Emotion-Oriented Coping Style Predicts Self-Harm in Response to Acute Psychiatric Hospitalization

Crisis ◽  
2020 ◽  
pp. 1-7
Author(s):  
Jacqueline M. Frei ◽  
Vladimir Sazhin ◽  
Melissa Fick ◽  
Keong Yap
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychiatric Hospitalization ◽  
Coping Styles ◽  
Psychiatric Inpatients ◽  
Borderline Personality ◽  
Self Report ◽  
Therapeutic Interventions ◽  
Coping Behaviors ◽  
Self Harm

Abstract. Psychiatric hospitalization can cause significant distress for patients. Research has shown that to cope with the stress, patients sometimes resort to self-harm. Given the paucity of research on self-harm among psychiatric inpatients, a better understanding of transdiagnostic processes as predictors of self-harm during psychiatric hospitalization is needed. The current study examined whether coping styles predicted self-harm after controlling for commonly associated factors, such as age, gender, and borderline personality disorder. Participants were 72 patients (mean age = 39.32 years, SD = 12.29, 64% male) admitted for inpatient treatment at a public psychiatric hospital in Sydney, Australia. Participants completed self-report measures of coping styles and ward-specific coping behaviors, including self-harm, in relation to coping with the stress of acute hospitalization. Results showed that younger age, diagnosis of borderline personality disorder, and higher emotion-oriented coping were associated with self-harm. After controlling for age and borderline personality disorder, higher levels of emotion-oriented coping were found to be a significant predictor of self-harm. Findings were partially consistent with hypotheses; emotion-oriented but not avoidance-oriented coping significantly predicted self-harm. This finding may help to identify and provide psychiatric inpatients who are at risk of self-harm with appropriate therapeutic interventions.

Rumination in Borderline Personality Disorder: Meta-Analysis

2018 ◽  
Author(s):  
Mara J. Richman ◽  
Zsolt Unoka ◽  
Robert Dudas ◽  
Zsolt Demetrovics
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotion Dysregulation ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
Sample Type ◽  
Moderator Variables ◽  
Analytic Review ◽  
Self Harm

Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and affective liability. Of this domain, ruminative behaviors have been considered a core feature of emotion dysregulation difficulties. Despite this, inconsistencies have existed in the literature regarding which rumination type is most prominent in those with BPD symptoms. Moreover, no meta-analytic review has been performed to date on rumination in BPD. Taking this into consideration, a meta-analysis was performed to assess how BPD symptoms correlate with rumination, while also considering clinical moderator variables (i.e., BPD symptom domain, co-morbidities, GAF score) and demographic moderator variables (i.e., age, gender, sample type, and education level). Analysis of correlation across rumination domains for the entire sample revealed a medium overall correlation between BPD symptoms and rumination. When assessing types of rumination, the largest correlation was among pain rumination followed by anger, depressive, and anxious rumination. Among BPD symptom domain, affective instability had the strongest correlation with increased rumination, followed by unstable relationships, identity disturbance, and self-harm/ impulsivity, respectively. Demographic variables showed no significance. Clinical implications are considered and further therapeutic interventions are discussed in the context of rumination.

scholarly journals A psychophysiological assessment of delayed emotional recovery across discrete emotions in borderline personality disorder and the impact of self-harm and suicidality

2021 ◽  
Author(s):  
Skye Fitzpatrick
Keyword(s):  
Borderline Personality Disorder ◽  
Suicidal Ideation ◽  
Personality Disorder ◽  
Learning Strategies ◽  
Borderline Personality ◽  
Self Report ◽  
Healthy Control ◽  
Self Harm ◽  
Emotional Recovery ◽  
The Impact

This study examined Linehan’s (1993) theory of delayed emotional recovery (i.e., emotions last longer) in borderline personality disorder (i.e., BPD), and whether non-suicidal self-injury and suicidal ideation modulate this process. BPD and healthy control (HC) groups were monitored via parasympathetic, sympathetic, and self-report indices after fear, anger, and sadness inductions. After the fear induction, the BPD group showed increases in emotional arousal as indicated by parasympathetic indices and no changes in sympathetic indices, whereas HCs showed no change in parasympathetic indices and decreases in sympathetic indices. Further, individuals with BPD with higher urges to commit suicide after the fear induction exhibited faster decreases in sympathetic responding than others. These findings suggest that individuals with BPD selectively show delayed emotional recovery and that suicidal ideation may quicken emotional recovery in this group. Those with BPD may benefit from learning strategies to quicken, or tolerate, delayed emotional recovery.

scholarly journals The Care Programme Approach and risk assessment of borderline personality disorder

2000 ◽  
Vol 24 (10) ◽  
pp. 381-384 ◽  
Author(s):  
Peter Whewell ◽  
Daria Bonanno
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Evaluation System ◽  
Significant Risk ◽  
Borderline Personality ◽  
Self Report ◽  
Care Programme ◽  
Self Harm ◽  
Core Self ◽  
Regular Contact

Aims and MethodsThis paper describes the validation of self-report of risk by patients with borderline personality disorder (BPD) as compared with the judgement of experienced psychotherapists in regular contact with them. The aim was to validate the Clinical Outcomes in Routine Evaluation System (CORE) self-report in order to be able to use it to monitor risk change for patients with BPD in psychotherapy and general psychiatric settings.ResultsThere was significant separation correlation between CORE risk sub-scales for self-harm, suicide and risk to others and therapists' estimation of significant risk v. no significant risk.Clinical ImplicationsUsing the cut-offs described, we suggest that the CORE questionnaire risk sub-scales can be used to assess significant risk for patients with BPD in psychotherapy, and in psychiatric and community health teams. The sub-scales should also prove valuable in allocating Care Programme Approach status.

Borderline Personality among Outpatients Seen by a Pain Management Specialist

2009 ◽  
Vol 39 (3) ◽  
pp. 341-344 ◽  
Author(s):  
Randy A. Sansone ◽  
J. David Sinclair ◽  
Michael W. Wiederman
Keyword(s):  
Borderline Personality Disorder ◽  
Pain Management ◽  
Personality Disorder ◽  
Borderline Personality ◽  
The Self ◽  
Self Report ◽  
Prevalence Rates ◽  
Axis Ii ◽  
Self Harm ◽  
Pain Patients

Objective: We examined the prevalence of borderline personality disorder among a sample of outpatients who were being initially evaluated by a pain management specialist. Method: Using two self-report measures for borderline personality disorder, the borderline personality scale of the Personality Diagnostic Questionnaire-4 (PDQ-4) and the Self-Harm Inventory (SHI), we explored prevalence rates of this Axis II disorder in a sample of 117 participants. Results: According to the PDQ-4 and the SHI, 9.4% and 14.5% of participants, respectively, met the criteria for borderline personality, with 6.8% meeting criteria on both measures. Conclusions: In this insured population of pain patients, rates of borderline personality, as determined by both measures, were comparable to rates of borderline personality in the general population.

scholarly journals A psychophysiological assessment of delayed emotional recovery across discrete emotions in borderline personality disorder and the impact of self-harm and suicidality

2021 ◽  
Author(s):  
Skye Fitzpatrick
Keyword(s):  
Borderline Personality Disorder ◽  
Suicidal Ideation ◽  
Personality Disorder ◽  
Learning Strategies ◽  
Borderline Personality ◽  
Self Report ◽  
Healthy Control ◽  
Self Harm ◽  
Emotional Recovery ◽  
The Impact

This study examined Linehan’s (1993) theory of delayed emotional recovery (i.e., emotions last longer) in borderline personality disorder (i.e., BPD), and whether non-suicidal self-injury and suicidal ideation modulate this process. BPD and healthy control (HC) groups were monitored via parasympathetic, sympathetic, and self-report indices after fear, anger, and sadness inductions. After the fear induction, the BPD group showed increases in emotional arousal as indicated by parasympathetic indices and no changes in sympathetic indices, whereas HCs showed no change in parasympathetic indices and decreases in sympathetic indices. Further, individuals with BPD with higher urges to commit suicide after the fear induction exhibited faster decreases in sympathetic responding than others. These findings suggest that individuals with BPD selectively show delayed emotional recovery and that suicidal ideation may quicken emotional recovery in this group. Those with BPD may benefit from learning strategies to quicken, or tolerate, delayed emotional recovery.

scholarly journals Predictors of suicide attempts in patients with borderline personality disorder over 16 years of prospective follow-up

2012 ◽  
Vol 42 (11) ◽  
pp. 2395-2404 ◽  
Author(s):  
M. M. Wedig ◽  
M. H. Silverman ◽  
F. R. Frankenburg ◽  
D. Bradford Reich ◽  
G. Fitzmaurice ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Self Report ◽  
Time Varying ◽  
Post Traumatic Stress ◽  
Completed Suicide ◽  
Self Harm

BackgroundIt is clinically important to understand the factors that increase the likelihood of the frequent and recurrent suicide attempts seen in those with borderline personality disorder (BPD). Although several studies have examined this subject in a cross-sectional manner, the aim of this study was to determine the most clinically relevant baseline and time-varying predictors of suicide attempts over 16 years of prospective follow-up among patients with BPD.MethodTwo-hundred and ninety in-patients meeting Revised Diagnostic Interview for Borderlines (DIB-R) and DSM-III-R criteria for BPD were assessed during their index admission using a series of semistructured interviews and self-report measures. These subjects were then reassessed using the same instruments every 2 years. The generalized estimating equations (GEE) approach was used to model the odds of suicide attempts in longitudinal analyses, controlling for assessment period, yielding an odds ratio (OR) and 95% confidence interval (CI) for each predictor.ResultsNineteen variables were found to be significant bivariate predictors of suicide attempts. Eight of these, seven of which were time-varying, remained significant in multivariate analyses: diagnosis of major depressive disorder (MDD), substance use disorder (SUD), post-traumatic stress disorder (PTSD), presence of self-harm, adult sexual assault, having a caretaker who has completed suicide, affective instability, and more severe dissociation.ConclusionsThe results of this study suggest that prediction of suicide attempts among borderline patients is complex, involving co-occurring disorders, co-occurring symptoms of BPD (self-harm, affective reactivity and dissociation), adult adversity, and a family history of completed suicide.

Borderline personality disorder: does its clinical features show specificity to differing developmental risk factors?

2018 ◽  
Vol 26 (4) ◽  
pp. 410-413 ◽  
Author(s):  
Gordon Parker ◽  
Stacey McCraw ◽  
Adam Bayes
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Clinical Sample ◽  
Diagnostic Interview ◽  
Borderline Personality ◽  
Self Report ◽  
Therapeutic Interventions ◽  
Identity Disturbance ◽  
Developmental Factors ◽  
Dsm Iv

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. Results: Childhood sexual abuse, affirmed by 49% of the sample, showed specificity in being linked with DIPD-defined affective instability. DIPD-defined identity disturbance also showed specificity in being associated only with reporting significant non-sexual developmental trauma. DIPD-defined anger and paranoia/dissociation showed minimal specificity and were associated with most antecedent developmental factors in adulthood. Conclusions: Differing manifestations of BPD are likely to be shaped by specific and non-specific developmental events. Clarification of such links has the potential to shape more specific therapeutic interventions.

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