Biting the hand that feeds: current opinion on the interpersonal causes, correlates, and consequences of borderline personality disorder

The prospective relation between borderline personality disorder symptoms and suicide risk: The mediating roles of emotion regulation difficulties and perceived burdensomeness

BACKGROUND

Despite the strong link between borderline personality disorder (BPD) symptoms and suicide risk, little is known about the mechanisms underlying this association. Theory-driven research clarifying the pathways through which BPD symptoms increase suicide risk over time is needed and may highlight relevant treatment targets for decreasing suicide risk among individuals with heightened BPD symptoms. This study examined the prospective relations among BPD symptoms, emotion regulation (ER) difficulties, perceived burdensomeness, thwarted belongingness, and suicide risk across five assessments over a 7-month period. Consistent with the interpersonal theory of suicide, we hypothesized that greater BPD symptoms would predict greater suicide risk over time via greater ER difficulties and, subsequently, greater perceived burdensomeness.

METHODS

A U.S. nationwide sample of 500 adults (47 % women; mean age = 40.0 ± 11.64) completed a prospective online study, including an initial assessment and four follow-up assessments over the next seven months.

RESULTS

Results revealed a significant indirect relation between BPD symptoms and greater suicide risk over time through greater ER difficulties and later perceived burdensomeness. Results also provided evidence for transactional relations between BPD symptoms and ER difficulties and suicide risk over time.

LIMITATIONS

All constructs were assessed via self-report questionnaire data. Our measure of suicide risk focuses on only suicidal ideation, plans, and impulses, and not suicide attempts or preparatory behaviors.

CONCLUSIONS

Results highlight both ER- and interpersonal-related factors as key mechanisms underlying suicide risk among community adults with BPD symptoms.

Perinatal foundations of personality pathology from a dynamical systems perspective

The development of personality pathology is an interactive process between biologically based susceptibilities, interpersonal patterns, and contextual factors across the lifespan. In this paper, we argue that these interactions begin before birth. We describe the perinatal period (i.e. pregnancy and up to one year postpartum) as a sensitive developmental window during which regulatory and stress response systems that confer risk for personality pathology begin forming. In addition, we present converging evidence for significant associations between perinatal factors and later life personality disorders. Finally, we present this perinatal perspective through the lens of dynamical systems theory and emphasize the promise of this framework for guiding future personality disorder research, prevention, and intervention.

The Relationship between Survival Sex and Borderline Personality Disorder Symptoms in a High Risk Female Population

Engaging in survival sex and mental illness are overrepresented within homeless populations. This article assesses the relationship between symptoms of borderline personality disorder (BPD) and engaging in survival sex among homeless women. One hundred and fifty-eight homeless women completed surveys on self-reported BPD symptomology and sexual history. Bivariate and multivariate analyses conducted in this study provided insights into the association of experiencing BPD symptoms and engaging in survival sex. Results indicate that some symptoms of BPD are robustly correlated with engaging in survival sex among homeless adult women. Implications for service agencies and others working with at-risk female populations are discussed.

Evaluating Emotional and Biological Sensitivity to Maternal Behavior among Self-injuring and Depressed Adolescent Girls Using Nonlinear Dynamics

High sensitivity and reactivity to behaviors of family members characterizes several forms of psychopathology, including self-inflicted injury (SII). We examined mother-daughter behavioral and psychophysiological reactivity during a conflict discussion using nonlinear dynamics to assess asymmetrical associations within time-series data. Depressed, SII, and control adolescents and their mothers participated (n=76 dyads). We expected that (1) mothers' evocative behaviors would affect behavioral and psychophysiological reactivity among depressed and, especially, SII adolescents, (2) adolescents' behaviors would not evoke mothers' behavioral or physiological reactivity, and (3) control teens and mothers would be less reactive, with no dynamic associations in either direction. Convergent cross-mapping with dewdrop regression, which identifies directional associations, indicated that mothers' behaviors evoked behavioral responses among depressed and SII participants, but psychophysiological reactivity for SII teens only. There were no effects of adolescents' behavior on mothers' reactivity. Results are interpreted based upon sensitivity theories and directions for further research are outlined.