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At least 1,225 records · Page 68Linked to original sources
PubMed1997

Rorschach revised DEPI and CDI with inpatient Major Depressives and Borderline Personality Disorder with major depression: validity issues.

This study focused on the clinical field validity of the Rorschach comprehensive system revised DEPI and CDI indices. Forty admission protocols from two inpatient adult DSM-III-R diagnosed samples, one with Major Depressive Disorder, uncomplicated, and one with Major Depressive Disorder and concurrent Borderline Personality Disorder, were compared. Hypotheses were (a) both groups would be identified by the revised DEPI and (b) if the Depressed Borderline group was not identified by the DEPI, it would be identified by the CDI. Both hypotheses were negated, raising questions regarding the validity of the indices for use in clinical diagnosis, treatment, and clinical research.

Adaptation, Psychological↗
PubMed1998

Therapists' differential countertransference reactions toward clients with major depression or borderline personality disorder.

The purpose of this study was to examine psychotherapists' differential countertransference reactions toward either clients diagnosed with either Major Depression or Borderline Personality Disorder. Specifically, psychotherapists' personal perceptions and emotional reactions to these clients were assessed utilizing the Impact Message Inventory and the Stress Appraisal Scale (N = 155). Direct feelings, action tendencies, cognitive attributions, and perceived anxiety were evaluated. Results indicated that clients with Borderline Personality Disorder are perceived as significantly more dominant and hostile, whereas clients with Major Depression were considered significantly more submissive, friendly, and salient. In addition, it was found that as clinicians' years of experience increased, degree of countertransference decreased. These results suggest that countertransference reactions can be measured empirically, that differential countertransference reactions are evoked toward clients manifesting different symptoms, and that awareness of countertransference may be important for positive therapeutic outcome.

Adult↗
PubMed1998

The Self-Harm Inventory (SHI): development of a scale for identifying self-destructive behaviors and borderline personality disorder.

Intentional self-harm behavior is an important clinical phenomenon that appears highly related to borderline personality disorder (BPD). Self-harm behavior in the context of borderline personality probably exists along a continuum from graphic, self-harm behavior to milder forms of self-sabotaging behavior that might be viewed as self-defeating Relatively little attention has been paid to developing a self-report measure of intentional self-harm, particularly as a screening device for detecting BPD. In Study 1, an initial list of self-harm behaviors encountered in clinical practice was narrowed to those behaviors related to BPD in a sample comprised of adults from both a mental health and non-mental health setting. All participants (N = 221) underwent a semistructured diagnostic interview for BPD. Using a cut-off score of 5 on the resulting 22-item Self-Harm Inventory (SHI), 83.7% of research participants were correctly classified as having BPD or not. In Study 2, women (N = 285) sampled from an outpatient medical setting completed the SHI and a widely used self-report measure of BPD. The SHI cut-off score resulted in correct classification of 87.9% of the individuals. In Study 3, using a sample of adults involuntarily hospitalized for psychiatric reasons (N = 32), the SHI performed at least as well as another self-report measure of BPD in diagnosing participants (the final diagnosis was based on a semistructured interview). The results are discussed with regard to potential advantages and utility of the SHI and need for further validation.

Adolescent↗
PubMed1999

Relationship between depression and borderline personality disorder.

The frequent occurrence of depressive symptoms in patients with borderline personality disorder has generated considerable interest in the nature of the relationship between borderline personality disorder and the depressive disorders. Data from the perspectives of phenomenology, biology, family history, course of illness, comorbidity patterns, and treatment response have been brought to bear on the question. Reviews based on research available by 1985 and 1991, respectively, arrived at differing conclusions: (1) that both disorders shared common but non-specific sources, and (2) that the two disorders were unrelated but co-occurred because of the high prevalence of each. Since the time of these reviews, additional evidence has become available from a wider range of biological investigations, better controlled comorbidity studies, studies of the relationship of psychosocial stressors to the course of each disorder and neuroimaging studies. In reviewing the more recent findings, we propose the less parsimonious hypothesis that the disorders co-occur, both because they share some common biological features and because the psychosocial sequella of each can contribute to the development of the other.

Borderline Personality Disorder↗
PubMed1988

Borderline personality disorder: replication of MMPI profiles.

The purpose of this study was to determine whether a particular MMPI profile is associated with borderline personality disorder (BPD). Forty-seven symptomatic volunteers who satisfied DSM-III criteria for borderline and/or schizotypal personality disorder were given the full MMPI. Concordance of MMPI profile for BDP confirmed the findings of four previous studies. Elevations were noted on F, D, PD, PA, PT, and SC. A subject's profile with this pattern is interpreted from item content as generally neurotic, dysthymic, socially withdrawn, suspicious, apathetic toward the future, affectively erratic, unable to anticipate the consequences of his or her own behavior, and unable to judge the social desirability of his or her own behavior. Correlations of the foregoing scales with a total BPD score ranged from .44 to .77, with a multiple R of .80 and a cross validity of .77. The accuracy of predicting actual BPD and non-BPD cases was 89%. Accordingly, the MMPI could be used as a coarse screen for BPD casefinding in that patients with the MMPI profiles above should be selected for more thorough diagnostic workup. In the future, the MMPI might be linked to other variables, such as drug response, to understand further the pathophysiology of BPD.

Adolescent↗
PubMed1991

A comparison of borderline and mild mental retardates assessed on the memory for designs and the WAIS-R.

A matched group (N = 114) between high errors and no error conditions on the MFD was examined in a population of borderline and mild mental retardates. Matched variables were sex, Full Scale IQ, and age. The MFD, PIAT, and the WAIS-R were administered to all subjects. Results on achievement tests showed that the mild mental retardation subjects with high errors on the MFD had lower achievement scores on the PIAT compared to the non-error group. The non-error group performed at a higher level on the Picture Arrangement, Vocabulary, Math, and Reading Comprehension. Borderline retardation subjects showed no significant differences between error and non-error groups on the PIAT and WAIS-R. These conclusions indicate that the MFD is a more sensitive indicator of intelligence differences than of organicity differences.

Adult↗
PubMed1991

Borderline, depressive, and schizophrenic discrimination by MMPI.

This study intended to differentiate among borderline personality disorder (BPD), schizophrenic, and depressed patients on the basis of their MMPI profiles. MMPI profiles of 237 psychiatric inpatients were selected on the basis of their primary DSM-III admission diagnoses. Analysis of MMPI mean scores and discriminant function analysis supports previous literature in describing borderline patients as having a broad spectrum of psychopathology typified by an attitude of alienation and rebelliousness, atypical thought content and/or process, and eccentric behavior. Schizophrenic patients are differentiated from BPD patients by the presence of thought disorder and psychotic-like manifestations. The depressed patients did not show the aforementioned extreme characteristics of the other two groups.

Adaptation, Psychological↗
PubMed1992

Psychotherapist personality characteristics and the perception of self and patients in the treatment of borderline personality disorder.

The influence of certain personality characteristics (tendency to depressive experiences, personal boundary preferences) on psychotherapist reaction to patients with borderline personality disorder was assessed by semantic differential ratings in an analogue study. Vignettes presented one of two patients enacting the Rewarding and Withdrawing object relations unit in two separate therapy sessions. Therapists higher on anaclitic depressive and fusion tendencies evaluated themselves less positively than other therapists (p less than .01) in the Withdrawing condition. They evaluated the patient less positively regardless of condition (p less than .05). High boundary therapists evaluated patients more positively (p less than .05) in the Withdrawing condition. They evaluated themselves more positively regardless of condition (p less than .05) and showed less tendency to devalue self and patient with the lower functioning borderline patient.

Adult↗
PubMed1992

Psychotherapist perceptions of self and patients in the treatment of borderline personality disorder.

Psychotherapists' reactions to patients with borderline personality disorder were assessed by semantic differential ratings in an analogue study. Vignettes presented one of two patients who enacted the Rewarding and Withdrawing object relations units in two separate therapy sessions. In response to the Rewarding object relations unit therapists evaluated themselves more positively and perceived themselves as more active and more potent than in response to the Withdrawing object relations unit (p less than .01). They also evaluated the patients more positively and perceived them as less active (p less than .01). These patterns were modified by some order effects and some differences in response to the two vignettes, which represented a lower and higher functioning borderline patient.

Adult↗
PubMed1993

Neuropsychological function in borderline personality disorder.

To evaluate the possibility of an underlying dimension of organicity in borderline personality disorder (BPD), a carefully diagnosed group of borderline patients was assessed across a wide range of neuropsychological functions and then was compared to an age- and education-matched non-patient control group. The BPD group had significantly lower Verbal, Performance, and Full Scale IQ scores on the WAIS-R. The BPD group also was impaired significantly on motor skills, figural memory, complex visuomotor integration, social or interpersonal intelligence, and on a measure of susceptibility to interference. This pattern of deficits localized to the fronto-temporal regions and became more pronounced when a subgroup analysis was performed. This study suggests that subtle organic factors may be operative in some, but not all, BPD patients.

Adult↗
PubMed1993

Association of sexual abuse and borderline personality disorder in eating disordered women.

It has been shown that sexual abuse is associated with the eating disorders, particularly those with a bulimic component. Existing research suggests that borderline personality disorder (or the cluster of behaviors behind this diagnosis) may be a mediating factor in that link. However, there is no evidence of specific patterns of association between the three phenomena. The present report studies these links in a case series of 115 eating-disordered women. It is shown that the links between and reported sexual abuse and borderline personality disorder vary according to the nature of the eating disorder. In particular, they were associated in anorexia of the bulimic subtype, but not in bulimia nervosa or in restrictive anorexia. The possible therapeutic implications of these findings are discussed.

Adolescent↗
PubMed2004

Neurobiological substrates of antisocial and borderline personality disorder: preliminary results of a functional fMRI study.

BACKGROUND: Neuropsychological and imaging studies of patients with antisocial (ASPD) and borderline personality disorder (BPD) are suggestive of frontal lobe dysfunction in these individuals. In normal subjects functional brain imaging has been used to investigate the neuroanatomy of impulse control. There are no such imaging studies in personality-disordered populations. AIM: This study aimed to investigate which neuronal networks are involved in response inhibition in Cluster B personality disorders and whether these are different from healthy subjects. HYPOTHESIS: We hypothesized that the personality-disordered sample would have attenuated orbitofrontal cortex responses during performance of a Go/NoGo task compared with healthy controls. METHOD: Eight inpatients with a DSM-IV diagnosis of borderline or antisocial personality disorder and eight healthy controls were scanned using fMRI while performing a Go/NoGo task. Impulsivity was assessed using the Barratt Impulsivity Scale (BIS) and the Impulsiveness-Venturesomeness-Empathy (IVE) inventory. RESULTS: In the control group the main focus of activation during response inhibition was in the prefrontal cortex, specifically the right dorsolateral and the left orbitofrontal cortex. Active regions in the patient group showed a more bilateral and extended pattern of activation across the medial, superior and inferior frontal gyri extending to the anterior cingulate. CONCLUSIONS: fMRI is a useful tool to detect brain activation during response inhibition. ASPD and BPD patients activate different neural networks to successfully inhibit pre-potent responses.

Adult↗
PubMed2004

Pitfalls in the cytological classification of borderline leprosy in the Ridley-Jopling scale.

This is a blinded, retrospective, correlative study of classification of leprosy by cytomorphology, clinical examination, and bacterial density. One hundred consecutive adequate aspirates from skin lesions of leprosy were studied. The Ridley-Jopling (R-J) five-group classification system was used. May-Gruenwald-Giemsa (MGG) and Ziehl-Neelsen (Z-N) stains were employed. Complete clinical, cytological, and bacteriological concordance was found in 88 patients. One-step mismatch in classification was seen in 12 patients with cytomorphological features of borderline-borderline (BB/mid-borderline) leprosy. Cytomorphological features of BB leprosy in aspirates from skin lesions should alert the cytopathologist to the possibility that the bacteriological index (BI) may vary widely. Appropriate steps must be taken to ensure accurate reporting of BI.

Azure Stains↗
PubMed2003

A dialectical behavior therapy program for people with an eating disorder and borderline personality disorder--description and outcome.

OBJECTIVE: To describe and evaluate a full dialectical behavior therapy (DBT) program for people with comorbid eating disorder and borderline personality disorder. The program included a novel skills training module written especially for eating-disordered patients. METHOD: The program was run for 18 months. Days in hospital and major acts of self-harm were counted for the 18 months before and after DBT. RESULTS: There were no dropouts from the program. The patients seemed to benefit. Most patients were neither eating disordered nor self-harming at follow-up. DISCUSSION: Full DBT is an expensive and demanding treatment but deserves consideration for patients with an eating disorder and co-morbid borderline personality disorder and self-harm. There is a need for a more systematic and thorough evaluation.

Adolescent↗
PubMed2006

Schema therapy for borderline personality disorder.

This article presents the Schema Therapy (Young, Klosko, & Weishaar, 2003) approach to the treatment of borderline personality disorder. Schema therapy draws on the cognitive-behavioral, attachment, psychodynamic, and emotion-focused traditions and conceptualizes patients who have borderline personality disorder as being under the sway of five modes or aspects of the self. The goal of the therapy is to reorganize this inner structure. To this end, there are four core mechanisms of change that are used in this therapy: (1) limited reparenting, (2) experiential imagery and dialogue work, (3) cognitive restructuring and education, and (4) behavioral pattern breaking. These interventions are used during the three phases of treatment: (1) bonding and emotional regulation, (2) schema mode change, and (3) development of autonomy.

Affect↗
PubMed2006

Interpersonal psychotherapy for borderline personality disorder: possible mechanisms of change.

This article describes the rationale for applying interpersonal psychotherapy (IPT) to the treatment of patients who have borderline personality disorder and explains the adaptation of standard IPT to that end. The authors describe the preliminary stages of adapting IPT for a pilot study to test its feasibility and potential efficacy and speculate on potentially therapeutic mechanisms for IPT in treating patients who have borderline personality disorder.

Adult↗
PubMed1993

Developing a systems approach to caring for persons with borderline personality disorder.

Most community mental health centers have not established a treatment approach for seriously ill persons with borderline personality disorder that is multi-focused, coordinated, comprehensive, and continuous. The authors propose that the systems approach to caring for persons with schizophrenia (Stein, Diamond, & Factor, 1990) be modified and tested for its efficacy in helping seriously ill persons with borderline personality disorder. The rationale for proposing this model of care and its underlying principles and clinical components is described in this paper.

Borderline Personality Disorder↗
PubMed1989

The use of contracts in the inpatient treatment of the borderline personality disorder.

This paper reviews and describes the clinical, administrative, and psychodynamic aspects of the use of contracts. The particular focus is on how the characteristic difficulties which borderline personality disorder patients encounter on inpatient services are helped by contracting. The use of contracts facilitates the therapeutic alliance, and aids in the avoidance of excessive regression and acting out. The improved stabilization of the patient permits a more constructive use of transference and countertransference, and facilitates a clearer examination of Axis I diagnosis and the use of medication. The contracting process can be a useful addition to the inpatient treatment of borderline personality disorder patients.

Acting Out↗