Unique Associations Between Borderline Personality Disorder Features and Suicide Ideation and Attempts in Adolescents

2013 ◽  
Vol 27 (5) ◽  
pp. 604-616 ◽  
Author(s):  
Catherine R. Glenn ◽  
Courtney L. Bagge ◽  
Augustine Osman
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Ideation ◽  
Borderline Personality

THE TREATMENT OF DELIBERATE SELF-HARM IN BORDERLINE PERSONALITY DISORDER USING DIALECTICAL BEHAVIOUR THERAPY: A PILOT STUDY IN A HIGH SECURITY HOSPITAL

2001 ◽  
Vol 29 (1) ◽  
pp. 85-92 ◽  
Author(s):  
Gail Low ◽  
David Jones ◽  
Conor Duggan ◽  
Mick Power ◽  
Andrew MacLeod
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Ideation ◽  
Borderline Personality ◽  
Institutional Setting ◽  
Behaviour Therapy ◽  
Deliberate Self Harm ◽  
Dialectical Behaviour Therapy ◽  
Self Harm

Deliberate self-harm (DSH) presents a significant health problem, especially as treatments have not been particularly successful in reducing repetition. Dialectical behaviour therapy (DBT; Linehan, 1993) is one approach that has reported some success in reducing self-harm rates in borderline personality disorder patients, who self-harm frequently, though it remains largely untested outside its original setting. The present study aimed to assess the effectiveness of DBT in self-harming women in an institutional setting in the United Kingdom where self-harm is common. Female patients at Rampton Hospital who were displaying self-harming behaviour and met criteria for borderline personality disorder (N = 10) participated in the full one-year treatment package of DBT. Patients were assessed on self-harm rates and on a number of psychological variables, pre-, during- and post-therapy, including a 6-month follow-up. There was a significant reduction in DSH during therapy, which was maintained at 6-month follow-up. This was paralleled by a reduction in dissociative experiences and an increase in survival and coping beliefs, alongside improvements in depression, suicide ideation, and impulsiveness. The findings are preliminary but the results suggest that DBT might provide an effective treatment for severe self-harm in institutional settings, and also highlight some of the psychological mechanisms that might mediate these improvements in self-harming behaviour.

Low Compliance to Pharmacological Treatment of Severe Chronic Illness: Passive Suicide Ideation in Borderline Personality Disorder?

2017 ◽  
Vol 41 (S1) ◽  
pp. S711-S711
Author(s):  
M. Bonea ◽  
I. Miclutia
Keyword(s):  
Liver Cirrhosis ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Interpersonal Relationships ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Treatment Plan ◽  
Primary Hypothyroidism ◽  
Borderline Personality ◽  
Affective Instability

IntroductionThe core features of Borderline Personality Disorder (BPD), such as deliberate self-harm, suicide attempts and demandingness in interpersonal relationships persist with age, even though impulsivity decreases. Impairing progressive disease combined with affective instability and chronic feelings of emptiness can lead to a desire for death.ObjectivesTo present a case of BPD with severe chronic endocrine pathology and liver cirrhosis who refused to take his treatment as prescribed.MethodsA case report is presented and discussed.ResultsWe report the case of a 61-year-old man with BPD and liver cirrhosis, complex endocrine pathology (pituitary adenoma, diabetes insipidus and primary hypothyroidism), type 2 diabetes mellitus with insulin therapy, essential hypertension and alcohol use disorder. He had a history of 5 suicide attempts caused by marked feelings of rejection and emptiness and a pattern of unstable relationships and lack of commitment, thus his marriage lasted only 2 years. He idealized and was extremely familiar with his clinician and displayed marked affective instability (dysphoria, periods of anger and despair, affective ambivalence towards his parents and recurrent depressive symptoms). Because of his liver disease, the psychotropic medication was ceased by his physician. The patient refused to follow the rest of his treatment plan and diet as prescribed, resulting in the deterioration of his somatic status. The patient denied an active suicidal ideation, but did not explain his non-compliance.ConclusionThe impairment from BPD and the risk of suicide persist even in older age affecting the outcome of co-morbid somatic conditions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

High Prevalence of Borderline Personality Disorder Among Psychiatric Inpatients Admitted for Suicidality

2021 ◽  
pp. 1-12
Author(s):  
Robert Gregory ◽  
Susan D. Sperry ◽  
Daniel Williamson ◽  
Rachael Kuch-Cecconi ◽  
Garry L. Spink
Keyword(s):  
Health Care ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Inpatient Care ◽  
Suicide Risk ◽  
Suicide Ideation ◽  
Psychiatric Inpatients ◽  
Borderline Personality ◽  
Care Utilization ◽  
High Prevalence

Borderline personality disorder (BPD) is associated with high risk of suicidality and high rates of health care utilization; however, the prevalence and characteristics of BPD among inpatients admitted for suicidality are unknown. In the present study of 72 adult psychiatric inpatients admitted for suicide risk, BPD was highly prevalent (n = 31; 43.1%), but 68% were misdiagnosed by admitting providers. Compared to patients without BPD, those with BPD were significantly younger, were prescribed more psychiatric medications, were more depressed, and had greater suicide ideation. Patients with BPD were also three times as likely to be readmitted to a psychiatric hospital at 30, 90, and 180 days postdischarge for an average of almost 9 days of inpatient care per patient for the first 180 days. In this sample, BPD was highly prevalent, underdiagnosed, and associated with frequent readmissions, findings that highlight the importance of improved recognition and access to specialized treatments.

High Prevalence of Borderline Personality Disorder Among Psychiatric Inpatients Admitted for Suicidality

2021 ◽  
Vol 35 (5) ◽  
pp. 776-787
Author(s):  
Robert Gregory ◽  
Susan D. Sperry ◽  
Daniel Williamson ◽  
Rachael Kuch-Cecconi ◽  
Garry L. Spink
Keyword(s):  
Health Care ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Inpatient Care ◽  
Suicide Risk ◽  
Suicide Ideation ◽  
Psychiatric Inpatients ◽  
Borderline Personality ◽  
Care Utilization ◽  
High Prevalence

Borderline personality disorder (BPD) is associated with high risk of suicidality and high rates of health care utilization; however, the prevalence and characteristics of BPD among inpatients admitted for suicidality are unknown. In the present study of 72 adult psychiatric inpatients admitted for suicide risk, BPD was highly prevalent (n = 31; 43.1%), but 68% were misdiagnosed by admitting providers. Compared to patients without BPD, those with BPD were significantly younger, were prescribed more psychiatric medications, were more depressed, and had greater suicide ideation. Patients with BPD were also three times as likely to be readmitted to a psychiatric hospital at 30, 90, and 180 days postdischarge for an average of almost 9 days of inpatient care per patient for the first 180 days. In this sample, BPD was highly prevalent, underdiagnosed, and associated with frequent readmissions, findings that highlight the importance of improved recognition and access to specialized treatments.

Psychological Treatments for Personality Disorders

2007 ◽  
pp. 641-658 ◽  
Author(s):  
Paul Crits-Christoph ◽  
Jacques P. Barber
Keyword(s):  
Social Skills ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Social Skills Training ◽  
Suicide Ideation ◽  
Skills Training ◽  
Borderline Personality

A Type 2 randomized clinical trial (RCT) of psychosocial treatment for avoidant personality disorder compared three group-administered behavioral interventions (graded exposure, standard social skills training, intimacy-focused social skills training) with a wait-list control; although all three treatments were more efficacious than the control condition, no differences among the treatments were identified either after the 10-week treatment or at follow-up. For the treatment of borderline personality disorder, a Type 1 RCT randomized 101 women with recent suicidal and self-injurious behaviors and borderline personality disorder to either dialectical behavior therapy (DBT) or community-treatment-by-experts psychotherapists (CTBE). Over the 2-year treatment and follow-up period, DBT was superior to CTBE on rates of suicide attempt, hospi-talization for suicide ideation, and overall medical risk (combining suicide attempts and self-injurious acts). Patients in the DBT group were also less likely to drop out of treatment and had fewer psychiatric emergency room visits and fewer psychiatric hospitalizations. There were no significant group differences on measures of depression, reasons for living, and suicide ideation, with patients in both treatment groups improving significantly on these measures. Four additional Type 2 and Type 3 studies support the efficacy of DBT as a treatment for borderline personality disorder with or without comorbid substance abuse or dependence. No RCTs of psychological treatment for other personality disorders have been reported. Several review articles have found a consistent adverse impact of personality disorders on outcomes of treatment for a wide range of Axis I disorders.

Treatment Attitude and Therapy Outcome in Patients With Borderline Personality Disorder

2008 ◽  
Vol 22 (3) ◽  
pp. 250-257 ◽  
Author(s):  
Amy Wenzel ◽  
Elizabeth L. Jeglic ◽  
Hollie J. Levy-Mack ◽  
Aaron T. Beck ◽  
Gregory K. Brown
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Ideation ◽  
Preliminary Evidence ◽  
Borderline Personality ◽  
Therapy Outcome ◽  
Future Research ◽  
Positive Attitudes ◽  
Two Measures

This study investigated the degree to which two ways of defining attitude toward treatment (i.e., attitude toward talking with a therapist about problems, expectation for improvement) predicted therapy outcome. The sample consisted of 28 patients who participated in an open clinical trial evaluating the efficacy of cognitive therapy for borderline personality disorder and who completed assessments at baseline and 12-month follow-up (Brown, Newman, Charlesworth, Crits-Cristoph, & Beck, 2004). When attitude toward treatment was defined as attitude toward talking with a therapist, this variable predicted suicide ideation and scores on two measures of depression at the 12-month assessment. When attitude toward treatment was defined as expectation for improvement, this variable predicted scores on one measure of depression and number of borderline personality disorder criteria met at the 12-month assessment. These results provide preliminary evidence that positive attitudes toward treatment are associated with more clinical improvement, although future research should replicate this finding with a better developed measure of treatment attitudes.

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.

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