Borderline Personality Disorder

2018 ◽  
pp. 245-270
Author(s):  
Carol S. North ◽  
Sean H. Yutzy
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Attempts ◽  
Controlled Trial ◽  
Borderline Personality ◽  
Historical Background ◽  
Self Mutilation ◽  
History Of ◽  
The Common ◽  
Cognitive Problems

Borderline personality disorder is a fairly recent label of a variously conceptualized phenomenon which has been characterized by affective instability and emotional crises, cognitive problems, impulsivity, and intense and unstable personal relationships. This chapter reviews the historical background, epidemiology, and clinical picture (including comorbidity) of borderline personality disorder. Although progress toward validation of this diagnosis has been made, the current definition does not appear to meet the accepted gold standard criteria for a syndrome that is currently considered valid (and reliable). The natural history of what is known is reviewed, as well as the common complications, including self-mutilation and suicide attempts. Treatment remains challenging at best, with few interventions meeting rigorous randomized controlled trial standards.

Comorbid Bipolar Disorder and Borderline Personality Disorder and History of Suicide Attempts

2014 ◽  
Vol 28 (3) ◽  
pp. 358-364 ◽  
Author(s):  
Mark Zimmerman ◽  
Jennifer Martinez ◽  
Diane Young ◽  
Iwona Chelminski ◽  
Theresa A. Morgan ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
History Of

scholarly journals Transcranial Magnetic Stimulation for Borderline Personality Disorder: Rationale, Stimulation Site and Methods

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
L. Cailhol ◽  
E. Bui ◽  
B. Roussignol ◽  
A.-H. Moncany ◽  
R. Klein ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Personality Disorder ◽  
Interpersonal Relationships ◽  
Magnetic Stimulation ◽  
Suicide Attempts ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trial ◽  
Borderline Personality ◽  
Post Traumatic Stress

Borderline personality disorder (BPD) is characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This disorder is associated with a significant rate of suicide attempts and completed suicides (4 to 10%), a major impairment in social functioning and an increased healthcare utilization cost. Treatments available include psychotherapy and pharmacotherapy. Research has shown some efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) on post-traumatic stress disorder and mood disorder which both share common biological or clinical features with BPD. It is then likely that rTMS might prove efficient on BPD symptoms.A review of the literature on neuroimaging and neuropsychology of BPD shows a hypoactivity of the dorsolateral prefrontal cortex which may be a potential target site for rTMS.We will conduct a pilot randomized sham-controlled trial on 30 BPD patients assessing the efficacy of a 10-day course of daily rTMS on neuropsychological tasks, BPD symptoms severity, risk taking behaviour, depression and general psychopathology.

Genetic, Developmental and Personality Correlates of Self-Mutilation in Depressed Patients

2006 ◽  
Vol 40 (3) ◽  
pp. 225-229 ◽  
Author(s):  
Peter R. Joyce ◽  
Janice M. McKenzie ◽  
Roger T. Mulder ◽  
Suzanne E. Luty ◽  
Patrick F. Sullivan ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Childhood Abuse ◽  
Term Treatment ◽  
Borderline Personality ◽  
Depressed Patients ◽  
Self Mutilation ◽  
Long Term Treatment ◽  
History Of

Objective: To examine whether the T allele of G protein β3 (GNβ3) is associated with self-mutilation in depressed patients. Method: A history of self-mutilation was systematically inquired about when recruiting depressed patients for a long-term treatment trial. Risk factors such as borderline personality disorder and childhood abuse experiences were systematically assessed, and patients were genotyped for polymorphisms of GNβ 3. Results: The T allele of GNβ 3, borderline personality disorder and childhood sexual abuse were all significantly associated with self-mutilation in depressed patients. These associations were significant in both univariate andmultivariate analyses, and as predicted were stronger in young depressed patients than in depressed patients of all ages. Conclusions: If the association between the T allele of GNβ 3and self-mutilation can be replicated, this may provide clues to understanding the neurobiology of self-mutilation.

scholarly journals Borderline personality disorder and prior suicide attempts define a severity gradient among hospitalized adolescent suicide attempters

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aveline Aouidad ◽  
David Cohen ◽  
Bojan Mirkovic ◽  
Hugues Pellerin ◽  
Sébastien Garny de La Rivière ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Anxiety Disorders ◽  
Adolescent Suicide ◽  
Suicide Attempts ◽  
Conduct Disorders ◽  
Borderline Personality ◽  
Self Injury ◽  
History Of ◽  
Clinical Interactions

Abstract Background Borderline personality disorder (BPD) and history of prior suicide attempt (SA) have been shown to be high predictors for subsequent suicide. However, no previous study has examined how both factors interact to modify clinical and suicide severity among adolescents. Methods This study presents a comprehensive assessment of 302 adolescents (265 girls, mean age = 14.7 years) hospitalized after a SA. To test clinical interactions between BPD and history of prior SA, the sample was divided into single attempters without BPD (non-BPD-SA, N = 80), single attempters with BPD (BPD-SA, N = 127) and multiple attempters with BPD (BPD-MA, N = 95). Results Univariate analyses revealed a severity gradient among the 3 groups with an additive effect of BPD on the clinical and suicide severity already conferred by a history of SA. This gradient encompassed categorical (anxiety and conduct disorders and non-suicidal-self-injury [NSSI]) and dimensional comorbidities (substance use and depression severity) and suicide characteristics (age at first SA). According to regression analyses, the BPD-MA group that was associated with the most severe clinical presentation also showed specific features: the first SA at a younger age and a higher prevalence of non-suicidal self-injury (NSSI) and anxiety disorders. The BPD-MA group was not associated with higher impulsivity or frequency of negative life events. Conclusions Based on these findings and to improve youth suicide prevention, future studies should systematically consider BPD and the efficacy of reinforcing early interventions for anxiety disorders and NSSI.

Abuse and Neglect in Childhood: Relationship to Personality Disorder Diagnoses

CNS Spectrums ◽  
2003 ◽  
Vol 8 (10) ◽  
pp. 737-754 ◽  
Author(s):  
Linda M. Bierer ◽  
Rachel Yehuda ◽  
James Schmeidler ◽  
Vivian Mitropoulou ◽  
Antonia S. New ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Childhood Trauma ◽  
Emotional Abuse ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Antisocial Personality ◽  
Abuse And Neglect ◽  
History Of

ABSTRACTBackground:Childhood history of abuse and neglect has been associated with personality disorders and has been observed in subjects with lifetime histories of suicidality and self-injury. Most of these findings have been generated from inpatient clinical samples.Methods:This study evaluated self-rated indices of sustained childhood abuse and neglect in an outpatient sample of well-characterized personality disorder subjects (n=182) to determine the relative associations of childhood trauma indices to specific personality disorder diagnoses or clusters and to lifetime history of suicide attempts or gestures. Subjects met criteria for ~2.5 Axis II diagnoses and 24% reported past suicide attempts. The Childhood Trauma Questionnaire was administered to assess five dimensions of childhood trauma exposure (emotional, physical, and sexual abuse, and emotional and physical neglect). Logistic regression was employed to evaluate salient predictors among the trauma measures for each cluster, personality disorder, and history of attempted suicide and self-harm. All analyses controlled for gender distribution.Results:Seventy-eight percent of subjects met dichotomous criteria for some form of childhood trauma; a majority reported emotional abuse and neglect. The dichotomized criterion for global trauma severity was predictive of cluster B, borderline, and antisocial personality disorder diagnoses. Trauma scores were positively associated with cluster A, negatively with cluster C, but were not significantly associated with cluster B diagnoses. Among the specific diagnoses comprising cluster A, paranoid disorder alone was predicted by sexual, physical, and emotional abuse. Within cluster B, only antisocial personality disorder showed significant associations with trauma scores, with specific prediction by sexual and physical abuse. For borderline personality disorder, there were gender interactions for individual predictors, with emotional abuse being the only significant trauma predictor, and only in men. History of suicide gestures was associated with emotional abuse in the entire sample and in women only; self-mutilatory behavior was associated with emotional abuse in men.Conclusion:These results suggest that childhood emotional abuse and neglect are broadly represented among personality disorders, and associated with indices of clinical severity among patients with borderline personality disorder. Childhood sexual and physical abuse are highlighted as predictors of both paranoid and antisocial personality disorders. These results help qualify prior observations of the association of childhood sexual abuse with borderline personality disorder.

The Symptoms of Borderline Personality Disorder Assessed in MSAD

2018 ◽  
pp. 45-66
Author(s):  
Mary C. Zanarini
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Borderline Patient ◽  
Self Mutilation ◽  
Suicide Threats ◽  
Special Relationships

This chapter describes the 24 symptoms of BPD assessed in this study. It also describes what each symptom may mean to a borderline patient and the best way for clinicians to handle these symptoms. Some of the symptoms studied are affective (depression and sorrow, anger and rage, anxiety and panic, feelings of helplessness, hopelessness, and worthlessness, and feelings of emptiness and loneliness), while others are cognitive (troubling but nonpsychotic problems, such as overvalued ideas of worthlessness and guilt, experiences of depersonalization and derealization, and nondelusional suspiciousness and ideas of reference; quasi-psychotic or psychotic-like symptoms [i.e., transitory, circumscribed, and somewhat reality-based delusions and hallucinations]). Others are impulsive (self-mutilation, suicide threats, suicide attempts), while yet others are interpersonal (manipulation, demandingness, entitlement, treatment regressions, special relationships, dependency and counter-dependency, distortions of the truth, sadomasochistic tendencies).

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