scholarly journals Altered memory and affective instability in prisoners assessed for dangerous and severe personality disorder

2007 ◽  
Vol 190 (S49) ◽  
pp. s20-s26 ◽  
Author(s):  
Tim Kirkpatrick ◽  
Eileen Joyce ◽  
John Milton ◽  
Conor Duggan ◽  
Peter Tyrer ◽  
...  

BackgroundPrevious studies of borderline personality disorder report neuropsychological impairments in several domains, including memory. No studies have compared memory functioning in high-risk prisoners with borderline personality disorder with similar prisoners with other personality disorders.AimsTo explore mnemonic impairments in prisoners undergoing personality assessment as part of the dangerous and severe personality disorder initiative or detained in a medium secure facility.MethodWe investigated memory function in 18 prisoners with borderline personality disorder and 18 prisoners with other personality disorders.ResultsPrisoners with borderline personality disorder exhibited a pattern of multi-modal impairments in the immediate and delayed recall of verbal and visual information, with some association with affective instability. These deficits were not associated with the severity of personality disturbance.ConclusionsThese data suggest that memory deficits have some specificity in relation to the constituent traits of borderline personality disorder and indicate that neuropsychological assessment may be a source of useful adjunctive information for distinguishing between the cognitive and psychological difficulties of individual prisoners.

2017 ◽  
Vol 6 (1) ◽  
pp. 145-154 ◽  
Author(s):  
Ian D. Roberts ◽  
Ian Krajbich ◽  
Jennifer S. Cheavens ◽  
John V. Campo ◽  
Baldwin M. Way

People with borderline personality disorder (BPD) tend to distrust others. We hypothesized that acetaminophen might reduce distrust in people with high BPD features because disordered affective responses are partially responsible for the interpersonal difficulties of people with BPD features, and acetaminophen has been shown in multiple studies to reduce negative affect. Using a double-blind, parallel-arm design, 284 young adult participants were administered either acetaminophen (1,000 mg; acute) or placebo and subsequently completed an economic trust game. BPD features were assessed with the Personality Assessment Inventory–Borderline Features scale. Participants with elevated BPD features showed less trust in their partners in the placebo condition but increased trust in the acetaminophen condition. Acetaminophen did not change expectations of trustee’s trustworthiness and did not impact trusting behavior in participants low in BPD features. Our results indicate that acetaminophen may reduce the behavioral distrust exhibited at high levels of BPD features.


2020 ◽  
Author(s):  
Philip Samuel Santangelo ◽  
Tobias D. Kokler ◽  
Marie-Luise Zeitler ◽  
Rebekka Knies ◽  
Nikolaus Kleindienst ◽  
...  

Abstract Background: Borderline personality disorder (BPD) is defined by a pervasive pattern of instability. According to prior findings and clinical theories, self-esteem instability and affective instability are key features of BPD. Previous e-diary studies showed that instability in self-esteem is heightened and that it is highly intertwined with affective instability in BPD in comparison to healthy controls (HC). The present study sought to extend these findings by adding symptomatologically remitted BPD patients (BPD-REM), i.e. former patients with BPD who met four or fewer BPD criteria within the past year, as a comparison group.Methods: To examine differences regarding self-esteem instability and affective instability, we used e-diaries for repeatedly collecting data on self-esteem, valence, and tense arousal 12 times a day for four consecutive days while participants underwent their daily life activities. Determining three different state-of-the-art instability indices and applying multilevel analyses, we compared 35 BPD-REM participants with previously reported 60 acute BPD patients (BPD-ACU) and 60 HC.Results: Our results revealed that self-esteem instability was significantly lower in the BPD-REM compared to the BPD-ACU group, irrespective of the instability index. In contrast, there were no significant differences regarding affective instability between the BPD-REM participants and those in the BPD-ACU group. The comparison between the BPD-REM with the HC indicated both a significantly higher instability in self-esteem as well as significantly heightened affective instability in the BPD-REM participants. Moreover, even though the associations were not significant, we found tentative support for the assumption that affective changes that are accompanied by changes in self-esteem are experienced as more burdensome and negatively impact the quality of life of remitted BPD participants.Conclusions: This study builds on growing evidence for the importance of self-esteem instability in BPD. Whereas affective instability has been reported in various psychiatric disorders and might indeed constitute a transdiagnostic marker of affective dysregulation, our results indicate that self-esteem instability might be a specific symptom that construes the unique pathology in BPD.


Author(s):  
Shaunak Ajit Ajinkya ◽  
Pranita Shantanu Sharma ◽  
Aparna Ramakrishnan

Introduction: Personality disorders are a group of behavioural patterns associated with significant personal and socio-occupational disturbances. Numerous studies have demonstrated borderline personality to be one of the most common personality disorders. It’s less often diagnosed with just a clinical assessment. Aim: To examine the proportion of patients with Borderline Personality Disorder (BPD), and its associated personality types and clinical syndromes, using the Millon Clinical Multiaxial Inventory version-III (MCMI-III). Materials and Methods: A retrospective observational study was carried out on 450 adult patients who attended the psychiatry outpatient department of an urban tertiary care hospital. They had been administered the MCMI-III, a self-rating questionnaire commonly used to provide information on personality types and associated clinical syndromes. Statistical Package for the Social Sciences (IBM SPSS, Windows) version 20.0 was used for statistical analyses. Data was expressed in terms of actual number, mean and percentages. Chi-Square or Fisher’s-exact test, as appropriate, was used for categorical data to test for associations. Odds ratio was estimated to measure strength of the association. Results: Borderline was the most common personality type comprising nearly half (46.63%) of the study population. 25.5% had borderline traits while 21.1% had Borderline Personality Disorder (BPD). BPD was significantly higher in females (p<0.001), younger age group below the age of 40 years (p<0.001) and unmarried persons (p<0.001). It was comorbid most with Anxiety (90.91%; OR=4.05; p<0.001), Major Depression (85.23%; OR=18.39; p<0.001), Post Traumatic Stress Disorder (PTSD) (46.59%; OR=6.30; p<0.001) and Thought disorders (56.82%; OR=18.15; p<0.001). Alcohol (22.73%; OR=3.54; p<0.001) and Drug dependence (13.64%; OR=11.52; p<0.001) were also seen significantly higher in patients with BPD. Personality types significantly comorbid with BPD were Sadistic, Depressive, Masochistic, Negativistic, Schizotypal, Avoidant, Dependent, Antisocial and Paranoid types, with odds being most for Sadistic personality (OR=9.44). Conclusion: It is recommended that mental health professionals and clinicians should start to look for underlying symptoms of BPD in patients of anxiety and mood syndromes. If found these patients should be directed for psychotherapy as early as possible. The MCMI psychological test would be an important contribution to this area, given the need for systematic, quick, and objective testing methods that facilitate the diagnosis.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S122-S122
Author(s):  
Nyakomi Adwok ◽  
Sharon Nightingale

AimsThe overarching aim of the session was to address and reduce stigma around Borderline Personality Disorder among doctors. The three main objectives were:To increase empathy and understanding around Borderline Personality Disorder by exposing junior doctors to service user perspectives outside a clinical setting;To address knowledge gaps identified by junior doctors in a self-reported questionnaire disseminated prior to the teaching session;To offer junior doctors a basic psychological framework to base their assessment and formulation of service users with personality disorders.Background‘Borderline Personality Disorder: The Person Behind the Label’ was the title of the first co-produced teaching session in the Leeds and York Partnership Foundation Trust (LYPFT). Prior to the teaching session, an online questionnaire was sent out to trainees. The results highlighted three key issues:Negative attitudes towards service users with personality disorders;Poor subjective knowledge of the psychological models of personality disorders;Perception among trainees that they do not receive adequate training to deal with the challenges service users with personality disorders present.MethodA teaching session was co-produced by a team of two service users, a principal clinical psychologist within the Leeds Personality Disorder Network (PDN) and a core Psychiatry trainee. It was delivered in a 75 minute session to 40 attendees consisting of both trainee doctors and consultants.ResultFeedback was collected immediately after the session through the use of anonymous feedback forms. The response to the training was overwhelmingly positive with all 28 respondents rating the session as 4/5 or 5/5 on a satisfaction scale ranging from 1 (poor) to excellent (5). Key themes from the feedback included appreciation for the service user perspective and teaching on psychological theory. The fourth question in the questionnaire: “How will this teaching impact your work?” produced the highest number of responses (25/28) and provided evidence that the above listed objectives of the session were met.ConclusionCo-produced teaching has great potential to address negative attitudes around highly stigmatised conditions by bridging the gap that often exists between service users and mental health professionals.


2014 ◽  
Author(s):  
Yosefa A. Ehrlich ◽  
Amir Garakani ◽  
Stephanie R Pavlos ◽  
Larry Siever

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.


2020 ◽  
pp. 119-130
Author(s):  
Joel Paris

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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