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CMAJ : Canadian Medical Association... Nov 2012
Review
Topics: Borderline Personality Disorder; Diagnosis, Differential; Evidence-Based Medicine; Female; Follow-Up Studies; Humans; Male; Neuropsychological Tests; Personality Disorders; Physician-Patient Relations; Psychiatric Status Rating Scales; Risk Assessment; Severity of Illness Index; Truth Disclosure
PubMed: 22988153
DOI: 10.1503/cmaj.090618 -
Dialogues in Clinical Neuroscience Jun 2013It is evident that the classification of personality disorder is shifting toward a dimensional trait model and, more specifically, the five-factor model (FFM). The... (Review)
Review
It is evident that the classification of personality disorder is shifting toward a dimensional trait model and, more specifically, the five-factor model (FFM). The purpose of this paper is to provide an overview of the FFM of personality disorder. It will begin with a description of this dimensional model of normal and abnormal personality functioning, followed by a comparison with a proposal for future revisions to DSM-5 and a discussion of its potential advantages as an integrative hierarchical model of normal and abnormal personality structure.
Topics: Diagnostic and Statistical Manual of Mental Disorders; Humans; Models, Psychological; Personality; Personality Disorders
PubMed: 24174888
DOI: 10.31887/DCNS.2013.15.2/ttrull -
Psychopathology 2021This article describes the mereological constitution of contents in the intentional acts of people affected by borderline personality disorder (BPD) or emotionally... (Review)
Review
This article describes the mereological constitution of contents in the intentional acts of people affected by borderline personality disorder (BPD) or emotionally unstable personality disorder (EUPD) in order to shed light on the origin of the emotional instability characterizing this disorder. The article will first discuss the emotional cycle of people affected by this disorder; second, it will focus on the mereological aspect of the meaning-making
1 experience in the intentional act; third, it will show how this meaning-making experience usually interacts with axiological2 qualities that affect the continuity of their sense of reality. From the investigation, it emerges that the mereological constitution of contents occurs in a way that is disruptive of the continuity of BPD/EUPDs' interaffective lifeworld as it generates intersubjective disturbances on the axiological, logical, and ontological levels. On this basis, as a concluding suggestion, the paper will propose an alternative way to approach the problem, soothe the disturbance, and encourage integration.Topics: Affective Symptoms; Borderline Personality Disorder; Emotions; Humans; Personality; Personality Disorders
PubMed: 34371504
DOI: 10.1159/000517932 -
Experimental and Clinical... Aug 2012There is a high degree of comorbidity between borderline personality disorder (BPD) and alcohol use disorders (AUDs). There is some evidence that this pattern of... (Review)
Review
There is a high degree of comorbidity between borderline personality disorder (BPD) and alcohol use disorders (AUDs). There is some evidence that this pattern of comorbidity may be associated with poorer prognosis. Although there are many different psychotherapeutic and pharmacological treatments for BPD and AUDs when they occur alone, there are very few treatment options when they occur together. The objective of this article was to review the existing treatment options-both psychotherapeutic and pharmacological-for patients with dual diagnoses of BPD and AUDs and to explore alternative treatment options that warrant further study. There have been a number of studies that have examined the efficacy of specific psychotherapies targeting drinking among patients with comorbid BPD; however, their efficacy in reducing BPD symptoms is unknown. There are also three psychotherapies that were specifically developed for patients with BPD and substance use disorders (SUDs), but only one of these (Dynamic Deconstructive Psychotherapy) has been tested among patients with dual diagnoses of BPD and AUDs. Research on pharmacotherapy for dual diagnoses of BPD and AUD is scarce, and no study has yet explored medication options that can concurrently manage symptoms of BPD and decrease alcohol consumption. Interestingly, there is growing evidence that anticonvulsants and second generation antipsychotics, the recent medications of choice for the management of BPD symptoms, may also reduce alcohol craving and consumption. Although premature, these findings are encouraging especially for this population of patients for whom treatment options are very limited.
Topics: Alcoholism; Borderline Personality Disorder; Humans; Personality Disorders
PubMed: 22686496
DOI: 10.1037/a0027999 -
Lakartidningen Dec 2016Personality disorders, violence and criminal behaviour The importance of personality disorders for violent and criminal behaviour is illustrated by their high prevalence... (Review)
Review
Personality disorders, violence and criminal behaviour The importance of personality disorders for violent and criminal behaviour is illustrated by their high prevalence in prison populations. Especially antisocial personality disorder and antisocial personality traits are linked to violence. During diagnostic assessment of personality disorders, violence risk screening is recommended. Cognitive behaviour treatment focused on violent behaviour has some effect in criminal populations, but the antisocial personality traits are resistant to treatment. Evidence for pharmacological treatment of repetitive aggressive behaviour is weak. But, bensodiazepines seem to increase the risk of violent behaviour among patients with personality disorders. Antisocial personality traits diminish over time. This spontaneous decrease can be delayed by comorbidity such as other personality disorder, substance use disorder, psychosis and attention deficit disorders. Therefore it is recommended to actively treat these comorbid conditions.
Topics: Antisocial Personality Disorder; Benzodiazepines; Criminal Behavior; Humans; Personality Disorders; Risk Assessment; Risk Factors; Violence
PubMed: 27959457
DOI: No ID Found -
Australasian Psychiatry : Bulletin of... Apr 2024There are few studies on the efficacy and acceptability of psychotherapy conducted via telehealth technology for people with personality disorder. This study aims to...
OBJECTIVE
There are few studies on the efficacy and acceptability of psychotherapy conducted via telehealth technology for people with personality disorder. This study aims to examine clinician perspectives on virtual psychotherapy.
METHOD
Twenty multidisciplinary mental health clinicians (85% female, average age 42 years) with at least 2 years of experience in telehealth psychotherapy contributed quantitative and qualitative ratings of acceptability and efficacy of this modality.
RESULTS
Likert scale ratings (1 = not, 5 = very) demonstrated high client acceptability (mean = 4.0), effectiveness (4.0) and high clinician acceptability (4.2) and sustainability (4.2). Three recommendations emerged from qualitative analysis: prioritising frame establishment, ensuring client safety online and maximising alliance-enhancing strategies.
CONCLUSIONS
This study, which collected quantitative and qualitative ratings of virtual psychotherapy, found that telehealth psychotherapy can be effective and acceptable for people with personality disorder. Strategies associated with success included strong governance, secure technology and careful attending to relationship management.
Topics: Humans; Female; Adult; Male; Psychotherapy; Personality Disorders; Mental Health; Telemedicine
PubMed: 38103036
DOI: 10.1177/10398562231222768 -
Child Psychiatry and Human Development Apr 2023This work presents a review of research papers examining the role of emerging personality pathology in suicidal ideation and behaviours in adolescence. Initially, 226...
This work presents a review of research papers examining the role of emerging personality pathology in suicidal ideation and behaviours in adolescence. Initially, 226 studies were selected in line with PRISMA guidelines, and 33 articles were finally included in this review. The data show percentages of any personality disorder diagnosis ranging from 19.5 to 22.8% in suicide attempters, while in autopsy studies, the rate of personality disorder diagnosis varied between 29.6 and 42.1%. The overwhelming majority of the studies focus on the role of borderline personality disorder (BPD) in suicidal behaviours, also highlighting its predictive role at a longitudinal level. Furthermore, the literature review shows that personality traits supposed to underlie BPD, such as affective instability, impulsivity and identity diffusion, have specific predictive links with suicidal conduct. Other personality pathology dimensions, such as aggressiveness, sadism and perfectionism that are associated with other personality disorders, namely, antisocial and narcissistic personality disorders, have also shown a significant mediating role for suicidal risk. Overall, these results seem to parallel the role of personality pathology in predicting suicide in adulthood and point to the relevance of assessing the presence of emerging patterns of personality disorders for the clinical management of suicidal risk in adolescence.
Topics: Humans; Adolescent; Suicidal Ideation; Suicide; Suicide, Attempted; Personality Disorders; Personality; Borderline Personality Disorder
PubMed: 34524583
DOI: 10.1007/s10578-021-01239-x -
Psychopathology 2020Difficulty with boredom was eliminated from the formal diagnostic criteria for borderline personality disorder (BPD) in 1994 based on significantly limited, unpublished... (Review)
Review
Difficulty with boredom was eliminated from the formal diagnostic criteria for borderline personality disorder (BPD) in 1994 based on significantly limited, unpublished data. However, it is apparent in clinical practice that boredom remains relevant to BPD. This review synthesizes empirical research, with consideration of theoretical accounts, to critically examine the relevance of boredom to BPD. We first briefly review issues in defining and measuring boredom and offer an expanded conceptualization for BPD, which includes the notion of boredom reactivity, before turning to boredom's differentiation from and overlap with feelings of emptiness, with which it was paired prior to its removal from the DSM. We then discuss perspectives on boredom's significance in BPD, briefly touching on its relevance in other personality disorders. We propose a Boredom Cascade Model that articulates how boredom and boredom reactivity interact with identity disturbance and chronic emptiness to create escalating patterns of behavioral dysregulation and make recommendations for research and treatment.
Topics: Borderline Personality Disorder; Boredom; Female; Humans; Male
PubMed: 33166987
DOI: 10.1159/000511312 -
Journal of Personality Disorders Apr 2017This study characterizes the personality disorder (PD) symptoms of patients who endorse a perplexing combination of low desire and high plans for suicide. Five PD...
This study characterizes the personality disorder (PD) symptoms of patients who endorse a perplexing combination of low desire and high plans for suicide. Five PD (antisocial, narcissistic, borderline, dependent, avoidant) symptoms were examined at the junction of two suicide risk factors: (a) suicidal desire/ideation and (b) resolved plans/preparations. Participants (N = 250) were recruited from U.S. Army Medical Center affiliated sites, including two outpatient clinics, an inpatient facility, and an emergency room. Self-report measures of PD and suicide symptoms were administered. The interaction of desire and plans was entered into multiple regression equations predicting PD symptoms. Patients endorsing low desire and high plans for suicide reported significantly more antisocial and narcissistic symptoms and fewer borderline, avoidant, and dependent PD symptoms. These findings support the existence of patients who endorse suicide plans in the absence of strong suicidal desire and suggest that they display antisocial and narcissistic personality characteristics. Future directions and clinical implications are discussed.
Topics: Adult; Female; Humans; Male; Middle Aged; Military Personnel; Outpatients; Personality Disorders; Suicide
PubMed: 26959962
DOI: 10.1521/pedi_2016_30_241 -
PloS One 2023Cognitive control is associated with impulsive and harmful behaviours, such as substance abuse and suicidal behaviours, as well as major depressive disorder (MDD) and...
Cognitive control is associated with impulsive and harmful behaviours, such as substance abuse and suicidal behaviours, as well as major depressive disorder (MDD) and borderline personality disorder (BPD). The association between MDD and BPD is partially explained by shared pathological personality traits, which may be underpinned by aspects of cognitive control, such as response inhibition. The neural basis of response inhibition in MDD and BPD is not fully understood and could illuminate factors that differentiate between the disorders and that underlie individual differences in cross-cutting pathological traits. In this study, we sought to explore the neural correlates of response inhibition in MDD and BPD, as well as the pathological personality trait domains contained in the ICD-11 personality disorder model. We measured functional brain activity underlying response inhibition on a Go/No-Go task using functional magnetic resonance imaging in 55 female participants recruited into three groups: MDD without comorbid BPD (n = 16), MDD and comorbid BPD (n = 18), and controls with neither disorder (n = 21). Whereas response-inhibition-related activation was observed bilaterally in frontoparietal cognitive control regions across groups, there were no group differences in activation or significant associations between activation in regions-of-interest and pathological personality traits. The findings highlight potential shared neurobiological substrates across diagnoses and suggest that the associations between individual differences in neural activation and pathological personality traits may be small in magnitude. Sufficiently powered studies are needed to elucidate the associations between the functional neural correlates of response inhibition and pathological personality trait domains.
Topics: Humans; Female; Depressive Disorder, Major; Borderline Personality Disorder; Brain; Personality Disorders; Impulsive Behavior
PubMed: 36608051
DOI: 10.1371/journal.pone.0280215