scholarly journals Perimenstrual Exacerbation of Symptoms in Borderline Personality Disorder: Evidence from Multilevel Models and the Carolina Premenstrual Assessment Scoring System

2017 ◽  
Author(s):  
Tory A. Eisenlohr-Moul ◽  
Katja M. Schmalenberger ◽  
Sarah A. Owens ◽  
Jessica R. Peters ◽  
Danyelle N. Dawson ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Scoring System ◽  
Multilevel Models ◽  
Borderline Personality ◽  
Instability Criterion ◽  
Cycle Phase ◽  
Emotional Symptoms ◽  
Emotional Instability ◽  
Clinically Significant

AbstractBackgroundIndividuals with borderline personality disorder (BPD) suffer from a constellation of rapidly shifting emotional, interpersonal, and behavioral symptoms. The menstrual cycle may contribute to symptom instability among females with this disorder.MethodsFifteen healthy, unmedicated females with BPD and without dysmenorrhea reported daily symptoms across 35 days. Urine luteinizing hormone (LH) and salivary progesterone (P4) were used to confirm ovulation and cycle phase. Cyclical worsening of symptoms was evaluated using (1) phase contrasts in multilevel models and (2) the Carolina Premenstrual Assessment Scoring System (C-PASS; Eisenlohr-Moul et al., 2017b), a protocol for evaluating clinically significant cycle effects on symptoms.ResultsMost symptoms demonstrated midluteal worsening, a perimenstrual peak, and resolution of symptoms in the follicular or ovulatory phase. Post-hoc correlations with person-centered progesterone revealed negative correlations with most symptoms. Depressive symptoms showed an unexpected delayed pattern in which baseline levels of symptoms were observed in the ovulatory and midluteal phases, and exacerbations were observed during both the perimenstrual and follicular phases. The majority of participants met C-PASS criteria for clinically significant (>=30%) symptom exacerbation. All participants met the emotional instability criterion of BPD, and no participant met DSM-5 criteria for premenstrual dysphoric disorder (PMDD).ConclusionsFemales with BPD may be at elevated risk for perimenstrual worsening of emotional symptoms. Longitudinal studies with fine-grained hormonal measurement as well as hormonal experiments are needed to determine the pathophysiology of perimenstrual exacerbation in BPD.

scholarly journals Perimenstrual exacerbation of symptoms in borderline personality disorder: evidence from multilevel models and the Carolina Premenstrual Assessment Scoring System

2018 ◽  
Vol 48 (12) ◽  
pp. 2085-2095 ◽  
Author(s):  
Tory A. Eisenlohr-Moul ◽  
Katja M. Schmalenberger ◽  
Sarah A. Owens ◽  
Jessica R. Peters ◽  
Danyelle N. Dawson ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Scoring System ◽  
Multilevel Models ◽  
Borderline Personality ◽  
Instability Criterion ◽  
Cycle Phase ◽  
Emotional Symptoms ◽  
Emotional Instability ◽  
Clinically Significant

AbstractBackgroundIndividuals with a borderline personality disorder (BPD) suffer from a constellation of rapidly shifting emotional, interpersonal, and behavioral symptoms. The menstrual cycle may contribute to symptom instability among females with this disorder.MethodsFifteen healthy, unmedicated females with BPD and without dysmenorrhea reported daily symptoms across 35 days. Urine luteinizing hormone and salivary progesterone (P4) were used to confirm ovulation and cycle phase. Cyclical worsening of symptoms was evaluated using (1) phase contrasts in multilevel models and (2) the Carolina Premenstrual Assessment Scoring System (C-PASS), a protocol for evaluating clinically significant cycle effects on symptoms.ResultsMost symptoms demonstrated midluteal worsening, a perimenstrual peak, and resolution of symptoms in the follicular or ovulatory phase. Post-hoc correlations with person-centered progesterone revealed negative correlations with most symptoms. Depressive symptoms showed an unexpected delayed pattern in which baseline levels of symptoms were observed in the ovulatory and midluteal phases, and exacerbations were observed during both the perimenstrual and follicular phases. The majority of participants met C-PASS criteria for clinically significant (⩾30%) symptom exacerbation. All participants met the emotional instability criterion of BPD, and no participant met DSM-5 criteria for premenstrual dysphoric disorder (PMDD).ConclusionsFemales with BPD may be at elevated risk for perimenstrual worsening of emotional symptoms. Longitudinal studies with fine-grained hormonal measurement as well as hormonal experiments are needed to determine the pathophysiology of perimenstrual exacerbation in BPD.

scholarly journals Differential Effects of the Menstrual Cycle on Reactive and Proactive Aggression in Borderline Personality Disorder

2018 ◽  
Author(s):  
Jessica R. Peters ◽  
Sarah A. Owens ◽  
Katja M. Schmalenberger ◽  
Tory A. Eisenlohr-Moul
Keyword(s):  
Borderline Personality Disorder ◽  
Menstrual Cycle ◽  
Personality Disorder ◽  
Aggressive Behavior ◽  
Reactive Aggression ◽  
Borderline Personality ◽  
Proactive Aggression ◽  
Cycle Phase ◽  
Emotional Symptoms ◽  
Reactive And Proactive Aggression

AbstractBorderline personality disorder (BPD) is characterized by rapidly shifting symptoms, including intense anger and aggressive behavior. Understanding how fluctuations in ovarian hormones across the menstrual cycle may contribute to symptom instability is key for accurate assessment of BPD symptoms and effective interventions. Reactive and proactive aggression, as well as anger in and out, were assessed daily in 15 physically healthy, unmedicated naturally cycling female individuals without dysmenorrhea meeting criteria for BPD across 35 days. Urine LH surge and salivary progesterone were used to confirm ovulation and verify cycle phase. Cyclical worsening of symptoms was evaluated using multilevel models to evaluate symptom differences between cycle phases. Both forms of aggressive behavior demonstrated marked cycle effects, with reactive aggression highest during perimenstrual cycle phases, co-occurring with increases in anger in and out. In contrast, highest levels of proactive aggression were observed during the follicular and ovulatory phases, when emotional symptoms and anger were otherwise at lowest levels. These findings highlight the importance of identifying the function of aggression when considering potential psychological and biological influences. Naturally cycling individuals with BPD may be at elevated risk for perimenstrual worsening of a range of interpersonally reactive symptoms, including reactive aggression, whereas proactive aggression may occur more in phases characterized by less emotional and cognitive vulnerability and greater reward sensitivity. Research on aggression in this population should consider cycle effects. Cycling individuals with BPD attempting to reduce aggressive behavior may benefit from cycle-tracking to increase awareness of these effects and to develop appropriate strategies.

scholarly journals Perimenstrual exacerbation of symptoms in borderline personality disorder: evidence from multilevel models and the Carolina Premenstrual Assessment Scoring System

2018 ◽  
Vol 48 (12) ◽  
pp. 2100-2100 ◽  
Author(s):  
Tory A. Eisenlohr-Moul ◽  
Katja M. Schmalenberger ◽  
Sarah A. Owens ◽  
Jessica R. Peters ◽  
Danyelle N. Dawson ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Scoring System ◽  
Multilevel Models ◽  
Borderline Personality ◽  
Exacerbation Of Symptoms

Association between 5-HTTLPR and neuroticism in borderline personality disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 816-816
Author(s):  
H. Silva Ibarra ◽  
J. Villarroel Garrido ◽  
P. Iturra Constant ◽  
S. Jerez Concha ◽  
M.L. Bustamante Calderon ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Promoter Region ◽  
Correlation Method ◽  
Borderline Personality ◽  
Transporter Gene ◽  
Emotional Instability ◽  
Personality Dimension ◽  
Significant Difference ◽  
Axis I

Neuroticism is characterized by emotional instability and the tendency to experience negative emotions such as anger, anxiety and depressed mood. Subjects with borderline personality disorder (BPD) present this personality dimension as a temperamental core trait. There has been proposed that neuroticism can appropriately describe the most important characteristics of BPD. The polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) has been implicated in depression, anxiety and suicide. It is estimated that 5-HTTLPR polymorphism account to 7 to 9% of inherited variance of neuroticism in personality. The aim of this study is to evaluate the association between neuroticism and 5-HTTLPR polymorphism in BPD. We evaluate personality with NEO PI R inventory in 104 BPD subjects (76 female/28 male) that did not meet criteria for axis I diagnoses and other personality disorders. The genetic analysis of 5-HTTLPR were performed determining the presence of long and short alleles, subjects were grouped in long/long (LL) and S-carriers (LS+SS). Statistical analysis were tested with parametric and correlation method with Stata10. We found significant difference in neuroticism between the genotype groups (F = 8.57, p = 0.0004) and lower levels of neuroticism in LL than S-carriers. Female have higher neuroticism than male. 5-HTTLPR polymorphism explains 18.02% of inherited variance in neuroticism. The S-carriers had 11.9 times higher risk of presenting elevated neuroticism compared with LL. We conclude that there are relation between 5-HTTLPR polymorphism and neuroticism in BPD. These results should contribute to the genetic study of BPD.

scholarly journals Resilience as a predictor of Quality of Life in participants with borderline personality disorder before and after treatment.

2020 ◽  
Author(s):  
Verónica Guillén ◽  
Mireia Esplugues Tormo ◽  
Sara Fonseca-Baeza ◽  
Cristina Botella ◽  
Rosa Baños ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavioural Therapy ◽  
Borderline Personality ◽  
Clinical Population ◽  
Before And After ◽  
Quality Of Life Index ◽  
Clinically Significant

Abstract Background: Studies have suggested that psychotherapy improves the Quality of Life (QoL) of participants with Borderline Personality Disorder (BPD). However, there are no studies on the differential efficacy of treatments on the QoL of participants with BPD. Moreover, the relationship between QoL and resilience has rarely been studied in participants with BPD. Objectives: a) to examine whether people with BPD have worse QoL than the non-clinical population; b) to examine whether there are statistically significant differences between Dialectical Behavioural Therapy (DBT), Systems Training for Emotional Predictability and Problem Solving (STEPPS), or Cognitive Behavioural Therapy-Treatment at Usual (CBT-TAU) in the improvement of QoL; c) to examine whether participants show clinically significant improvements in QoL after treatment; d) to analyse whether resilience is associated with QoL before and after the BPD treatment; e) to analyse whether resilience is a predictor of QoL at pre-treatment and posttreatment. Method: The sample comprised 403 participants (n = 202 participants diagnosed with BPD and n = 201 non-clinical). Participants filled out the Quality of Life Index, Resilience Scale, and Beck Depression Inventory. The clinical participants received one of these possible treatments, DBT, STEPPS, or CBT-TAU. MANOVA and regression analyses were performed. Results: a) participants diagnosed with BPD had statistically significant lower resilience than the non-clinical population; b) all three forms of psychotherapy statistically improved QoL, but there were no statistically significant differences between DBT, STEPPS, and CBT-TAU in the improvement of QoL; c) participants did not show clinically significant improvements in QoL after treatment; d) resilience was associated with QoL before and after treatment; and e) resilience was a predictor of QoL before and after treatment. Conclusion: It is necessary to assess QoL and Resilience in studies on psychotherapy with BPD patients.

scholarly journals The case for cautious paternalism in the emergency management of patients with borderline personality disorder

2021 ◽  
pp. 1-3
Author(s):  
Giles Newton-Howes
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Sense Of Self ◽  
Well Being ◽  
Modern Medicine ◽  
Medical Intervention ◽  
Borderline Personality ◽  
Emotional Instability ◽  
Potential Threat ◽  
Patient’S Will

Summary Principlism is the dominant ethical theory in modern medicine. Autonomy is ‘king’ of the principles espoused and operationalised in consent. Consent is the mechanism by which all medical interactions occur. In borderline personality disorder (BPD) there is often a diffuse sense of self, emotional instability and impulsivity that can lead to medically dangerous non-suicidal self-injury, acute medical intervention and then a withdrawal of consent while the potential threat to the person's well-being remains high. Claims of lack of capacity lack veracity, and simply acting against the patient's will may be illegal. Understanding the will and preferences of patients is a step forward, but it is not always possible in time-sensitive situations. A cautious paternalism is therefore warranted both to ensure the patient's well-being while being honest as to the reasons for this, and to possibly build epistemic trust between the medical system and the patient with BPD.

scholarly journals Resilience as a predictor of Quality of Life in participants with borderline personality disorder before and after treatment.

2020 ◽  
Author(s):  
Verónica Guillén ◽  
Mireia Esplugues Tormo ◽  
Sara Fonseca-Baeza ◽  
Cristina Botella ◽  
Rosa Baños ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavioural Therapy ◽  
Borderline Personality ◽  
Clinical Population ◽  
Before And After ◽  
Quality Of Life Index ◽  
Clinically Significant

Abstract Background: Studies have suggested that psychotherapy improves the Quality of Life (QoL) of participants with Borderline Personality Disorder (BPD). However, there are no studies on the differential efficacy of treatments on the QoL of participants with BPD. Moreover, the relationship between QoL and resilience has rarely been studied in participants with BPD. Objectives: a) to examine whether people with BPD have worse QoL than the non-clinical population; b) to examine whether there are statistically significant differences between Dialectical Behavioural Therapy (DBT), Systems Training for Emotional Predictability and Problem Solving (STEPPS), or Cognitive Behavioural Therapy-Treatment at Usual (CBT-TAU) in the improvement of QoL; c) to examine whether participants show clinically significant improvements in QoL after treatment; d) to analyse whether resilience is associated with QoL before and after the BPD treatment; e) to analyse whether resilience is a predictor of QoL at pre-treatment and posttreatment. Method: The sample comprised 403 participants (n = 202 participants diagnosed with BPD and n = 201 non-clinical). Participants filled out the Quality of Life Index, Resilience Scale, and Beck Depression Inventory. The clinical participants received one of these possible treatments, DBT, STEPPS, or CBT-TAU. MANOVA and regression analyses were performed. Results: a) participants diagnosed with BPD had statistically significant lower resilience than the non-clinical population; b) all three forms of psychotherapy statistically improved QoL, but there were no statistically significant differences between DBT, STEPPS, and CBT-TAU in the improvement of QoL; c) participants did not show clinically significant improvements in QoL after treatment; d) resilience was associated with QoL before and after treatment; and e) resilience was a predictor of QoL before and after treatment. Conclusion: It is necessary to assess QoL and Resilience in studies on psychotherapy with BPD patients.

scholarly journals Resilience as a predictor of quality of life in participants with borderline personality disorder before and after treatment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Verónica Guillén ◽  
Mireia Esplugues Tormo ◽  
Sara Fonseca-Baeza ◽  
Cristina Botella ◽  
Rosa Baños ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavioural Therapy ◽  
Borderline Personality ◽  
Clinical Population ◽  
Before And After ◽  
Quality Of Life Index ◽  
Clinically Significant

Abstract Background Studies have suggested that psychotherapy improves the Quality of Life (QoL) of participants with Borderline Personality Disorder (BPD). However, there are no studies on the differential efficacy of treatments on the QoL of participants with BPD. Moreover, the relationship between QoL and resilience has rarely been studied in participants with BPD. Objectives: a) to examine whether people with BPD have worse QoL than the non-clinical population; b) to examine whether there are statistically significant differences between Dialectical Behavioural Therapy (DBT), Systems Training for Emotional Predictability and Problem Solving (STEPPS), or Cognitive Behavioural Therapy-Treatment at Usual (CBT-TAU) in the improvement of QoL; c) to examine whether participants show clinically significant improvements in QoL after treatment; d) to analyse whether resilience is associated with QoL before and after the BPD treatment; e) to analyse whether resilience is a predictor of QoL at pre-treatment and posttreatment. Method The sample comprised 403 participants (n = 202 participants diagnosed with BPD and n = 201 non-clinical). Participants filled out the Quality of Life Index, Resilience Scale, and Beck Depression Inventory. The clinical participants received one of these possible treatments, DBT, STEPPS, or CBT-TAU. MANOVA and regression analyses were performed. Results a) participants diagnosed with BPD had statistically significant lower resilience than the non-clinical population; b) all three forms of psychotherapy statistically improved QoL, but there were no statistically significant differences between DBT, STEPPS, and CBT-TAU in the improvement of QoL; c) participants did not show clinically significant improvements in QoL after treatment; d) resilience was associated with QoL before and after treatment; and e) resilience was a predictor of QoL before and after treatment. Conclusion It is necessary to assess QoL and Resilience in studies on psychotherapy with BPD patients.

scholarly journals The Statistical Specificity of Emotion Dynamics in Borderline Personality Disorder

2021 ◽  
pp. 1-22
Author(s):  
Marlies Houben ◽  
Merijn Mestdagh ◽  
Egon Dejonckheere ◽  
Jasmien Obbels ◽  
Pascal Sienaert ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Major Depressive Episode ◽  
Well Being ◽  
Borderline Personality ◽  
Emotional States ◽  
Emotional Instability ◽  
Control Groups ◽  
Major Depressive ◽  
Emotion Dynamics

Persons with borderline personality disorder (BPD) experience heightened emotional instability. Different components underlie instability, and the relation between instability and well-being could be confounded by average emotionality and within-person standard deviation across emotional states, reflecting variability. Therefore, the goal was to examine which pattern of emotion dynamics parsimoniously captures the emotional trajectories of persons with BPD. Forty persons with BPD, 38 clinical controls in a major depressive episode, and 40 healthy controls rated the intensity of their emotions 10 times a day for 1 week. After correction for differences in average emotionality, persons with BPD showed heightened emotional instability compared to both control groups. When additionally correcting for emotional variability, the authors found that instability indices did not differ between groups anymore. This shows that persons with BPD differ from control groups in the magnitude of emotional deviations from the emotional baseline, and not necessarily in the degree of abruptness of these deviations.

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