods, behavior, and relationships, is also associated with heightened suicidal ideation. Prior research has demonstrated that BPD and suicidal ideation are prevalent among women in substance use treatment. Efforts to treat substance use in this population are made difficult due to the severity of BPD, and it is possible that mindfulness-based interventions specific to substance use could be an effective approach for this population. However, basic research is needed on the relationship between dispositional mindfulness, BPD, and suicidal ideation among women in treatment for substance use to support their associations, which was the purpose of the present study. Pre-existing medical records were reviewed from a residential substance use treatment center. A total of 81 female patients were included in the current study. Patients completed self-report measures of mindfulness, BPD, suicidal ideation, substance use, and impression management at treatment intake. Findings demonstrated dispositional mindfulness to be negatively associated with BPD features and suicidal ideation. With the exception of self-harm, this negative relationship was found even after controlling for age, substance use, and impression management. Future research should examine whether mindfulness-based interventions are an effective treatment for comorbid substance use and BPD.
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Affiliation(s)
- Ryan C Shorey
- Ohio University, Department of Psychology, Athens, OH, USA.
| | - JoAnna Elmquist
- University of Tennessee, Knoxville, Department of Psychology, Knoxville, TN, USA
| | | | | | | | - Gregory L Stuart
- University of Tennessee, Knoxville, Department of Psychology, Knoxville, TN, USA
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Anderson JL, Sellbom M, Sansone RA, Songer DA. Comparing External Correlates of DSM-5 Section II and Section III Dimensional Trait Operationalizations of Borderline Personality Disorder. J Pers Disord 2016; 30:193-210. [PMID: 25905733 DOI: 10.1521/pedi_2015_29_189] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The current study evaluated the relative associations of the DSM-5 Section II operationalization of Borderline Personality Disorder (BPD) and dimensional traits included in a diagnosis of BPD in DSM-5 Section III with conceptually relevant external criterion variables. It is important to determine whether or not Section II BPD and constellation of Section III BPD traits have similar positions in the nomological network representing the BPD construct. Moreover, it is important to determine whether or not the trait-based Section III BPD diagnosis is an improvement upon the categorical Section II diagnosis in regard to its associations with external criteria. To evaluate this, we used two samples, a patient sample consisting of 145 psychiatric patients and a university sample consisting of 399 undergraduate students. We conducted a series of correlation and regression analyses in order to determine the relative associations of these two diagnostic methodologies with relevant external criteria. Correlation analyses did not favor either model, but indicated that both Section II and Section III BPD have associations with external criterion variables relevant to BPD. The regression analyses tended to favor the trait-based Section III model, supporting the construct validity and use of the trait profile for BPD in DSM-5 Section III. Generally, it was concluded that the Section II and Section III operationalizations have similar positions in a nomological network representing the BPD construct.
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Affiliation(s)
| | - Martin Sellbom
- Research School of Psychology, The Australian National University
| | - Randy A Sansone
- Wright State University School of Medicine and Kettering Medical Center, Kettering, Ohio
| | - Douglas A Songer
- Wright State University School of Medicine and Miami Valley Hospital, Dayton, Ohio
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Shorey RC, Elmquist J, Anderson S, Stuart GL. The Relationship between Antisocial and Borderline Features and Aggression in Young Adult Men in Treatment for Substance Use Disorders. J Psychoactive Drugs 2016; 48:115-23. [PMID: 26941068 PMCID: PMC4949949 DOI: 10.1080/02791072.2015.1130885] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
There is a large literature documenting that adult men in treatment for substance use disorders perpetrate more aggression than men without substance use disorders. Unfortunately, there is minimal research on aggression among young adult men (i.e., 18-25 years of age) in treatment for substance use. Moreover, although aggression is more likely to occur when individuals are acutely intoxicated by alcohol or drugs, research also suggests that antisocial (ASPD) and borderline (BPD) personality features increase the chances an individual will use aggression. The current study therefore examined the associations between ASPD and BPD features, including specific features that are reflective of impulsivity, and aggression in young adult men in treatment for substance use disorders (N = 79). Controlling for age, education, alcohol and drug use, ASPD features were positively associated with various indicators of aggression (e.g., physical, verbal, attitudinal), whereas BPD features were only associated with physical aggression. However, ASPD and BPD features that were specific to impulsivity were robustly related to indicators of aggression. Findings suggest that substance use treatment should attempt to target ASPD and BPD features in young adult men, which may help reduce aggression after treatment.
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Schermer JA, Martin RA, Martin NG, Lynskey MT, Trull TJ, Vernon PA. Humor styles and borderline personality. PERSONALITY AND INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1016/j.paid.2015.07.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gratz KL, Dixon-Gordon KL, Chapman AL, Tull MT. Diagnosis and Characterization of DSM-5 Nonsuicidal Self-Injury Disorder Using the Clinician-Administered Nonsuicidal Self-Injury Disorder Index. Assessment 2015; 22:527-39. [PMID: 25604630 PMCID: PMC5505727 DOI: 10.1177/1073191114565878] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite the inclusion of nonsuicidal self-injury disorder (NSSID) in the DSM-5, research on NSSID is limited and no studies have examined the full set of DSM-5 NSSID diagnostic criteria. Thus, this study examined the reliability and validity of a new structured diagnostic interview for NSSID (the Clinician-Administered NSSI Disorder Index; CANDI) and provides information on the clinical characteristics and features of DSM-5 NSSID. Data on the interrater reliability, internal consistency, and construct validity of the CANDI and associated characteristics of NSSID were collected in a community sample of young adults (N = 107) with recent recurrent NSSI (≥10 lifetime episodes of NSSI, at least one episode in the past year). Participants completed self-report measures of NSSI characteristics, psychopathology, and emotion dysregulation, as well as diagnostic interviews of borderline personality disorder (BPD) and lifetime mood, anxiety, and substance use disorders. The CANDI demonstrated good interrater reliability and adequate internal consistency. Thirty-seven percent of participants met criteria for NSSID. NSSID was associated with greater clinical and diagnostic severity, including greater NSSI versatility, greater emotion dysregulation and psychopathology, and higher rates of BPD, bipolar disorder, posttraumatic stress disorder, social anxiety disorder, and alcohol dependence. Findings provide support for the reliability, validity, and feasibility of the CANDI.
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Affiliation(s)
- Kim L Gratz
- University of Mississippi Medical Center, Jackson, MS, USA
| | | | | | - Matthew T Tull
- University of Mississippi Medical Center, Jackson, MS, USA
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37
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Meyer JK, Morey LC. Borderline personality features and associated difficulty in emotion perception: An examination of accuracy and bias. Personal Ment Health 2015; 9:227-40. [PMID: 26104825 DOI: 10.1002/pmh.1299] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 05/22/2015] [Accepted: 05/27/2015] [Indexed: 12/30/2022]
Abstract
Research on borderline personality disorder (BPD) has consistently found that those with the disorder often experience volatile interpersonal interactions, and several areas of research have been dedicated to the understanding of the mechanisms behind these interpersonal struggles. One of the most common theories is that the emotional dysregulation that is characteristic of BPD may adversely impact these interpersonal interactions, perhaps through a resulting misperception of emotional states in others. The purpose of the current study was to examine perception of negative affect in those with borderline personality features using a signal detection paradigm, a modified version of the Reading the Mind in the Eyes Task. Results support the hypothesis of atypical perception of negative emotions in BPD, but with disinhibitory aspects of the disorder demonstrating the largest potential influence. This finding was obtained even after controlling for gender differences that were also observed on this task. These results suggest that an examination of trait components of BPD may be necessary for a complete understanding of the emotion perception abilities of those with the disorder.
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Anderson JL, Sellbom M. Construct Validity of theDSM–5Section III Personality Trait Profile for Borderline Personality Disorder. J Pers Assess 2015; 97:478-86. [DOI: 10.1080/00223891.2015.1051226] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Conway CC, Hammen C, Brennan PA. Adolescent precursors of adult borderline personality pathology in a high-risk community sample. J Pers Disord 2015; 29:316-33. [PMID: 25248011 PMCID: PMC5653280 DOI: 10.1521/pedi_2014_28_158] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Longitudinal studies of the exact environmental conditions and personal attributes contributing to the development of borderline personality disorder (BPD) are rare. Furthermore, existing research typically examines risk factors in isolation, limiting our knowledge of the relative effect sizes of different risk factors and how they act in concert to bring about borderline personality pathology. The present study investigated the prospective effects of diverse acute and chronic stressors, proband psychopathology, and maternal psychopathology on BPD features in a high-risk community sample (N = 700) of youth followed from mid-adolescence to young adulthood. Multivariate analyses revealed significant effects of maternal externalizing disorder history, offspring internalizing disorder history, family stressors, and school-related stressors on BPD risk. Contrary to expectations, no interactions between chronically stressful environmental conditions and personal characteristics in predicting borderline personality features were detected. Implications of these findings for etiological theories of BPD and early screening efforts are discussed.
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Affiliation(s)
- Christopher C. Conway
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Constance Hammen
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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Drapkin ML, Eddie D, Buffington AJ, McCrady BS. Alcohol-Specific Coping Styles of Adult Children of Individuals with Alcohol Use Disorders and Associations with Psychosocial Functioning. Alcohol Alcohol 2015; 50:463-9. [PMID: 25802055 DOI: 10.1093/alcalc/agv023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 02/24/2015] [Indexed: 11/12/2022] Open
Abstract
Parental alcohol use disorders (AUDs) have been conceptualized as a chronic stressor that can lead to deleterious long-term outcomes in children of individuals with AUDs. Yet, while many individuals are detrimentally affected by their parents' problematic alcohol use, and go on to manifest psychological problems, others do not. How individuals cope with the stress of having a parent with an AUD is believed to be an important moderator of this differential outcome. This study assessed whether individuals' alcohol-specific coping styles predicted alcohol use, positive or negative life events, and depression, using a sample of 465 college students, of whom 20% were adult children of individuals with alcohol use disorders, colloquially known as adult children of alcoholics (ACOAs), and a battery of well-validated, self-report measures. Participant ACOAs reported less 'engaged' and 'total' alcohol-specific coping strategies and more 'withdrawal' alcohol-specific coping strategies than their non adult children of alcoholics (NACOAs) counterparts. Across participants, women reported more 'engaged', 'tolerant/inactive', and 'total' coping than men. Although ACOAs reported significantly more negative life events, which predicted more passive coping styles, they did not differ significantly from NACOAs on measures of problematic alcohol use or depression, supporting theories of resilience in ACOAs regardless of their alcohol-specific coping styles. For NACOAs, 'tolerant' coping predicted greater depression and alcohol-related problems; 'engaged' coping predicted fewer alcohol problems. Results suggest that ACOAs cope differently with problematic alcohol use among relatives and friends compared with NACOAs and are more likely to experience negative life events. Additionally, alcohol-related coping strategies have more predictive utility in NACOAs than ACOAs.
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Affiliation(s)
- Michelle L Drapkin
- Philadelphia VA Medical Center, Philadelphia, PA, USA Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - David Eddie
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | | | - Barbara S McCrady
- The Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, NM, USA
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Scheiderer EM, Wood PK, Trull TJ. The comorbidity of borderline personality disorder and posttraumatic stress disorder: revisiting the prevalence and associations in a general population sample. Borderline Personal Disord Emot Dysregul 2015; 2:11. [PMID: 26401313 PMCID: PMC4579516 DOI: 10.1186/s40479-015-0032-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 07/08/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The comorbidity of borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) is frequent, yet not well understood. The influence of childhood sexual abuse (CSA) in the development of this comorbidity has been a focus of prior clinical studies, but empirical evidence to generalize this focus to the broader population is lacking. Primary aims of the present study included evaluation of: (a) the association of this comorbidity with decrements in health-related quality of life (HRQOL) and (b) the importance of CSA as a predictive factor for this comorbidity in a general population sample. METHODS We utilized data from Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions, a nationally representative face-to-face survey evaluating mental health in the non-institutionalized adult population of the United States. Data from respondents who met criteria for BPD and/or PTSD were analyzed (N = 4104) to assess potential associations between and among lifetime BPD-PTSD comorbidity, CSA, gender, healthcare usage, and mental and physical HRQOL. RESULTS Lifetime comorbidity of BPD and PTSD was associated with more dysfunction than either individual disorder; and the factors of gender, age, and CSA exhibited significant effects in the prediction of this comorbidity and associated decrements in HRQOL. CONCLUSIONS Results support the measured focus on CSA as an important, but not necessary, etiologic factor and emphasize this comorbidity as a source of greater suffering and public health burden than either BPD or PTSD alone. The differential impact of these disorders occurring alone versus in comorbid form highlights the importance of diagnosing both BPD and PTSD and attending to lifetime comorbidity.
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Affiliation(s)
- Emily M Scheiderer
- 104 Psychology Building, University of Missouri - Columbia, Columbia, MO 65211 USA
| | - Phillip K Wood
- 210 McAlester Hall, University of Missouri - Columbia, Columbia, MO 65211 USA
| | - Timothy J Trull
- 210 McAlester Hall, University of Missouri - Columbia, Columbia, MO 65211 USA
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Kuo JR, Khoury JE, Metcalfe R, Fitzpatrick S, Goodwill A. An examination of the relationship between childhood emotional abuse and borderline personality disorder features: the role of difficulties with emotion regulation. CHILD ABUSE & NEGLECT 2015; 39:147-155. [PMID: 25192957 DOI: 10.1016/j.chiabu.2014.08.008] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 08/06/2014] [Accepted: 08/08/2014] [Indexed: 06/03/2023]
Abstract
Childhood abuse has been consistently linked with borderline personality disorder (BPD) and recent studies suggest that some forms of childhood abuse might be uniquely related to both BPD and BPD features. In addition, difficulties with emotion regulation have been found to be associated with childhood abuse, BPD, as well as BPD features. The present study examined (1) whether frequency of childhood emotional abuse is uniquely associated with BPD feature severity when controlling for other forms of childhood abuse and (2) whether difficulties with emotion regulation accounts for the relationship between childhood emotional abuse and BPD feature severity. A sample of undergraduates (n=243) completed the Childhood Trauma Questionnaire - Short Form, Difficulties in Emotion Regulation Scale, and Borderline Symptom List-23. Multiple regression analyses and Structural Equation Modeling were conducted. Results indicated that frequency of childhood emotional abuse (and not sexual or physical abuse) was uniquely associated with BPD feature severity. In addition, while there was no direct path between childhood emotional abuse, childhood physical abuse, or childhood sexual abuse and BPD features, there was an indirect relationship between childhood emotional abuse and BPD features through difficulties with emotion regulation. These findings suggest that, of the different forms of childhood abuse, emotional abuse specifically, may have a developmental role in BPD pathology. Prevention and treatment of BPD pathology might benefit from the provision of emotion regulation strategies.
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Affiliation(s)
- Janice R Kuo
- Department of Psychology, Ryerson University, Canada
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Rosenbach C, Renneberg B. Rejection sensitivity as a mediator of the relationship between experienced rejection and borderline characteristics. PERSONALITY AND INDIVIDUAL DIFFERENCES 2014. [DOI: 10.1016/j.paid.2014.05.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sauer-Zavala S, Barlow DH. The case for borderline personality disorder as an emotional disorder: Implications for treatment. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/cpsp.12063] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Stepp SD, Whalen DJ, Scott LN, Zalewski M, Loeber R, Hipwell AE. Reciprocal effects of parenting and borderline personality disorder symptoms in adolescent girls. Dev Psychopathol 2014; 26:361-78. [PMID: 24443951 PMCID: PMC4103652 DOI: 10.1017/s0954579413001041] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Theories of borderline personality disorder (BPD) postulate that high-risk transactions between caregiver and child are important for the development and maintenance of the disorder. Little empirical evidence exists regarding the reciprocal effects of parenting on the development of BPD symptoms in adolescence. The impact of child and caregiver characteristics on this reciprocal relationship is also unknown. Thus, the current study examines bidirectional effects of parenting, specifically harsh punishment practices and caregiver low warmth, and BPD symptoms in girls aged 14-17 years based on annual, longitudinal data from the Pittsburgh Girls Study (N = 2,451) in the context of child and caregiver characteristics. We examined these associations through the use of autoregressive latent trajectory models to differentiate time-specific variations in BPD symptoms and parenting from the stable processes that steadily influence repeated measures within an individual. The developmental trajectories of BPD symptoms and parenting were moderately associated, suggesting a reciprocal relationship. There was some support for time-specific elevations in BPD symptoms predicting subsequent increases in harsh punishment and caregiver low warmth. There was little support for increases in harsh punishment and caregiver low warmth predicting subsequent elevations in BPD symptoms. Child impulsivity and negative affectivity, and caregiver psychopathology were related to parenting trajectories, while only child characteristics predicted BPD trajectories. The results highlight the stability of the reciprocal associations between parenting and BPD trajectories in adolescent girls and add to our understanding of the longitudinal course of BPD in youth.
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Standish AJ, Benfield JA, Bernstein MJ, Tragesser S. Characteristics of Borderline Personality Disorder and Disgust Sensitivity. PSYCHOLOGICAL RECORD 2014. [DOI: 10.1007/s40732-014-0039-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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A Preliminary Examination of the Role of Emotion Differentiation in the Relationship between Borderline Personality and Urges for Maladaptive Behaviors. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2014; 36:616-625. [PMID: 25750478 DOI: 10.1007/s10862-014-9423-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Impulsive, maladaptive, and potentially self-damaging behaviors are a hallmark feature of borderline personality (BP) pathology. Difficulties with emotion regulation have been implicated in both BP pathology and maladaptive behaviors. One facet of emotion regulation that may be particularly important in the relation between BP pathology and urges for maladaptive behaviors is emotion differentiation. METHODS Over one day, 84 participants high (n = 34) and low (n = 50) in BP pathology responded to questions regarding state emotions and urges to engage in maladaptive behaviors using handheld computers, in addition to a measure of emotion-related difficulties controlling impulsive behaviors. RESULTS Results revealed that individuals high in BP pathology reported greater emotion-related impulsivity as well as daily urges to engage in maladaptive behaviors. However, the association between BP group and both baseline emotion-related impulsivity and daily urges for maladaptive behaviors was strongest among individuals who had low levels of positive emotion differentiation. Conversely, negative emotion differentiation did not significantly moderate the relationships between BP group and either emotion-related difficulties controlling impulsive behaviors or state urges for maladaptive behaviors. LIMITATIONS Limitations to the present study include the reliance upon an analogue sample and the relatively brief monitoring period. CONCLUSIONS Despite limitations, these results suggest that, among individuals with high BP pathology, the ability to differentiate between positive emotions may be a particularly important target in the reduction of maladaptive behaviors.
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Scott LN, Stepp SD, Pilkonis PA. Prospective associations between features of borderline personality disorder, emotion dysregulation, and aggression. Personal Disord 2014; 5:278-88. [PMID: 24635753 DOI: 10.1037/per0000070] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Difficulties with emotion regulation and behavioral instability, including impulsive aggression, are seen as core dimensions underlying borderline personality disorder (BPD). Although both BPD and antisocial personality disorder (ASPD) are associated with impulsivity and aggressive behavior, difficulties regulating emotions may be associated uniquely with BPD and may explain distinctive associations between BPD and aggression. This study was designed to examine the unique prospective associations between BPD symptoms at baseline, difficulties with emotion regulation and trait impulsivity, and psychological and physical aggression (both perpetration and victimization) over the course of a year after controlling for ASPD symptoms in a mixed clinical and community sample of adults (N = 150). Results of a multivariate path analysis demonstrated that associations between BPD symptoms at baseline and later psychological and physical aggression were fully mediated by difficulties with emotion regulation. Although BPD symptoms also predicted trait impulsivity, impulsivity did not predict aggression after controlling for emotion dysregulation. ASPD symptoms were directly associated with physical assault perpetration and victimization but were not associated with emotion dysregulation, impulsivity, or psychological aggression. These findings suggest that although both BPD and ASPD are associated with aggressive behaviors, associations between BPD symptoms and aggression are mediated uniquely by difficulties regulating emotions.
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Affiliation(s)
- Lori N Scott
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Stephanie D Stepp
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Paul A Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine
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Geiger PJ, Peters JR, Baer RA. Using a measure of cognitive distortion to examine the relationship between thought suppression and borderline personality features: A multi-method investigation. PERSONALITY AND INDIVIDUAL DIFFERENCES 2014. [DOI: 10.1016/j.paid.2013.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Courtney-Seidler EA, Klein D, Miller AL. Borderline personality disorder in adolescents. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2013. [DOI: 10.1111/cpsp.12051] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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