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D'Aurizio G, Di Stefano R, Socci V, Rossi A, Barlattani T, Pacitti F, Rossi R. The role of emotional instability in borderline personality disorder: a systematic review. Ann Gen Psychiatry 2023; 22:9. [PMID: 36918920 PMCID: PMC10011773 DOI: 10.1186/s12991-023-00439-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/25/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND The emotional regulation process plays a pivotal role in daily-life functioning, modulating goal-directed and adaptive behavior. Conversely, altering this cognitive function can disrupt self-regulation and bring emotional dysregulation. Emotional instability could represent a core characteristic of BPD, also modulating the BPD symptom's onset. This systematic review aims to summarize the existing literature reporting the role of emotional instability in BPD to better define the role of the impairment of the emotional processes in the onset of the cognitive and behavioral symptoms of this complex mental disorder. METHODS MEDLINE, Scopus and Web of Science were independently searched for relevant studies. Eligible studies had to be identifiable through database searching, published and accessible. This systematic review was conducted according to PRISMA guidelines. The search period was from 2012 to 14 September 2022. RESULTS A pool of 120 studies was identified, out of which 11 met the selection criteria and were included. Overall, the studies confirm a relationship between emotional instability and borderline personality disorder. CONCLUSIONS The evidences retrieved seem to point out the role of the emotional impairment not only in worsening of the disorder, but could also be one of the risk factors for its onset.
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Affiliation(s)
- Giulia D'Aurizio
- Chair of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100, L'Aquila, Italy
| | - Ramona Di Stefano
- Chair of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100, L'Aquila, Italy.
| | - Valentina Socci
- Chair of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100, L'Aquila, Italy
| | - Alessandro Rossi
- Chair of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100, L'Aquila, Italy
| | - Tommaso Barlattani
- Chair of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100, L'Aquila, Italy
| | - Francesca Pacitti
- Chair of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100, L'Aquila, Italy
| | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Personality Disorders in Childhood: Validity of the Coolidge Personality and Neuropsychological Inventory for Children (CPNI). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074050. [PMID: 35409734 PMCID: PMC8998288 DOI: 10.3390/ijerph19074050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 12/10/2022]
Abstract
BACKGROUND A growing body of evidence has shown that maladaptive traits and emerging patterns of personality can be traced to an early stage of development and may be assessed in childhood. The goal of present study was to provide preliminary data on the validity of the Coolidge Personality and Neuropsychological Inventory for Children (CPNI), an instrument designed to assess personality pathologies and other clinical conditions in childhood. METHOD A sample of 146 clinicians completed the CPNI, as well as the Child Behavior Checklist (CBCL) to evaluate the behavioral problems and social competencies, regarding a child (aged 6-11 years) who had been in their care between 2 and 12 months. The clinicians also filled out a clinical questionnaire to provide information on the children, their families, and psychotherapies. RESULTS There were significant and clinically consistent associations between the CPNI and CBCL. They confirmed the good concurrent (convergent and discriminant) validity of the CPNI. CONCLUSIONS The findings seem to support the validity of the CPNI as diagnostic instrument, taking children's PDs and behavioral problems into account. Despite some limitations, the CPNI represents a helpful measure to evaluate the children's personality configurations according to the DSM model. It may be employed along with other tools based on other diagnostic frameworks within the context of a multi-method and multi-informant assessment to provide an accurate and comprehensive formulation of children's overall functioning.
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Fortunato A, Tanzilli A, Lingiardi V, Speranza AM. Childhood Personality Assessment Q-Sort (CPAP-Q): A Clinically and Empirically Procedure for Assessing Traits and Emerging Patterns of Personality in Childhood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6288. [PMID: 34200700 PMCID: PMC8296064 DOI: 10.3390/ijerph18126288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Despite increasing research confirming the existence of childhood personalities, which are recognizable from a developmental perspective, controversies over the possibility to assess personality in childhood have continued. The purpose of this study was to provide initial data on the validation of the Childhood Personality Assessment Q-Sort (CPAP-Q), a clinician report instrument that can be employed to evaluate children's personalities and address the gap in the field of emerging personality in children classification. METHOD A sample of 135 clinicians completed the CPAP-Q to assess the personality features of 135 children (ages 4-11) who had been in their care between two and 12 months. The clinicians completed a clinical questionnaire to collect information on them, the children, and their families, as well as the Child Behavior Checklist (CBCL), to evaluate the children's behavioral problems and social competencies. RESULTS Q-factor analysis identified seven specific emerging personality patterns: psychological health, borderline/impulsive, borderline/dysregulated, schizoid, inhibited/self-critical, obsessive, and dysphoric/dependent. These patterns revealed good levels of validity and reliability. CONCLUSIONS These findings are preliminary, but seem to support the possibility of evaluating emerging personality patterns in childhood and their developmental pathways that may lead to personality disorders in adolescence and adulthood. The CPAP-Q promises to significantly contribute to less explored research areas and encourage systematic studies of children assessment, promoting best practices for individualized diagnoses.
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Affiliation(s)
- Alexandro Fortunato
- Department of Dynamic and Clinical Psychology, and Health Studies, “Sapienza”, University of Rome, Via Degli Apuli, 1, 00185 Rome, Italy; (A.T.); (V.L.); (A.M.S.)
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Hall K, Youssef G, Simpson A, Sloan E, Graeme L, Perry N, Moulding R, Baker AL, Beck AK, Staiger PK. An Emotion Regulation and Impulse Control (ERIC) Intervention for Vulnerable Young People: A Multi-Sectoral Pilot Study. Front Psychol 2021; 12:554100. [PMID: 33868064 PMCID: PMC8047628 DOI: 10.3389/fpsyg.2021.554100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 03/08/2021] [Indexed: 01/01/2023] Open
Abstract
Objective: There is a demonstrated link between the mental health and substance use comorbidities experienced by young adults, however the vast majority of psychological interventions are disorder specific. Novel psychological approaches that adequately acknowledge the psychosocial complexity and transdiagnostic needs of vulnerable young people are urgently needed. A modular skills-based program for emotion regulation and impulse control (ERIC) addresses this gap. The current one armed open trial was designed to evaluate the impact that 12 weeks exposure to ERIC alongside usual care had on young people's ability to regulate emotions, as well as examine potential moderating mechanisms. Methods: Seventy nine young people (50.6% male; M = 19.30; SD = 2.94) were enrolled to the 12 week intervention period. Twenty one practitioners from youth and community health services delivered relevant ERIC modules adjunct to usual care. Linear mixed effects regression (with random intercept) was used to examine change over time across the primary outcome of emotion dysregulation and secondary outcomes of depression, anxiety, stress, experiential avoidance and mindfulness. Moderation analyses were conducted to test whether the magnitude of change in emotion dysregulation moderated change over time in secondary outcomes. Results: Analyses revealed significant improvement in the primary outcome of emotion dysregulation with a moderate effect size (Mean Change = -10.24, 95% CI (-14.41, -6.06; Cohen's dav = -0.53), in addition to decreases in the secondary outcomes of depression, anxiety, stress and experiential avoidance. No improvements in mindfulness were reported. Moderation analyses revealed that the residualised change over time in emotion dysregulation moderated the change over time in symptoms of distress, depression, anxiety, stress, experiential avoidance, and mindfulness. Conclusion: Reductions in the severity of emotion dysregulation, depression, anxiety, stress and experiential avoidance are promising, and were evident despite the complexity of the participants and the diversity of the service setting. The improvements found in each outcome were only observed for those young people whose emotion regulation also improved, providing preliminary evidence for the role of emotion regulation as a key treatment target in this population.
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Affiliation(s)
- Kate Hall
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, VIC, Australia
| | - George Youssef
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Angela Simpson
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, VIC, Australia
| | - Elise Sloan
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, VIC, Australia
| | - Liam Graeme
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Natasha Perry
- School of Medicine and Public Health (Psychiatry), University of Newcastle, Newcastle, NSW, Australia
| | - Richard Moulding
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, VIC, Australia
| | - Amanda L. Baker
- School of Medicine and Public Health (Psychiatry), University of Newcastle, Newcastle, NSW, Australia
| | - Alison K. Beck
- School of Medicine and Public Health (Psychiatry), University of Newcastle, Newcastle, NSW, Australia
| | - Petra K. Staiger
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, VIC, Australia
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Bridges-Curry Z, Glenn LE, Felton JW. Are emotions better left unknown? Sex-specific effects of emotional awareness and daily hassles on internalizing symptoms among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:113-117. [PMID: 31532333 DOI: 10.1080/07448481.2019.1654483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 03/28/2019] [Accepted: 07/31/2019] [Indexed: 06/10/2023]
Abstract
Amid growing concern about internalizing disorders on college campuses, few researchers have examined the ways emotional awareness deficits may contribute to risk. We examined the effect of the interaction between daily hassles, emotional awareness, and sex on depression and anxiety symptoms. Participants: Data were collected from 196 college students (Mage = 19.6, SDage = 2.26) at a large university in June 2016. Methods: Participants completed online surveys to assess daily hassles, emotional awareness, and internalizing symptoms. Results: Daily hassles were significantly associated with internalizing symptoms, p < .01. For women, daily hassles were significantly associated with internalizing symptoms at all levels of emotional awareness, ps < .05. For men, daily hassles were significantly associated with internalizing symptoms only at high levels of emotional awareness, ps < .05. Conclusion: Future researchers could examine the context in which emotional awareness may be most beneficial to college students.
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Affiliation(s)
- Zoe Bridges-Curry
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Lara E Glenn
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Julia W Felton
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, Michigan, USA
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Fostering School Belonging in Secondary Schools Using a Socio-Ecological Framework. EDUCATIONAL AND DEVELOPMENTAL PSYCHOLOGIST 2020. [DOI: 10.1017/edp.2016.5] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Zafar T. Potential biomarkers of emotional stress induced neurodegeneration. eNeurologicalSci 2020; 21:100292. [PMID: 33294647 PMCID: PMC7695868 DOI: 10.1016/j.ensci.2020.100292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 01/14/2023] Open
Abstract
Mental health is a matter of great significance and interest both socially and scientifically. The present review aims to provide an informative platform about the classical biomarkers available to identify and diagnose the neurodegeneration induced by emotional stress and depression. Present article provides an expert comprehensive overview of the universally accepted markers and their mechanism of action involved in emotional stress assessment and its management. This envisioned piece of work emphasize on the incorporation of clinical markers in classical psychiatry experiments will make the information more significant, reliable and universally accepted. The information summaries in the article will facilitates the researchers of clinical psychiatry, neuropharmacology and neuropsychiatry in management of depressive disorders along with the identification of possible neurodegenerative association. Health is an overall outcome of emotional, physiological, endocrinological and neurological factors. Emotional stress and depression are silent causes of neurodegeneration. Clinical markers play a vital role in the management of neurological health. Endocrine secretions play a vital role in mediation of various neurotransmission, nerves excitability and neurodegeneration.
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Affiliation(s)
- Tabassum Zafar
- Department of Bioscience, Faculty of Life Sciences, Barkatullah University, Bhopal 462026, Madhya Pradesh, India
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Brumariu LE, Owen MT, Dyer N, Lyons-Ruth K. Developmental Pathways to BPD-Related Features in Adolescence: Infancy to Age 15. J Pers Disord 2020; 34:104-129. [PMID: 32539619 DOI: 10.1521/pedi_2020_34_480] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The self-damaging behaviors central to borderline personality disorder (BPD) become prominent in adolescence. Current developmental theories cite both early family processes and childhood dysregulation as contributors to BPD, but longitudinal data from infancy are rare. Using the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development database (SECCYD; N = 1,364), we examined path models to evaluate parent and child contributors from infancy/preschool, middle childhood, and adolescence to adolescent BPD-related features. In addition, person-centered latent class analyses (LCA) investigated whether adolescent BPD-related features were more strongly predicted by particular patterns of maladaptive parenting. Path modeling identified unique influences of maternal insensitivity and maternal depression on BPD-related features, first, through social-emotional dysregulation in middle childhood, and second, through continuity from infancy in maternal insensitivity and depression. LCA results indicated that early withdrawn parenting was particularly predictive of BPD-related features in adolescence. Results suggest multiple points of intervention to alter pathways toward adolescent borderline psychopathology.
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Affiliation(s)
- Laura E Brumariu
- Derner School of Psychology, Adelphi University, Garden City, New York
| | | | - Nazly Dyer
- Institutional Data Analytics, University of Houston-Downtown
| | - Karlen Lyons-Ruth
- Department of Psychiatry, Harvard Medical School at Cambridge Health Alliance, Cambridge, Massachusetts
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Thomson ND, Beauchaine TP. Respiratory Sinus Arrhythmia Mediates Links Between Borderline Personality Disorder Symptoms and Both Aggressive and Violent Behavior. J Pers Disord 2019; 33:544-559. [PMID: 30307825 DOI: 10.1521/pedi_2018_32_358] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although emotion dysregulation (ED) is a core symptom of borderline personality disorder (BPD), tests of associations between ED and aggression and violence-which are common to BPD-are sparse. The authors evaluated mediating effects of an autonomic vulnerability to ED on links between BPD symptoms and (a) reactive aggression, (b) proactive aggression, and (c) histories of interpersonal violence in a sample of young adults (N = 104), ages 18-22 years. Low baseline respiratory sinus arrhythmia (RSA) mediated the association between BPD symptoms and reactive aggression. In contrast, although BPD symptoms were correlated with proactive aggression, no mediational effect was found. In addition, low RSA mediated the association between BPD symptoms and histories of interpersonal violence. Collectively, these findings add evidence that neurobiological vulnerability to ED contributes to aggressive and violent behavior among those with BPD.
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Affiliation(s)
- Nicholas D Thomson
- Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University Health, Richmond, Virginia, and University of Durham, Durham, UK
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Thamby A, Desai G, Mehta UM, Chaturvedi SK. Deficits in Theory of Mind and Emotional Awareness in Somatoform Disorders. Indian J Psychol Med 2019; 41:368-374. [PMID: 31391671 PMCID: PMC6657473 DOI: 10.4103/ijpsym.ijpsym_382_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Emotions develop from a less differentiated to a highly differentiated level, and their arrest at a lower level is hypothesized to result in somatization. The present study aimed at investigating the Theory of Mind and emotional awareness in patients with somatoform disorders. MATERIALS AND METHODS Twenty patients with somatoform disorders, along with 20 healthy controls matched for age, sex, and education, were recruited after obtaining informed consent. Assessments included semi-structured proforma for sociodemographic and clinical details; Scale for Assessment of Somatic Symptoms (SASS) for somatic symptoms; and Patients Health Questionnaire (PHQ) to assess somatic symptoms, depression, and anxiety. Emotional awareness was measured using the Levels of Emotional Awareness Scale (LEAS), in which the participants had to provide descriptions of feelings of self and the other person in 20 imaginary situations. The responses were scored using a standardized manual. The Theory of Mind was measured using the Social Cognition Rating Tool in Indian Settings (SOCRATIS). RESULTS The two groups did not differ on any demographic parameters. Patients with somatoform disorders scored significantly lower on emotional awareness (t = -3.74; P < 0.001) and the Theory of Mind (t = -3.56; P < 0.001). The above differences remained significant even after controlling for comorbid depressive and anxiety symptoms. CONCLUSION Patients with somatoform disorders are likely to have Theory of Mind and emotional awareness deficits independent of mood states. Future studies are needed to assess whether these deficits are trait- or state-dependent and whether they are cause or effect.
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Affiliation(s)
- Abel Thamby
- Department of Psychiatry NIMHANS, Bengaluru, Karnataka, India
| | - Geetha Desai
- Department of Psychiatry NIMHANS, Bengaluru, Karnataka, India
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An Emotion Regulation Treatment for Young People With Complex Substance Use and Mental Health Issues: A Case-Series Analysis. COGNITIVE AND BEHAVIORAL PRACTICE 2018. [DOI: 10.1016/j.cbpra.2017.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Abstract
This article aims to review the concept of emotion dysregulation, focusing on issues related to its definition, meanings and role in psychiatric disorders. Articles on emotion dysregulation published until May 2016 were identified through electronic database searches. Although there is no agreement about the definition of emotion dysregulation, the following five overlapping, not mutually exclusive dimensions of emotion dysregulation were identified: decreased emotional awareness, inadequate emotional reactivity, intense experience and expression of emotions, emotional rigidity and cognitive reappraisal difficulty. These dimensions characterise a number of psychiatric disorders in various proportions, with borderline personality disorder and eating disorders seemingly more affected than other conditions. The present review contributes to the literature by identifying the key components of emotion dysregulation and by showing how these permeate various forms of psychopathology. It also makes suggestions for improving research endeavours. Better understanding of the various dimensions of emotion dysregulation will have implications for clinical practice. Future research needs to address emotion dysregulation in all its multifaceted complexity so that it becomes clearer what the concept encompasses.
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Boucher MÈ, Pugliese J, Allard-Chapais C, Lecours S, Ahoundova L, Chouinard R, Gaham S. Parent-child relationship associated with the development of borderline personality disorder: A systematic review. Personal Ment Health 2017; 11:229-255. [PMID: 28771978 DOI: 10.1002/pmh.1385] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 05/16/2017] [Accepted: 05/23/2017] [Indexed: 11/12/2022]
Abstract
The parent-child relationship (PCR) is considered as a central factor in most contemporary theories on the aetiology of borderline personality disorder (BPD). This systematic review aimed to answer the three following questions: (1) How is the PCR described by BPD participants and their parents in comparison to other normative and clinical groups? (2) Which aspects of the PCR are specifically associated with a BPD diagnosis in adulthood? (3) How can the facets of the PCR identified in the reviewed studies shed light on the general aetiological models of BPD? Forty studies were retained and divided into three categories: perspective of BPD probands, perspective of their parents and perspective of family. Borderline personality disorder participants consistently reported a much more dysfunctional PCR compared to normal controls. Comparisons with participants presenting DSM-IV Axis-I and Axis-II disorders were a lot less consistent. BPD probands rated more negatively the PCR compared to their parents. Low parental care and high parental overprotection may represent a general risk factor for psychopathology, different from normal controls but common to BPD and other mental disorders. An interesting candidate for a specific PCR risk factor for BPD appears to be parental inconsistency, but further studies are necessary to confirm its specificity. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Marie-Ève Boucher
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
| | - Jessica Pugliese
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
| | - Catherine Allard-Chapais
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
| | - Serge Lecours
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
| | - Lola Ahoundova
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
| | - Rachel Chouinard
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
| | - Sarah Gaham
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
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Ordóñez A, Prado-Gascó VJ, Villanueva L, González R. Propiedades psicométricas del Cuestionario de conciencia emocional en población infantil española. REVISTA LATINOAMERICANA DE PSICOLOGIA 2016. [DOI: 10.1016/j.rlp.2015.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Skrzypińska D, Szmigielska B. Dream-reality confusion in borderline personality disorder: a theoretical analysis. Front Psychol 2015; 6:1393. [PMID: 26441768 PMCID: PMC4569816 DOI: 10.3389/fpsyg.2015.01393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 09/01/2015] [Indexed: 11/30/2022] Open
Abstract
This paper presents an analysis of dream-reality confusion (DRC) in relation to the characteristics of borderline personality disorder (BPD), based on research findings and theoretical considerations. It is hypothesized that people with BPD are more likely to experience DRC compared to people in non-clinical population. Several variables related to this hypothesis were identified through a theoretical analysis of the scientific literature. Sleep disturbances: problems with sleep are found in 15–95.5% of people with BPD (Hafizi, 2013), and unstable sleep and wake cycles, which occur in BPD (Fleischer et al., 2012), are linked to DRC. Dissociation: nearly two-thirds of people with BPD experience dissociative symptoms (Korzekwa and Pain, 2009) and dissociative symptoms are correlated with a fantasy proneness; both dissociative symptoms and fantasy proneness are related to DRC (Giesbrecht and Merckelbach, 2006). Negative dream content: People with BPD have nightmares more often than other people (Semiz et al., 2008); dreams that are more likely to be confused with reality tend to be more realistic and unpleasant, and are reflected in waking behavior (Rassin et al., 2001). Cognitive disturbances: Many BPD patients experience various cognitive disturbances, including problems with reality testing (Fiqueierdo, 2006; Mosquera et al., 2011), which can foster DRC. Thin boundaries: People with thin boundaries are more prone to DRC than people with thick boundaries, and people with BPD tend to have thin boundaries (Hartmann, 2011). The theoretical analysis on the basis of these findings suggests that people who suffer from BPD may be more susceptible to confusing dream content with actual waking events.
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Affiliation(s)
- Dagna Skrzypińska
- Unit of Sleep Psychology, Institute of Psychology, Jagiellonian University Krakow, Poland
| | - Barbara Szmigielska
- Unit of Sleep Psychology, Institute of Psychology, Jagiellonian University Krakow, Poland
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Cavazzi T, Becerra R. Psychophysiological Research of Borderline Personality Disorder: Review and Implications for Biosocial Theory. EUROPES JOURNAL OF PSYCHOLOGY 2014. [DOI: 10.5964/ejop.v10i1.677] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ford JD, Courtois CA. Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personal Disord Emot Dysregul 2014; 1:9. [PMID: 26401293 PMCID: PMC4579513 DOI: 10.1186/2051-6673-1-9] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 05/18/2014] [Indexed: 12/23/2022] Open
Abstract
Complex PTSD (cPTSD) was formulated to include, in addition to the core PTSD symptoms, dysregulation in three psychobiological areas: (1) emotion processing, (2) self-organization (including bodily integrity), and (3) relational security. The overlap of diagnostic criteria for cPTSD and borderline personality disorder (BPD) raises questions about the scientific integrity and clinical utility of the cPTSD construct/diagnosis, as well as opportunities to achieve an increasingly nuanced understanding of the role of psychological trauma in BPD. We review clinical and scientific findings regarding comorbidity, clinical phenomenology and neurobiology of BPD, PTSD, and cPTSD, and the role of traumatic victimization (in general and specific to primary caregivers), dissociation, and affect dysregulation. Findings suggest that BPD may involve heterogeneity related to psychological trauma that includes, but extends beyond, comorbidity with PTSD and potentially involves childhood victimization-related dissociation and affect dysregulation consistent with cPTSD. Although BPD and cPTSD overlap substantially, it is unwarranted to conceptualize cPTSD either as a replacement for BPD, or simply as a sub-type of BPD. We conclude with implications for clinical practice and scientific research based on a better differentiated view of cPTSD, BPD and PTSD.
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Affiliation(s)
- Julian D Ford
- University of Connecticut Health Center MC1410, 263 Farmington Avenue, Farmington, CT 06030-1410 USA
| | - Christine A Courtois
- Independent Pactice, Washington, DC, Elements Behavioral Health, Promises, Malibu, CA USA
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18
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Zhang T, Chow A, Wang L, Yu J, Dai Y, Lu X, Good MJD, Good BJ, Xiao Z. Childhood maltreatment profile in a clinical population in China: a further analysis with existing data of an epidemiologic survey. Compr Psychiatry 2013; 54:856-64. [PMID: 23597603 PMCID: PMC4144995 DOI: 10.1016/j.comppsych.2013.03.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Revised: 02/20/2013] [Accepted: 03/04/2013] [Indexed: 10/27/2022] Open
Abstract
To determine the lifetime prevalence and diverse profiles of types of childhood maltreatment (CM) in a high-risk clinical sample using standardized assessment tools (Child Trauma Questionnaire, CTQ) in China, Shanghai, 2090 subjects were sampled from the Shanghai Mental Health Centre. Personality disorder (PD) was assessed using the Personality Diagnostic Questionnaire (PDQ-4+) and subjects were interviewed using the Structured Clinical Interview (SCID-II). CTQ was used to assess CM in five domains (emotional abuse, EA; physical abuse, PA; sexual abuse, SA; emotional neglect, EN; and physical neglect, PN). The prevalence estimate of EA in the sample is 22.2%, followed by 17.8% of PA, and 12.5% of SA. The prevalence estimate was more frequent in PN (65.0%) and in EN (34.0%) than in childhood abuse (EA, PA and SA). It seems that males reported more PA and females reported more SA, the older subjects reported more neglect and the younger subjects reported more abuse. There was a higher prevalence of EA and SA in borderline PD patients (44.4%, 22.5%), PA in antisocial PD patients (38.9%). Multi-PD patients reported more forms of CM in childhood. Additionally, factor analysis of CTQ items confirmed factorial validity by identifying a five-factor structure that explained 50% of the total variance. These findings support the view that prevalence of CM was commonly experienced in clinical population during their childhood, especially for subjects with PDs. Factorial validity in PN needs to be further improved, and can in part be culturally explained.
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Affiliation(s)
- TianHong Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, PR China
| | - Annabelle Chow
- Deakin University, School of Psychology, Melbourne, Australia
| | - LanLan Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, PR China
| | - JunHan Yu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, PR China
| | - YunFei Dai
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, PR China
| | - Xi Lu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, PR China
| | - Mary-Jo D. Good
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Byron J. Good
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - ZePing Xiao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, PR China, Correspondence to Zeping Xiao, MD, PhD, Shanghai Mental Health Center, 600 South Wanping Road, Shanghai 200030, PR China. , or
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19
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De Clercq B, De Fruyt F. A Five-Factor Model framework for understanding childhood personality disorder antecedents. J Pers 2013; 80:1533-63. [PMID: 22320207 DOI: 10.1111/j.1467-6494.2012.00778.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The present contribution reviews evidence that supports the relevance of childhood antecedents of personality disorders, and advocates that the validity of a Five-Factor Model framework for describing general trait differences in childhood can be extended towards the field of developmental personality difficulties. In addition, we suggest that several traditional childhood Axis I conditions include a substantial trait component that may be responsible for the recurring finding that childhood Axis I disorders are predictive for adult Axis II disorders. Given the valuable information provided by a trait assessment, we further propose to integrate dimensional personality and personality pathology measures as standard tools in mental health assessments at a young age.
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Affiliation(s)
- Barbara De Clercq
- Department of Developmental, Personality and Social Psychology, Ghent University, Gent, Belgium.
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20
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Pathways from harsh parenting to adolescent antisocial behavior: a multidomain test of gender moderation. Dev Psychopathol 2012; 24:857-70. [PMID: 22781859 DOI: 10.1017/s0954579412000417] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We tested for gender moderation within a multidomain model of antisocial behavior (ASB) among community youth, drawn from the Project on Human Development in Chicago Neighborhoods study. Youths (N = 1,639) were 9 to 12 years old at baseline and were followed for two additional waves, spaced approximately 2.5 years apart. We hypothesized that harsh and physically coercive parenting, a familial level risk factor, would impact individual level risk factors for ASB, such as childhood temperament ratings of emotionality and inhibitory control, and preadolescent externalizing and internalizing symptoms, as well as involvement with antisocial peers. We further hypothesized that this process and its impact on ASB would be moderated by gender. We used both multiple indicator multiple causes and multiple group analyses to test for gender moderation and a structural equation modeling multiple mediation framework to evaluate the strength of indirect effects. We tested the role of family, individual, and peer level influences on ASB, after accounting for the role of known contextual factors, including poverty, race, and neighborhood. Our overall model fit the data well for males and females, indicating harsh parenting, disinhibition, emotionality, and peers exert a strong influence on risk for ASB. Gender moderated the pathway from harsh parenting to externalizing behavior, such that this was a significant pathway for girls, but not boys. We discussed the importance of these findings with regard to intervention planning for youth at risk for ASB and future gender-informed models of ASB.
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21
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The interplay of emotional instability, empathy, and coping on prosocial and aggressive behaviors. PERSONALITY AND INDIVIDUAL DIFFERENCES 2012. [DOI: 10.1016/j.paid.2012.05.022] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Davies PT, Manning LG, Cicchetti D. Tracing the cascade of children's insecurity in the interparental relationship: the role of stage-salient tasks. Child Dev 2012; 84:297-312. [PMID: 22925122 DOI: 10.1111/j.1467-8624.2012.01844.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study examined whether children's difficulties with stage-salient tasks served as an explanatory mechanism in the pathway between their insecurity in the interparental relationship and their disruptive behavior problems. Using a multimethod, multi-informant design, 201 two-year-old children and their mothers participated in 3 annual measurement occasions. Structural equation modeling analyses indicated that coder ratings of children's insecure responses to interparental conflict from a maternal interview predicted observer ratings of their difficulties with stage-salient tasks (i.e., emotion regulation, autonomy, resourceful problem solving) 1 year later after controlling for initial stage-salient task performance. Stage-salient task difficulties, in turn, predicted experimenter reports of children's behavior problems 1 year later. Associations remained robust in the broader context of other pathways hypothesized in prevailing developmental cascade models.
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23
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Burke JD, Stepp SD. Adolescent disruptive behavior and borderline personality disorder symptoms in young adult men. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 40:35-44. [PMID: 21853377 DOI: 10.1007/s10802-011-9558-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Very few studies have prospective information, especially regarding males, on the prediction of Borderline Personality Disorder (BPD) in adulthood from psychiatric disorders in childhood. Certain childhood disorders, however, have notably similar features in common with BPD. In particular, the affective dysfunction, hostility and interpersonal conflict of Oppositional Defiant Disorder (ODD) and the impulsivity of Attention Deficit Hyperactivity Disorder (ADHD) in particular may be indicative of an early developmental path towards BPD. The present study uses longitudinal data from a clinical sample of 177 boys, initially between the ages of 7 and 12, who were followed up annually to age 18, and who were reassessed at age 24 (n = 142). The study examines the prediction from repeated childhood measures of psychopathology measured annually through adolescence to BPD symptoms assessed at age 24, accounting for the effects of covariates including substance use, other personality disorders at age 24 and harsh physical punishment. The prevalence of BPD in this sample was consistent with other population estimates. Attention Deficit Hyperactivity Disorder (ADHD) and ODD were the only child psychiatric disorders to predict BPD symptoms, and the oppositional behavioral dimension of ODD was particularly predictive of BPD. These results indicate possible developmental links between early psychiatric disorders and BPD.
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Affiliation(s)
- Jeffrey D Burke
- Western Psychiatric Institute and Clinic, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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24
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Underwood MK, Beron KJ, Rosen LH. Joint trajectories for social and physical aggression as predictors of adolescent maladjustment: internalizing symptoms, rule-breaking behaviors, and borderline and narcissistic personality features. Dev Psychopathol 2011; 23:659-78. [PMID: 21532919 PMCID: PMC3082442 DOI: 10.1017/s095457941100023x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This investigation examined the relation between developmental trajectories jointly estimated for social and physical aggression and adjustment problems at age 14. Teachers provided ratings of children's social and physical aggression in Grades 3, 4, 5, 6, and 7 for a sample of 255 children (131 girls, 21% African American, 52% European American, 21% Mexican American). Participants, parents, and teachers completed measures of the adolescent's adjustment to assess internalizing symptoms, rule-breaking behaviors, and borderline and narcissistic personality features. Results showed that membership in a high and rising trajectory group predicted rule-breaking behaviors and borderline personality features. Membership in a high desister group predicted internalizing symptoms, rule-breaking behaviors, and borderline and narcissistic personality features. The findings suggest that although low levels of social and physical aggression may not bode poorly for adjustment, individuals engaging in high levels of social and physical aggression in middle childhood may be at greatest risk for adolescent psychopathology, whether they increase or desist in their aggression through early adolescence.
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Affiliation(s)
- Marion K Underwood
- School of Behavioral and Brain Sciences, University of Texas at Dallas, 800 West Campbell Road, GR 41, Richardson, TX 75080, USA.
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