A Recurrent Question: What Is Borderline?

2019 ◽  
Vol 33 (3) ◽  
pp. 341-369 ◽  
Author(s):  
Maja Zandersen ◽  
Mads Gram Henriksen ◽  
Josef Parnas
Keyword(s):  
Personality Disorder ◽  
Diagnostic Category ◽  
The United States ◽  
Borderline Personality ◽  
Schizophrenia Spectrum Disorders ◽  
Similar Tendency ◽  
Schizophrenia Spectrum ◽  
The Status ◽  
Spectrum Disorders ◽  
Conceptual Difficulties

The status of borderline personality disorder (BPD) as a diagnostic category is a matter of continuing controversy. In the United States, BPD is one of the most frequent diagnoses of psychiatric inpatients, and a similar tendency emerges in Europe. Nearly all theoretical aspects of BPD have been questioned, including its very position as a personality disorder. In this article, we trace the evolution of the borderline concept from the beginning of the 20th century to the current psychometric research. We argue that the status of BPD is fraught with conceptual difficulties, including an unrecognized semantic drift of major phenomenological terms (e.g., identity), a lack of general principles for the distinction of BPD and the major psychiatric syndromes (e.g., schizophrenia spectrum disorders), and insufficient definitions of key nosological concepts. These difficulties illustrate general problems in today's psychiatry that require consideration.

scholarly journals Anxiety symptoms in a major mood and schizophrenia spectrum disorders

2016 ◽  
Vol 37 ◽  
pp. 1-7 ◽  
Author(s):  
B. Karpov ◽  
G. Joffe ◽  
K. Aaltonen ◽  
J. Suvisaari ◽  
I. Baryshnikov ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mood Disorders ◽  
Borderline Personality ◽  
Anxiety Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Comorbid Anxiety ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

AbstractBackgroundComorbid anxiety symptoms and disorders are present in many psychiatric disorders, but methodological variations render comparisons of their frequency and intensity difficult. Furthermore, whether risk factors for comorbid anxiety symptoms are similar in patients with mood disorders and schizophrenia spectrum disorders remains unclear.MethodsThe Overall Anxiety Severity and Impairment Scale (OASIS) was used to measure anxiety symptoms in psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n = 113), bipolar disorder (BD, n = 99), or depressive disorder (DD, n = 188) in the Helsinki University Psychiatric Consortium Study. Bivariate correlations and multivariate linear regression models were used to examine associations of depressive symptoms, neuroticism, early psychological trauma and distress, self-efficacy, symptoms of borderline personality disorder, and attachment style with anxiety symptoms in the three diagnostic groups.ResultsFrequent or constant anxiety was reported by 40.2% of SSA, 51.5% of BD, and 55.6% of DD patients; it was described as severe or extreme by 43.8%, 41.4%, and 41.2% of these patients, respectively. SSA patients were significantly less anxious (P = 0.010) and less often avoided anxiety-provoking situations (P = 0.009) than the other patients. In regression analyses, OASIS was associated with high neuroticism, symptoms of depression and borderline personality disorder and low self-efficacy in all patients, and with early trauma in patients with mood disorders.ConclusionsComorbid anxiety symptoms are ubiquitous among psychiatric patients with mood or schizophrenia spectrum disorders, and in almost half of them, reportedly severe. Anxiety symptoms appear to be strongly related to both concurrent depressive symptoms and personality characteristics, regardless of principal diagnosis.

Performance-Based Assessment of Social Cognition in Borderline Versus Psychotic Psychopathology

2019 ◽  
Vol 40 (2) ◽  
pp. 95-111
Author(s):  
Jeremy M. Ridenour ◽  
Katie C. Lewis ◽  
John M. Poston ◽  
Destiny N. Ciecalone
Keyword(s):  
Social Cognition ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Partial Support ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Performance Based Assessment ◽  
Spectrum Disorders ◽  
Social Causality

Abstract. Individuals diagnosed with borderline personality disorder (BPD) and schizophrenia spectrum disorders (SSD) are known to display deficits in social cognition (SC). Our sample comprised 81 patients enrolled in residential treatment for complex psychopathology. We used performance-based assessments to test the hypothesis that individuals with SSD would display decrements on the cognitive/perceptual facets of SC, whereas individuals with BPD would evidence greater dysfunction on the affective/interpersonal facets of SC, with consideration taken for how gender may interact with diagnosis to influence results. Our findings suggested that women with SSD displayed more impaired understanding of social causality compared with their female BPD counterparts, while female patients with BPD evidenced greater expectation for aggression in their SC compared with women with SSD. These findings provide partial support for our hypotheses while highlighting the importance of accounting for the influence of gender on SC functional disparities between these two groups.

scholarly journals A multinational case−control study comparing forensic and non-forensic patients with schizophrenia spectrum disorders: the EU-VIORMED project

2021 ◽  
pp. 1-11
Author(s):  
Giovanni de Girolamo ◽  
Laura Iozzino ◽  
Clarissa Ferrari ◽  
Pawel Gosek ◽  
Janusz Heitzman ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Interpersonal Violence ◽  
Case Control Study ◽  
Case Control ◽  
Schizophrenia Spectrum Disorders ◽  
Forensic Patients ◽  
Schizophrenia Spectrum ◽  
History Of ◽  
Spectrum Disorders ◽  
Control Study

Abstract Background The relationship between schizophrenia and violence is complex. The aim of this multicentre case–control study was to examine and compare the characteristics of a group of forensic psychiatric patients with a schizophrenia spectrum disorders and a history of significant interpersonal violence to a group of patients with the same diagnosis but no lifetime history of interpersonal violence. Method Overall, 398 patients (221 forensic and 177 non-forensic patients) were recruited across five European Countries (Italy, Germany, Poland, Austria and the United Kingdom) and assessed using a multidimensional standardised process. Results The most common primary diagnosis in both groups was schizophrenia (76.4%), but forensic patients more often met criteria for a comorbid personality disorder, almost always antisocial personality disorder (49.1 v. 0%). The forensic patients reported lower levels of disability and better social functioning. Forensic patients were more likely to have been exposed to severe violence in childhood. Education was a protective factor against future violence as well as higher levels of disability, lower social functioning and poorer performances in cognitive processing speed tasks, perhaps as proxy markers of the negative syndrome of schizophrenia. Forensic patients were typically already known to services and in treatment at the time of their index offence, but often poorly compliant. Conclusions This study highlights the need for general services to stratify patients under their care for established violence risk factors, to monitor patients for poor compliance and to intervene promptly in order to prevent severe violent incidents in the most clinically vulnerable.

A transdiagnostic investigation of ‘theory of mind’ and ‘jumping to conclusions’ in patients with persecutory delusions

2007 ◽  
Vol 38 (11) ◽  
pp. 1577-1583 ◽  
Author(s):  
R. Corcoran ◽  
G. Rowse ◽  
R. Moore ◽  
N. Blackwood ◽  
P. Kinderman ◽  
...  
Keyword(s):  
Theory Of Mind ◽  
Probabilistic Reasoning ◽  
Diagnostic Category ◽  
Mental States ◽  
Psychotic Depression ◽  
Cognitive Effects ◽  
Schizophrenia Spectrum Disorders ◽  
Persecutory Delusions ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

BackgroundA tendency to make hasty decisions on probabilistic reasoning tasks and a difficulty attributing mental states to others are key cognitive features of persecutory delusions (PDs) in the context of schizophrenia. This study examines whether these same psychological anomalies characterize PDs when they present in the context of psychotic depression.MethodPerformance on measures of probabilistic reasoning and theory of mind (ToM) was examined in five subgroups differing in diagnostic category and current illness status.ResultsThe tendency to draw hasty decisions in probabilistic settings and poor ToM tested using story format feature in PDs irrespective of diagnosis. Furthermore, performance on the ToM story task correlated with the degree of distress caused by and preoccupation with the current PDs in the currently deluded groups. By contrast, performance on the non-verbal ToM task appears to be more sensitive to diagnosis, as patients with schizophrenia spectrum disorders perform worse on this task than those with depression irrespective of the presence of PDs.ConclusionsThe psychological anomalies associated with PDs examined here are transdiagnostic but different measures of ToM may be more or less sensitive to indices of severity of the PDs, diagnosis and trait- or state-related cognitive effects.

Study of Pathological Personality as a Modulating Factor of Schizotypy

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
L. Moreno ◽  
J. Valero ◽  
A.M. Gaviria ◽  
A. Hernández ◽  
J.A. Gutiérrez-Zotes ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Normal Population ◽  
Emotional Dysregulation ◽  
Point Of View ◽  
Healthy Controls ◽  
Social Avoidance ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Aims:From a dimensional point of view, the schizotypal features would be continuously distributed in normal population and individuals with schizophrenia spectrum disorders. in the latter, differences have been found in personality traits between the diagnostic categories of the dimension, and also different schizotypy scores between them. in this study our main objective was to specify the domains and traits of pathological personality that can be considered risk factors for schizotypy.Method:SPQ and DAPP-BQ were administered to a sample of 91 subjects that were divided in four groups: psychotic patients with schizophrenia spectrum disorders, siblings of patients from this spectrum, patients with personality disorders, and healthy controls.Results:Patients with personality disorders presented the highest scores of schizotypy measured with SPQ, followed by psychotic patients, siblings, and finally the healthy controls. both groups of patients obtained higher pathological personality scores compared to siblings and controls. in the psychotic patients and their siblings emotional dysregulation, dissocial behavior and inhibition domains correlated with the SPQ factors, while in the personality disorder patients SPQ correlated only with inhibition. the trait social avoidance appears to be a predictive variable of psychometric schizotypy.Conclusions:Pathological personality underlying the schizotypy of psychotic patients of schizophrenia spectrum and their siblings is different from that of the personality disorder group. Social avoidance is a risk factor for schizotypy measured with SPQ.

scholarly journals Exploring schizophrenia spectrum psychopathology in borderline personality disorder

2019 ◽  
Vol 270 (8) ◽  
pp. 969-978
Author(s):  
Maja Zandersen ◽  
Josef Parnas
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Psychiatric Evaluation ◽  
Main Diagnosis ◽  
Schizophrenia Spectrum Disorders ◽  
Diagnostic Systems ◽  
Schizotypal Personality ◽  
Schizophrenia Spectrum ◽  
Icd 10

Abstract We have previously argued that the current borderline personality disorder (BPD) diagnosis is over-inclusive and clinically and conceptually impossible to distinguish from the schizophrenia spectrum disorders. This study involves 30 patients clinically diagnosed with BPD as their main diagnosis by three BPD dedicated outpatient treatment facilities in Denmark. The patients underwent a careful and time-consuming psychiatric evaluation involving several senior level clinical psychiatrists and researchers and a comprehensive battery of psychopathological scales. The study found that the vast majority of patients (67% in DSM-5 and 77% in ICD-10) in fact met the criteria for a schizophrenia spectrum disorder, i.e., schizophrenia (20%) or schizotypal (personality) disorder (SPD). The schizophrenia spectrum group scored significantly higher on the level of disorders of core self as measured by the Examination of Anomalous Self-Experiences Scale (EASE). The BPD criterion of “identity disturbance” was significantly correlated with the mean total score of EASE. These findings are discussed in the light of changes from prototypical to polythetic diagnostic systems. We argue that the original prototypes/gestalts informing the creation of BPD and SPD have gone into oblivion during the evolution of polythetic criteria.

scholarly journals Psycholinguistics Analysis of Schizophrenia Spectrum Disorders Patients’ Writing and Oral Speech (on the Example of the Autobiographical Texts)

2021 ◽  
Vol 28 (2) ◽  
pp. 38-44
Author(s):  
E. M. Akhmetzyanova ◽  
I. A. Tregubenko
Keyword(s):  
Personality Disorder ◽  
Text Analysis ◽  
Speech Disorders ◽  
Expert Assessment ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Oral Speech ◽  
Autobiographical Texts ◽  
Spectrum Disorders ◽  
Healthy Participants

Introduction. There are speech disorders as one of the psychopathology diagnostics criteria in ICD and DSM. However, the linguistic component is not enough studied, so the study topic is actual. The use of text analysis allows to apply psycholinguistics approach to the objectification of thinking disorders. The objective of the study was aimed to detect psycholinguistics features of oral and written speech in patients with schizophrenia.Methods and materials. Participants were 29 schizophrenia patients, 20 patients with personality disorder and 25 healthy participants. Methods: expert assessment, anamnestic assessment, experimental-psychological (tests of thinking, collect memories), linguistic analysis, statistical analysis.Results. Oral speech of patients with schizophrenia is complex and volume, the writing speech is «factual», lexically varied and low communicative. In oral and writing speech of patients with schizophrenia, there are three text types correlated with thinking disorders. Texts of patients with schizophrenia are less volume, simpler in structure, describe more facts than thoughts and feelings, unlike patients with personality disorder and healthy participants.Conclusion. Texts of patients with schizophrenia, personality disorder and healthy participants are different in formal linguistics characteristics. Such characteristics of the speech of patients suffering from schizophrenia as a lot of impersonal sentences describing object attribute, complexly organized speech, emphasis on describing emotions and oneself using the pronoun «I» allow to suppose that the patient has thinking disorders: thinking distortion by formal and latent ways of object attributions, thinking purposefulness disorder, thinking «versatility».

Screening Adolescents for Schizophrenia-Spectrum Disorders

2000 ◽  
Author(s):  
B. Cornblatt ◽  
M. Obuchowski ◽  
S. Roberts ◽  
S. Pollack ◽  
L. Erienmeyer-Kimling
Keyword(s):  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders
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