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A research protocol was developed to test a theoretical model regarding impulsivity in borderline personality (BP) disorder. It was hypothesized that the impact of identity disturbance of individuals with BP features on their response-inhibition functions could be explained by the disposition of their self-concept to increase the intensity of negative emotions. Participants with different levels of BP features were assigned to a self-description condition (N=29) that had the potential to manipulate the identity coherence, or a control condition (N=27) prior to a response inhibition task with high and low arousal emotional stimuli. We also explored the relationship between participants' self-description and their performance on the inhibition task. The results showed a significant interaction between condition, level of BP features, valence, and stimulus intensity on commission errors. Post-hoc analysis did not reveal significant differences. In addition, a moderate correlation was found between a lesser differentiated description of the self and a higher mean of errors of commission. This preliminary study highlights the relevance of studying the relationship between the self-concept and inhibition regarding borderline impulsivity. The findings should be replicated with a larger sample and with individuals who meet the diagnostic criteria., (Copyright © 2022 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Borderline personality disorder (BPD) is a severe mental disorder characterized by a dysfunctional pattern of affective instability, impulsivity, and disturbed interpersonal relationships. Dialectical Behavior Therapy (DBT®) is the most effective treatment for Borderline Personality Disorder, but demand for DBT® far exceeds existing clinical resources. Most patients with BPD never receive DBT®. Incorporating computer technology into the DBT® could help increase dissemination. Immersive Virtual Reality technology (VR) is becoming widely available to mainstream consumers. This case study explored the feasibility/clinical potential of using immersive virtual reality technology to enhance DBT® mindfulness skills training of a 32 year old female diagnosed with BPD. Prior to using VR, the patient experienced difficulty practicing DBT® mindfulness due to her emotional reactivity, and difficulty concentrating. To help the patient focus her attention, and to facilitate DBT® mindfulness skills learning, the patient looked into virtual reality goggles, and had the illusion of slowly floating down a 3D computer-generated river while listening to DBT® mindfulness training audios. Urges to suicide, self-harm, urges to quit therapy, urges to use substances, and negative emotions were all reduced after each VR mindfulness session. VR mindfulness was well accepted/liked by the patient, and increased positive emotions. Although case studies are scientifically inconclusive by nature, results from this feasibility study were encouraging. Future controlled studies are needed to quantify whether VR-enhanced mindfulness training has long term benefits e.g., increasing patient acceptance and/or improving therapeutic outcome. Computerizing some of the DBT® skills treatment modules would reduce cost and increase dissemination.

This paper evaluates representation of clinical consequences of developmental psychological trauma in the current proposal of DSM-5. Despite intensive efforts by its proponents for two decades, it is not known yet if Complex PTSD will take a place in the final version of DSM-5. Recognition of dissociative character of several symptom dimensions and introduction of items about negative affects such as shame and guilt imply an indirect improvement toward better coverage of the consequences of developmental trauma in the existing category of PTSD. As disorders with highest prevalence of chronic traumatization in early years of life, dissociative disorders and personality disorder of borderline type are maintained as DSM-5 categories; however, recognition of a separate type of trauma-related personality disorder is unlikely. While a preschooler age variant of PTSD is under consideration, the proposed diagnosis of Developmental Trauma Disorder (child version of Complex PTSD) has not secured a place in the DSM-5 yet. We welcome considerations of subsuming Adjustment Disorders, Acute Stress Disorder, PTSD, and Dissociative Disorders under one rubric, i.e., Section of Trauma, Stress, or Event Related Disorders. Given the current conceptualization of DSM-5, this paper proposes Complex PTSD to be a subtype of the DSM-5 PTSD. Composition of a trauma-related disorders section would facilitate integration of knowledge and expertise about interrelated and overlapping consequences of trauma.For the abstract or full text in other languages, please see Supplementary files under Reading Tools online

The goal of this study was to examine social feedback processing among emerging adults with borderline personality features (BPF). Participants (N = 118; 66.9% female) completed ratings of BPF and a computerized peer interaction task designed to measure processing of rejection and acceptance cues at the neurophysiological (i.e., electroencephalogram [EEG]), behavioral, and self-report levels. When covarying symptoms of depression and social anxiety, greater BPF were associated with heightened neural processing of social acceptance cues, accounting for reactivity to neutral and rejection cues, as demonstrated by an enhanced reward positivity (RewP) component. Additionally, BPF were associated with less adaptive voting in response to peer acceptance, such that emerging adults with higher BPF made fewer votes to keep peers in the game who had provided acceptance feedback to participants. These neural and behavioral patterns associated with BPF highlight the potential role of social reward processing in borderline personality. Specifically, emerging adults high in BPF show a hyper-responsiveness to social acceptance at the neural level but difficulty modulating behavioral responses in an adaptive way to obtain more social rewards. Future research replicating these effects across development may guide efforts to address and prevent the profound social dysfunction associated with BPF. • BPF were associated with alterations in processing peer acceptance cues. • At the neural level, BPF were associated with an enhanced RewP to acceptance. • BPF were also associated with less adaptive voting in response to peer acceptance. • Findings suggest impairments in modulating responses to acceptance unique to BPF. • Targeting adaptive responses to acceptance may be relevant to intervention for BPF. [ABSTRACT FROM AUTHOR]

Background: Emotion dysregulation is core to many biopsychosocial models of Borderline Personality Disorder (BPD) and is often targeted as part of their associated psychological therapies. Several distinct specialist psychotherapies are thought to be effective for people diagnosed with BPD but it is unclear whether they share common change mechanisms. Some evidence suggests that Mindfulness Based Interventions improve competency in emotion regulation as well as trait mindfulness, which are both plausibly associated with good treatment outcomes. It is unclear whether the association between the severity of BPD symptoms and emotion dysregulation is mediated by trait mindfulness. Would improvement in trait mindfulness mediate an association between lower severity of BPD symptoms and fewer problems of emotion dysregulation?, Methods: One thousand and twelve participants completed online, single time-point, self-report questionnaires., Results: As predicted, the severity of BPD symptoms was significantly and positively associated with emotion dysregulation with a large effect size (r = .77). Trait mindfulness mediated this relationship as the 95% confidence interval for the indirect effect did not cross zero (size of direct effect = .48 and size of indirect effect = .29 [.25, .33]., Conclusions: The relationship between the severity of BPD symptoms and emotion dysregulation was confirmed in this dataset. As hypothesised, this relationship was mediated by trait mindfulness. Process measures of emotion dysregulation and mindfulness should be included in intervention studies for people diagnosed with BPD to understand if improvements in these factors are a universal occurrence with good response to treatment. Other process measures should also be explored to identify other factors involved in the relationship between BPD symptoms and emotion dysregulation., (© 2023. The Author(s).)

The article discusses a study which examines the measurement invariance and factor structure of the Borderline Personality Features Scale for Children (BPFS-C) among Canadian adolescents. Topics discussed include the possible sex differences in rates of the borderline personality in adolescence and children, the measurement of child depressive symptoms, and the use of Confirmatory Factor Analysis to complete the BPFS-C data.

Contemporary object-relation theory of personality postulates that the level of severity of personality organization parallels the nature and extent of problems in the patient's sexual life. The study aims at exploring the relationship between dimensions of Borderline Personality Organization (BPO) (as assessed according to Otto Kernberg's model), sexual functioning, quality of sexual life and paraphilias in a community sample of men. One-hundred and thirty-six healthy men were asked to complete a set of questionnaires including the Inventory of Personality Organization (IPO), the International Index of Erectile Function, the Sexual Quality of Life Questionnaire, and a checklist to assess the prevalence of paraphilias. High scores on IPO subscales were significantly associated with low overall satisfaction in sexual functioning, low quality of sexual life, and the presence of paraphilias. Results expand previous findings on the relationship between features of BPO and core components of sexual life and support the need for an assessment of personality functioning in subjects reporting sexual problems. [ABSTRACT FROM AUTHOR]

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Borderline personality disorder (BPD) is a severe mental disorder characterized by a dysfunctional pattern of affective instability, impulsivity, and disturbed interpersonal relationships. Dialectical Behavior Therapy (DBT®) is the most effective treatment for Borderline Personality Disorder, but demand for DBT® far exceeds existing clinical resources. Most patients with BPD never receive DBT®. Incorporating computer technology into the DBT® could help increase dissemination. Immersive Virtual Reality technology (VR) is becoming widely available to mainstream consumers. This case study explored the feasibility/clinical potential of using immersive virtual reality technology to enhance DBT® mindfulness skills training of a 32 year old female diagnosed with BPD. Prior to using VR, the patient experienced difficulty practicing DBT® mindfulness due to her emotional reactivity, and difficulty concentrating. To help the patient focus her attention, and to facilitate DBT® mindfulness skills learning, the patient looked into virtual reality goggles, and had the illusion of slowly “floating down” a 3D computer-generated river while listening to DBT® mindfulness training audios. Urges to commit suicide, urges to self harm, urges to quit therapy, urges to use substances, and negative emotions were all reduced after each VR mindfulness session and VR mindfulness was well accepted/liked by the patient. Although case studies are scientifically inconclusive by nature, results from this feasibility study were encouraging. Future controlled studies are needed to quantify whether VR-enhanced mindfulness training has long term benefits e.g., increasing patient acceptance and/or improving therapeutic outcome. Computerizing some of the DBT® skills treatment modules would reduce cost and increase dissemination. [ABSTRACT FROM AUTHOR]

Since its inception, the concept of “secondary psychopathy” has been contrasted with primary psychopathy on the grounds of neuroticism, affect instability, and anxiety. Nonetheless, while the etiology of primary psychopathy, and its various possible expressions, has received ample attention, secondary psychopathy has been largely neglected and only discussed in cluster-analytic studies. This paper seeks to fill that caveat by delineating the continuum on which secondary psychopathic individuals may be set apart and exploring potential sources of within group homogeneity and heterogeneity. While secondary psychopathic individuals share a number of etiological antecedents (attachment problems, childhood maltreatment, neurobiological dysfunctions) they can vary on different temperamental predispositions and specific types of maltreatment experienced in childhood (neglect/abuse vs. trauma/abuse, low vs. high prefrontal catecholaminergic activity), thus creating the heterogeneity observed in this group. Secondary psychopathic individuals may be situated on a continuum that spans from attentional hyposensitivity and cognitive distractibility on the far left side, associated with deficient prefrontal catecholamine activity and childhood neglect/abuse, ultimately culminating in more detached expressions of secondary psychopathy (callousness, hedonism, and low worrying), to attentional hypersensitivity and cognitive rigidity on the far right side, associated with non-optimally high levels of catecholamine activity and childhood relational trauma/abuse leading to more unstable expressions of secondary psychopathy (hostility, neuroticism, instability, and worrying). [ABSTRACT FROM AUTHOR]

Aim: To investigate impulsive behaviors in pathological buying (PB). Methods: The study included three groups matched for age and gender: treatment seeking outpatients with PB (PB+), treatment seeking psychiatric inpatients without PB (PB-), and a healthy control group (HC). PB was assessed by means of the Compulsive Buying Scale and by the impulse control disorder (ICD) module of the research version of the Structured Clinical Interview for DSM-IV (SCID-ICD). All participants answered questionnaires concerning symptoms of borderline personality disorder, selfharming behaviors, binge eating and symptoms of attention deficit and hyperactivity disorder (ADHD). In addition, comorbid ICDs were assessed using the SCID-ICD. Results: The PB+ and PB- groups did not differ with regard to borderline personality disorder or ADHD symptoms, but both groups reported significantly more symptoms than the HC group. Frequencies of self-harming behaviors did not differ between the three groups. Patients with PB were more often diagnosed with any current ICD (excluding PB) compared to those without PB and the HC group (38.7% vs. 12.9% vs. 12.9%, respectively, p=.017). Discussion: Our findings confirm prior research suggesting more impulsive behaviors in patients with and without PB compared to healthy controls. The results of the questionnaire-based assessment indicate that outpatients with PB perceive themselves equally impulsive and self-harm as frequently as inpatients without PB; but they seem to suffer more often from an ICD as assessed by means of an interview. [ABSTRACT FROM AUTHOR]

Baron-Cohen's ‛extreme male brain’ theory postulates that autism involves exaggerated male-typical psychology, with reduced empathizing (considered here as social–emotional interest, motivation and abilities) and increased systemizing (non-social, physical-world and rule-based interest, motivation and abilities), in association with its male-biased sex ratio. The concept of an ‘extreme female brain’, involving some combination of increased empathizing and reduced systemizing, and its possible role in psychiatric conditions, has been considerably less well investigated. Female-biased sex ratios have been described in two conditions, depression and borderline personality disorder (BPD), that also show evidence of increases in aspects of empathy in some studies. We evaluated the hypothesis that BPD and depression can be conceptualized in the context of the ‘extreme female brain’ by: (1) describing previous conceptualizations of the extreme female brain model, (2) reviewing evidence of female-biased sex ratios in BPD and depression, (3) conducting meta-analyses of performance on the Reading the Mind in the Eyes test (RMET) among individuals with BPD, clinical or sub-clinical depression, and other psychiatric conditions involving altered social cognition and mood (schizophrenia, bipolar disorder, eating disorders, and autism), in relation to disorder sex ratios, and (4) evaluating previous evidence of increased empathic performance in these, and related, psychiatric conditions, and (5) synthesizing these lines of evidence into models for causes and effects of an ‘extreme female brain’. Our primary empirical results are that RMET performance is enhanced in sub-clinical depression, preserved in borderline personality disorder, and reduced in other disorders (by meta-analyses), and that across disorders, more male-biased patient sex ratios are strongly associated with worse RMET performance of patients relative to controls. Our findings, in conjunction with previous work, suggest that increased cognitive empathizing mediates risk and expression of some psychiatric conditions with evidence of female biases, especially sub-clinical depression and borderline personality disorder, in association with increased attention to social stimuli, higher levels of social and emotional sensitivity, negative emotion biases, and over-developed mentalist thought. These results link evolved human sex differences with psychiatric vulnerabilities and symptoms, and lead to specific suggestions for future work. [ABSTRACT FROM AUTHOR]

There is a large literature documenting that adult men in treatment for substance use disorders perpetrate more aggression than men without substance use disorders. Unfortunately, there is minimal research on aggression among young adult men (i.e., 18–25 years of age) in treatment for substance use. Moreover, although aggression is more likely to occur when individuals are acutely intoxicated by alcohol or drugs, research also suggests that antisocial (ASPD) and borderline (BPD) personality features increase the chances an individual will use aggression. The current study therefore examined the associations between ASPD and BPD features, including specific features that are reflective of impulsivity, and aggression in young adult men in treatment for substance use disorders (N = 79). Controlling for age, education, alcohol and drug use, ASPD features were positively associated with various indicators of aggression (e.g., physical, verbal, attitudinal), whereas BPD features were only associated with physical aggression. However, ASPD and BPD features that were specific to impulsivity were robustly related to indicators of aggression. Findings suggest that substance use treatment should attempt to target ASPD and BPD features in young adult men, which may help reduce aggression after treatment. [ABSTRACT FROM PUBLISHER]

Background: This study explores the possibility that religious fundamentalism (RF) may be linked to deficits in personality structure, which is in contrast to the general assumption that religiosity and spirituality are positively related to mature personality development. Sampling and Methods: To test this hypothesis, 327 (232 female) college students completed the Multidimensional Inventory for Religious/ Spiritual Well-Being together with the Innsbrucker Religious Fundamentalism Scale. In addition, the 'vulnerable dark triad' of personality ('vulnerable narcissism', subscale of the Pathological Narcissism Inventory; 'secondary psychopathy', subscale of Levenson's Self-Report Psychopathy Scale; 'borderline personality', of the Borderline Personality Inventory) was assessed. Results: In general, the relation between spirituality and healthy personality functioning was confirmed. In addition to greatly overlapping with 'general religiosity' (p < 0.001), RF was also relevantly predicted by narcissistic ('hiding the self') and borderline ('primitive defenses') personality facets (p < 0.05 for both). Conclusions: Based on these preliminary data, we conclude that specific structural deficits in personality might lead to more rigorous variants of religious/spiritual beliefs such as RF. Further research in clinical surroundings as well as in religious extremist groups is recommended. [ABSTRACT FROM AUTHOR]

This research examined whether following social and physical aggression trajectories across Grades 3-12 predicted psychological maladjustment. Teachers rated participants' (n = 287, 138 boys) aggressive behavior at the end of each school year. Following the 12th grade, psychosocial outcomes were measured: rule-breaking behaviors, internalizing symptoms, and narcissistic and borderline personality features. Following the highest social aggression trajectory predicted rule-breaking behavior; the medium social aggression trajectory was not a significant predictor of any outcome. Following the highest physical aggression trajectory predicted rule-breaking, internalizing symptoms, and narcissism, whereas the medium physical aggression trajectory predicted rule-breaking and internalizing symptoms. [ABSTRACT FROM AUTHOR]

Objective The study focused on the relationship between mixed depression and borderline personality disorder ( BPD). Method The sample comprised 2811 patients with a major depressive episode ( MDE). Clinical characteristics were compared in patients with ( BPD+) and without ( BPD−) comorbid BPD and in BPD+ with ( MXS+) and without ( MXS−) mixed features according to DSM-5 criteria. Results A total of 187 patients (6.7%) met the criteria for BPD. A DSM- IV- TR diagnosis of bipolar disorder ( BD) was significantly more frequent in patients with BPD+ than in patients with BPD. Patients with BPD+ were significantly younger and reported lower age at onset than BPD−. Patients with BPD+ also showed more hypomania/mania in first-degree relatives in comparison with patients with BPD−, as well as more psychiatric comorbidity, mixed features, atypical features, suicide attempts, prior mood episodes and antidepressant-induced hypo/manic switches. Mixed features according to DSM-5 criteria were observed in 52 (27.8%) BPD+. In comparison with MXS−, MXS+ were significantly younger at age of onset and at prior mood episode and had experienced more mood episodes and hypo/manic switches with antidepressant treatments. Conclusion Major depressive episode patients with comorbid BPD reported a high prevalence of mixed features and BD. The presence of DSM-5 mixed features in MDE patients with BPD may be associated with complex course and reduced treatment response. [ABSTRACT FROM AUTHOR]

BACKGROUND The aim of this research is to determine the level of emotion regulation, studied through the method of variable action orientation vs. state and its relationship with depressiveness and dimension of the reasons for living and self-harming behaviour of patients with borderline personality disorder. PARTICIPANTS AND PROCEDURE The research studied 61 patients diagnosed with an emotionally unstable personality of borderline type. The research used the Polish adaptation of tests to measure the action vs. state orientation (SSI-K), the self-harming behaviour (SHI), depression (BDI) and the reasons for living vs. suicidal tendency (RFL-I). RESULTS In people with borderline personality disorder, the level of emotion regulation (action vs. state orientation), reasons for living and depression are predictors of self-harming behaviour. The experience of a depressive episode or lack thereof does not have a relationship with the increase of self-harming. Analysis of the interaction between variables showed that the reasons for living and the action orientation after failure are related to the reduction of self-harming behaviour in all subjects. In depressed people, state orientation is associated with an increase in the action orientation with decreased self-destructive behaviours. CONCLUSIONS High levels of reasons for living in interaction with the action orientation have a negative relationship with the self-harming behaviour of patients diagnosed with borderline personality disorder. Among those subjects, depressive patients, a statistically lower level of self-harm is related to the action orientation. These results suggest that therapeutic treatment is important to activate both reasons for living as well as action orientation as effective dimensions in preventing self-harming. [ABSTRACT FROM AUTHOR]

The article reports on the various psychological aspects of women perpetrators of intimate partner violence (IPV), and mentions prevalence of various self-harm behaviors among IPV abused women's; and treatment implications for the perpetration of intimate partner violence.

This study examined the association between trauma exposure, PTSD, suicide attempts, and other psychopathology among 316 racially/ethnically diverse HIV-infected men and women who underwent semi-structured psychiatric assessment. In addition, the role of psychological resilience in trauma exposure was examined in the context of neurological symptoms and functional status. Nearly half (47.8%; 151/316) of the participants reported trauma exposure, of which 47.0% (71/151) developed PTSD. Among trauma-exposed individuals, those with a current psychiatric diagnosis reported more neurological symptoms and lower functional status. Trauma exposure without PTSD was associated with a higher rate of panic disorder and substance-induced mental disorders. Trauma-exposed individuals who did not develop PTSD were less likely than those who reported no trauma exposure to meet criteria for major depressive disorder (MDD). Trauma exposure, MDD, borderline personality disorder, and substance-induced mental disorders were independently associated with increased odds of suicide attempt. These results indicate that co-morbid psychiatric disorders are common among trauma exposed individuals with a history of PTSD, but those with trauma exposure who do not develop PTSD are less likely to experience MDD. The role of other co-morbid psychopathologies in the genesis of suicidal behavior among individuals living with HIV deserves further study. [ABSTRACT FROM AUTHOR]

Objective Borderline Personality Disorder ( BPD) and the affective disorders, in particular depression, share some overlap in symptomatology and a set of common psychosocial determinants. The purpose of the current study was to provide further evidence informing debates of diagnostic distinction by quantifying (1) self-reported symptomatic comorbidity of the two disorders and (2) relative contributions of parental bonding and early maladaptive schemas to adult levels of borderline and depressive symptomatology. Method A general population sample of 411 participants, ranging from 18 to 65 years (99 males and 312 females), completed the questionnaire package. Results Retrospectively reported level of parental care was found to account for significant unique variance in adult borderline and depressive symptomatology. Furthermore, schemas of the Disconnection/ Rejection domain and others were found to significantly and concordantly predict both borderline and depressive symptomatology. Participants reporting substantive levels of borderline symptoms also reported depressive symptoms outside the normal range. Conclusions These findings support significant overlap in the symptomatology, co-severity and psychosocial determinants of BPD and depression. These data have implications for the management and early prevention of both depression and BPD. [ABSTRACT FROM AUTHOR]

The present study examined the phenotypic, genetic, and environmental correlations between four humor styles (affiliative, self-enhancing, aggressive, and self-defeating) and four dimensions of borderline personality disorder (affective instability, identity disturbance, negative relationships, self-harm) as well as a total borderline personality disorder score. Participants were 574 same-sex Australian adult twin pairs. At the phenotypic level, the two adaptive humor style dimensions (affiliative and self-enhancing) were found to correlate negatively with borderline personality and the two maladaptive humor style dimensions (aggressive and self-defeating) were found to have positive correlations with borderline personality. Bivariate genetic analyses demonstrated significant genetic, common environment, and unique environmental correlations. These results indicate that a large component of the phenotypic association between borderline personality disorder and humor style arises from the influence of shared familial and environmental factors associated with both phenotypes. [ABSTRACT FROM AUTHOR]

Two studies were conducted to test whether psychopathy, narcissism, and borderline personality are linked to impairment in affective empathy experience. In both studies, two forms of affective empathy (emotional contagion and empathic concern) were covertly manipulated and measured. Use of state empathy change scores and data aggregation across both studies and a third previously published study revealed little evidence of a consistent negative association between most measures of narcissistic, borderline, or psychopathic traits and affective empathy change scores. The one exception was the psychopathic trait of Callous Affect, which revealed consistent negative associations with affective empathy change scores. Specifically, relative to neutral stimuli, Callous Affect was associated with lower emotional contagion of sadness to sad faces, lower emotional contagion of sadness, anger, and fear to those in need, and lower empathic concern to those in need. The results suggest that claims of clear links between affective empathy impairment and most traits comprising narcissism and borderline personality are unsubstantiated when subjected to critical test conditions. Moreover, emotional callousness, as opposed to other psychopathic traits, appears to be responsible for the proposed link between psychopathy and affective empathy impairment. [ABSTRACT FROM AUTHOR]

Objective.The purpose of the present study was to further examine the efficacy of the Self-Harm Inventory (SHI) as a proxy measure in diagnosing borderline personality disorder, with the comparison measure being the Personality Diagnostic Questionnaire-4 (PDQ-4).Methods.We undertook a meta-analysis of data from our previous studies of psychiatric inpatients (N= 270) and internal medicine outpatients (N= 2587), all of whom completed both the SHI and the PDQ-4.Results.Scores on the SHI and PDQ-4 were strongly correlated, especially after correcting for attenuation due to measurement unreliability (0.78 in the compiled inpatient psychiatry sample and 0.83 in the compiled internal medicine sample). Moreover, the SHI demonstrated statistically significantly greater reliability coefficients relative to the PDQ-4.Conclusions.Based upon comparison with the PDQ-4, the SHI appears to be an efficacious proxy measure of borderline personality symptomatology in both psychiatric inpatient samples and primary care outpatient samples. [ABSTRACT FROM AUTHOR]

Résumé Le trouble bipolaire et le trouble de la personnalité borderline présentent une incidence sur la vie des patients tant sur la symptomatologie que sur la qualité de vie. Ces deux troubles semblent avoir des similitudes cliniques ne facilitant pas le diagnostic. En effet, les dimensions affectives, tant d’un point de vue de la labilité que de l’intensité ainsi qu’au niveau de l’impulsivité, rendent difficile la distinction clinique entre ces deux pathologies. Au travers de cette revue de la littérature, nous tenterons de mettre en avant les différences, au niveau de l’affectivité et de l’impulsivité, entre le trouble bipolaire et le trouble de la personnalité borderline afin de tenter d’apporter une finesse clinique entre ces deux pathologies dans le but, à plus long terme, d’affiner la prise en charge thérapeutique. Bipolar disorder and borderline personality have an impact on patients’ life regarding to the symptomatology and the quality of life. Both disorders appear to have clinical similarities which do not facilitate the diagnosis. Indeed, the affective dimensions, both lability and intensity and as well as impulsivity, make clinical distinction difficult between these two pathologies. Through this review, we have described affective and impulsive dimensions for each disorder in a first time and we have tried to highlight the differences, concerning affectivity and impulsivity, between bipolar disorder and borderline personality disorder to refine the therapeutic treatment of both disorders in a second time. The main differences between bipolar disorder and borderline personality disorder concern the fact that patients with borderline personality disorder seem to have a higher level of affective intensity and impulsivity. Moreover, bipolar patients have fluctuations between “Anxiety” and “Depression” in terms of affective lability whereas borderline patients fluctuate between “Euthymia”, “Depression” and “Elation”. [ABSTRACT FROM AUTHOR]

Borderline personality disorder is a personality dysfunction that is characterized by disinhibition and impulsivity, which oftentimes manifest as self-regulation difficulties. Patients with this disorder have always been present in medical settings, but have been described as “difficult patients” rather than patients with borderline personality disorder. According to empirical findings, a number of behaviors and medical syndromes/diagnoses are suggestive of borderline personality disorder. Suggestive behaviors in the medical setting may include aggressive or disruptive behaviors, the intentional sabotage of medical care, and excessive healthcare utilization. Suggestive medical syndromes and diagnoses in the medical setting may include alcohol and substance misuse (including the abuse of prescription medications), multiple somatic complaints, chronic pain, obesity, sexual impulsivity, and hair pulling. While not all-inclusive or diagnostic, these behaviors and syndromes/diagnoses may invite further clinical evaluation of the patient for borderline personality disorder. [ABSTRACT FROM AUTHOR]

Objectives. The extant literature on borderline personality disorder (BPD) and compliance with mental health treatment contains conflicting findings. However, among those individuals with this type of personality dysfunction, reduced compliance with mental health treatment appears to be the predominant theme. To our knowledge, the relationship between BPD and compliance with general health care has not been studied. In addition, there is no prior study in this area examining a primary care population. Methods. Using a cross-sectional survey methodology among a sample of internal medicine outpatients ( N = 261), we assessed borderline personality symptoms with two self-report measures and general health care compliance or adherence with four self-report measures. Results. With the exception of on-time arrival for doctor appointments, the remaining compliance variables demonstrated statistically significant relationships at the p < 0.01-0.001 levels, with borderline personality symptoms predicting reduced compliance (i.e., conscientiousness with medical treatment, regular dental check-ups, timely completion of laboratory work, following doctor's exercise and nutrition instructions, remembering to take medications, and Medical Outcomes Study General Adherence Score). Conclusions. Compared with participants without borderline personality symptoms, those participants with such symptoms in this study evidenced lower general health care compliance. [ABSTRACT FROM AUTHOR]

Aim. This work aims to present the difficulties in the assessment of sanity of a perpetrator involved in the so-called dyadic death, which in Poland is identified with the occurrence of sever mood disturbances at the time of the crime. Methods. A case of a man who killed his wife and two children is presented. The perpetrator himself tried to commit suicide by cutting his veins with a razor. Commentary. The authors underline diagnostic difficulties which were encountered in the analysed case, they point out the necessity to go beyond the phenomenological aspect of "dyadic death" and the need for multidimensional clinical evaluation of the perpetrator. The rarity of similar acts and low survival rate of perpetrators leaves experts with relatively small amount of opinion giving experience. Thus, there is a need for high accuracy research and careful consideration. [ABSTRACT FROM AUTHOR]

Objective. This study investigated the prevalence and severity of neurological soft signs (NSS), and their relationships with borderline personality (BP) traits in adolescents. Methods. Eighty-nine adolescents with BP traits (BP-trait group), and 89 adolescents without traits of any personality disorder (control group), were recruited in China. BP traits were diagnosed by the BPD subscale of the Personality Diagnostic Questionnaire for the DSM-IV (PDQ-4+). The soft sign subscales of the Cambridge Neurological Inventory were administered to all participants. The group differences in prevalence of soft signs and in NSS scores were analyzed, as well as the associations between the NSS scale and borderline personality traits. Results. Five soft signs were significantly more frequent in adolescents with BP traits. A total of 59.6% of adolescents with BP traits exhibited at least 1 NSS, whereas only 34.8% of adolescents without BP traits did ( p < 0.01). A total of 42.7% of adolescents in the BP-trait group exhibited at least 2 NSS, while only 16.9% of adolescents without BP traits did ( p < 0.001). Moreover, adolescents with BP traits showed more sensory integration, disinhibition, total neurological soft signs, left-side soft signs, and right-side soft signs, than adolescents without BP traits. Sensory integration and disinhibition were positively associated with BP traits. Conclusion. These findings suggest that adolescents with BP traits may have a nonfocal abnormality of the central nervous system. [ABSTRACT FROM AUTHOR]

Based on an analysis of the profound social and cultural changes that underlie what has been described as the new expressive subjectivity of late modernity, this essay tries to show its constitutive affinity with the pathology of identity that many authors consider as a central feature not only of the borderline or narcissistic syndrome, but also of many of the most common and representative mental disorders of our time. [ABSTRACT FROM AUTHOR]

Despite growing evidence for the efficacy of Gratz and colleagues' emotion regulation group therapy (ERGT) for deliberate self-harm (DSH) among women with borderline personality disorder (BPD), the proposed mechanism of change in this treatment (i.e., emotion regulation) remains largely unexamined. This study examined change in emotion dysregulation as a mediator of the effects of this ERGT on DSH and BPD symptoms, as well as the extent to which change in emotion dysregulation during treatment predicts further improvements in DSH during a 9-month follow-up. Participants included 61 female outpatients with BPD and recent DSH who were randomly assigned to receive this ERGT in addition to their ongoing outpatient therapy immediately ( n = 31) or after 14 weeks ( n = 30). Measures of emotion dysregulation, DSH, and BPD symptoms were administered pre- and post-treatment or -waitlist, and at 9-months post-treatment (for participants in both conditions who received ERGT). Results from a series of mediation analyses provide further support for emotion regulation as a mechanism of change in this treatment. Specifically, results revealed that improvements in emotion dysregulation over the course of treatment mediated the observed reductions in BPD cognitive and affective symptoms during treatment and predicted further improvements in DSH during follow-up. [ABSTRACT FROM AUTHOR]

Se describe el caso de una mujer de 18 años, quien fue hospitalizada por intento de suicidio secundario a intoxicación medicamentosa, con graves complicaciones clínicas como alteraciones del estado de conciencia, complicaciones cardiovasculares y electrocardiográficas. Una vez establecidas las medidas de soporte se instauró evaluación psiquiátrica encontrando múltiple comorbilidad, como la asociación de trastorno bipolar y trastorno límite de la personalidad, entre otros diagnósticos. Desde este enfoque psicodinámico y farmacológico, se contribuyó a la búsqueda de la etiología, la disminución del riesgo suicida y la estabilización del cuadro afectivo, abordando los aspectos correspondientes a una estructura organizacional limítrofe o borderline de la personalidad. Se pretende aportar información a otras especialidades para proporcionar una perspectiva integral, principalmente la psicodinámica. The case of a woman of 18 years old, who was hospitalized for attempted suicide secondary to drug intoxication, with serious clinical complications such as disturbances of consciousness, cardiovascular complications and electrocardiographic changes. Once established supportive measures, the psychiatric evaluation found multiple comorbidities, such as the association of bipolar disorder and borderline personality disorder, among other diagnoses. From this psychodynamic and pharmacological approach contributed to the search for the etiology, decreased suicide risk and stabilization of affective symptoms, and dealing with issues related to organizational structure borderline personality. It is intended to provide information to other specialties to provide a comprehensive perspective, mainly psychodynamic. [ABSTRACT FROM AUTHOR]

The current clinical demand consists of a significant number of borderline patients. This study sought to conduct an integrative review of the affective bonds of teenagers/adults diagnosed with borderline personality disorder. Bases of national and international databases were consulted. For a selection of articles used the base SCIELO. The articles included in the study were published between 2011 to 2014 and had three languages: portuguese, english and spanish. Publications is refined in order to avoid bias and/or tracking error of the content in question, valuing borderline. The results presented in analysis were history of weakened bond permeated by representations of negligence, low support, abandonment and lack of protection. Life stories with violence and traumatic experiences of various orders were identified. We also emphasize the need for studies on the borderline adolescent and expanding qualitative research on the matter to enable better management and intervention. [ABSTRACT FROM AUTHOR]