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Health Science Reports Jun 2024Borderline personality disorder (BPD) is a common psychiatric disorder associated with a high risk of suicide attempts, death by suicide, and non-suicidal self-injury...
The relationship between borderline personality disorder and self-injurious/suicidal behaviors in adolescents and young adults: A protocol for systematic review and meta-analysis.
BACKGROUND & AIMS
Borderline personality disorder (BPD) is a common psychiatric disorder associated with a high risk of suicide attempts, death by suicide, and non-suicidal self-injury (NSSI). A systematic and comprehensive understanding of the link between BPD and suicide and self-injury in adolescents and young adults is crucial for effective public health prevention strategies. This protocol outlines our approach to summarize the evidence on the association between BPD diagnosis and self-injurious/suicidal behaviors including death by suicide, nonfatal suicide attempts, NSSI, and self-harm behavior through a systematic review and meta-analysis.
METHODS
The protocol is registered (PROSPERO: CRD42022363329) and developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P)-2015 statement. We will conduct a comprehensive literature search using electronic databases including MEDLINE, EMBASE, SCOPUS, Web of Science, CINHAL, and PsycINFO. The review will include studies that meet the specific inclusion criteria and will be searched using multiple databases A meta-analysis will be conducted using a fixed-effects or random-effects approach based on the level of heterogeneity. Subgroup analysis and meta-regression will be performed if necessary.
CONCLUSION
This study is unique, as it is the first of its kind to systematically review and analyze the existing literature on this topic. The results of this study will provide important evidence on the magnitude of this relationship overall and in different subgroups, which can be used to inform the development of effective prevention and treatment strategies.
PubMed: 38863733
DOI: 10.1002/hsr2.2143 -
Scientific Reports Jun 2024The 18-item version of the Experiences in Close Relationships-revised (ECR-R-18) is a valid and reliable scale used among Thai adolescents. However, it revealed...
The 18-item version of the Experiences in Close Relationships-revised (ECR-R-18) is a valid and reliable scale used among Thai adolescents. However, it revealed problematic items that impacted the scale's internal consistency. The study aimed to achieve two objectives: (1) develop a new, shorter scale by retaining only highly loaded items equally between attachment anxiety and attachment avoidance, and (2) evaluate the psychometric properties of the shorter ECR-R version compared to the existing 18-item scale. Objective 1 was achieved through Study 1, involving 204 youths aged 16-18 years (64% female). All participants completed the 18-item ECR-R, and exploratory factor analysis was conducted to identify suitable items for the new ECR-R-AD. Objective 2 was fulfilled in Study 2, which included a total of 443 students in grades aged 15-18 years old (88% female) from Thai boarding schools in Northern Thailand. All participants completed both the 18-item ECR-R, and confirmatory factor analysis of both the existing 18-item and the new shorter scale was performed and compared. Additional measures including the Rosenberg Self-Esteem Scale, Perceived Stress Scale-10, and Relationship Questionnaire were completed alongside the ECR-R to assess convergent, discriminant, and criterion validity. The invariance test for the new ECR-R across genders was conducted using multigroup confirmatory factor analysis. For objective 1, Study 1 developed a new scale called "ECR-R-10-AD" with 10 items, comprising 5 for attachment anxiety and 5 for attachment avoidance. The McDonald's omega values were 0.866 for avoidance and 0.823 for anxiety subscales. The corrected correlation between the ECR-R-18 and ECR-R-10-AD was significant. For objective 2, Study 2 found that the first-order two-factor solution model fit the data best for the ECR-R-10-AD. Convergent, discriminant, and criterion validity with other measurements and invariance tests based on sex were established for the ECR-R-AD. The ECR-R-10-AD provided sufficient psychometric properties among Thai adolescents. Factorial validity, convergent validity, and measurement invariance were established. As the ECR-R-10-AD is brief, it can be administered with less burden. Limitations and future research were discussed.
Topics: Humans; Adolescent; Female; Male; Psychometrics; Thailand; Surveys and Questionnaires; Reproducibility of Results; Factor Analysis, Statistical; Anxiety; Interpersonal Relations; Southeast Asian People
PubMed: 38862724
DOI: 10.1038/s41598-024-64437-2 -
Frontiers in Public Health 2024Food Addiction (FA) and other well-known risk behavior as substance misuse tend to co-occur and may share similar risk and protective factors. The aim of this study was...
OBJECTIVE
Food Addiction (FA) and other well-known risk behavior as substance misuse tend to co-occur and may share similar risk and protective factors. The aim of this study was to assess the association between the diagnosis/severity of FA and psychosocial domains typically related to risk behavior syndrome in a large, nationally representative community sample of Generation Z underage Italian students.
METHOD
The sample consisted of 8,755 students (3,623 from middle schools, 5,132 from high schools). A short version of the Yale Food Addiction Scale 2.0 was administered to evaluate FA. Risk and protective factors related to demographic, personality, behavior, and family variables were examined. Stepwise multivariate logistic and linear regressions were conducted.
RESULTS
The prevalence of FA was 30.8%. Female gender, social anxiety and depression symptoms, social withdrawal risk, Internet gaming disorder, social media addiction, current substance use, social challenge engagement and experienced doxing boosted the chance of FA diagnosis, whereas eating fruit and vegetables, playing competitive sports and an average sleep duration of 7-8 h per night reduced these odds. FA severity was significantly and positively associated with trait impulsiveness, social anxiety and depressive symptoms, risk of social withdrawal, recent substance use, social media, and gaming addiction, doxing suffered and risky social challenges participation. Negative associations between the severity of FA and fruit and vegetable diet habits were found.
CONCLUSION
Our findings confirm that FA is widespread among Italian adolescents. The associations between the diagnosis and severity of FA and psychosocial risk factors for health, including, addictive and deviant behaviors related to digital misuse, suggest its belonging to the risk behavior constellation. Health promotion schemes based on a multicomponent strategy of intervention should consider the inclusion of FA and its psychosocial correlates.
Topics: Humans; Female; Male; Italy; Adolescent; Risk Factors; Food Addiction; Protective Factors; Problem Behavior; Students; Surveys and Questionnaires; Prevalence; Child
PubMed: 38859893
DOI: 10.3389/fpubh.2024.1414110 -
Journal of Clinical Medicine Research May 2024Attrition is an important problem in clinical practice and research. However, the predictors of dropping out from cognitive behavioral therapy (CBT) for panic disorder...
BACKGROUND
Attrition is an important problem in clinical practice and research. However, the predictors of dropping out from cognitive behavioral therapy (CBT) for panic disorder (PD) are not fully understood. In this study, we aimed to build a dropout prediction model for CBT for PD using machine learning (ML) algorithms.
METHODS
We treated 208 patients with PD applying group CBT. From baseline data, the prediction analysis was carried out using two ML algorithms, random forest and light gradient boosting machine. The baseline data included five personality dimensions in NEO Five Factor Index, depression subscale of Symptom Checklist-90 Revised, age, sex, and Panic Disorder Severity Scale.
RESULTS
Random forest identified dropout during CBT for PD showing that the accuracy of prediction was 88%. Light gradient boosting machine showed that the accuracy was 85%.
CONCLUSIONS
The ML algorithms could detect dropout after CBT for PD with relatively high accuracy. For the purpose of clinical decision-making, we could use this ML method. This study was conducted as a naturalistic study in a routine clinical setting. Therefore, our results in ML approach could be generalized to regular clinical settings.
PubMed: 38855785
DOI: 10.14740/jocmr5167 -
Frontiers in Psychiatry 2024Writing involves the activation of different processing modes than reading comprehension, and therefore the level of activation varies depending on the moment and the...
ABSTRACT
Writing involves the activation of different processing modes than reading comprehension, and therefore the level of activation varies depending on the moment and the task.
OBJECTIVES
to analyze the profiles in terms of the proposed coding from the PROESC in terms of personality disorders [Antisocial Personality Disorder (ASPD) with drugs possession and consumption crimes (DPCC) and Obsessive-Compulsive Personality Disorder (OCPD)] with gender violence crimes (GVC) in the prisoners.
DESIGN
The sample was composed of 194 men. The participants were divided into two groups. Group 1 (ASPD; DPCC) consisted of 81 men, and Group 2 (OCPD; GVC) consisted of 113 men.
MAIN OUTCOME MEASURES
They completed the Demographic, Offense, and Behavioral Interview in Institutions, the International Personality Disorders Examination (IPDE), and Writing Processes Evaluation Battery (PROESC).
RESULTS
Group 2 made more mistake than Group 1 in narratives tasks.
CONCLUSION
Participants know phoneme-grapheme correspondence rules, language disturbances of a reiterative and persistent nature may appear in those who show compulsive behavior.
PubMed: 38855649
DOI: 10.3389/fpsyt.2024.1391463 -
Industrial Psychiatry Journal 2024Youth involvement in gaming has become an important concern for mental health professionals due to its significant impact on functionality and relationships. However,...
BACKGROUND
Youth involvement in gaming has become an important concern for mental health professionals due to its significant impact on functionality and relationships. However, the gaming motives and associated family relationships and personality traits in the Indian context are poorly understood.
AIM
The study examined problematic online gaming, including Internet gaming disorder in connection to gaming motives and personality, especially as they impact family relationships among Indian youth.
MATERIALS AND METHODS
The study consisted of 179 participants (86 males; 93 females) with the age range of 18-25 years who were involved in Internet gaming in the last 1 year. The subjects were recruited using an online survey. Tools used were brief and included the Gaming Usage Questionnaire, Internet Gaming Disorder Scale-Short-Form, Motivation for Online Gaming Questionnaire UCLA Loneliness Scale, Sheehan Disability Scale, Brief Family Relationships Questionnaire, and MINI International Personality Item Pool.
RESULTS
The mean age of the participants was 21.99 ± 2.202 years. A stepwise multivariate regression analysis indicated that escape and competition motives, low cohesion in family relationships, low level of conscientiousness, and low level of intellect/imagination contributed to problematic gaming behaviors.
CONCLUSIONS
The study established a relationship between gaming motives and both internal and external factors associated with problematic online gaming. Generalizing the findings across a larger youth population would help in developing informed preventive measures to reduce the risk of developing a gaming disorder.
PubMed: 38853819
DOI: 10.4103/ipj.ipj_123_23 -
BMC Psychiatry Jun 2024Several studies have observed that mentalization-based treatment (MBT) is an effective treatment for borderline personality disorder (BPD), but its effectiveness for...
BACKGROUND
Several studies have observed that mentalization-based treatment (MBT) is an effective treatment for borderline personality disorder (BPD), but its effectiveness for other personality disorders (PDs) has hardly been examined. Additionally, the evidence supporting the claim that MBT improves mentalizing capacity is scarce. The present study examined whether (i) patients with a broad range of PDs enrolled in an MBT program would improve on several outcome measures (ii) mentalizing capacity would improve over time; (iii) patients with BPD would improve more than those with non-borderline PDs.
METHOD
Personality disorders, psychiatric symptoms, social functioning, maladaptive personality functioning and mentalizing capacity were measured in a group of individuals with various PDs (n = 46) that received MBT. Assessments were made at baseline and after 6, 12, and 18 months of treatment. The severity of psychiatric symptoms, measured using the Outcome Questionnaire 45, was the primary outcome variable.
RESULTS
Overall, enrollment in the MBT program was associated with a decrease in psychiatric symptoms and an improvement of personality functioning, social functioning for a mixed group of PDs (all p's .01). Bigger effect sizes were observed for BPD patients (n = 25) than for patients with non-BPD (n = 21), but the difference failed to reach statistical significance (p = 0.06). A primary analysis showed that the decrease in psychiatric symptoms was significant in BPD patients (p = 0.01), not in non-BPD (p = 0.19) patients. However, a sufficiently powered secondary analysis with imputed data showed that non-BPD patients reported a significant decrease in psychiatric symptoms too (p = 0.01). Mentalizing capacity of the whole group improved over time (d = .68 on the Toronto Alexithymia Scale and 1.46 on the Social Cognition and Object Relations System).
DISCUSSION
These results suggest that MBT coincides with symptomatic and functional improvement across a broad range of PDs and shows that MBT is associated with improvements in mentalizing capacity. As the study is not experimental in design, we cannot make causal claims.
CONCLUSION
Mentalization-based treatment may be an effective treatment for patients with a broad range of PDs.
TRIAL REGISTRATION
The study design was approved by the Leiden University Ethical Committee.
Topics: Humans; Female; Adult; Male; Mentalization; Personality Disorders; Borderline Personality Disorder; Middle Aged; Treatment Outcome; Young Adult; Theory of Mind
PubMed: 38849750
DOI: 10.1186/s12888-024-05865-2 -
Borderline Personality Disorder and... Jun 2024The physical and psychological benefits of physical activity are well-known, and physical activity has been proven to be a helpful adjunct to psychotherapeutic treatment...
BACKGROUND
The physical and psychological benefits of physical activity are well-known, and physical activity has been proven to be a helpful adjunct to psychotherapeutic treatment for many symptomatic disorders, including mood and anxiety disorders. The current study explores physical inactivity levels in patients with borderline personality disorder (BPD). The first aim of this study is to describe the 12-year course of physical inactivity in patients with BPD. The second aim is to examine predictors of physical inactivity, including adversity experiences, comorbid symptomatic (formerly axis I) disorders, medical disorders, and demographic factors.
METHODS
Two hundred and forty-five patients with BPD were interviewed seven times over 12-years of prospective follow-up as part of the McLean Study of Adult Development (MSAD). Patients were categorized as ever-recovered (i.e., patient had experienced a symptomatic and psychosocial recovery from BPD) or never-recovered. At each follow-up, patients reported physical activity levels (minutes of exercise per week) via a semi-structured interview- the Medical History and Services Utilization Interview (MHSUI). Data was collected from June 1992 to December 2018.
RESULTS
Never-recovered patients with BPD were significantly more inactive than their ever-recovered counterparts (p < 0.001). These rates of inactivity remained stable over time for both groups. Two significant multivariate predictors of inactivity were found: obesity (p = 0.003) and PTSD (p < 0.001).
CONCLUSIONS
Non-recovered BPD patients are more likely to be inactive than patients who have recovered. Both clinical and medical factors appear to contribute to inactivity levels in patients with BPD.
PubMed: 38845011
DOI: 10.1186/s40479-024-00253-4 -
Turk Psikiyatri Dergisi = Turkish... 2024The validity and clinical significance of the characteristics of borderline personality disorder (BPD) in adolescents are increasingly being recognized. The persistence... (Review)
Review
The validity and clinical significance of the characteristics of borderline personality disorder (BPD) in adolescents are increasingly being recognized. The persistence of BPD characteristics in adolescence is high and is associated with negative interpersonal, academic, professional, and financial outcomes. In the literature, BPD characteristics observed in children and adolescents are explained with psychodynamic theories, developmental models, and evolutionary approaches. Emotional dysregulation, interpersonal dysfunction, impulsivity, and self-harming behavior, negative life events, temperament characteristics, neuropsychological dysfunctions, neuroanatomical, genetic, hormonal, and immunological factors may play a role in BPD etiopathogenesis. This review aims to address different approaches and relevant factors for the development of BPD. The articles published between 1968-2021 in the PubMed database were reviewed, and prominent studies were selected for evaluation. The importance of invalidating environment, epistemic freezing and hypermentalization, complex or attachment trauma is emphasized in psychodynamic and developmental literature. In the evolutionary approach, on the other hand, romantic relationships and the onset of reproduction are emphasized as the reason for the emergence of symptoms during adolescence, and it is argued that BPD is related to the rapid life history strategy. It is stated that a decrease in volume in the orbitofrontal cortex and anterior cingulate cortex, which are involved in top-down emotional processing, and an increase in the activity of thalamus and hippocampus regions, which are involved in bottom-up emotional processing are observed in adolescents with BPD characteristics when compared to healthy controls. It is thought that the increase in activation in the superior temporal gyrus and precuneus observed in adolescents with BPD features is a neural indicator of hypermentalization, and the increase in activation in the insula is a neural indicator of social pain. It has been reported that the decrease in resting heart rate and the increase in heart rate variability observed in adolescents with BPD symptoms are associated with the activation of the parasympathetic system. BPD in adolescents is a disorder that challenges clinicians in terms of diagnosis, differential diagnosis, and treatment. It is crucial to evaluate the factors related to etiopathogenesis in BPD in a multifaceted and detailed manner. Keywords: Borderline Personality Disorder, Difficulty in Emotion Regulation, Mentalization, Trauma, Self-harming Behavior, Temperamental Characteristics.
Topics: Humans; Borderline Personality Disorder; Adolescent; Child
PubMed: 38842155
DOI: 10.5080/u26852