scholarly journals How many causal pathways must symptoms form before we call them a borderline? A hierarchical network model of borderline personality disorder

2018 ◽  
Author(s):  
Zsolt Unoka ◽  
Mara J. Richman ◽  
Dániel Czégel
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Network Model ◽  
Emotion Dysregulation ◽  
Borderline Personality ◽  
Directed Network ◽  
Causal Relationships ◽  
Hierarchical Network ◽  
Cross Sectional ◽  
Causal Pathways

Borderline personality disorder (BPD) is characterized by impulsivity, emotion dysregulation, disturbed relationships, and identity disturbances. Despite the known variable co-occurrence of BPD symptoms, the possible causal relationships are not well understood. We addressed this by creating a hierarchical network model of BPD, which identifies the most likely acyclic causal pathways that are driving BPD development. Cross-sectional data was obtained from the Structured Clinical Interview-II (SCID-II), and possible causal relationships between symptoms were identified from conditional independence relations. The symptoms’ hierarchy values, assessing their role in causal pathways, was determined by a random walk-based algorithm. By analyzing the directed network of BPD symptoms, it was found that symptoms in initial stages of causal pathways were abandonment, physical fights, impulsivity, suicidal threats, identity disturbances, and affective instability. Based on the assessed role symptoms play in causal pathways of BPD development, specific symptoms can be targeted during early diagnosis and clinical assessment.

Rumination in Borderline Personality Disorder: Meta-Analysis

2018 ◽  
Author(s):  
Mara J. Richman ◽  
Zsolt Unoka ◽  
Robert Dudas ◽  
Zsolt Demetrovics
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotion Dysregulation ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
Sample Type ◽  
Moderator Variables ◽  
Analytic Review ◽  
Self Harm

Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and affective liability. Of this domain, ruminative behaviors have been considered a core feature of emotion dysregulation difficulties. Despite this, inconsistencies have existed in the literature regarding which rumination type is most prominent in those with BPD symptoms. Moreover, no meta-analytic review has been performed to date on rumination in BPD. Taking this into consideration, a meta-analysis was performed to assess how BPD symptoms correlate with rumination, while also considering clinical moderator variables (i.e., BPD symptom domain, co-morbidities, GAF score) and demographic moderator variables (i.e., age, gender, sample type, and education level). Analysis of correlation across rumination domains for the entire sample revealed a medium overall correlation between BPD symptoms and rumination. When assessing types of rumination, the largest correlation was among pain rumination followed by anger, depressive, and anxious rumination. Among BPD symptom domain, affective instability had the strongest correlation with increased rumination, followed by unstable relationships, identity disturbance, and self-harm/ impulsivity, respectively. Demographic variables showed no significance. Clinical implications are considered and further therapeutic interventions are discussed in the context of rumination.

Primary care and suicidality among psychiatric outpatients: The patient-doctor relationship matters

2020 ◽  
pp. 009121742097799
Author(s):  
Krista Schultz ◽  
Sharan Sandhu ◽  
David Kealy
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Primary Care Physician ◽  
Population Based ◽  
Borderline Personality ◽  
Care Physician ◽  
Cross Sectional

Objective The purpose of the current study is to examine the relationship between the quality of the Patient-Doctor Relationship and suicidality among patients seeking mental health care; specifically, whether patients who perceive having a more positive relationship with primary care physician will have lower levels of suicidality. Method Cross-sectional population-based study in Greater Vancouver, Canada. One-hundred ninety-seven participants were recruited from three Mental Health Clinics who reported having a primary care physician. Participants completed a survey containing questions regarding items assessing quality of Patient-Doctor Relationship, general psychiatric distress (K10), borderline personality disorder, and suicidality (Suicidal Behaviours Questionnaire-Revised-SBQ-R). Zero-order correlations were computed to evaluate relationships between study variables. Hierarchical regression analysis was used to control for confounding variables. Results The quality of the patient doctor relationship was significantly negatively associated with suicidality. The association between the quality of the patient-doctor relationship and suicidality remained significant even after controlling for the effects of psychiatric symptom distress and borderline personality disorder features. Conclusions The degree to which patients’ perceive their primary care physician as understanding, reliable, and dedicated, is associated with a reduction in suicidal behaviors. Further research is needed to better explicate the mechanisms of this relationship over time.

scholarly journals The neurodevelopmental trajectory of Borderline Personality Disorder: a review

2018 ◽  
Author(s):  
Siobhan R Edinboro ◽  
Tobias Nolte ◽  
Iris Vilares
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Brain Function ◽  
Emotion Dysregulation ◽  
Grey Matter ◽  
Neural Correlates ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
Adult Onset ◽  
Neurodevelopmental Model

Borderline Personality Disorder (BPD) is a complex psychological condition characterised by affective instability, cognitive impairment, problematic behaviours and social dysfunction. Due to the variability in symptomatic profiles, efforts have recently been directed towards comprehending the disorder from a neurological standpoint within the aforementioned domains. Although adolescent-onset BPD is now reliably diagnosed as the adult-onset variant, a limited number of studies address the neural correlates of first presentation BPD. Moreover, research investigating the outcomes of therapeutic interventions on brain function and morphology is scarce. Preliminary findings consistently cite the involvement of grey matter deficiencies of the orbitofrontal cortex, hippocampus and amygdala in the neuropathology of BPD. Additionally, frontolimbic white matter deficits are thought to be implicated. Functionally, over-activity in limbic regions such as the cingulate cortices and amygdala are believed to partially account for emotion dysregulation, though the neural correlates of cognitive, social and behavioural impairments are relatively poorly understood. The present review will endeavour to evaluate the existing neurobiological evidence for BPD in adolescence as well as adulthood. Finally, a rudimentary neurodevelopmental model of BPD will be proposed.

Failures to Imagine

2016 ◽  
Vol 36 (3) ◽  
pp. 270-300 ◽  
Author(s):  
Reed Maxwell ◽  
Steven Jay Lynn ◽  
Scott Lilienfeld
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Imagery ◽  
Emotional Regulation ◽  
Preliminary Evidence ◽  
Borderline Personality ◽  
Self Report ◽  
Future Research ◽  
Cross Sectional ◽  
Visual Mental Imagery

Although interest in the relationship between mental imagery and psychopathology has increased greatly over the last decade, few publications to date have examined relationships between personality-related psychopathology and mental imagery use, abilities, or both. However, we have reason to expect that substantive relationships may exist. For example, studies have consistently linked psychopathy and borderline personality disorder to problems in emotion experience and emotion regulation, and a growing number of studies indicate that deficits in visual mental imagery use and ability in particular may contribute to such problems. Using correlational data from multiple self-report measures of normal and pathological personality functioning and visual mental imagery, our study presents preliminary evidence for lower levels of self-reported visual mental imagery use, abilities, or both among noncriminal individuals with higher levels of self-reported psychopathy and individuals with greater emotional regulation difficulties, a core feature of borderline personality disorder. We also found significant relationships among self-reported visual mental imagery use, ability, or both, and personality variables shown to strongly predict psychopathy and emotional regulation difficulties. Limitations of the study, especially its reliance on a correlational, cross-sectional design, are discussed, and implications for future research are explored.

scholarly journals Emotion dysregulation as a maintenance factor of borderline personality disorder features

2014 ◽  
Vol 55 (3) ◽  
pp. 657-666 ◽  
Author(s):  
Stephanie D. Stepp ◽  
Lori N. Scott ◽  
Jennifer Q. Morse ◽  
Kimberly A. Nolf ◽  
Michael N. Hallquist ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotion Dysregulation ◽  
Borderline Personality

Self-Compassion Mediates the Relationship Between Mindfulness and Borderline Personality Disorder Symptoms

2018 ◽  
Vol 32 (6) ◽  
pp. 838-856 ◽  
Author(s):  
Hannah J. Scheibner ◽  
Anna Daniels ◽  
Simon Guendelman ◽  
Franca Utz ◽  
Felix Bermpohl
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Symptom Severity ◽  
Emotion Dysregulation ◽  
Borderline Personality ◽  
Psychological Process ◽  
Healthy Controls ◽  
Self Compassion ◽  
Nonclinical Sample ◽  
The Relationship

Individuals suffering from borderline personality disorder (BPD) experience difficulties with mindfulness. How mindfulness influences BPD symptoms, however, is still unknown. We hypothesized that the relationship between mindfulness and BPD symptoms would be mediated by self-compassion. In study 1, we recruited 29 individuals with BPD and 30 group-matched healthy controls. In study 2, we complemented our results with findings from a larger, nonclinical sample of 89 participants that were recruited during an open-house event at the local university. All participants completed questionnaires assessing self-compassion, mindfulness, BPD symptom severity, and emotion dysregulation. In both studies, self-compassion mediated the relationship between mindfulness and BPD symptom severity as well as between mindfulness and emotion dysregulation. Self-compassion seems to be one psychological process that could explain the relationship between mindfulness and BPD symptoms. One promising approach in therapy could be to target self-compassion more directly during mindfulness trainings and interventions.

B·RIGHT: usability and satisfaction with a mobile app for self-managing emotional crises in patients with borderline personality disorder

2020 ◽  
pp. 103985622092432
Author(s):  
Álvaro Frías ◽  
Carol Palma ◽  
Ana Salvador ◽  
Elena Aluco ◽  
Sara Navarro ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotion Dysregulation ◽  
Borderline Personality ◽  
Mobile App ◽  
Negatively Associated ◽  
System Usability Scale ◽  
Emergency Units ◽  
Symptom List ◽  
User Friendly

Objective: Borderline personality disorder (BPD) is a severe mental disorder characterized by emotional crises. To date, crisis interventions for BPD have been conducted via telephone calls and emergency units, which are associated with an extra amount of resources. The aim of this research was to test the usability and satisfaction with a psychotherapeutic mobile app for self-managing crises in BPD. Method: The B·RIGHT app was designed based on Artificial Intelligence psychotherapeutic algorithms. Usability and satisfaction with the app were assessed in 25 outpatients diagnosed with BPD (84% female, mean age = 35.80 years) using the System Usability Scale (SUS) and other questionnaires. Clinical features were assessed using the Borderline Symptom List, the Difficulties in Emotion Regulation Scale and Beck’s Depression Inventory. Results: Patients with BPD considered the app user-friendly (mean total score = 4.03) and highly satisfactory (mean total score = 4.02), resulting in a positive user experience (mean total score = 4.09). Total usability was negatively associated with age ( r = −.44), positively associated with educational level ( rho = .47) and with overall emotion dysregulation ( r = .51), and negatively associated with depression severity ( r = −.47). Conclusions: The usability and satisfaction testing of the B·RIGHT app showed promising findings, which warrant further research in order to validate its effectiveness.

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