Sarah Hauryski, Alexandra Potts, Alison Swigart, Dara Babinski, Daniel A Waschbusch, Lauren N Forrest
{"title":"Characterizing psychopharmacological prescribing practices in a large cohort of adolescents with borderline personality disorder.","authors":"Sarah Hauryski, Alexandra Potts, Alison Swigart, Dara Babinski, Daniel A Waschbusch, Lauren N Forrest","doi":"10.1186/s40479-024-00262-3","DOIUrl":"10.1186/s40479-024-00262-3","url":null,"abstract":"<p><strong>Background: </strong>Psychiatric medications are not efficacious for treating borderline personality disorder (BPD), yet many patients with BPD are prescribed multiple psychiatric medications. This study aimed to (1) characterize psychiatric medication prescribing practices in adolescents with BPD and (2) assess whether demographic features are associated with prescribing practices.</p><p><strong>Method: </strong>This sample was N = 2950 pediatric patients with BPD (ages 10-19) across the U.S. Data came from the NeuroBlu database, which includes data from 30 U.S. healthcare systems and hundreds of hospitals. Poisson regressions and chi-squared tests determined whether gender, race, and ethnicity were associated with (1) number of unique psychiatric medications prescribed and (2) number of unique medication classes prescribed.</p><p><strong>Results: </strong>Roughly two-thirds (64.85%) of youth were prescribed any medications. Of these youth, 79.40% were prescribed ≥ 2 unique medications and 72.66% were prescribed ≥ 2 unique medications classes. The mean number of unique medications was 3.50 (SD = 2.50). The mean number of unique medication classes was 2.35 (SD = 1.15). The most commonly prescribed medication classes were antidepressants and antipsychotics, which were often prescribed in combination. Poisson regressions showed that boys were prescribed more unique medications (M = 3.67) than girls (M = 3.47). Non-Latinx youth were prescribed significantly more unique medications (M = 44.12) than Latinx youth (M = 3.60, p = .01).</p><p><strong>Conclusions: </strong>Results characterize psychiatric medication prescribing practices in youth with BPD. Prescribing practices vary by demographics, such that boys and non-Latinx youth are prescribed more medications than girls and Latinx youth, respectively. These demographic differences suggest that prescribers may treat BPD differently based on patient demographic characteristics.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11302085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Group intervention for family members of people with borderline personality disorder based on Dialectical Behavior Therapy: Implementation of the Family Connections® program in France and Switzerland.","authors":"Satchel Cohen, Virginie Salamin, Nader Perroud, Karen Dieben, Déborah Ducasse, Amaury Durpoix, Florence Guenot, Hervé Tissot, Ueli Kramer, Mario Speranza","doi":"10.1186/s40479-024-00254-3","DOIUrl":"10.1186/s40479-024-00254-3","url":null,"abstract":"<p><strong>Background: </strong>Families and significant others of people with borderline personality disorder (BPD) show increased levels of psychological distress. Family Connections®, a 12-week group intervention based on the principles of Dialectical Behavior Therapy, was designed to provide families with both information about the disorder and emotion regulation skills. It has been progressively implemented in French-speaking European countries.</p><p><strong>Methods: </strong>We conducted an observational, multicenter study in France and Switzerland. In total, 149 participants of the Family Connections program were included among five centers. Burden, depression, coping, and emotion regulation were assessed before and after the intervention.</p><p><strong>Results: </strong>One-way repeated measures MANOVA showed that the burden, depressive symptoms, emotion regulation and coping all changed significantly after the intervention (p < 0.001, partial η<sup>2</sup> = 0.297). T-tests showed that the burden significantly decreased after the intervention (p < 0.0001, d = -0.48), as did depressive symptoms (p < 0.0001, d = -0.36) and difficulties in emotion regulation (p < 0.0001, d =-0.32) whereas coping improved (p < 0.0001, d = 0.53). Two-way mixed ANOVA showed that burden reduction was stronger among female than male participants (p = 0.048, η<sup>2</sup> = 0.027). Before the intervention, the burden was higher for female than male participants (p < 0.001). An initial linear regression showed the burden reduction to be associated with a decrease in the resignation of the participants (β = 0.19, p = 0.047). A second linear regression showed the burden reduction to be associated with the intensity of the relatives' symptoms at baseline (β = 0.22, p = 0.008) and improvement of emotional clarity of the participants (β = 0.25, p = 0.006).</p><p><strong>Conclusion: </strong>This Dialectical Behavior Therapy-Based psychoeducational intervention is an appropriate way to support French-speaking European families of people with BPD.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A second chance for first impressions: evidence for altered impression updating in borderline personality disorder.","authors":"Kevin Konegen, Georg Halbeisen, Georgios Paslakis","doi":"10.1186/s40479-024-00259-y","DOIUrl":"10.1186/s40479-024-00259-y","url":null,"abstract":"<p><strong>Background: </strong>Individuals with borderline personality disorder (BPD) frequently alter between idealizing and devaluing other persons, which has been linked to an increased tendency to update self-relevant beliefs and impressions. We hypothesized that increased impression updating could stem from reduced attitude contextualization, i.e., a process in which impression-disconfirming information is linked to contextual cues.</p><p><strong>Methods: </strong>Individuals diagnosed with BPD and controls (recruited online, with unknown diagnostic status) completed an impression formation paradigm. They first learned about the positive or negative behaviors of others in one Context A (e.g., Person 1 is helpful), followed by learning about behaviors of the opposite valence in a second Context B (Person 1 is rude). We also manipulated between participants whether the observed behaviors were directed toward the study participants (self-relevant) or, more generally, at other people (other-relevant). The contexts were marked by differently-colored backgrounds (e.g., yellow vs. blue), to avoid influences of prior knowledge or experiences. After exposure to information in both contexts, participants rated their impressions of the persons in Context A, Context B, and, crucially, a previously unknown Context C (white background). We examined whether the initial or an updated impression (re-)emerged in Context C.</p><p><strong>Results: </strong>Initial impressions remained stable and dominated the ratings of controls across contexts A, B, and C for both self-relevant and other-relevant behaviors, consistent with contextualizing impression-disconfirming information. As expected, however, individuals with BPD only showed updated impression ratings in Context C for self-relevant behaviors, consistent with the assumed reduced tendency to contextualize impression-disconfirming self-relevant information. Further exploratory analyses suggest that more severe BPD symptoms predicted more pronounced impression updating in the self-relevant condition.</p><p><strong>Conclusions: </strong>The findings help to illuminate the mechanisms underlying interpersonal problems in individuals with BPD. People with BPD are not just more inclined to discard positive first impressions but to re-evaluate disliked others when they behave positively, contributing to the volatility of interactions with others. Contextualization has known and modifiable antecedents, and the study may thus provide potential targets for therapeutic intervention. Future studies will need to replicate the findings with specified controls.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11256375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Babette Renneberg, Joost Hutsebaut, Ann Berens, Chiara De Panfilis, Katja Bertsch, Andres Kaera, Ueli Kramer, Christian Schmahl, Michaela Swales, Svenja Taubner, Mariana Mendoza Alvarez, Julia Sieg
{"title":"Towards an informed research agenda for the field of personality disorders by experts with lived and living experience and researchers.","authors":"Babette Renneberg, Joost Hutsebaut, Ann Berens, Chiara De Panfilis, Katja Bertsch, Andres Kaera, Ueli Kramer, Christian Schmahl, Michaela Swales, Svenja Taubner, Mariana Mendoza Alvarez, Julia Sieg","doi":"10.1186/s40479-024-00257-0","DOIUrl":"10.1186/s40479-024-00257-0","url":null,"abstract":"<p><strong>Background: </strong>We describe a collection of themes for a research agenda for personality disorders that was originally formulated for the ESSPD Borderline Congress in 2022.</p><p><strong>Methods: </strong>Experts with lived and living experience (EE), researchers and clinicians met virtually, exchanged ideas and discussed research topics for the field of personality disorders. The experts - patients, relatives, significant others - named the topics they thought most relevant for further research in the field. These topics were presented at the ESPPD conference in October 2022.</p><p><strong>Results: </strong>The five top themes were: 1. Prevention, early detection and intervention, 2. Recovery beyond symptom improvement, 3. Involvement of relatives in treatment, 4. Gender dysphoria, and 5. Stigma.</p><p><strong>Conclusions: </strong>In general, the topics reflect current issues and changes in societal values. Overarching aims of research on these topics are the improvement of social participation and integration in society, better dissemination of research, and better information of the general public and political stakeholders.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Léa Villet, Abtine Madjlessi, Anne Revah-Levy, Mario Speranza, Nadia Younes, Jordan Sibéoni
{"title":"The lived experience of French parents concerning the diagnosis of their children with borderline personality disorder.","authors":"Léa Villet, Abtine Madjlessi, Anne Revah-Levy, Mario Speranza, Nadia Younes, Jordan Sibéoni","doi":"10.1186/s40479-024-00258-z","DOIUrl":"10.1186/s40479-024-00258-z","url":null,"abstract":"<p><strong>Background: </strong>Psychiatrists often hesitate to diagnose borderline personality disorder (BPD). While individuals with BPD have reported both positive and negative experiences upon receiving their diagnosis, no study has specifically explored this issue among parents. Parents of children diagnosed with BPD can benefit from recently developed family-support interventions such as the Family Connections program. Our study aimed to explore the experiences of parents learning about their child's BPD diagnosis and to investigate the impact of the Family Connections program on their experiences.</p><p><strong>Methods: </strong>This qualitative study, conducted in France following the five-stage IPSE method, involved parents of children with BPD recruited through the Family Connections association in Versailles. We conducted semi-structured interviews and used purposive sampling for data collection until data saturation was reached. Data analysis was performed using a descriptive and structuring approach with NVivo 12 software to elucidate the structure of lived experiences.</p><p><strong>Results: </strong>The study included 21 parents. The structure of the lived experiences was characterized by three central axes: (1) the long and difficult road to diagnosis; (2) communicating the BPD diagnosis to parents: a necessary step; (3) the pitfalls of receiving the diagnosis. The Family Connections program provided significant support in these areas, particularly in understanding the diagnosis, enhancing communication with their child, and reducing social isolation.</p><p><strong>Conclusion: </strong>These findings highlight the challenges parents face when receiving a BPD diagnosis for their child and underscore the need for an early, clear, and detailed explanation of the diagnosis. The specific experiences of receiving the diagnosis are indicative of the broader care experience parents undergo and highlight their need and right to be informed, supported, and guided throughout their child's treatment.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marialuisa Cavelti, Yasmine Blaha, Stefan Lerch, Christian Hertel, Thomas Berger, Corinna Reichl, Julian Koenig, Michael Kaess
{"title":"The evaluation of a stepped care approach for early intervention of borderline personality disorder.","authors":"Marialuisa Cavelti, Yasmine Blaha, Stefan Lerch, Christian Hertel, Thomas Berger, Corinna Reichl, Julian Koenig, Michael Kaess","doi":"10.1186/s40479-024-00256-1","DOIUrl":"10.1186/s40479-024-00256-1","url":null,"abstract":"<p><strong>Background: </strong>The current study evaluated the stepped care approach applied in AtR!Sk; a specialized outpatient clinic for adolescents with BPD features that offers a brief psychotherapeutic intervention (Cutting Down Program; CDP) to all patients, followed by a more intensive Dialectical Behavioral Therapy for Adolescents (DBT-A) for those whose symptoms persist.</p><p><strong>Methods: </strong>The sample consisted of 127 patients recruited from two AtR!Sk clinics. The number of BPD criteria, psychosocial functioning, severity of overall psychopathology, number of days with non-suicidal self-injury (NSSI; past month), and the number of suicide attempts (last 3 months) were assessed at clinic entry (T0), after CDP (T1), and at 1- and 2-year follow-up (T2, T3). Based on the T1 assessment (decision criteria for DBT-A: ≥ 3 BPD criteria & ZAN-BPD ≥ 6), participants were allocated into three groups; CDP only (n = 74), CDP + DBT-A (eligible and accepted; n = 36), CDP no DBT-A (eligible, but declined; n = 17).</p><p><strong>Results: </strong>CDP only showed significantly fewer BPD criteria (T2: β = 3.42, p < 0.001; T3: β = 1.97, p = 0.008), higher levels of psychosocial functioning (T2: β = -1.23, p < 0.001; T3: β = -1.66, p < 0.001), and lower severity of overall psychopathology (T2: β = 1.47, p < 0.001; T3: β = 1.43, p = 0.002) over two years compared with CDP no DBT-A, while no group differences were found with regard to NSSI and suicide attempts. There were no group differences between CDP + DBT-A and CDP no DBT-A, neither at T2 nor at T3.</p><p><strong>Discussion: </strong>The findings support the decision criterion for the offer of a more intense therapy after CDP. However, there was no evidence for the efficacy of additional DBT-A, which might be explained by insufficient statistical power in the current analysis.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isabel V Glass, Frances R Frankenburg, Mary C Zanarini
{"title":"Longitudinal description and prediction of physical inactivity among patients with borderline personality disorder and personality-disordered comparison subjects.","authors":"Isabel V Glass, Frances R Frankenburg, Mary C Zanarini","doi":"10.1186/s40479-024-00253-4","DOIUrl":"10.1186/s40479-024-00253-4","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11157732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Symptom domains and psychosocial functioning in borderline personality disorder.","authors":"Ines Culina, Setareh Ranjbar, Pauline Maillard, Chantal Martin-Soelch, Sylvie Berney, Stéphane Kolly, Jérémie André, Philippe Conus, Ueli Kramer","doi":"10.1186/s40479-024-00255-2","DOIUrl":"10.1186/s40479-024-00255-2","url":null,"abstract":"<p><strong>Background: </strong>Borderline personality disorder (BPD) is often characterized by severe functional impairment, even after a decrease in symptoms. A comprehensive understanding of psychosocial functioning in BPD is necessary to tailor treatment offer, which should address relevant aspects of daily life. The aims of the present study are to (1) conduct a cross-sectional comparison of functioning of a group with BPD and a non-BPD clinical comparison group at service entry, and to (2) assess the relationship between intensity of BPD symptom domains and psychosocial functioning.</p><p><strong>Methods: </strong>The sample consists of N = 65 participants with BPD and N = 57 participants from the clinical comparison group without BPD (non-BPD group). The Revised Borderline Follow-up Interview (BFI-R) was used to evaluate psychosocial functioning and the Revised Diagnostic Interview for Borderlines (DIB-R) to assess BPD symptoms. Linear, logistic, and multinomial regression models were run separately for each aspect of functioning as a function of BPD status or BPD symptom domains.</p><p><strong>Results: </strong>Only 23% of participants in the BPD group fulfilled criteria for good overall psychosocial functioning, compared to 53% in the non-BPD group. Furthermore, participants in the BPD group were less likely to have completed a high number of years of education, to work consistently, to be financially independent, to be in a cohabiting relationship and have a good relationship with parents. In addition, various links were identified between BPD symptom domains and functional impairments.</p><p><strong>Conclusions: </strong>Consistent with prior research, the main impairments in functioning in the BPD group are found in the educational and vocational domains. Though some domains show impairment, others, like friendships, may act as potential resources. Further investigation on the relationships with symptom domains is required.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Madelyn Thomson, Marialuisa Cavelti, Stefan Lerch, Julian Koenig, Corinna Reichl, Ines Mürner-Lavanchy, Andrea Wyssen, Michael Kaess
{"title":"Clinical profiles of adolescent personality pathology: a latent structure examination of the Semi-Structured Interview for Personality Functioning DSM-5 (STiP-5.1) in a help-seeking sample","authors":"Madelyn Thomson, Marialuisa Cavelti, Stefan Lerch, Julian Koenig, Corinna Reichl, Ines Mürner-Lavanchy, Andrea Wyssen, Michael Kaess","doi":"10.1186/s40479-024-00252-5","DOIUrl":"https://doi.org/10.1186/s40479-024-00252-5","url":null,"abstract":"Despite the introduction of dimensional conceptualisations of personality functioning in the latest classification systems, such as Criterion A of the Alternative Model of Personality Disorders in the DSM-5, heterogeneous clinical presentation of personality pathology remains a challenge. Relatedly, the latent structure of personality pathology as assessed by the Semi-Structured Interview for Personality Functioning DSM-5 (STiP-5.1) has not yet been comprehensively examined in adolescents. Therefore, this study aimed to examine the latent structure of the STiP-5.1, and, based on those findings, to describe any unique clinical profiles that might emerge. The final sample comprised 502 participants aged 11–18 years consecutively recruited from a specialised personality disorder outpatient service, as well as general day clinic and inpatient wards at the University Hospital University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Bern, Switzerland. Participants were assessed using the STiP-5.1, as well as a battery of other psychological measures by clinical psychologists or trained doctoral students. Variations of Factor Analysis, Latent Class Analysis and Factor Mixture Models (FMM) were applied to the STiP-5.1 to determine the most appropriate structure. The best fitting model was an FMM comprising four-classes and two factors (corresponding to self- and interpersonal-functioning). The classes differed in both overall severity of personality functioning impairment, and in their scores and clinical relevance on each element of the STiP-5.1. When compared to the overall sample, classes differed in their unique clinical presentation: class 1 had low impairment, class 2 had impairments primarily in self-functioning with high depressivity, class 3 had mixed levels of impairment with emerging problems in identity and empathy, and class 4 had severe overall personality functioning impairment. A complex model incorporating both dimensional and categorical components most adequately describes the latent structure of the STiP-5.1 in our adolescent sample. We conclude that Criterion A provides clinically useful information beyond severity (as a dimensional continuum) alone, and that the hybrid model found for personality functioning in our sample warrants further attention. Findings can help to parse out clinical heterogeneity in personality pathology in adolescents, and help to inform early identification and intervention efforts.","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140598788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rose Gholami Mazinan, Christina Dudek, Hannah Warkentin, Maja Finkenstaedt, Johanna Schröder, Richard Musil, Leonhard Kratzer, Johannes Fuss, Sarah V Biedermann
{"title":"Borderline personality disorder and sexuality: causes and consequences of dissociative symptoms.","authors":"Rose Gholami Mazinan, Christina Dudek, Hannah Warkentin, Maja Finkenstaedt, Johanna Schröder, Richard Musil, Leonhard Kratzer, Johannes Fuss, Sarah V Biedermann","doi":"10.1186/s40479-024-00251-6","DOIUrl":"10.1186/s40479-024-00251-6","url":null,"abstract":"<p><strong>Background: </strong>Sexual risk behavior in patients diagnosed with borderline personality disorder (BPD) is supposed to be associated with traumatic experiences and dissociative symptoms. Nevertheless, scientific research thereon is scarce which might be due to the high prevalence of sexual trauma and fear of overwhelming patients with explicit sexual content.</p><p><strong>Methods: </strong>We investigated a clinical sample of patients diagnosed with BPD (n = 114) and compared them to a sample of matched healthy controls (HC) (n = 114) concerning the dissociative symptoms derealization, depersonalization, and conversion in sexual situations. In a subgroup of patients with BPD (n = 41) and matched HC (n = 40) dissociative symptoms after exposure to an acoustically presented erotic narrative were assessed in the lab. Regression analyses were used to examine the associations between sexual trauma, post-traumatic stress disorder (PTSD), dissociation in sexual situations, and risky sexual behavior.</p><p><strong>Results: </strong>Patients diagnosed with BPD endorsed higher dissociative symptoms in sexual situations retrospectively and in the lab compared to HC. Regression analyses revealed that depersonalization and conversion symptoms in sexual situations were explained by severity of BPD, while derealization was explained by PTSD symptomatology. Impulsive and sexual behavior with an uncommitted partner were higher in the BPD group and explained by derealization, while conversion showed an inverse association.</p><p><strong>Conclusion: </strong>Our findings highlight the importance of addressing distinct dissociative symptoms in sexual situations when counselling and treating women with BPD. In the long term, this could contribute to a reduction in sexual risk behavior in patients with BPD.</p><p><strong>Trial registration: </strong>This analysis is part of a larger ongoing study and was registered prior to accessing the data (Registration trial DRKS00029716).</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}