Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder Using Exploratory Structural Equation Modeling in a Trauma-Exposed Urban Sample

2021 ◽  
Author(s):  
Abigail Powers ◽  
Jessica M. Petri ◽  
Chelsea Sleep ◽  
Yara Mekawi ◽  
Emma C. Lathan ◽  
...  
Keyword(s):  
Structural Equation Modeling ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Structural Equation ◽  
Borderline Personality ◽  
Equation Modeling ◽  
Complex Ptsd ◽  
Exploratory Structural Equation Modeling ◽  
Urban Sample

Progression from interpersonal problems to suicidal ideation and suicidal behavior in borderline personality disorder

2020 ◽  
Author(s):  
Timothy Allen ◽  
Michael Hallquist ◽  
Aidan G.C. Wright ◽  
Alexandre Dombrovski
Keyword(s):  
Borderline Personality Disorder ◽  
Suicidal Ideation ◽  
Personality Disorder ◽  
Negative Affect ◽  
Structural Equation ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Equation Modeling ◽  
Interpersonal Dysfunction ◽  
Suicidal Crisis

Importance: Clinicians treating borderline personality disorder (BPD) are often faced with the difficult challenge of assessing when, and for whom, risk for suicide is greatest. Addressing this dilemma requires longitudinal, prospective data from high-risk samples with an elevated base rate of suicide attempts.Objective: To test whether dispositional characteristics modulate the pathway from interpersonal dysfunction to suicide in BPD. Design: This longitudinal, observational study was conducted between 1990 and 2020. Data were analyzed between April and July 2020. Participants were assessed annually for up to 30 years (mean number of follow-ups = 7.82). Setting: Participants were recruited from inpatient, outpatient, and community referral sources.Participants: 458 individuals (Mean age = 28.59, 77% female) diagnosed with BPD.Main Outcomes and Measures: Presence or absence of a suicide attempt within one year of each follow-up assessment. Multilevel structural equation modeling was used to 1) examine longitudinal, within-person transitions from interpersonal dysfunction to suicidal ideation to suicide attempts (i.e., the [I]nterpersonal-[I]deation-[A]ttempt pathway); and 2) evaluate whether two maladaptive personality dimensions, negative affect and disinhibition, moderated these transitions.Results: At the within-person level, there was support for the I-I-A pathway: suicidal ideation accounted for the association between interpersonal dysfunction and suicide attempts. Personality further moderated each component of the I-I-A pathway: negative affect was associated with a stronger coupling between interpersonal dysfunction and ideation; and disinhibition was associated with a stronger coupling between ideation and attempts. Conclusions and Relevance: The escalation from interpersonal difficulties to a suicidal crisis in BPD involves two psychologically distinct process. An internalizing process links interpersonal dysfunction to suicidal ideation and is facilitated by trait negative. An additional externalizing process links suicidal ideation to suicide attempts, and is facilitated by trait disinhibition. Assessment of these intra- and interindividual risk factors may inform clinical decisions about when, and for whom, crisis intervention is necessary.

scholarly journals Momentary interpersonal processes of suicidal surges in borderline personality disorder

2020 ◽  
pp. 1-11
Author(s):  
Aleksandra Kaurin ◽  
Alexandre Y. Dombrovski ◽  
Michael N. Hallquist ◽  
Aidan G. C. Wright
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Structural Equation ◽  
Borderline Personality ◽  
Equation Modeling ◽  
Interpersonal Processes ◽  
Interpersonal Perceptions ◽  
Affective Dysregulation ◽  
Assessment Protocol ◽  
Suicidal Crisis

Abstract Background Suicide rates are high in borderline personality disorder (BPD) where interpersonal problems trigger intense affective dysregulation and impulses to act on suicidal thoughts. To date, however, no study has examined how interpersonal stressors contribute to momentary within-person links among affect and impulsivity with suicidal ideation (SI), and how those links vary over time in people's daily lives. Methods A total of 153 individuals diagnosed with BPD and 52 healthy controls completed a 21-day ecological momentary assessment protocol. Of these 153 individuals with BPD, 105 had a history of suicide attempts. Multilevel structural equation modeling was used to examine dynamic links among interpersonal perceptions, affect, state impulsivity, and suicidal intent. Results Aggregated across interactions, lower perceived warmth in others was associated with SI. This direct relationship, however, did not extend to momentary within-person associations. Instead, interpersonal conflicts were linked to SI indirectly via greater negative affect and lower positive affect. While a robust within-person link between interpersonal perceptions and impulsivity emerged, impulsivity did not account for the relationship between interpersonal perceptions and SI. Conclusion This intensive longitudinal study illustrates momentary interpersonal signatures of an emerging suicidal crisis. Among people with BPD at high risk for suicide, interpersonal triggers initiate a cascade of affective dysregulation, which in turn gives rise to SI.

Negative Affectivity and Disinhibition as Moderators of an Interpersonal Pathway to Suicidal Behavior in Borderline Personality Disorder

2022 ◽  
pp. 216770262110566
Author(s):  
Timothy A. Allen ◽  
Michael N. Hallquist ◽  
Aidan G. C. Wright ◽  
Alexandre Y. Dombrovski
Keyword(s):  
Borderline Personality Disorder ◽  
Suicidal Ideation ◽  
Personality Disorder ◽  
Suicidal Behavior ◽  
Structural Equation ◽  
Suicide Attempts ◽  
Negative Affectivity ◽  
Borderline Personality ◽  
Equation Modeling ◽  
Interpersonal Dysfunction

In this longitudinal study, we examined whether personality traits moderate the link between interpersonal dysfunction and suicidal behavior in a high-risk sample of 458 individuals diagnosed with borderline personality disorder. Participants were assessed annually for up to 30 years (mean number of follow-ups = 7.82). Using multilevel structural equation modeling, we examined (a) longitudinal, within-persons relationships among interpersonal dysfunction, suicidal ideation, and suicide attempts and (b) moderation of these relationships by negative affectivity and disinhibition. Negative affectivity predicted a stronger within-persons coupling between interpersonal dysfunction and suicidal ideation. Disinhibition predicted a stronger coupling between ideation and suicide attempts. Assessing negative affectivity and disinhibition in a treatment setting may guide clinician vigilance toward people at highest risk for interpersonally triggered suicidal behaviors.

scholarly journals Within- and Between-Persons Effects of Self-Esteem and Affective State as Antecedents and Consequences of Dysfunctional Behaviors in the Everyday Lives of Patients With Borderline Personality Disorder

2020 ◽  
Vol 8 (3) ◽  
pp. 428-449 ◽  
Author(s):  
Philip S. Santangelo ◽  
Jana Holtmann ◽  
Georg Hosoya ◽  
Martin Bohus ◽  
Tobias D. Kockler ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Structural Equation ◽  
Affective State ◽  
Emotional Valence ◽  
Self Esteem ◽  
Borderline Personality ◽  
Equation Modeling ◽  
The Everyday ◽  
Antecedents And Consequences

Dysfunctional behaviors are conceptualized as maladaptive affective coping attempts in borderline personality disorder (BPD). The recent benefits-and-barriers model extended the affective function assumption by adding self-esteem as a barrier to engaging in dysfunctional behaviors. Patients with BPD ( N = 119) carried e-diaries to report their current self-esteem, emotional valence, tense arousal, and whether they engaged in dysfunctional behaviors 12 times a day for 4 days. Dynamic structural equation modeling revealed that on the within-person level, high momentary negative affect predicted dysfunctional behaviors, and on the between-person level, low trait self-esteem predicted dysfunctional behaviors. We also found an association between engaging in dysfunctional behaviors and momentary self-esteem and trait levels of valence and tense arousal. Moreover, our results indicate a deterioration of, rather than relief from, negative affective state after dysfunctional behaviors. These findings highlight the importance of emotion-regulation skills and reestablishing a positive self-view as important treatment targets to reduce dysfunctional behaviors in BPD.

scholarly journals Psychosocial functioning in adolescents with non-suicidal self-injury: the roles of childhood maltreatment, borderline personality disorder and depression

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Denisa Ghinea ◽  
Anna Fuchs ◽  
Peter Parzer ◽  
Julian Koenig ◽  
Franz Resch ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Childhood Maltreatment ◽  
Psychosocial Functioning ◽  
Structural Equation ◽  
Borderline Personality ◽  
Equation Modeling ◽  
Depression Severity ◽  
Psychosocial Impairment ◽  
Self Injury

Abstract Background There is a lack of studies examining psychosocial functioning in patients with non-suicidal self-injury (NSSI), especially in adolescents, and rates of impaired functioning in existing literature vary considerably. These variations may be attributable to further risk factors that influence psychosocial functioning. Thus, the aim of the study was to examine whether adolescent NSSI patients with childhood maltreatment (CM), a known risk factor for lower psychosocial functioning, may differ from adolescent NSSI patients without CM, and whether these differences may be explained by the severity of comorbid disorders. Specifically, we examined whether severity of borderline personality disorder (BPD), depression and posttraumatic stress disorder may explain differences in psychosocial functioning in NSSI patients with and without CM. Methods Data of 368 adolescents with NSSI disorder from an outpatient clinic were analyzed using structural equation modeling. Clinicans’ rating of the Global Assessment of Functioning Scale (GAF) was collected, in addition to clinical interviews. Results Results indicate that GAF scores were lower among NSSI patients with CM and that the difference in psychosocial functioning between these groups was explained by BPD and depression severity. Conclusions Psychosocial functioning in NSSI patients varies depending on whether they have experienced CM or not. Specifically, these differences seem to be attributable to higher BPD and depression severity in adolescent NSSI patients with CM. Clinicians should ensure to assess CM and focus on BPD and depression severity in this population. Treatment of BPD and depression may notably reduce psychosocial impairment in NSSI patients with CM.

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