Comparing Dimensional Models Assessing Personality Traits and Personality Pathology Among Adult ADHD and Borderline Personality Disorder

Objective: To examine the prevalence and characteristics of pregnant women with borderline personality pathology (defined as borderline personality disorder and borderline personality traits) referred to a perinatal consultation-liaison psychiatry service. Method: Socio-demographic and clinical data, and diagnoses made according to Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria were recorded for all women referred to and seen by the perinatal consultation-liaison psychiatry service over an 18-month period. Data were analysed using descriptive statistics and logistic regression analysis. Results: A total of 318 women were seen. The most common diagnoses found were depressive disorder (25.5%) and anxiety disorder (15.1%). Borderline personality disorder was found in 10.1% of women and almost one in five women had two or more borderline personality traits (19.5%). When compared to women with other diagnoses, women with borderline personality pathology had higher rates of unplanned pregnancy, being unpartnered, substance use during pregnancy and higher rates of child safety services involvement as a child or in a previous pregnancy. Over 40% of women with borderline personality pathology were referred to child safety services in the current pregnancy and a diagnosis of borderline personality pathology increased the risk of child safety services involvement by almost sixfold (odds ratio: 5.5; 95% confidence interval = [1.50, 20.17]). Conclusion: The prevalence of borderline personality pathology in antenatal women identified at antenatal screening and the recognition that women with borderline personality pathology are ‘high-risk’ caregivers argue for borderline personality pathology to be recognised as a high priority for investment in service development.

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Positive Emotion in Borderline Personality Disorder

The Oxford Handbook of Positive Emotion and Psychopathology ◽

10.1093/oxfordhb/9780190653200.013.22 ◽

2019 ◽

pp. 332-352

Author(s):

Jill M. Hooley ◽

Sara R. Masland

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Positive Emotions ◽

Negative Emotions ◽

Negative Mood ◽

Severe Form ◽

Borderline Personality ◽

Negative Emotionality ◽

Personality Pathology ◽

Emotional Experiences

Borderline personality disorder (BPD) is a severe form of personality pathology characterized by high levels of negative emotionality. Because negative emotions are so central to the clinical presentation of BPD, the issue of how people with this disorder process and experience positive emotional experiences is relatively unexplored. This chapter provides an overview of what is currently known about positive emotions and BPD. Although the literature is characterized by many inconsistencies, our review suggests that people with BPD do indeed experience positive emotions. However, their recall of positive emotional experiences appears to be reduced, perhaps because such experiences are more transient, less stable, and more likely to be quickly replaced by negative emotions. Problems with the identification and accurate differentiation of positive emotions may also play a role. Such difficulties may conspire to create a psychological world for people with BPD that is characterized by a focus on negative mood and negative emotional experiences. In addition to focusing on negative affect, we suggest that it might also be clinically beneficial to make problems with positive affect a specific clinical target.

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Screening for depression with the Edinburgh Postnatal Depression Scale and finding borderline personality disorder

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867418804067 ◽

2018 ◽

Vol 53 (5) ◽

pp. 424-432 ◽

Cited By ~ 7

Author(s):

Fiona Judd ◽

Stephanie Lorimer ◽

Richard H Thomson ◽

Angela Hay

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Personality Traits ◽

Pregnant Women ◽

Postnatal Depression ◽

Edinburgh Postnatal Depression Scale ◽

Past History ◽

Depression Scale ◽

Borderline Personality ◽

Borderline Personality Traits

Objective: The aim of the study was to explore the range of psychiatric diagnoses seen in pregnant women who score above the ‘cut-off’ on the Edinburgh Postnatal Depression Scale when this is used as a routine screening instrument in the antenatal period. Method: Subjects were all pregnant women referred to and seen by the Perinatal Consultation-Liaison Psychiatry Team of a tertiary public hospital over a 14-month period. Edinburgh Postnatal Depression Scale score at maternity ‘booking-in’ visit, demographic and clinical data were recorded and diagnoses were made according to Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria following clinical interview(s) and review of documented past history. Data were analysed using descriptive statistics. Results: A total of 200 patients who had completed the Edinburgh Postnatal Depression Scale were seen for assessment; 86 (43%) scored ⩾13 on Edinburgh Postnatal Depression Scale. Of those scoring 13 or more on Edinburgh Postnatal Depression Scale, 22 (25.6%) had a depressive disorder. In total, 12 patients (14%) had an anxiety disorder, 14 (16.3%) had borderline personality disorder and 13 (15.1%) had a substance use disorder. An additional 23 women (26.7%) had two or more borderline personality traits. Conclusion: Psychiatric assessment of women who scored 13 or more on the Edinburgh Postnatal Depression Scale at routine antenatal screening identified a significant number with borderline personality disorder or borderline personality traits rather than depressive or anxiety disorders. Clinical Practice Guidelines note the importance of further assessment for all women who score 13 or more on the Edinburgh Postnatal Depression Scale. The findings here suggest that this assessment should be made by a clinician able to identify personality pathology and organise appropriate and timely interventions.

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Personality Disorders

10.2310/im.1319 ◽

2014 ◽

Author(s):

Yosefa A. Ehrlich ◽

Amir Garakani ◽

Stephanie R Pavlos ◽

Larry Siever

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Personality Traits ◽

Personality Disorders ◽

Diagnostic Criteria ◽

Early Adulthood ◽

Borderline Personality ◽

Clinical Population ◽

Organizational System ◽

Medical Disorders

Personality can be defined as an organizational system of self that shapes the manner in which a person interacts with his or her environment. Personality traits develop in adolescence or early adulthood and are thought to be shaped by early childhood experiences and enduring throughout a lifetime. Personality traits that prevent an individual from being able to function in society or that cause significant distress are diagnosed as personality disorders. A thorough history is needed to rule out other psychiatric and medical disorders. This chapter reviews the diagnostic criteria, differential diagnosis, comorbidity, prevalence, etiology (including genetics and neurobiology), prognosis, and treatment of paranoid, schizoid, schizotypal, borderline, antisocial, narcissistic, histrionic, avoidant, obsessive-compulsive, and dependent personality disorders. A discussion of the relevance of personality disorders to primary care practices and approaches to managing such patients is also included. Tables describe the diagnostic criteria of each personality disorder. Figures illustrate the prevalence of personality disorders in the general and psychiatric populations; schizotypal personality disorder in the community, general population, and clinical population; childhood trauma in individuals with personality disorder; and comorbid disorders in individuals with borderline personality disorder. A model of brain processing in borderline personality disorder is also featured. This chapter contains 5 highly rendered figures, 10 tables, 230 references, and 5 MCQs.

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Personality and Personality Disorder

Overdiagnosis in Psychiatry ◽

10.1093/med/9780197504277.003.0009 ◽

2020 ◽

pp. 119-130

Author(s):

Joel Paris

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Personality Traits ◽

Mood Disorders ◽

Suicidal Behavior ◽

Borderline Personality ◽

Clear Cut ◽

Normal People ◽

Affective Instability

Personality traits differ among normal people, and one should only diagnose a personality disorder (PD) in the presence of a clear-cut impairment of functioning. Most of these disorders lie on a spectrum with traits, but those that cause prominent symptoms present more often in psychiatry The most clinically important category of PD is borderline personality disorder (BPD), but this condition is widely underdiagnosed. Since these patients often present with depression and/or affective instability, clinicians often see them as suffering from mood disorders, and treat them unsuccessfully with antidepressants. However, this population, which shows repetitive suicidal behavior, needs to be correctly diagnosed to be referred for specialized psychotherapy.

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Induced illusory body ownership in borderline personality disorder

Neuroscience of Consciousness ◽

10.1093/nc/niz017 ◽

2019 ◽

Vol 2019 (1) ◽

Cited By ~ 3

Author(s):

Eli S Neustadter ◽

Sarah K Fineberg ◽

Jacob Leavitt ◽

Meagan M Carr ◽

Philip R Corlett

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Personality Traits ◽

Predictive Coding ◽

Diagnostic Interview ◽

Borderline Personality ◽

Hand Position ◽

Body Ownership ◽

Clinical Literature ◽

Proprioceptive Drift

Abstract One aspect of selfhood that may have relevance for borderline personality disorder (BPD) is variation in sense of body ownership. We employed the rubber hand illusion to manipulate sense of body ownership in BPD. We extended previous research on illusory body ownership in BPD by testing: (i) two illusion conditions: asynchronous and synchronous stimulation, (ii) relationship between illusion experience and BPD symptoms, and (iii) relationship between illusion experience and maladaptive personality traits. We measured illusion strength (questionnaire responses), proprioceptive drift (perceived shift in physical hand position), BPD symptoms (Revised Diagnostic Interview for Borderlines score), and maladaptive personality traits (Personality Inventory for DSM-5) in 24 BPD and 21 control participants. For subjective illusion strength, we found main effects of group (BPD > healthy control, F(1, 43) = 11.94, P = 0.001) and condition (synchronous > asynchronous, F(1, 43) = 22.80, P < 0.001). There was a group × condition interaction for proprioceptive drift (F(1, 43) = 6.48, P = 0.015) such that people with BPD maintained illusion susceptibility in the asynchronous condition. Borderline symptom severity correlated with illusion strength within the BPD group, and this effect was specific to affective (r = 0.45, P < 0.01) and cognitive symptoms (r = 0.46, P < 0.01). Across all participants, trait psychoticism correlated with illusion strength (r = 0.44, P < 0.01). People with BPD are more susceptible to illusory body ownership than controls. This is consistent with the clinical literature describing aberrant physical and emotional experiences of self in BPD. A predictive coding framework holds promise to develop testable mechanistic hypotheses for disrupted bodily self in BPD.

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