Introducing STEPPS on an Inpatient Unit in Italy

2016 ◽  
pp. 120-139
Author(s):  
Andrea Fossati ◽  
Roberta Alesiani ◽  
Silvia Boccalon ◽  
Laura Giarolli ◽  
Serena Borroni ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Hospital Admission ◽  
Mood Disorder ◽  
Mood Disorders ◽  
Suicide Attempts ◽  
Inpatient Unit ◽  
Inpatient Setting ◽  
History Of ◽  
Destructive Behaviors

This chapter describes how STEPPS has been adapted for inpatients with borderline personality disorder and co-occurring mood disorders at San Raffaele Hospital in Milan, Italy. All of the participants had a history of multiple hospitalizations and suicide attempts before entering STEPPS. The chapter describes how the program was modified for the inpatient setting. The patients begin the program during hospital admission to an inpatient unit and continue twice-weekly following discharge. The admission typically lasts one month, and the STEPPS program begins after remission of the acute mood disorder symptoms. Following discharge, the group program meets twice weekly for 45 minutes; the typical 20 session program is increased to 30 sessions. STEPPS was used as a stand-alone treatment for these patients. Data show that STEPPS has contributed to a reduction in self-destructive behaviors and frequency of hospitalization.

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

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.

A Family Study of Outpatients With Borderline Personality Disorder and No History of Mood Disorder

2000 ◽  
Vol 14 (3) ◽  
pp. 208-217 ◽  
Author(s):  
Lawrence P. Riso ◽  
Daniel N. Klein ◽  
Rochelle L. Anderson ◽  
Paige Crosby Ouimette
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mood Disorder ◽  
Family Study ◽  
Borderline Personality ◽  
History Of

scholarly journals Borderline Personality Disorder with Paranoid Features

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Adina Isabell Iancu ◽  
◽  
Monica-Georgiana Lazăr ◽  
Simona Trifu ◽  
◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Defense Mechanisms ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Stressful Events ◽  
Axis Ii ◽  
Appropriate Treatment ◽  
Destructive Behaviors ◽  
Poor Management

This paper aims to evaluate the current and dynamic profile of a 19-year-old with Borderline Personality Disorder (BPD) with paranoid features. The case allows us to detect how the symptoms associated with BPD evolve on a background of poor management of potentially stressful events. There is a Borderline personality structure with obvious paranoid features, which pushes the patient into dysfunctional behaviors, aggressive acts and suicidal tendencies, the patient's instability, chaotic sexuality, addictive and self-harming behavior being observed. There are elements specific to an antisocial personality with narcissistic notes, which highlight impulsive and manipulative tendencies, accompanied by recurrent conflicts and delinquency. The clinical picture of axis II pathology is highlighted, an accentuated aspect being represented by the deficient defense mechanisms, which prevent the integration of the events in an adequate way. Considering the patient's self-destructive behaviors, impulsiveness, and multiple addictions, in the absence of appropriate treatment, psychotherapy, and/or pharmacological treatment, several future complications may occur, including risks of future problems with the law, self-destructive behaviors, and suicide attempts.

A Mediation Analysis of Childhood Maltreatment and Suicidal Behavior among Patients with Depressive or Bipolar Disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S85-S85
Author(s):  
K. Aaltonen ◽  
T. Rosenström ◽  
I. Baryshnikov ◽  
B. Karpov ◽  
T. Melartin ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Suicidal Ideation ◽  
Personality Disorder ◽  
Mood Disorders ◽  
Childhood Maltreatment ◽  
Suicidal Behaviour ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Borderline Personality Disorder Traits

IntroductionSubstantial evidence supports association between childhood maltreatment and suicidal behaviour, however, a limited number of studies have examined psychological mechanisms mediating the relationship among patients with mood disorders.ObjectiveTo investigate directly the potential intermediating mechanisms between childhood maltreatment and suicidal behaviour among patients with mood disorders.AimsWe examine by formal mediation analyses, if:– the effect of childhood maltreatment on suicidal behaviour is mediated through borderline personality disorder traits;– the mediation effect differs between lifetime suicidal ideation and lifetime suicide attempts.MethodsDepressive disorder and bipolar disorder (ICD-10-DCR) patients (n = 287) from the Helsinki university psychiatric consortium (HUPC) Study were surveyed on self-reported childhood experiences, current depressive symptoms, borderline personality disorder traits and lifetime suicidal behaviour. Psychiatric records served to complement the information on suicide attempts.ResultsThe influence of childhood maltreatment on lifetime suicidal ideation and lifetime suicide attempts showed comparable total effects. In formal mediation analyses, borderline personality disorder traits mediated all of the total effect of childhood maltreatment on lifetime suicide attempts, but only 21% of the total effect on lifetime suicide ideation. The mediation effect was stronger for lifetime suicide attempts compared to ideation (P = 0.002) and independent of current depressive symptoms.ConclusionsThe mechanisms of the effect of childhood maltreatment on suicidal ideation and attempts may diverge among psychiatric patients with mood disorders. Borderline personality disorder traits may contribute to these mechanisms, although the influence appears considerably stronger for suicide attempts than for suicide ideation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Borderline Personality Disorder with Paranoid Features

2021 ◽  
Author(s):  
Adina Isabell Iancu ◽  
Monica-Georgiana Lazăr ◽  
Simona Trifu
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Defense Mechanisms ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Stressful Events ◽  
Axis Ii ◽  
Appropriate Treatment ◽  
Destructive Behaviors ◽  
Poor Management

This paper aims to evaluate the current and dynamic profile of a 19-year-old with Borderline Personality Disorder (BPD) with paranoid features. The case allows us to detect how the symptoms associated with BPD evolve on a background of poor management of potentially stressful events. There is a Borderline personality structure with obvious paranoid features, which pushes the patient into dysfunctional behaviors, aggressive acts and suicidal tendencies, the patient's instability, chaotic sexuality, addictive and self-harming behavior being observed. There are elements specific to an antisocial personality with narcissistic notes, which highlight impulsive and manipulative tendencies, accompanied by recurrent conflicts and delinquency. The clinical picture of axis II pathology is highlighted, an accentuated aspect being represented by the deficient defense mechanisms, which prevent the integration of the events in an adequate way. Considering the patient's self-destructive behaviors, impulsiveness, and multiple addictions, in the absence of appropriate treatment, psychotherapy, and/or pharmacological treatment, several future complications may occur, including risks of future problems with the law, self-destructive behaviors, and suicide attempts.

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.

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