Substance Misuse Is Associated With Increased Psychiatric Severity Among Treatment-Seeking Individuals With Borderline Personality Disorder

2018 ◽  
Vol 32 (5) ◽  
pp. 694-708 ◽  
Author(s):  
Laura M. Heath ◽  
Lise Laporte ◽  
Joel Paris ◽  
Kevin Hamdullahpur ◽  
Kathryn J. Gill
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Substance Misuse ◽  
Severity Index ◽  
Borderline Personality ◽  
Addiction Severity Index ◽  
Psychiatric Severity ◽  
High Prevalence ◽  
Almost All ◽  
The Impact

Despite high prevalence rates of concurrent borderline personality disorder (BPD) and substance use disorders (SUDs), little is known about the impact of substance misuse on the presentation of BPD. Sixty-five individuals with BPD were assessed at intake and at 3- and 6-month follow-up. Assessment included validated instruments such as the Addiction Severity Index and the Revised Symptom Checklist (SCL-90-R). Over half (58.5%) of individuals entering treatment were currently misusing substances. Substance misuse was associated with more legal and employment problems, greater mood disturbance, impulsivity, and psychiatric severity, including almost all SCL-90-R subscales. For the majority of patients (58%), there was little change in substance misuse post-treatment. The high prevalence of substance misuse and its association with psychiatric severity among individuals with BPD suggest that substance misuse should be a targeted behavior during treatment, and further specialized interventions are needed for individuals with comorbid BPD and SUD.

scholarly journals Paliperidone ER in the Treatment of Borderline Personality Disorder: A Pilot Study of Efficacy and Tolerability

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Silvio Bellino ◽  
Paola Bozzatello ◽  
Camilla Rinaldi ◽  
Filippo Bogetto
Keyword(s):  
Borderline Personality Disorder ◽  
Pilot Study ◽  
Personality Disorder ◽  
Adverse Events ◽  
Mechanism Of Action ◽  
Severity Index ◽  
Borderline Personality ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Dsm Iv

Antipsychotics are recommended for the treatment of impulsive dyscontrol and cognitive perceptual symptoms of borderline personality disorder (BPD). Three reports supported the efficacy of oral risperidone on BPD psychopathology. Paliperidone ER is the metabolite of risperidone with a similar mechanism of action, and its osmotic release reduces plasmatic fluctuations and antidopaminergic effects. The aim of this study is to evaluate efficacy and safety of paliperidone ER in BPD patients. 18 outpatients with a DSM-IV-TR diagnosis of BPD were treated for 12 weeks with paliperidone ER (3–6 mg/day). They were assessed at baseline, week 4, and week 12, using the CGI-Severity item, the BPRS, the HDRS, the HARS, the SOFAS, the BPD Severity Index (BPDSI), and the Barratt Impulsiveness Scale (BIS-11). Adverse events were evaluated with the DOTES. Paliperidone ER was shown to be effective and well tolerated in reducing severity of global symptomatology and specific BPD symptoms, such as impulsive dyscontrol, anger, and cognitive-perceptual disturbances. Results need to be replicated in controlled trials.

Differential Change of Borderline Personality Disorder Traits During Dialectical Behavior Therapy for Adolescents

2019 ◽  
Vol 33 (1) ◽  
pp. 119-134 ◽  
Author(s):  
Arne Buerger ◽  
Gloria Fischer-Waldschmidt ◽  
Florian Hammerle ◽  
Kristin von Auer ◽  
Peter Parzer ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Suicide Attempts ◽  
Treatment Options ◽  
Skills Training ◽  
Borderline Personality ◽  
Secondary Outcomes ◽  
The Impact

Despite the expansion of treatment options for adults with borderline personality disorder (BPD), research on treatment options for adolescent BPD is scarce. The aim of this study was to investigate the impact of dialectical behavior therapy for adolescents (DBT-A) on the individual trait level as primary outcome; and the frequency of suicide attempts and nonsuicidal self-injury, self-reported BPD core pathology, and general psychopathology as secondary outcomes. Seventy-two adolescents (aged 12–17 years) with full- or subsyndromal BPD were treated with DBT-A (25 single sessions, 20 sessions of skills training), and 13 patients (18.1%) withdrew during treatment. From baseline to post-treatment, the number of BPD traits decreased significantly (p ≤ .001). All secondary outcomes decreased significantly as well (p ≤ .001). Results of this uncontrolled study suggest that beside self-harm, DBT-A may also have a beneficial impact on other features of BPD.

Access to Evidence-Based Services for Individuals With Borderline Personality Disorder

2019 ◽  
pp. 155-176
Author(s):  
Peter King ◽  
Jennifer M. Martin
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Sexual Assault ◽  
Treatment Outcomes ◽  
Psychological Factors ◽  
Borderline Personality ◽  
Evidence Based ◽  
International Literature ◽  
High Prevalence ◽  
Key Features

This chapter outlines the key features of the diagnosis of borderline personality disorder. This is a diagnosis that has attracted significant levels of stigma and has generally been viewed as difficult to treat. This has resulted in often inadequate service responses for people experiencing high levels of distress. Increased understanding is facilitated by exploring precipitating factors leading to this diagnosis, including invalidating and often traumatizing environments. Available evidence from Australian and international literature is considered, with main treatments identified to inform improved treatment outcomes. The need for attention to biological, psychological factors is highlighted and in particular acknowledgment of the high prevalence of trauma, particularly childhood sexual assault, amongst the mostly women who are given this diagnosis.

scholarly journals The Italian Version of the Borderline Personality Disorder Severity Index IV: Psychometric Properties, Clinical Usefulness, and Possible Diagnostic Implications

2018 ◽  
Vol 32 (2) ◽  
pp. 207-219 ◽  
Author(s):  
Ester di Giacomo ◽  
Arnoud Arntz ◽  
Maria Fotiadou ◽  
Eugenio Aguglia ◽  
Lavinia Barone ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychometric Properties ◽  
Clinical Presentation ◽  
Severity Index ◽  
Borderline Personality ◽  
Structured Interviews ◽  
Italian Version ◽  
Good Internal Consistency ◽  
First Time

Borderline personality disorder (BPD) has a core embodied in affective and behavioral dysregulations, impulsivity, and relational disturbance. Clinical presentation might be heterogeneous due to a combination of different symptoms listed in the DSM-5. Clinical diagnosis and assessment of the severity of manifestations might be improved through the administration of structured interviews such as the Borderline Personality Disorder Severity Index, 4th edition (BPDSI-IV). The psychometric properties of the Italian version of the BPDSI-IV were examined for the first time in 248 patients affected by BPD and 113 patients affected by bipolar disorder, proving to be a valid and accurate instrument with good internal consistency and high accuracy. The Italian version also demonstrates significant validity in the discrimination between these clinical groups (p < 5001).

Neuropsychological function in bulimia with comorbid borderline personality disorder and depression

2006 ◽  
Vol 18 (3-4) ◽  
pp. 162-167 ◽  
Author(s):  
Cecilia M. Bourke ◽  
Richard J. Porter ◽  
Patrick Sullivan ◽  
Cynthia M. Bulik ◽  
Frances A. Carter ◽  
...  
Keyword(s):  
Executive Function ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Neuropsychological Tests ◽  
Neuropsychological Test ◽  
Borderline Personality ◽  
Neuropsychological Function ◽  
Test Results ◽  
Trail Making ◽  
The Impact

Background:In bulimia nervosa (BN), borderline personality disorder (BPD) and major depression (MDD) are frequently comorbid conditions. Executive function has been found to be impaired in BPD and MDD, but the impact of comorbidity on neuropsychological function has rarely been investigated.Objective:To investigate neuropsychological function in BN with a focus on comorbid BPD and MDD.Methods:One hundred forty-four medication-free female patients entering a study of psychological treatments for BN performed a brief battery of neuropsychological tests. Comorbid MDD and BPD were systematically identified using standard interviews. Neuropsychological test results were compared.Results:Forty-one subjects had comorbid BPD and 35 had comorbid MDD, while 15 had both. There was no effect of comorbid MDD, but there was a significant effect of BPD and a significant interaction between the diagnosis of MDD and BPD on executive tasks (trail making and Stroop). Thus, compared with subjects without BPD, subjects with BPD performed significantly worse on tests of executive function, while the group with both comorbidities performed even worse.Conclusions:There appears to be an additive effect of BPD and MDD resulting in impaired executive neuropsychological function. Future studies on either disorder and on BN should examine and account for the effect of comorbidity.

Impact of Childhood Maltreatment in Borderline Personality Disorder on Treatment Response to Intensive Dialectical Behavior Therapy

2019 ◽  
pp. 1-19 ◽  
Author(s):  
Sebastian Euler ◽  
Esther Stalujanis ◽  
Hannah J. Lindenmeyer ◽  
Rosetta Nicastro ◽  
Ueli Kramer ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Treatment Response ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Childhood Maltreatment ◽  
Emotional Abuse ◽  
Borderline Personality ◽  
The Impact

Childhood maltreatment (CM), including emotional, physical, and sexual abuse and emotional and physical neglect, is associated with severity of borderline personality disorder (BPD). However, knowledge on the impact of CM on treatment response is scarce. The authors investigated whether self-reported CM or one of its subtypes affected treatment retention, depressive symptoms, and impulsivity throughout short-term intensive dialectical behavior therapy (I-DBT) in 333 patients with BPD. Data were analyzed with linear and logistic regressions and linear mixed models, using a Bayesian approach. Patients who reported childhood emotional abuse had a higher dropout rate, whereas it was lower in patients who reported childhood emotional neglect. Emotional neglect predicted a greater decrease of depressive symptoms, and global CM predicted a greater decrease of impulsivity. The authors concluded that patients with BPD who experienced CM might benefit from I-DBT in specific symptom domains. Nonetheless, the impact of emotional abuse on higher dropout needs to be considered.

Impact of dialectical behavior therapy on incidence of suicidal attempts and non-suicidal self injury among a sample of Egyptian borderline personality disorder patients

2016 ◽  
Vol 33 (S1) ◽  
pp. s270-s270
Author(s):  
A. Abdelkarim ◽  
D. Nagui Rizk ◽  
M. Esmaiel ◽  
H. Helal
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Borderline Personality ◽  
Language And Culture ◽  
Self Injury ◽  
Suicidal Attempts ◽  
Competing Interest ◽  
Almost All

IntroductionDialectical behavior therapy (DBT) is a comprehensive psycho-social treatment developed by Marsha Linehan and originally designed for persons meeting criteria for borderline personality disorder (BPD). DBT is considered as a standard evidence based treatment for suicidal BPD patients in most international guidelines. Although its effectiveness has been proved in multiple studies across different patient populations but almost all the research was conducted in North American or European countries. The current study was the first trial to apply DBT in Egypt with a different language and culture than where the treatment was originally developed.ObjectivesAssessment of incidence of suicidal attempts and non-suicidal self-injury (NSSI) among a sample of Egyptian BPD patients enrolled in an outpatient DBT program.AimThe aim of the current study was to estimate impact of comprehensive DBT on suicidal attempts and NSSI when applied to Egyptian BPD patients.MethodsTwenty-five BPD patients, 4 males and 21 females, were included in a comprehensive outpatient DBT program for one year and incidence of suicidal attempts and NSSI were calculated.ResultsFive patients only attempted suicide again with an incidence of 20% and a mean of one attempt/patient. Seven patients attempted NSSI with an incidence of 28%, an overall 22 incidents and a mean of 3 incidents/patient.ConclusionAlthough this was the first time to apply DBT in an Egyptian population, DBT proved to be an effective psycho-therapeutic intervention for suicidal BPD patients across regardless of different language or culture.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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