Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “borderline”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 559 records · Page 31Linked to original sources
PubMedDate not supplied

Patterns of self-harm behavior among women with borderline personality symptomatology: psychiatric versus primary care samples.

The current study investigated differences in self-harm behavior among individuals with borderline personality symptomatology from two different clinical settings. Participants were women, between the ages of 18 and 45, from an outpatient mental health setting or a primary care setting. Each participant completed the Self-Harm Inventory (SHI) and the borderline personality scale of the Personality Diagnostic Questionnaire-Revised (PDQ-R). Using a predetermined cut-off for substantial borderline personality symptomatology on the SHI, group comparisons with chi(2) analyses indicated that "overdosed" and "hit self" were significantly more common in the mental health subsample whereas "abused laxatives" was significantly more common in the primary care subsample. Using a predetermined cut-off for borderline personality on the PDQ-R, chi-square analyses indicated that "overdosed" and "hit self" remained significantly more common in the mental health subsample. Despite these differences, there was remarkable similarity of symptoms between groups. The implications of these findings are discussed.

Adolescent↗
PubMed2000

Clinical guidelines for psychotherapy for patients with borderline personality disorder.

In planning a course of psychotherapy for borderline patients, clinicians must take into account the heterogeneity of the clinical presentation in the borderline domain. Borderline personality disorder is usually accompanied, for example, by one or several "symptom disorders," such as an eating disorder, depression, posttraumatic stress disorder, premenstrual tension, dissociative disorder, or anxiety disorder--not to mention one or more other personality disorders. The nature of the "comorbidity" in each patient will determine which medications, if any, are applicable. The accompanying personality disorders will have an impact on amenability to psychotherapy. The main forms of therapy currently in use are supportive, cognitive-behavioral (including dialectical behavioral therapy) and psychodynamic (including transference-focused psychotherapy). Group therapy is often used adjunctively with any of these approaches. The main question is no longer, Which of these approaches is best, overall? but rather, Which approach is best for which type of borderline patient? Contemporary research is addressed to this latter question.

Adult↗
PubMed2000

Being a case manager for persons with borderline personality disorder: perspectives of community mental health center clinicians.

The scope of case management has expanded to include persons with chronic, nonpsychotic disorders, in particular, persons diagnosed with borderline personality disorder. Despite more widespread use, literature about case management for persons with this disorder is limited. To address this gap in knowledge, a study of the day-to-day experiences of case managers who care for persons with borderline personality disorder was conducted. Seventeen community mental health center case managers gave their informed consent to participate in individual, in-depth interviews. The interviews were analyzed using an interpretive phenomenological research approach. The analysis showed a pattern of monitoring self-involvement. The case managers monitored themselves in terms of expressing concern and setting boundaries. These shared practices highlight a central and unique component of being a case manager for persons with borderline personality disorder, that is, the case manager's focus of attention is on self. By focusing on the self, case managers seek to retain control of the nature of the relationship. The author asserts that the matter to be resolved is not to determine whether retaining or relinquishing control is better, but rather, how best to help practitioners maintain a helpful relationship over time with persons who have borderline personality disorder. In an effort to accomplish this goal, questions about current helping practices and suggestions for working collaboratively with persons who have this diagnosis are provided.

Attitude of Health Personnel↗
PubMed1994

Social perceptions and borderline personality disorder: the relation to mood disorders.

We used the Structural Analysis of Social Behavior (SASB) to compare the social perceptions of borderline, unipolar, and bipolar-depressed inpatients. As predicted, borderline subjects differed from bipolar-depressed and unipolar subjects in their social perceptions. Borderline subjects viewed their relationships to their mother, hospital staff, and other patients as more hostile and autonomous than did mood disordered subjects. The results are discussed in terms of an integrative theory of borderline personality that considers the psychobiology of interpersonal relationships and attachment disruptions.

Adult↗
PubMed2001

Expression of inducible nitric oxide synthase and nitrotyrosine in borderline leprosy lesions.

BACKGROUND: In the response to T-helper cell (Th1)-type cytokines and interactions with pathogens, high levels of nitric oxide (NO) are produced by activated macrophages expressing the inducible NO synthase (iNOS). The role and importance of reactive nitrogen intermediates (RNIs) such as NO and peroxynitrite in the host response to diseases caused by intracellular pathogens such as Mycobacterium leprae and M. tuberculosis is unclear. OBJECTIVES: The aim of this study was to investigate the presence of local production of NO and peroxynitrite in borderline leprosy by using antibodies against iNOS and the product of peroxynitrite, nitrotyrosine (NT). METHODS: We detected the presence of iNOS and NT in skin biopsies from borderline leprosy patients, with and without reversal reaction (RR), by immunohistochemistry (n = 26). RESULTS: In general, the granulomas from borderline leprosy lesions with and without RR showed high and specific expression of iNOS and NT. Moreover, strong immunoreactivity to iNOS and NT was observed in granulomas surrounding and infiltrating dermal nerves. The expression of iNOS and NT was also strong in keratinocytes, fibroblasts and endothelial cells in close relation to the granulomatous reaction. In contrast, normal human skin showed no expression of iNOS and NT in these cells. CONCLUSIONS: We conclude that iNOS and NT are expressed in granulomas from borderline leprosy patients with and without RR and propose that RNIs might be involved in the nerve damage following RR in leprosy.

Biopsy↗
PubMed2001

Borderline personality traits in hysterical neurosis.

The objective of the present study is to demonstrate the traits of the psychopathology of Borderline Personality Disorder (BPD) compared with hysterical neurosis. A total of 48 subjects with BPD and 40 subjects with hysterical neurosis both defined by DSM-III-R were assessed by Diagnostic Interview for Borderlines (DIB). Statistical analysis was done by quantification of the second type, a multivariate data analysis. The total scores of DIB were BPD group, 6.13 +/- 1.52; hysterical neurosis group, 4.9 +/- 2.12 (t = 3.05, P = 0.0016). The correlation ratio (index of to what extent the two groups are discriminated) was 0.2442. Among the four parameters of: (i) affect, (ii) cognition, (iii) impulse-action pattern, (iv), and interpersonal relationships, the partial coefficient correlations of (iii) and (iv) were significantly high (0.342, 0.287, P < 0.01). The question items with high independent coefficients were manipulation (0.4416), intolerance of aloneness (0.3797), demanding nature (0.3768), self-mutilation (0.3609), visual hallucination (0.3395). Those with low score of independent coefficients were counterdependency (0.0533), identity disturbance (0.1010), depression (0.1551), loneliness (0.1752), hypomanic episode (0.1936). Both of BPD and hysterical neurosis groups were not so fairly well discriminated. However, these results suggested that impulse-action pattern and disorder of interpersonal relationships were traits of borderline personality disorder. We could admit manipulation, intolerance of aloneness as its symptoms. In addition, counterdependency, identity disturbance were comparatively common to both. There were some borderline personality traits symptomatically in hysterical neurosis.

Adolescent↗
PubMed1990

Differentiating ego functions of borderline and narcissistic personalities.

This study investigated differences in ego functions of borderline and narcissistic personality disorders through examining responses to Rorschach structural and content variables. Reality testing, thought process, affective regulation, impulse control, and the defenses of splitting and grandiosity were examined from Rorschach protocols of 50 borderlines and 26 narcissists. The borderlines produced greater distortion in reality testing, p less than .05; the narcissists produced more insidious thought process disturbance, p less than .05; and higher functioning groups demonstrated greater control of impulses, p less than .05. Borderlines in this sample demonstrated more affective constriction than the narcissists and used more splitting, p less than .05; narcissists used more grandiosity, p less than .05. Implications of this study are (a) ego functions mature inconsistently, (b) affective responsivity influences ego disorganization, and (c) level of functioning and IQ are related to the production of Rorschach variables.

Adolescent↗
PubMedDate not supplied

Does childhood sexual abuse cause borderline personality disorder?

Several studies have found that women with borderline personality disorder are more likely than controls to report a history of childhood sexual abuse. Researchers have generally assumed that childhood sexual abuse causes borderline personality disorder, but there are other possible interpretations of the association. We surveyed psychologists about the likelihood that patients with various personality disorders would engage in behaviors relevant to several alternative interpretations. Relative to patients with other personality disorders and to the "typical outpatient," patients with borderline personality disorder were rated as especially likely to misinterpret or misremember social interactions, to lie manipulatively and convincingly, and to have voluntarily entered destructive sexual relationships, possibly even at young ages. We discuss the plausibility of relevant alternative interpretations of the association between childhood sexual abuse and borderline personality disorder.

Adult↗
PubMed2003

Temperament, childhood environment and psychopathology as risk factors for avoidant and borderline personality disorders.

OBJECTIVE: To evaluate childhood experiences (neglect and abuse), temperament and childhood and adolescent psychopathology as risk factors for avoidant and borderline personality disorders in depressed outpatients. METHOD: One hundred and eighty depressed outpatients were evaluated for personality disorders. Risk factors of childhood abuse, parental care, temperament, conduct disorder symptoms, childhood and adolescent anxiety disorders, depressive episodes, hypomania and alcohol and drug dependence were obtained by questionnaires and interviews. RESULTS: Avoidant personality disorder can be conceptualized as arising from a combination of high harm avoidance (shy, anxious), childhood and adolescent anxiety disorders and parental neglect. Borderline personality disorder can be formulated as arising from a combination of childhood abuse and/or neglect, a borderline temperament (high novelty seeking and high harm avoidance), and childhood and adolescent depression, hypomania, conduct disorder and alcohol and drug dependence. CONCLUSIONS: Combinations of risk factors from the three domains of temperament, childhood experiences and childhood and adolescent psychopathology make major contributions to the development of avoidant and borderline personality disorders.

Adolescent↗
PubMed2005

Low hospital inpatient readmission rate in patients with borderline personality disorder: a naturalistic study at Southern Health, Victoria, Australia.

OBJECTIVE: To study how the standard management protocol and the special management contract relate to the clinical profile of patients with borderline personality disorder and their hospital admission pattern. METHOD: A retrospective review was undertaken using naturalistic data from the Client Management Interface over a 2-year period. The standard management protocol patient group and the special treatment contract patient group were compared with respect to variables which included basic demographic data, number of admissions, length of stay and comorbidity. RESULTS: Eighty patients received a diagnosis of borderline personality disorder. The majority (81.2%) were managed with the standard management protocol and only 41.5% had more than one admission. For those who received a special treatment contract (18.8%), 93.3% of them had more than one admission. The special treatment contract group had a significantly higher total number of admissions (p < 0.001), a higher number of admissions when they received (p < 0.001) and did not receive (p = 0.001) a diagnosis of borderline personality disorder, a higher number of comorbidities (p = 0.004) but not more presentations to the emergency department. CONCLUSIONS: Most patients with borderline personality disorder treated with the standard management protocol had a low readmission rate. The small group of patients with comorbidities managed with a special treatment contract had multiple readmissions but not more crisis presentations to the emergency department. Further studies are required to elucidate the therapeutic mechanism of the standard management protocol and special treatment contract and how that impacts on presentations and admissions to a hospital.

Adolescent↗
PubMed1995

Effect of fluoxetine on anger in symptomatic volunteers with borderline personality disorder.

Clinical data and uncontrolled observations have suggested that fluoxetine is helpful in some patients with borderline personality disorder. This article describes the results of a 13-week double-blind study of volunteer subjects with mild to moderately severe borderline personality disorder. Thirteen fluoxetine recipients and nine placebo recipients received treatment. Pretreatment and posttreatment measures were obtained for global mood and functioning, anger, and depression. The most striking finding from this study was a clinically and statistically significant decrease in anger among the fluoxetine recipients. This decrease was independent of changes in depression. These data support previous observations that fluoxetine may reduce anger in patients with borderline personality disorder. The number of subjects in this study was small, the placebo responsiveness was high, and the clinical characteristics of the patients were in the mild to moderate range of severity. The data cannot be extrapolated to more severely ill borderline patients, but further study of fluoxetine and other selective serotonin reuptake inhibitors is indicated in this population.

Adult↗
PubMed1991

Self-ratings of anger and hostility in borderline personality disorder.

Forty-six patients with borderline personality disorder with and without major depression and 27 normal volunteers completed the Buss-Durkee Hostility Inventory, a self-rating scale of anger and hostility. The patients with borderline personality had significantly higher scores than the normal volunteers. The scores of the patients with borderline personality disorders were not related to gender, treatment or research setting, the degree of acute distress, or the presence of major depression. These findings suggest that a proneness to anger and hostility are enduring characteristics of borderline personality disorder and that anger and depression may represent independent clinical conditions with independent biological mechanisms regulating these two affective states.

Adult↗
PubMed1999

Primitive defense mechanisms in schizophrenics and borderline patients.

In this study, patients with neurotic disorders, borderline patients, acute schizophrenics, and chronic schizophrenics were studied with regard to primitive defense mechanisms. Primitive defense mechanisms were assessed by means of the Lerner Defense Scale (LDS). In this study, the LDS was applied to the Holtzman Inkblot Technique. With the exception of primitive idealization, borderline patients used all primitive defense mechanisms significantly more frequently than patients with neurotic disorders, that is, splitting, projective identification, primitive denial, and primitive devaluation. Compared with both acute and chronic schizophrenics, borderline patients used primitive devaluation at a significantly higher degree of frequency. Both acute and chronic schizophrenics differed from patients with neurotic disorders by using splitting and projective identification significantly more frequently. However, there were differences concerning primitive devaluation and idealization. The defense structure of chronic schizophrenics was heterogenous. Except for primitive idealization, all primitive defense mechanisms correlated significantly with self-report measures of identity diffusion and impaired reality testing, which is consistent with theoretical assumptions. By a discriminant analysis, 90% of the borderline patients, 80% of the patients with neurotic disorders, 76% of the acute schizophrenics, and 92% of the chronic schizophrenics were classified correctly.

Acute Disease↗
PubMed1981

Adolescent suicide attempts and borderline personality disorder: clinical features.

Although suicide among adolescents has been increasing over the past decade, there are surprisingly few clinical studies regarding teen-agers who have attempted suicide. A previous study showed borderline personality disorder as the most common underlying personality problem among a group of predominantly hospitalized adolescents. This paper focuses on the clinical characteristics of 22 teen-agers with a borderline personality disorder who had attempted suicide. The essential pattern of a borderline personality was a persistent instability in a variety of areas, including interpersonal relations, mood, behavior, and self-image. The most prominent characteristics associated with suicide attempts by these adolescents were a tendency to react severely to loss, poorly controlled anger, and self-defeating impulsivity. Many of the characteristic behavioral symptoms of these borderline patients must be determined by a longitudinal history of the teen-ager's life. Specific treatment approaches are needed for these patients.

Adolescent↗
PubMed2006

Topiramate treatment for women with borderline personality disorder: a double-blind, placebo-controlled study.

Borderline personality disorder is a common and severe psychiatric illness. The goal of this study was to determine whether topiramate can influence patients' borderline psychopathology, health-related quality of life, and interpersonal problems. Women meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Structured Clinical Interview II criteria for borderline personality disorder were randomly assigned in a 1:1 ratio to topiramate titrated from 25 to 200 mg/d (n = 28) or placebo (n = 28) for 10 weeks. Primary outcome measures were changes on the Symptom-Checklist, on the SF-36 Health Survey, and on the Inventory of Interpersonal Problems. Body weight and additional side effects were assessed weekly. According to the intent-to-treat principle, significant changes (all P < 0.001) on the somatization, interpersonal sensitivity, anxiety, hostility, phobic anxiety, and Global Severity Index scales of the Symptom Checklist were observed in the topiramate-treated subjects after 10 weeks (no significant changes on the obsessive-compulsive, depression, paranoid ideation, and psychoticism scales). In the SF-36 Health Survey, significant differences were observed on all 8 scales (all P < 0.01 or P < 0.001). In the Inventory of Interpersonal Problems, significant differences (all P < 0.001) were found in the scales for overly autocratic, overly competitive, overly introverted, and overly expressive (no significant differences in the scales for overly cold, overly subassertive/subservient, overly exploitable/compliant, and overly nurturant/friendly). Weight loss was additionally observed (p < 0.001). Topiramate appears to be a safe and effective agent in the treatment in women with borderline personality disorder. Additional weight loss can be expected.

Adolescent↗
PubMed2003

Clinical features and impairment in women with Borderline Personality Disorder (BPD) with Posttraumatic Stress Disorder (PTSD), BPD without PTSD, and other personality disorders with PTSD.

The aims of this study were to examine differences in clinical features, impairment, and types of childhood traumas among women with borderline personality disorder (BPD), women with BPD and posttraumatic stress disorder (PTSD), and those with other personality disorders and PTSD. Using baseline data from the Collaborative Longitudinal Study of Personality Disorders, 186 women were divided into 3 groups (BPD+PTSD, BPD, PTSD), based on structured diagnostic interviews for Axis I and Axis II disorders and compared on selected clinical variables. The additional diagnosis of PTSD in borderline women did not significantly increase the degree of borderline pathology and psychiatric morbidity but did significantly increase general dysfunction and the occurrence of hospitalization. The additional diagnosis of BPD in women with PTSD significantly increased the features of suicide proneness and impulsiveness. Both groups of women with PTSD reported significantly more types of childhood traumas relative to borderline women without PTSD. Consistent with other research, the findings suggest that PTSD does not appear to alter the central features of BPD. The clinical implications of our findings are considered.

Adolescent↗
PubMed2005

Psychotic features in borderline patients: is there a connection to mood dysregulation?

OBJECTIVE: To investigate the relationship between lifetime mood and psychotic spectrum features in patients with borderline personality disorder (BPD). METHOD: The study sample consisted of BPD patients with (n=39, BPD-M) or without (n=21, BPD-no M) lifetime mood disorders. The diagnostic assessment was conducted with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). The diagnosis of BPD was made clinically and then confirmed by Gunderson's diagnostic interview for borderlines. Subjects were also administered the Structured Clinical Interview for Psychotic Spectrum (SCI-PSY) and the Mood Spectrum self-report questionnaire (MOODS-SR). RESULTS: BPD-M had significantly higher scores than BPD-no M on the 'lifetime' mood spectrum subdomains 'depressive mood' and 'depressive cognition'. The two groups did not differ on the scores of psychotic spectrum except for higher 'hypertrophic self-esteem' scores in BPD-no M. In BPD-no M both the depressive and the manic-hypomanic component of mood spectrum were significantly correlated with the 'delusion' subdomain of the psychotic spectrum. The depressive component was correlated with 'depersonalization/derealization' and the manic-hypomanic component was correlated with 'hypertrophic self-esteem'. In BPD-M, the manic-hypomanic component of mood spectrum was correlated with different subdomains of the psychotic spectrum: 'hypertrophic self-esteem', 'self-reference', 'interpretive attitude', 'anger/overreactivity, 'unusual and odd thoughts', 'illusions', 'delusions', 'hallucinations' and 'catatonia'. The depressive component of mood spectrum was 'uncorrelated' with the subdomains of the psychotic spectrum. CONCLUSIONS: Our data support the hypothesis that 'lifetime' manic-hypomanic mood dysregulations are correlated with psychotic spectrum features in borderline patients. The assessment of these spectrum features in borderline patients may be useful to inform treatment choices.

Adolescent↗
PubMed1985

Characterizing anger in the DSM-III borderline personality disorder.

Anger has traditionally been described as the most intense and prevalent affect in the borderline patient. This study was designed to characterize anger in the borderline patient in an in-depth analysis by determining whether inpatients with DSM-III borderline personality disorder differed from controls with dysthymic disorder. Standardized rating instruments including subscales of the Profile of Mood States, Brief Psychiatric Rating Scale, and Minnosota Multiphasic Personality Inventory were utilized. Results generally indicated that borderline patients manifested more severe anger than dysthymic controls. The findings are discussed in light of previous psychodynamic, empirical, and research literature.

Adolescent↗