Borderline personality disorder features in adolescent girls: P300 evidence of altered brain maturation

Executive functions and borderline personality features in adolescents with major depressive disorder

Background

Executive functions (EF) consolidate during adolescence and are impaired in various emerging psychiatric disorders, such as pediatric Major Depressive Disorder (pMDD) and Borderline Personality Disorder. Previous studies point to a marked heterogeneity of deficits in EF in pMDD. We examined the hypothesis that deficits in EF in adolescents with pMDD might be related to comorbid Borderline Personality features (BPF).

Methods

We examined a sample of 144 adolescents (15.86 ± 1.32) diagnosed with pMDD. Parents rated their child's EF in everyday life with the Behavior Rating Inventory of Executive Function (BRIEF) and BPF with the Impulsivity and Emotion Dysregulation Scale (IED-27). The adolescents completed equivalent self-rating measures. Self- and parent-ratings of the BRIEF scores were compared with paired t-Tests. Correlation and parallel mediation analyses, ICC, and multiple regression analyses were used to assess symptom overlap, parent-child agreement, and the influence of depression severity.

Results

Over the whole sample, none of the self- or parent-rated BRIEF scales reached a mean score above T > 65, which would indicate clinically impaired functioning. Adolescents tended to report higher impairment in EF than their parents. Depression severity was the strongest predictor for BPF scores, with Emotional Control predicting parent-rated BPF and Inhibit predicting self-rated BPF. Furthermore, the Behavioral Regulation Index, which includes EF closely related to behavioral control, significantly mediated the relationship between depression severity and IED-27 factors emotional dysregulation and relationship difficulties but not non-suicidal self-injuries.

Conclusion

On average, adolescents with depression show only subtle deficits in executive functioning. However, increased EF deficits are associated with the occurrence of comorbid borderline personality features, contributing to a more severe overall psychopathology. Therefore, training of executive functioning might have a positive effect on psychosocial functioning in severely depressed adolescents, as it might also improve comorbid BPF.

Clinical trial registration

www.ClinicalTrials.gov, identifier NCT03167307.

EEG Markers in Emotionally Unstable Personality Disorder-A Possible Outcome Measure for Neurofeedback: A Narrative Review

Objectives. There is growing evidence for the use of biofeedback (BF) in affective disorders, dissocial personality disorder, and in children with histories of abuse. Electroencephalogram (EEG) markers could be used as neurofeedback in emotionally unstable personality disorder (EUPD) management especially for those at high risk of suicide when emotionally aroused. This narrative review investigates the evidence for EEG markers in EUPD. Methods. PRISMA guidelines were used to conduct a narrative review. A structured search method was developed and implemented in collaboration with an information specialist. Studies were identified via 3 electronic database searches of MEDLINE, Embase, and PsycINFO. A predesigned inclusion/exclusion criterion was applied to selected papers. A thematic analysis approach with 5 criteria was used. Results. From an initial long list of 5250 papers, 229 studies were identified and screened, of which 44 met at least 3 of the predesigned inclusion criteria. No research to date investigates EEG-based neurofeedback in EUPD. A number of different EEG biomarkers are identified but there is poor consistency between studies. Conclusions. The findings heterogeneity may be due to the disorder complexity and the variable EEG related parameters studied. An alternative explanation may be that there are a number of different neuromarkers, which could be clustered together with clinical symptomatology, to give new subdomains. Quantitative EEGs in particular may be helpful to identify more specific abnormalities. EEG standardization of neurofeedback protocols based on specific EEG abnormalities detected may facilitate targeted use of neurofeedback as an intervention in EUPD.

Evidence for Altered Neural Processing in Patients With Borderline Personality Disorder

Abstract. Borderline personality disorder (BPD) is characterized by difficulties in emotion regulation, self-identity disturbances, self-injurious behavior, and reduced inhibitory control. Event-related potential (ERP) studies have sought to reveal the neural correlates of cognitive distortions and behavioral alterations in BPD. The article presents an overview of the existing ERP literature pertaining to BPD and discusses whether any one of the electrophysiological findings could serve as a reliable and specific marker for BPD. In short, ERP studies investigating P300 tentatively suggest impaired inhibitory control. Moreover, reduced error- and feedback-related processing and impaired response inhibition seem to be associated with impulsivity and risk-taking behavior in BPD patients. However, these findings are not specific for BPD. Regarding emotional and self-referential information processing, individuals with BPD display heightened vigilance toward social threat impacting their cognitive performance in various social-cognitive tasks demonstrating alterations of early negative and late positive potentials. These multifaceted electrophysiological alterations may be attributed to dysfunctional activity and connectivity of frontal brain regions and the limbic system.

Neural Responses to Signals for Behavior Change: Greater Within-Person Variability is Associated With Risk Factors for Substance Dependence

BACKGROUND

An impaired ability to change behavior in the face of cues indicating a need for change is one means of defining risk for substance dependence. The present study used a cognitive task administered in a laboratory as a model of this process. It focused on 2 known and related correlates of risk (conduct disorder, borderline personality disorder) and examined their associations with reactivity to cues requesting a change in motor behavior.

METHODS

A total of 224 teenagers, 14 to 19 years of age, performed a task during which white noise bursts were used to cue a requirement to reverse the mapping of right and left key press responses onto high- and low-frequency pure tones during a subsequent trial block. The amplitude of the P300 electroencephalographic (EEG) response to each cue was summarized by calculating its across-trial average as well as its intertrial variability (ITV). In addition, the number of motor response reversal failures (perseveration errors) was calculated.

RESULTS

The ITV of the P300 response to cues for behavior change was superior to its average amplitude in revealing associations with risk: It was significantly greater among teenagers with more conduct problems and more borderline personality disorder symptoms in comparison with their less-affected peers. ITV was also positively correlated with perseveration errors. No group differences were found in P300 amplitude averaged over trials.

CONCLUSIONS

The findings suggest that the measurement of intertrial variability in brain activity may be more valuable than the average level for revealing neurophysiological differences associated with impulsivity and personality risk factors for dependence. EEG measures may be particularly valuable in this context because they offer superior temporal resolution and signal-to-noise characteristics.

P300 development from infancy to adolescence

This article provides an overview of P300 research from infancy through adolescence. First, a brief historical overview is provided highlighting seminal studies that began exploration of the P300 component in developmental groups. Overall, these studies suggest that the P300 can be detected in children and appears to reflect similar cognitive processes to those in adults; however, it is significantly delayed in its latency to peak. Second, two striking findings from developmental research are the lack of a clear P300 component in infancy and differential electrophysiological responses to novel, unexpected stimuli in children, adolescents, and adults. Third, contemporary questions are described, which include P300-like components in infancy, alteration of P300 in atypically developing groups, relations between P300 and behavior, individual differences of P300, and neural substrates of P300 across development. Finally, we conclude with comments regarding the power of a developmental perspective and suggestions for important issues that should be addressed in the next 50 years of P300 research.

Face and gaze perception in borderline personality disorder: An electrical neuroimaging study

Humans are sensitive to gaze direction from early life, and gaze has social and affective values. Borderline personality disorder (BPD) is a clinical condition characterized by emotional dysregulation and enhanced sensitivity to affective and social cues. In this study we wanted to investigate the temporal-spatial dynamics of spontaneous gaze processing in BPD. We used a 2-back-working-memory task, in which neutral faces with direct and averted gaze were presented. Gaze was used as an emotional modulator of event-related-potentials to faces. High density EEG data were acquired in 19 females with BPD and 19 healthy women, and analyzed with a spatio-temporal microstates analysis approach. Independently of gaze direction, BPD patients showed altered N170 and P200 topographies for neutral faces. Source localization revealed that the anterior cingulate and other prefrontal regions were abnormally activated during the N170 component related to face encoding, while middle temporal deactivations were observed during the P200 component. Post-task affective ratings showed that BPD patients had difficulty to disambiguate neutral gaze. This study provides first evidence for an early neural bias toward neutral faces in BPD independent of gaze direction and also suggests the importance of considering basic aspects of social cognition in identifying biological risk factors of BPD.

A systematic review of the neurobiological underpinnings of borderline personality disorder (BPD) in childhood and adolescence

Contemporary theories for the aetiology of borderline personality disorder (BPD) take a lifespan approach asserting that inborn biological predisposition is potentiated across development by environmental risk factors. In this review, we present and critically evaluate evidence on the neurobiology of BPD in childhood and adolescence, compare this evidence to the adult literature, and contextualise within a neurodevelopmental framework. A systematic review was conducted to identify studies examining the neurobiological (i.e. genetic, structural neuroimaging, neurophysiological, and neuropsychological) correlates of BPD symptoms in children and adolescents aged 19 years or under. We identified, quality assessed, and narratively summarised 34 studies published between 1980 and June 2016. Similar to findings in adult populations, twin studies indicated moderate to high levels of heritability of BPD, and there was some evidence for gene-environment interactions. Also consistent with adult reports is that some adolescents with BPD demonstrated structural (grey and white matter) alterations in frontolimbic regions and neuropsychological abnormalities (i.e. reduced executive function and disturbances in social cognition). These findings suggest that neurobiological abnormalities observed in adult BPD may not solely be the consequence of chronic morbidity or prolonged medication use. They also provide tentative support for neurodevelopmental theories of BPD by demonstrating that neurobiological markers may be observed from childhood onwards and interact with environmental factors to increase risk of BPD in young populations. Prospective studies with a range of repeated measures are now required to elucidate the temporal unfurling of neurobiological features and further delineate the complex pathways to BPD.

Heritability and molecular-genetic basis of the P3 event-related brain potential: a genome-wide association study

P3 amplitude is a candidate endophenotype for disinhibitory psychopathology, psychosis, and other disorders. The present study is a comprehensive analysis of the behavioral- and molecular-genetic basis of P3 amplitude and a P3 genetic factor score in a large community sample (N = 4,211) of adolescent twins and their parents, genotyped for 527,829 single nucleotide polymorphisms (SNPs). Biometric models indicated that as much as 65% of the variance in each measure was due to additive genes. All SNPs in aggregate accounted for approximately 40% to 50% of the heritable variance. However, analyses of individual SNPs did not yield any significant associations. Analyses of individual genes did not confirm previous associations between P3 amplitude and candidate genes but did yield a novel association with myelin expression factor 2 (MYEF2). Main effects of individual variants may be too small to be detected by GWAS without larger samples.

The development of prospective memory across adolescence: an event-related potential analysis

Prospective memory (PM) is an important cognitive function vital for day-to-day functioning. Although there has been extensive research into the decline of PM in older adulthood, little is known about its developmental trajectory throughout adolescence, a time of important brain maturation. In the present study, the development of PM was examined in 85 participants across the following groups: 12 to 13-year-olds (n = 19), 14 to 15-year-olds (n = 21), 16 to 17-year-olds (n = 19), and 18 to 19-year-olds (n = 26). A 30-cue (30 min) event-based PM task (with font-color stimuli as PM cues and a lexical-decision task as the ongoing task) was used while recording Event-Related Potentials (ERPs). The well-established neural correlates of PM, the N300 and parietal positivity, were examined across the age groups. In addition, hierarchical multiple regressions were used to examine the unique contribution of executive functioning measures (viz., the Self-Ordered Pointing Task [SOPT], the Stroop task, and Trail Making Test [TMT]) on the ERP components of PM (after controlling for age). First, the established components of ERPs associated with prospective remembering (i.e., N300 and parietal positivity) were detected for each age group. Second, although there were no significant age- group differences on the amplitude of the N300, the amplitude of the parietal positivity was found to be different between the 12 to 13-year-olds and 18 to 19-year-olds (viz., the 12 to 13-year-olds had the highest amplitude). Third, for the contribution of executive functioning measures on the amplitude of the ERP components of PM, the regression on the N300 was not significant, however, the SOPT beta weights were significant predictors of the amplitude of the parietal positivity. This relationship was found to be specific for the central and right electrode region. These findings are discussed within the context of brain development and executive functioning along with particular task demands, which may contribute to age-related PM differences across adolescence. Moreover, the findings suggest that cognitive processes associated with parietal positivity may continue to develop across adolescence.

A Long-Term Longitudinal Examination of the Effect of Early Onset of Alcohol and Drug Use on Later Alcohol Abuse

BACKGROUND

Early onset of alcohol use has been linked to later alcohol problems in adulthood. Currently, it is not clear whether early onset of marijuana and tobacco use similarly predicts alcohol problems. Moreover, most studies examining the effect of early substance use onset on later problems only have followed youth into their early 20s. Therefore, the primary goal of this study was to examine whether early onset of alcohol, marijuana, and tobacco use predicts alcohol problems beyond the transition to adulthood.

METHODS

The sample included 225 15-19-year-old youth (60% girls; 62% Caucasian) who were surveyed in three time periods: 1993-1998 (Time 1), 1998-2003 (Time 2), and 2003-2007 (Time 3). Participants reported their age of onset for regular drinking, tobacco use, and marijuana use. At each time of measurement, they also completed surveys relating to their alcohol use and abuse.

RESULTS

Participants with an earlier age of onset of drinking regularly scored higher on the Michigan Alcoholism Screening Test (MAST) and drank more frequently to get high and drunk throughout their 20s. Tobacco use onset and marijuana use onset were not associated with later alcohol use or abuse.

CONCLUSIONS

Results from this study suggest that the relationship between the onset of substance use and later substance abuse may be substance specific. Of note, early onset of regular drinking was associated with alcohol problems during adulthood, underscoring the importance of delaying the onset of regular alcohol use among youth.

Borderline personality disorder in four different age groups: a cross-sectional study of community residents in Germany

Studies examining the natural course of borderline personality disorder (BPD) over the life span have yielded declining prevalence rates in older age groups. However, there is evidence that different BPD symptoms have different longitudinal patterns, with impulsivity decreasing with advancing age and negative affect remaining stable into late adulthood. However, since all studies dealt with treated, clinical samples of BPD patients, it is not yet known whether this represents the natural course of BPD symptoms or just mirrors difference in treatability of these symptoms. The authors addressed this issue by investigating a nonclinical population and compared prevalence of BPD, impulsivity, and depressivity in various age groups from adolescence to late adulthood (N = 2,488); all individuals were assessed by standardized clinical interviews. Syndromal and subsyndromal BPD rates sharply decreased between adolescents and young adults and remained stable thereafter. Whereas the same course was found for impulsivity, depressivity increased between young, middle-aged, and older adults. The present results support the hypothesis that age-related decreases in BPD diagnosis might be attributable to declining levels of impulsivity, whereas the persistence of a subsyndromal BPD might be attributable to an enduring negative affect.

Transdermal nicotine administration and the electroencephalographic activity of substance abusers in treatment

OBJECTIVES

It is widely recognized that individuals with alcohol or illicit substance abuse disorders often smoke cigarettes. However, few studies have examined the direct effects of nicotine among substance abuse subgroups. The current study examined patterns of electroencephalographic (EEG) activity in alcohol-dependent (AD), stimulant-dependent (StimD), alcohol- and stimulant-dependent (ASD) participants, as well as community controls (CC). All participants were regular smokers.

METHODS

After overnight nicotine abstinence, subjects were administered either a high (14 or 21 mg) or low (7mg) dose transdermal nicotine patch. EEG data were collected during a 2 minute eyes open and 5 minute eyes closed baseline recording session, which occurred as part of a larger study of brain electrophysiology.

RESULTS

The most interesting finding was a differential pattern of nicotine dose effects by group. EEGs of Controls and ASD participants did not distinguish between high and low nicotine doses; whereas, nicotine administration in the AD and StimD groups resulted in opposite findings across a range of spectral bands.

CONCLUSIONS

Although further research is warranted, these results may have implications for the study of smoking cessation and attentional functioning among substance abusers in treatment. These data suggest that nicotine-related changes in neurophysiology may be associated with specific brain areas and/or specific drug histories and reinforce the need for caution in generalizing among such groups.

Altered emotional information processing in borderline personality disorder: an electrophysiological study

Emotional dysregulation is one of the key symptoms of patients with borderline personality disorder (BPD). In the present study it is hypothesized that borderline patients display a cortical hyper-responsivity to emotional stimuli compared with a healthy control group. Further, we aimed to examine whether BPD patients were able to suppress stimuli with negative emotional valence as well as healthy control participants could. This is the first study addressing the electrophysiological processing of emotional stimuli in BPD. The electrophysiological response to emotional information was studied among 30 BPD patients and compared with the response in 30 normal controls using event-related potentials (ERPs). Participants were shown pictures selected from the International Affective Picture System with neutral, positive, and negative valence. After performing an attentional task, the participants were asked to perform a reappraisal task. The assignment was to consciously suppress emotions that might occur after viewing pictures with an unpleasant content. Borderline patients displayed larger late positive potentials (LPP) to pictures with an unpleasant valence as compared with the control group, indicating an enhanced elaborative processing of unpleasant stimuli. However, they did not differ on the reappraisal task. Borderline patients show an enhanced emotional cortical reactivity to unpleasant stimuli as compared with a control group. This suggests an emotional dysfunctioning in BPD patients. This feature might be an important focus in the treatment of BPD.

A finer examination of the role that negative affect plays in the relationship between paternal alcoholism and the onset of alcohol and marijuana use

OBJECTIVE

This study was designed to separately examine the relations between four fundamental components of negative affect (sadness, fear, guilt, and hostility) and the onset of substance use. An additional goal was to examine the potential mediating roles that these components of negative affect play in the relationship between paternal alcoholism and the initiation of substance use.

METHOD

The sample included 200 adolescents ages 15-19 years (62% girls; 68% white; 56% children of alcoholics [COAs]) and their fathers. The adolescents were followed up 5 years later when they were in early adulthood. Participants completed a clinical psychiatric interview and self-report questionnaires that assessed negative affect and substance use.

RESULTS

Results from structural equation modeling indicated that higher levels of hostility and lower levels of guilt were associated with earlier substance-use initiation. In addition, hostility played an indirect role in the relationship between paternal alcoholism and the onset of marijuana use, with COAs reporting higher hostility levels than non-COAs and higher hostility predicting earlier marijuana use.

CONCLUSIONS

These results underscore the importance of separately examining different components of negative affect when investigating the role that negative affect plays in substance use.

Anterior cingulate volume in adolescents with first-presentation borderline personality disorder

Reports of volumetric abnormalities in the anterior cingulate cortex (ACC) in adults with established borderline personality disorder (BPD) are inconsistent, and it is not known whether such abnormalities are present early in the disorder. We aimed to investigate ACC volume in a first-presentation teenage BPD sample with minimal exposure to treatment. Fifteen female BPD patients and 15 healthy female control participants underwent magnetic resonance imaging (MRI) scanning. ACC volumes were estimated using a reliable method that accounts for inter-individual variation in sulcal morphology, and measurements were compared between the two groups. Analysis of variance revealed a decrease in volume of the left ACC in BPD patients compared with control participants. This volumetric change was correlated with parasuicidal behavior and impulsivity. A measure of ACC volume asymmetry was also correlated with fear of abandonment symptoms. Our results suggest that ACC volumetric abnormalities early in the course of BPD might be related to clinical correlates of the disorder. Longitudinal studies are needed to examine the nature of this abnormality over the course of the disorder.

A biosocial developmental model of borderline personality: Elaborating and extending Linehan's theory

Over the past several decades, research has focused increasingly on developmental precursors to psychological disorders that were previously assumed to emerge only in adulthood. This change in focus follows from the recognition that complex transactions between biological vulnerabilities and psychosocial risk factors shape emotional and behavioral development beginning at conception. To date, however, empirical research on the development of borderline personality is extremely limited. Indeed, in the decade since M. M. Linehan initially proposed a biosocial model of the development of borderline personality disorder, there have been few attempts to test the model among at-risk youth. In this review, diverse literatures are reviewed that can inform understanding of the ontogenesis of borderline pathology, and testable hypotheses are proposed to guide future research with at-risk children and adolescents. One probable pathway is identified that leads to borderline personality disorder; it begins with early vulnerability, expressed initially as impulsivity and followed by heightened emotional sensitivity. These vulnerabilities are potentiated across development by environmental risk factors that give rise to more extreme emotional, behavioral, and cognitive dysregulation. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

A comparison of three vulnerability models for the onset of substance use in a high-risk sample

OBJECTIVE

The purpose of this prospective study was to compare the following three vulnerability models for early-onset substance use in a high-risk sample: the deviance proneness model, the negative affect regulation model, and a comprehensive model including both delinquency and negative affect.

METHOD

The sample included 249 15- to 19-year-old adolescents (57% children of alcoholics) and their fathers, all of whom were seen at follow-up 5 years later. At both times of measurement, participants completed a clinical psychiatric interview and a battery of self-report questionnaires assessing temperament, negative affect, delinquency, and substance use.

RESULTS

Although all of the models fit the data well, the deviance proneness model was parsimonious and provided the best fit. Delinquency played a significant mediating role, whereas negative affect did not. Moreover, negative affect and delinquency were not significantly related to one another.

CONCLUSIONS

Results from this study suggest that the deviance proneness model may be a more useful theoretical framework than the negative affect regulation model or a comprehensive model when examining the onset of substance use, particularly in a high-risk sample.

Fact or fiction: diagnosing borderline personality disorder in adolescents

Borderline Personality Disorder (BPD) has long been considered a mental health problem that results in considerable costs in terms of human suffering and psychiatric expenses among adult patients. Although the diagnosis of BPD for adolescents is frequently used in clinical settings, the field of mental health has questioned whether one should diagnose BPD among adolescents. This paper reviews the recent empirical literature (identified through PsycINFO 1980 to present) to evaluate prevalence, reliability, and validity of a BPD diagnosis in adolescents. It is concluded that the features BPD diagnoses in adolescents are comparable to those in adults. Furthermore, there appears to be a legitimate subgroup of adolescents for whom the diagnosis remains stable over time as well as a less severe subgroup that moves in and out of the diagnosis. While caution is warranted, formal assessment of BPD in adolescents may yield more accurate and effective treatment for adolescents experiencing BPD symptomatology. More longitudinal research is necessary to further explicate the issues of diagnosing BPD in adolescents.

P3 components of the event-related potential and marijuana dependence in Southwest California Indians

Native Americans have some of the highest rates of marijuana use and abuse, yet neurobiological measures associated with addiction to marijuana in this population remain unknown. The present investigation evaluated associations between the P350 and P450 components of the event-related potential (ERP) elicited by affective stimuli, and marijuana dependence in a population of Southwest California (SWC) Indian adults. Three hundred and seventeen participants with a mean age of 30 years who were free of major Axis I and psychiatric diagnoses and antisocial personality disorder were categorized as: (1) no marijuana use disorders or other drug dependence diagnoses; (2) marijuana dependence and no other drug dependence diagnoses; and (3) marijuana dependence and other drug dependence diagnoses. ERPs were collected using a facial discrimination task that generated a late positive component with two peaks at approximately P350 and P450 milliseconds. Multivariate analyses of variance was used to detect associations between the two component peaks and the three participant groups taking into consideration age, gender and the presence of a lifetime diagnosis of alcohol dependence. Increases in the latency of both the P350 and P450 component peaks were found to be associated with the diagnosis of marijuana dependence and marijuana dependence co-morbid with other drug dependence. Women appeared to be more impacted than men are. A diagnosis of marijuana dependence was not associated with any changes in late component amplitudes. Taken together these studies suggest that marijuana dependence may be associated with delays in the evaluation and identification of emotional stimuli in SWC Indians.

Paternal alcoholism and youth substance abuse: the indirect effects of negative affect, conduct problems, and risk taking

This longitudinal study followed 200 adolescents into early adulthood to explore the potential mediating roles that hostility, sadness, conduct problems, and risk-taking play in the relationship between paternal alcoholism and substance abuse. Results indicated that paternal alcoholism predicted hostility; in turn, hostility predicted risk taking, which predicted substance abuse.

Electrophysiological responses to affective stimuli in Mexican Americans: Relationship to alcohol dependence and personality traits

The relationship between the P450 component elicited by affective stimuli and: a personal history of alcohol dependence, antisocial personality disorder/conduct disorder (ASPD/CD) or affective anxiety disorders (ANYAXAF) was examined in Mexican Americans, a group with high rates of heavy drinking. Data from two hundred and twenty two young adults between the ages of 18 and 30 were used in the analyses. ERPs were collected using a task that required discrimination between faces with neutral, sad and happy facial expressions. DSM-IIIR diagnoses were obtained using a structured interview and personality traits were indexed using the Maudsley personality inventory. Men had significantly diminished P450 responses, when compared to women which were further reduced in men with ASPD/CD; whereas, a significant increase in P450 amplitudes was seen in those participants with ANYAXAF. P450 amplitudes were also significantly increased in men with high extraversion scores and in women with high neuroticism scores. No significant associations were seen between the P450 amplitude and the diagnosis of alcohol dependence. These data suggest that interpretations of P450 responses in Mexican Americans need to take into account the interactions between gender, the affective valence of the eliciting stimuli, as well as psychiatric status.

Do personality characteristics and risk taking mediate the relationship between paternal substance dependence and adolescent substance use?

This longitudinal study examined whether adolescent personality characteristics and risk taking mediate the relationship between paternal substance dependence and adolescent substance use. At Time 1, the sample included 249 15-19 year-old adolescents and their fathers. These individuals also were assessed 5 years later (Time 2). Results indicated that paternal substance dependence directly and indirectly (via personality and risk taking) predicted adolescent substance use. Paternal substance dependence had significant direct effects on age when the adolescent first used marijuana and significant indirect effects on age when regular drinking began, age when first used marijuana, and frequency of drinking to get "high" or "drunk." All of the indirect personality effects were via adolescent disinhibition. In addition, adolescent risk taking further mediated personality and adolescent substance use. Results from this study are discussed in relation to an epigenetic perspective of human development.

Childhood antecedents of personality disorder

PURPOSE OF REVIEW

Given the substantial continuity of personality and axis I psychopathology from childhood to adult life, the present review explores whether and how recent research findings support the notion that personality disorders have their developmental precipitants in childhood. Potential childhood personality disorder antecedents will be reviewed from different research areas to enhance an insight into the genesis of a major set of adult psychiatric disorders with profound impact on the daily life.

RECENT FINDINGS

There exists increasing evidence that personality disorders have their origins in early years of life at the observable symptomatic, biological, and genetic levels. A clear need for prospective (behavior genetic) studies, however, exists that will ultimately verify how and when childhood personality disorder features turn into adult maladaptive trait patterns. It is further suggested that these designs require a comprehensive taxonomy for the description of personality disorder antecedents in a developmentally appropriate way.

SUMMARY

The call for a developmental perspective on adult personality disorders in recent debates on the construction of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has created new avenues for an integrative longitudinal perspective on personality disorders and should stimulate child psychiatrists to consider the significance of emerging personality disorder symptoms at a young age.

Tobacco Use, Alcohol Dependence, and Cognitive Performance

Chronic alcohol abuse has long been associated with a mild, generalized pattern of cognitive decrements. However, it is important to note that problem drinking rarely occurs in isolation from abuse of other drugs. For people dependent upon alcohol, tobacco is one of the mostly commonly coabused substances. Recent research suggests that individuals with alcohol dependency may gravitate toward tobacco use, in part, because of the positive effects of nicotine on aspects of cognitive performance that may be compromised as a consequence of chronic alcohol misuse. In this article, the author focuses on the effects of nicotine on behavioral and electrophysiological indexes of cognitive performance, and the impact of these effects on alcohol-related cognitive decrements. The author discusses implications of these findings in the context of treatment and recovery of people with alcoholism.

Brain maturation in conduct disorder versus borderline personality disorder

Conduct disorder (CD) and borderline personality disorder (BPD) have been associated with abnormalities in brain function. The present study assessed whether adolescents with significant symptoms of CD and BPD display abnormal brain maturation. Participants recruited from the community were categorized as CD only, BPD only, CD plus BPD, or controls with neither CD nor BPD. Brain maturation was estimated by the amplitude difference in the P300 event-related brain potential between participants < versus > or = 17 years old. With increasing age, controls and BPD only participants exhibited a P300 amplitude decline. This pattern was not evident in the CD only and CD plus BPD groups. The different brain maturation patterns seen in adolescents with CD versus BPD symptoms may contribute to differences in age-of-onset, clinical course, and resistance to treatment.