Faculty Opinions recommendation of The 10-year course of PTSD in borderline patients and axis II comparison subjects.

10.1093/med-psych/9780195370607.003.0016 ◽

2018 ◽

pp. 171-174

Author(s):

Mary C. Zanarini

Keyword(s):

Risk Factors ◽

Sexually Abused ◽

Female Gender ◽

Physical Assault ◽

Clinical Implications ◽

Axis Ii ◽

Borderline Patients ◽

History Of ◽

At baseline, borderline patients reported higher rates of adult rape and physical assault by a partner than Axis II comparison subjects. Four risk factors were found to significantly predict whether borderline patients had an adult history of being a victim of physical and/or sexual violence before their index admission: female gender, a substance use disorder that began before the age of 18, childhood sexual abuse, and emotional withdrawal by a caretaker (a form of neglect). At six-year and 10-year follow-up, borderline patients reported higher rates of being verbally, emotionally, physically, and sexually abused or assaulted than did Axis II comparison subjects. However, each of these forms of abuse declined significantly over time. The clinical implications of these prevalence and predictive findings are discussed.

The 10-year course of physically self-destructive acts reported by borderline patients and axis II comparison subjects

Acta Psychiatrica Scandinavica ◽

10.1111/j.1600-0447.2008.01155.x ◽

2008 ◽

Vol 117 (3) ◽

pp. 177-184 ◽

Cited By ~ 111

Author(s):

M. C. Zanarini ◽

F. R. Frankenburg ◽

D. B. Reich ◽

G. Fitzmaurice ◽

I. Weinberg ◽

...

Keyword(s):

Axis Ii ◽

The 10-year course of PTSD in borderline patients and axis II comparison subjects

Acta Psychiatrica Scandinavica ◽

10.1111/j.1600-0447.2011.01717.x ◽

2011 ◽

Vol 124 (5) ◽

pp. 349-356 ◽

Cited By ~ 22

Author(s):

M. C. Zanarini ◽

S. Hörz ◽

F. R. Frankenburg ◽

J. Weingeroff ◽

D. B. Reich ◽

...

Keyword(s):

Axis Ii ◽

Sexual Issues over Time

10.1093/med-psych/9780195370607.003.0017 ◽

2018 ◽

pp. 175-180

Author(s):

Mary C. Zanarini

Keyword(s):

Sexual Orientation ◽

Study Groups ◽

Sexual Relationship ◽

Intimate Partners ◽

Same Sex ◽

Axis Ii ◽

Borderline Patients ◽

And Gender ◽

We studied two types of sexual issues over time. The first issue was sexual relationship difficulties, which we defined as avoiding sex for fear of becoming symptomatic, or becoming symptomatic after having sex. The second issue was sexual orientation and gender of relationship choice. At six-year follow-up, we found that sexual relationship difficulties were significantly more common among borderline patients than among Axis II comparison subjects, although the rate was declining in both study groups. At 16-year follow-up, the same pattern was found for non-recovered versus recovered borderline patients. In terms of the second issue, patients with BPD were significantly more likely than Axis II comparison subjects to report homosexual or bisexual orientation and intimate same-sex relationships. In addition, patients with BPD were significantly more likely than Axis II comparison subjects to report changing the gender of intimate partners, but not sexual orientation, at some point during the follow-up period.

Physical Health and Medical Treatment

10.1093/med-psych/9780195370607.003.0015 ◽

2018 ◽

pp. 161-170

Author(s):

Mary C. Zanarini

Keyword(s):

Physical Health ◽

Psychosocial Functioning ◽

Dysfunctional Attitudes ◽

Axis Ii ◽

Lifestyle Choices ◽

Health Related ◽

Borderline Patients ◽

Lack Of Exercise ◽

Opioid Medications ◽

Remitted borderline patients were found to have better physical health, make better health-related lifestyle choices, and use fewer costly forms of treatment, such as ER visits, than non-remitted borderline patients. This same pattern was found 10 years later for recovered vs. non-recovered borderline patients. At both time points, obesity was the most common serious health problem, and smoking and lack of exercise were the most common poor lifestyle choices. Obesity was found to be related to poor psychosocial functioning in most realms. Recovered borderline patients had better sleep quality and were not as troubled by dysfunctional attitudes about sleep as non-recovered borderline patients. Borderline patients also reported higher levels of physical pain than Axis II comparison subjects. However, a substantial minority were able to use opioid medications responsibly over time.

Additional Symptom Areas over Time

10.1093/med-psych/9780195370607.003.0009 ◽

2018 ◽

pp. 99-106

Author(s):

Mary C. Zanarini

Keyword(s):

Predictive Models ◽

Axis Ii ◽

Borderline Patients ◽

Comprehensive Manner ◽

This chapter details the course of symptom areas that were not covered in Chapter 6, or were covered in a non-comprehensive manner. These symptom areas are anxiety, shame, dissociation, and 17 specific cognitions (e.g., overvalued ideas, ideas of reference). These symptoms tended to decrease over time, but they also tended to remain significantly more severe or more common among borderline patients than among Axis II comparison subjects. Multivariate predictive models were also found for the severity of anxiety and the severity of shame. Taken together, these symptoms represent areas of suffering that would benefit from more clinical attention and support.

SEXUAL RELATIONSHIP DIFFICULTIES AMONG BORDERLINE PATIENTS AND AXIS II COMPARISON SUBJECTS

The Journal of Nervous and Mental Disease ◽

10.1097/01.nmd.0000081628.93982.1d ◽

2003 ◽

Vol 191 (7) ◽

pp. 479-482 ◽

Cited By ~ 29

Author(s):

Mary C. Zanarini ◽

Elizabeth A. Parachini ◽

Frances R. Frankenburg ◽

Julieta B. Holman ◽

John Hennen ◽

...

Keyword(s):

Sexual Relationship ◽

Axis Ii ◽

Severity of Anxiety Symptoms Reported by Borderline Patients and Axis II Comparison Subjects: Description and Prediction Over 16 Years of Prospective Follow-Up

Journal of Personality Disorders ◽

10.1521/pedi_2014_28_141 ◽

2014 ◽

Vol 28 (6) ◽

pp. 767-777 ◽

Cited By ~ 4

Author(s):

Mary C. Zanarini ◽

Frances R. Frankenburg ◽

Garrett M. Fitzmaurice

Keyword(s):

Anxiety Symptoms ◽

Axis Ii ◽

Psychosocial Functioning of Borderline Patients and Axis II Comparison Subjects Followed Prospectively for Six Years

Journal of Personality Disorders ◽

10.1521/pedi.19.1.19.62178 ◽

2005 ◽

Vol 19 (1) ◽

pp. 19-29 ◽

Cited By ~ 75

Author(s):

Mary C. Zanarini ◽

Frances R. Frankenburg ◽

John Hennen ◽

D. Bradford Reich ◽

Kenneth R. Silk

Keyword(s):

Psychosocial Functioning ◽

Axis Ii ◽

Defense Mechanisms over Time

10.1093/med-psych/9780195370607.003.0018 ◽

2018 ◽

pp. 181-188

Author(s):

Mary C. Zanarini

Keyword(s):

Defense Mechanisms ◽

Clinical Settings ◽

Time Varying ◽

Acting Out ◽

Axis Ii ◽

Borderline Patients ◽

Clinical Meaning ◽

Borderline Diagnosis ◽

At baseline, three defenses were found in multivariate analyses to be significantly associated with a borderline diagnosis. Two of these defenses were immature and one was neurotic: acting out, emotional hypochondriasis (i.e., transformation of feelings of sorrow, rage, and terror into unremitting complaints about the lack of understanding that others display), and undoing. At 16-year follow-up, borderline patients could still be differentiated from Axis II comparison subjects, and improvement was found in many defenses. In addition, four time-varying defense mechanisms were found to predict time-to-recovery. One was mature and three were immature: humor, acting out, emotional hypochondriasis, and projection. The clinical meaning and usefulness of assessing defenses over time, particularly immature defenses, in clinical settings is discussed.