{"title":"Predictors of Effects in Brief Psychiatric Treatment for Borderline Personality Disorder.","authors":"Loris Grandjean, Stéphane Kolly, Ueli Kramer","doi":"10.1521/pedi.2023.37.6.741","DOIUrl":"10.1521/pedi.2023.37.6.741","url":null,"abstract":"<p><p>If evidence points to the equal efficacy of all <i>bona fide</i> treatments for borderline personality disorder (BPD) in general, it may not necessarily be true for a specific individual, nor do such general conclusions help in the triage of clients in clinical services. We investigated potential therapy outcome predictors for participants with a BPD diagnosis (N = 99). They were assessed on scales including the Outcome Questionnaire-45.2 (OQ-45), the Inventory of Interpersonal Problems-64, and the Borderline Symptom List. Our analyses revealed that individuals with low levels of symptom distress at intake had the smallest change in total OQ-45 score over the course of brief treatment, while the individuals with high levels of symptom distress had a mean large change in total score (-23). We observed that individuals with high symptom loads AND low levels of interpersonal problems at intake seemed to have the best progress.</p>","PeriodicalId":48175,"journal":{"name":"Journal of Personality Disorders","volume":"37 6","pages":"741-750"},"PeriodicalIF":2.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alma M Bitran, Christina M Temes, Tess C Gecha, Isabel V Glass, Frances R Frankenburg, Garrett M Fitzmaurice, Mary C Zanarini
{"title":"The 8-Year Course of Acute Physical Pain Reported by Patients With Borderline Personality Disorder and Comparison Subjects With Other Personality Disorders.","authors":"Alma M Bitran, Christina M Temes, Tess C Gecha, Isabel V Glass, Frances R Frankenburg, Garrett M Fitzmaurice, Mary C Zanarini","doi":"10.1521/pedi.2023.37.6.678","DOIUrl":"10.1521/pedi.2023.37.6.678","url":null,"abstract":"<p><p>The present study examines the 8-year course of physical pain and its interference with functioning in patients with borderline personality disorder (BPD) and a comparison group of patients with other personality disorders (other-PD). Participants completed the Brief Pain Inventory (BPI) at five assessments, each separated by 2 years. Results showed that across all 13 domains assessed, participants with BPD reported significantly higher levels of acute physical pain and its functional interference than other-PD comparison subjects. The severity of physical pain and its interference with multiple domains of functioning were relatively stable over 8 years of assessment for both study groups. Within the BPD group, pain was significantly associated with older age, comorbid major depressive disorder (MDD), and history of a physically violent partner. Taken together, these results suggest that physical pain is a serious health issue for individuals with BPD that interferes with functioning across a wide spectrum of areas.</p>","PeriodicalId":48175,"journal":{"name":"Journal of Personality Disorders","volume":"37 6","pages":"678-690"},"PeriodicalIF":2.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Specificity of Insecure Attachment in Adolescents With Borderline Personality Disorder in Psychiatric Inpatient and Community-Dwelling Adolescents.","authors":"Onyinyechi Obi-Obasi, Kiana Cano, Carla Sharp","doi":"10.1521/pedi.2023.37.6.751","DOIUrl":"10.1521/pedi.2023.37.6.751","url":null,"abstract":"<p><p>Borderline personality disorder (BPD) has been conceptualized as a disorder of attachment. However, the specificity of attachment insecurity to BPD in adolescents remains unclear. In this study, an inpatient sample (n = 521), of which 173 (33.2%) met the criteria for BPD, and a control sample of community-dwelling adolescents (n = 294) ages 12-17 were compared on a self-report measure of attachment security. In addition, hierarchical regression analyses were carried out to examine the incremental contribution of BPD symptoms, over and above internalizing and externalizing symptoms, in predicting attachment security. Results showed expected group differences such that adolescents with BPD evidenced higher levels of attachment insecurity to both fathers and mothers than psychiatric and community-dwelling controls. BPD features also incremented internalizing and externalizing problems associated with attachment security. However, because psychiatric controls also evidenced high levels of attachment insecurity, we conclude that while attachment insecurity is particularly salient for BPD, it is not necessarily specific to the disorder.</p>","PeriodicalId":48175,"journal":{"name":"Journal of Personality Disorders","volume":"37 6","pages":"751-760"},"PeriodicalIF":2.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julia I Kunz, Anna Frey, Katja Bertsch, Barbara B Barton, Leonie Blei, Hannah M Schirle, Franziska Konvalin, Andrea Jobst, Richard Musil, Frank Padberg, Matthias A Reinhard
{"title":"Loneliness Is Associated With Lower Self- and Clinician-Rated Levels of Personality Functioning.","authors":"Julia I Kunz, Anna Frey, Katja Bertsch, Barbara B Barton, Leonie Blei, Hannah M Schirle, Franziska Konvalin, Andrea Jobst, Richard Musil, Frank Padberg, Matthias A Reinhard","doi":"10.1521/pedi.2023.37.6.724","DOIUrl":"10.1521/pedi.2023.37.6.724","url":null,"abstract":"<p><p>Personality disorders (PDs) are associated with interpersonal dysfunction, loneliness, and reduced social embeddedness. This study investigates loneliness and social network size in association with self- and clinician-rated personality functioning regarding the <i>DSM-5's</i> Alternative Model for Personality Disorders (AMPD). Eighty psychiatric inpatients including participants with and without PDs completed the Semi-structured Interview for Personality Functioning, the Level of Personality Functioning Scale - Brief Form, the UCLA Loneliness Scale, and the Social Network Index. Patients with PDs reported more loneliness and personality dysfunctioning than patients without PDs. Social network size did not differ between patient groups and showed lower correlations with personality functioning compared to loneliness. Loneliness was further associated with deficits in personality functioning. Deficits in distinct AMPD domains and loneliness may constitute transdiagnostically relevant factors that are related and mutually reinforcing. This could be important for identifying patients beyond PD diagnoses who are at risk of poor psychosocial functioning and require tailored psychotherapy.</p>","PeriodicalId":48175,"journal":{"name":"Journal of Personality Disorders","volume":"37 6","pages":"724-740"},"PeriodicalIF":2.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kiran Boone, Diana J Whalen, Deanna M Barch, Joan L Luby, Katherine R Luking
{"title":"Self-Reported Gonadal Pubertal Timing Predicts Adolescent Borderline Personality Symptoms: Two Extended Replications With Prospective and Cross-Sectional Data.","authors":"Kiran Boone, Diana J Whalen, Deanna M Barch, Joan L Luby, Katherine R Luking","doi":"10.1521/pedi.2023.37.6.661","DOIUrl":"10.1521/pedi.2023.37.6.661","url":null,"abstract":"<p><p>The current study investigated the understudied relationship between pubertal timing and borderline personality disorder (BPD) symptoms in males and females. We conducted hierarchical linear regressions in a longitudinal Cohort 1 (<i>N</i> = 117) and a cross-sectional Cohort 2 (<i>N</i> = 127). Cohort 1: Pubertal timing was self-reported at age 10; BPD symptoms and covariates were assessed between ages 13 and 19. Cohort 2: All assessments were between ages 8 and 12. Covariates: race, age, internalizing and externalizing symptoms, and income-to-needs ratio. Sex differences were examined post hoc. In Cohort 1, early gonadal timing was associated with more BPD symptoms in females (beta = .46, <i>p</i> = .002), and late gonadal timing was associated with more BPD symptoms in males (beta = -.23, <i>p</i> = .035). In Cohort 2, early gonadal timing was associated with more BPD symptoms (beta = .21, <i>p</i> = .033) without sex moderation. Results indicate that early gonadal development could be a risk indicator for the emergence of BPD in adolescence, particularly in females, which could inform causal mechanisms and intervention targets.</p>","PeriodicalId":48175,"journal":{"name":"Journal of Personality Disorders","volume":"37 6","pages":"661-677"},"PeriodicalIF":2.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Social and Occupational Functioning in Individuals With BPD: A Systematic Review.","authors":"Abhijatya Dhar, Phillipa Hay, Tanya Meade","doi":"10.1521/pedi.2023.37.6.691","DOIUrl":"10.1521/pedi.2023.37.6.691","url":null,"abstract":"<p><p>This systematic review aimed to explore social and occupational functioning levels in individuals with BPD and whether this varies according to symptomatic status, age, or gender. A multi-database search was conducted for articles, and of the 1164 records identified, 19 were included in this review. Of the 15 studies reporting on social functioning, 13 indicated significant levels of impairment, and of the 14 studies reporting on global functioning, all indicated significant impairment across both clinical and in-remission populations. Occupational functioning was primarily assessed as either a part of global functioning or by subscales within social functioning, highlighting a lack of use of dedicated measures for its assessment. This systematic review found that individuals with BPD experience a range of significant impairments in functioning persisting across the lifespan. Further studies are warranted to explore levels of functional impairment across all functional domains and factors associated with continual functional impairment in this population.</p>","PeriodicalId":48175,"journal":{"name":"Journal of Personality Disorders","volume":"37 6","pages":"691-723"},"PeriodicalIF":2.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Author Index to Volume 37 Journal of Personality Disorders.","authors":"","doi":"10.1521/pedi.2023.37.6.761","DOIUrl":"10.1521/pedi.2023.37.6.761","url":null,"abstract":"","PeriodicalId":48175,"journal":{"name":"Journal of Personality Disorders","volume":"37 6","pages":"761-766"},"PeriodicalIF":2.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tobias Nolte, Joost Hutsebaut, Carla Sharp, Chloe Campbell, Peter Fonagy, Anthony Bateman
{"title":"The Role of Epistemic Trust in Mentalization-Based Treatment of Borderline Psychopathology","authors":"Tobias Nolte, Joost Hutsebaut, Carla Sharp, Chloe Campbell, Peter Fonagy, Anthony Bateman","doi":"10.1521/pedi.2023.37.5.633","DOIUrl":"https://doi.org/10.1521/pedi.2023.37.5.633","url":null,"abstract":"Building on the notion of epistemic trust as facilitating social learning, in this article we clarify how interventions from mentalization-based treatment (MBT) for borderline personality disorder generate this process. We suggest first that being mentalized is a critical cue in interactions to establish epistemic trust and second that epistemic mistrust may represent a final common pathway through which aversive relational experiences in the past may exert their influence on treatments—both as a disposition of the patient and as a characteristic of the therapist-patient encounter. By charting MBT interventions from the initial assessment and formulation, through individual and group therapy sessions, to re-engaging with the wider social environment, we examine how each of these can establish a “we-mode,” an interpersonal experience associated with being mentalized that unlocks the barrier posed by epistemic vigilance. In addition, implications for relational mentalizing and rupture and repair within the therapeutic relationship are discussed.","PeriodicalId":48175,"journal":{"name":"Journal of Personality Disorders","volume":"29 22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136117673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Interpersonal Trust and Borderline Personality Disorder: Insights From Clinical Practice and Research: Introduction.","authors":"Eric A Fertuck, Emanuele Preti","doi":"10.1521/pedi.2023.37.5.469","DOIUrl":"10.1521/pedi.2023.37.5.469","url":null,"abstract":"<p><p>Individuals suffering from borderline personality disorder (BPD) show a pervasive sense that others cannot be trusted, are vulnerable to negative therapeutic reactions, and can oscillate between idealized and persecutory interactions with others. These trust processing impairments impact both the immediate and wider social milieu of individuals with BPD, including therapist-patient interactions. Recently, research started unraveling the social-cognitive mechanisms of these impairments in BPD. In this Special Issue, we attempt to close the gap between research findings and clinical theories on trust processing impairment in BPD. The first section includes five original studies on trust processing in BPD. The second section includes five articulations of trust processing impairment as a treatment target in evidence-based treatments for BPD and as an indispensable \"common factor\" in the treatment of BPD. These cutting-edge research and clinical contributions advance a potential integrative, clinical science framework for conceptualizing and intervening effectively with those who struggle with BPD.</p>","PeriodicalId":48175,"journal":{"name":"Journal of Personality Disorders","volume":"37 5","pages":"469-474"},"PeriodicalIF":2.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eric A Fertuck, Stephanie A Fischer, Robert D Melara
{"title":"Atypical Neural Plasticity and Behavioral Effects of Trustworthiness Learning in Borderline Personality Disorder Features.","authors":"Eric A Fertuck, Stephanie A Fischer, Robert D Melara","doi":"10.1521/pedi.2023.37.5.542","DOIUrl":"10.1521/pedi.2023.37.5.542","url":null,"abstract":"<p><p>This study distinguishes interpersonal trust learning with a novel trust learning paradigm in participants high (H-BPD) and low (L-BPD) in BPD features. Neutral faces were paired with trust-relevant behaviors in four conditions: trustworthy, untrustworthy, ambiguously trustworthy, and mixed trustworthiness. After training, participants rated faces on untrustworthiness as electroencephalographic measures were recorded. H-BPD rated neutral faces as significantly more untrustworthy than L-BPD at both time periods. Negative and ambiguous trustworthiness pairing conditions led to higher ratings of untrustworthiness, whereas trustworthy and mixed descriptors led to lower ratings of untrustworthiness. Learning enhanced the amplitude of an early sensory event-related potential (ERP) component (i.e., P1) for both groups. The slow-wave ERP, an index of sustained attention, revealed greater focus after learning to trustworthy descriptors in H-BPD and to untrustworthy descriptors in L-BPD. H-BPD utilized greater effort to overcome an inherent mistrust bias and L-BPD to overcome unexpected untrustworthy information.</p>","PeriodicalId":48175,"journal":{"name":"Journal of Personality Disorders","volume":"37 5","pages":"542-558"},"PeriodicalIF":2.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}