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Akça S, Gençöz F. The Experience of Disgust in Women Exposed to Domestic Violence in Turkey. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP14538-NP14563. [PMID: 33926278 DOI: 10.1177/08862605211013953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In trauma, fear as a basic emotion that evokes avoidance after exposure to a traumatic event is important for posttraumatic process. Another emotion causing avoidance is disgust. Despite the fact that disgust also plays an important role in trauma, there is limited information about how it is experienced during and after exposure to the traumatic event. In this study, the aim was to understand how women experience disgust during and after domestic violence, as a prolonged and repeated traumatic experience, and how they try to cope with disgust evoking situations in this process. For this aim, qualitative methodology was used. With purposive sampling, six women exposed to domestic violence including physical, verbal and sexual abuse were interviewed. With each woman, approximately seven semi-structured interviews were completed. Forty-one interviews were audio recorded and transcribed. Data was analyzed by Interpretative Phenomenological Analysis. At the end of the analysis, three superordinate themes, namely, experience of perpetrator-directed disgust with gustatory expressions of moral disgust and association of disgust in domestic abuse to daily life experiences; experience of self-disgust with two themes of internalization of assault without awareness and contamination by sexual abuse; coping with disgust in domestic violence with four subthemes, namely, avoidance from perpetrator, reidentification of the perpetrator with substitutive identity, alienation from self, reidentification of self with new relationships were constructed. Results showed that disgust is experienced in a repressed way as a result of the aversive nature of traumatic experience. The results were evaluated in psychological, social and cultural contexts. Their implications for understanding disgust in domestic violence were discussed.
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Affiliation(s)
| | - Faruk Gençöz
- Middle East Technical University, Ankara, Turkey
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Vicard-Olagne M, Pereira B, Rougé L, Cabaillot A, Vorilhon P, Lazimi G, Laporte C. Signs and symptoms of intimate partner violence in women attending primary care in Europe, North America and Australia: a systematic review and meta-analysis. Fam Pract 2022; 39:190-199. [PMID: 34448843 DOI: 10.1093/fampra/cmab097] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a prevalent yet underdiagnosed health issue, and primary care practitioners are in a unique front-line position to provide care and counsel for the victims. OBJECTIVE To identify the signs and symptoms of women exposed to IPV who attended primary care, regardless motive of consultation. METHODS Systematic review and meta-analysis on Cochrane, PubMed, Embase and CINAHL between 1946 and 2020. Eligible studies had to be original quantitative research, on women aged >15 years, attending primary care settings in Europe, North America and Australia and interviewed on their status as victims of IPV and on their signs and symptoms. RESULTS Of 1791 articles identified, 57 were selected. Associations were found between IPV and signs and symptoms of depression [19 studies: overall odds ratio (OR) = 3.59, 95% confidence interval (CI; 2.7-4.7, I2 = 94.6%)], anxiety [9 studies: overall OR = 2.19, 95% CI (1.75-2.73, I2 = 84%)], gynaecological and/or sexually transmitted infections [6 studies: overall OR = 2.82, 95% CI (2.1-3.8, I2 = 41%)] and combination of somatic symptoms [5 studies: standard mean deviation = 0.795, 95% CI (0.62-0.97, I2 = 0%)]. CONCLUSIONS Women exposed to IPV may present with clinical symptoms and signs other than bodily injury. Policy implications knowing these symptoms presented by women victims of IPV can help GPs identify and treat them. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018089857.
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Affiliation(s)
- Mathilde Vicard-Olagne
- Faculty of Medicine, EA7280, Department of General Practice, Clermont Auvergne University, Clermont-Ferrand F-63001
| | - Bruno Pereira
- Clinical Research and Innovation Department, University Hospital-Clermont-Ferrand, Clermont-Ferrand F-63001
| | - Laure Rougé
- Faculty of Medicine, EA7280, Department of General Practice, Clermont Auvergne University, Clermont-Ferrand F-63001
| | - Aurélie Cabaillot
- Faculty of Medicine, Inserm 1107, Neuro-Dol, Observatoire Français des Médicaments Antalgiques (OFMA), Department of General Practice
| | - Philippe Vorilhon
- Clinical Research and Innovation Department, University Hospital-Clermont-Ferrand, Clermont-Ferrand F-63001.,Faculty of Medicine, UPU ACCePT, Department of General Practice, Clermont Auvergne University, Clermont-Ferrand F-63001
| | - Gilles Lazimi
- Faculty of Medicine, Department of General Practice, Pierre et Marie Curie University, Paris F-75005, France
| | - Catherine Laporte
- Faculty of Medicine, EA7280, Department of General Practice, Clermont Auvergne University, Clermont-Ferrand F-63001.,Clinical Research and Innovation Department, University Hospital-Clermont-Ferrand, Clermont-Ferrand F-63001
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Emotional Schemas Contribute to Suicide Behavior and Self-Harm: Toward Finding Suicidal Emotional Schemas (SESs). Int J Cogn Ther 2021. [DOI: 10.1007/s41811-021-00115-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Neyshabouri MD, Dolatshahi B, Mohammadkhani P. PTSD symptoms and self-injury behaviors among Iranian soldiers: the mediator roles of rumination and social support. COGENT PSYCHOLOGY 2020. [DOI: 10.1080/23311908.2020.1733333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
| | - Behrooz Dolatshahi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Parvaneh Mohammadkhani
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Moore KE, Gobin RL, McCauley HL, Kao CW, Anthony SM, Kubiak S, Zlotnick C, Johnson JE. The relation of borderline personality disorder to aggression, victimization, and institutional misconduct among prisoners. Compr Psychiatry 2018; 84:15-21. [PMID: 29660674 PMCID: PMC6002930 DOI: 10.1016/j.comppsych.2018.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 03/07/2018] [Accepted: 03/15/2018] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE Borderline personality disorder (BPD) is highly prevalent among incarcerated populations; however, research has yet to examine whether prisoners diagnosed with BPD experience greater interpersonal dysfunction and institutional misconduct while incarcerated. PROCEDURE This study drew from a sample of 184 male and female prisoners diagnosed with major depressive disorder (MDD) in a randomized trial of depression treatment. The presence of a BPD diagnosis (n = 69) was analyzed as a predictor of disciplinary incidents/infractions (i.e., fights, arguments with staff, disciplinary infractions, isolation), time spent in isolation, and types of aggression and victimization experiences during incarceration. RESULTS There was a trend suggesting prisoners with BPD were about twice as likely as those without BPD to report disciplinary incidents/infractions (OR = 1.76 [0.93, 3.32], p = 0.075). Having a BPD diagnosis was unrelated to time in isolation and overall aggression and victimization. However, prisoners with BPD were more likely than those without BPD to perpetrate and be victimized by psychological aggression. Due to high rates of antisocial personality disorder (ASPD) in the sample as a whole (72%), additional analyses compared outcomes across prisoners with no BPD or ASPD diagnosis, BPD diagnosis only, ASPD diagnosis only, and comorbid BPD and ASPD. Prisoners with comorbid BPD and ASPD were no more likely than prisoners with ASPD only to report disciplinary incidents/infractions, but were significantly more likely than those with ASPD only to report perpetrating and being victimized by psychological aggression. CONCLUSIONS Among prisoners with MDD, those with a BPD diagnosis have increased risk of psychological aggression and disciplinary infractions during incarceration.
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Affiliation(s)
- Kelly E. Moore
- Yale University School of Medicine, Department of Psychiatry, 389 Whitney Ave, New Haven, CT 06511,Correspondence concerning this article should be addressed to Kelly E. Moore [Address: 389 Whitney Avenue, New Haven, CT 06511; ; Cell: 203-785-3225]
| | - Robyn L. Gobin
- University of Illinois Urbana-Champaign, Department of Kinesiology and Community Health, 1206 South Fourth Street, Champaign, IL 61820
| | - Heather L. McCauley
- Michigan State University, Department of Human Development & Family Studies, 552 W. Circle Drive, 13E Human Ecology, East Lansing, MI 48824
| | - Chien-Wen Kao
- Columbia University, Department of Counseling and Clinical Psychology, 525 West 120th St., New York, NY 10027
| | - Stephanie M. Anthony
- Michigan State University, College of Human Medicine, Division of Public Health, 200 E. 1st Street, Flint, MI 48502
| | - Sheryl Kubiak
- Michigan State University, School of Social Work and Consortium on Gender-based Violence, 655 Auditorium Rd., East Lansing, MI 48824
| | - Caron Zlotnick
- Brown University Medical School and Butler Hospital, Department of Psychiatry and Human Behavior, 345 Blackstone Boulevard, Providence, RI 02906
| | - Jennifer E. Johnson
- Michigan State University, College of Human Medicine, Division of Public Health, 200 E. 1st Street, Flint, MI 48502
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Wilson S, Stroud CB, Durbin CE. Interpersonal dysfunction in personality disorders: A meta-analytic review. Psychol Bull 2017; 143:677-734. [PMID: 28447827 DOI: 10.1037/bul0000101] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Personality disorders are defined in the current psychiatric diagnostic system as pervasive, inflexible, and stable patterns of thinking, feeling, behaving, and interacting with others. Questions regarding the validity and reliability of the current personality disorder diagnoses prompted a reconceptualization of personality pathology in the most recent edition of the psychiatric diagnostic manual, in an appendix of emerging models for future study. To evaluate the construct and discriminant validity of the current personality disorder diagnoses, we conducted a quantitative synthesis of the existing empirical research on associations between personality disorders and interpersonal functioning, defined using the interpersonal circumplex model (comprising orthogonal dimensions of agency and communion), as well as functioning in specific relationship domains (parent-child, family, peer, romantic). A comprehensive literature search yielded 127 published and unpublished studies, comprising 2,579 effect sizes. Average effect sizes from 120 separate meta-analyses, corrected for sampling error and measurement unreliability, and aggregated using a random-effects model, indicated that each personality disorder showed a distinct profile of interpersonal style consistent with its characteristic pattern of symptomatic dysfunction; specific relationship domains affected and strength of associations varied for each personality disorder. Overall, results support the construct and discriminant validity of the personality disorders in the current diagnostic manual, as well as the proposed conceptualization that disturbances in self and interpersonal functioning constitute the core of personality pathology. Importantly, however, contradicting both the current and proposed conceptualizations, there was not evidence for pervasive dysfunction across interpersonal situations and relationships. (PsycINFO Database Record
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Affiliation(s)
- Sylia Wilson
- Department of Psychology, University of Minnesota
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Prevalence and Correlates of Self-Harm in the German General Population. PLoS One 2016; 11:e0157928. [PMID: 27362348 PMCID: PMC4928828 DOI: 10.1371/journal.pone.0157928] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 06/07/2016] [Indexed: 11/23/2022] Open
Abstract
The study aimed at evaluating the psychometric properties of the German version of the Self- Harm Inventory (SHI) and examining the lifetime prevalence and correlates of self-harm in a representative German population sample (N = 2,507; age mean = 48.79, SD = 18.11; range 14 to 94 years; 55.5% women) using the SHI. All participants answered the German SHI, the short form of the Barratt Impulsiveness Scale (BIS-15), the ultra-brief Patient Health Questionnaire for Depression and Anxiety (PHQ-4), and provided sociodemographic information. The one-factorial structure of the SHI was replicated using a confirmatory factor analysis. Internal consistency coefficients were sufficient and in line with previous studies. Almost half of the sample (49%) acknowledged at least one self-harming behavior over the life-span, most frequently indirect forms of self-harm. The rate of participants who engaged in at least one SHI behavior was higher among men than women (51.6% vs. 46.9%, respectively, χ2= 5.38, p = 0.020). Higher SHI scores were related to younger age, male gender, living alone, more symptoms of anxiety and depression (PHQ-4), higher impulsivity scores (BIS-15), and suffering from obesity grade 2. Women engaged more often in discreet forms of self-harm than men, e.g., preventing wounds from healing, exercising an injury, starving, and abusing laxatives. In terms of other indirect self-harming behaviors, men admitted more often driving recklessly, being promiscuous and losing a job on purpose, while women reported more frequently engaging in emotionally abusive relationships. With respect to direct self-harm, women were more likely to endorse suicide attempts and cutting, while men admitted more often head-banging. The findings suggest that self-harm constitutes a common problem. Future longitudinal studies are required to examine the natural course, sociodemographic and psychopathological risk factors, as well as possible time-trends of self-harming behaviors in more depth.
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Horton M, Wright N, Dyer W, Wright-Hughes A, Farrin A, Mohammed Z, Smith J, Heyes T, Gilbody S, Tennant A. Assessing the risk of self-harm in an adult offender population: an incidence cohort study. Health Technol Assess 2014; 18:1-151, vii-viii. [PMID: 25348581 DOI: 10.3310/hta18640] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Self-harm is common among prisoners, particularly female prisoners. In 2007, concerned about the rising incidence, the prison service introduced a care-planning system called Assessment, Care in Custody, and Teamwork (ACCT). To date, it does not incorporate a standardised diagnostic test to estimate the risk of future self-harm. OBJECTIVE To identify potential screening instruments, or items from those instruments, to predict the risk of self-harm among prisoners. PARTICIPANTS Prisoners who had been assigned to an ACCT during the recruitment period. DESIGN A multistage prospective cohort study. Following a pilot study, instruments were administered to prisoners by interview at baseline, and followed up for 6 months (or until point of release if this was sooner) to ascertain self-harm status. Instruments were assessed for unidimensionality, scalability (Mokken) and quantitative structure (Rasch). Area under the curve (AUC) analysis was used to examine the ability of instruments and/or their items to predict future self-harm. Cox proportional hazards regression models were used to examine the multivariate predictive ability of the scales and various sociodemographic and sentencing factors. SETTING Three prisons (including one women's prison) in northern England. MAIN OUTCOME MEASURES A set of standardised questionnaires, including the Prison Screening Questionnaire (PriSnQuest), Revised Borderline Symptom List-23 (frequency-based responses) (BSL-23-F), Self-Harm Inventory (SHI), Patient Health Questionnaire (PHQ-9) and the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM), together with sociodemographic and sentencing data. RESULTS In total, 450 prisoners consented to participate in the study, of whom 26% were female. The mean age of participants was 31.2 years. Over half of male prisoners recruited were on remand, compared with just over one-fifth (22.6%) of female prisoners. The average tariff of those sentenced was 41 months, of which 14.7 months, on average, had been served. Just over one-third of ACCTs had been initiated because of a known self-harm event, and over one-quarter (27.8%) of participants self-harmed during the follow-up period. Thus, almost half (46.7%) of those entered into the study were reported to have self-harmed, either from their index ACCT, or subsequently, or both. Cutting was the most frequent behaviour (51%). All screening instruments showed some evidence of unidimensionality, and four out of five showed scaling criteria consistent with ordinal scaling, so verifying the validity of the cut points. However, many showed gender bias and failure to fit the Rasch measurement model. While a resolution was made in most cases, both ordinal raw scores and latent interval scale estimates failed to show predictive value when applied within AUC analysis (0.491-0.566) or adjusted Cox proportional hazards models. However, good predictive values were shown for gender-specific sets of items, thus providing easily applied screening indexes. CONCLUSIONS While four out of five potential screening instruments were found to have acceptable psychometric properties within this setting, their predictive validity of all instruments was poor under AUC analysis. Gender-specific item sets were put together to form two screening indexes with formative indicators which gave reasonable AUC values, particularly so for females. The indexes provide identification of low-medium-high risk of self-harm, and so may help to inform potential care pathways and decisions to sign prisoners off from the ACCT. Future work should concentrate on refining a set of predictive screening items among different offender populations and investigating the time point at which this set of items should be administered. Future work may also look at the different magnitudes of risk as indicators for care pathways. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Mike Horton
- Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Nat Wright
- HMP Leeds Health Care Department, Leeds, UK
| | - Wendy Dyer
- Department of Sociology and Criminology, University of Durham, , UK
| | - Alex Wright-Hughes
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Amanda Farrin
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | | | - Jamie Smith
- North East Offender Health Commissioning Unit, Durham University Science Park, County Durham, UK
| | - Tom Heyes
- Brampton Primary Care Medical Centre, Rotherham, UK
| | - Simon Gilbody
- Department of Health Sciences, University of York, York, UK
| | - Alan Tennant
- Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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Sansone RA, Tahir NA, Buckner VR, Wiederman MW. The relationship between borderline personality symptomatology and somatic preoccupation among internal medicine outpatients. PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2012; 10:286-90. [PMID: 18787678 DOI: 10.4088/pcc.v10n0403] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Accepted: 01/07/2008] [Indexed: 10/20/2022]
Abstract
OBJECTIVE In this study, we examined the relationship between borderline personality symptomatology and somatic preoccupation among a sample of internal medicine outpatients. METHOD Using a cross-sectional approach and a sample of convenience, we surveyed 116 patients who presented for nonemergent medical care in an outpatient resident clinic between September 2005 and August 2007. Survey measures for borderline personality disorder (BPD) were the Personality Diagnostic Questionnaire-4 (PDQ-4) (DSM-IV criteria) and the Self-Harm Inventory (SHI), both self-report measures. The study measure for somatic preoccupation was the Bradford Somatic Inventory, also self-report in format. RESULTS In this study sample, both measures of BPD demonstrated significant correlations with the measure of somatic preoccupation (PDQ-4, r = 0.58, p < .001; SHI, r = 0.53, p < .001). CONCLUSION In primary care settings, patients with high levels of somatic preoccupation should be evaluated for borderline personality symptomatology.
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Affiliation(s)
- Randy A Sansone
- Departments of Psychiatry and Internal Medicine, Wright State University School of Medicine, Dayton, Ohio, USA.
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Abstract
AbstractThis study investigated the relationship between attachment, mood and deliberate self-harm (DSH) in a nonclinical population (n= 114). In addition to a range of risky behaviours, the most commonly reported DSH behaviours wereHead-banging(47%),Hitting(46%),Scratching(38%) andCutting(34%). Those who engaged in DSH had poorer quality of attachment to both parents but not peers, and higher levels of depression, anxiety and stress. Path analysis was then used to examine the interaction between attachment, mood and DSH. The impact of the quality of attachment on DSH was found to be mediated by stress, which suggests that DSH may be a maladaptive coping mechanism. Attachment to father and peers was found to be more influential than attachment to mother. Our findings suggest that DSH may be more prevalent in the community than previously recognised, and that attachment, which is currently neglected in DSH research, warrants further investigation in both clinical and nonclinical populations.
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Stepp SD, Smith TD, Morse JQ, Hallquist MN, Pilkonis PA. Prospective associations among borderline personality disorder symptoms, interpersonal problems, and aggressive behaviors. JOURNAL OF INTERPERSONAL VIOLENCE 2012; 27:103-24. [PMID: 21859760 PMCID: PMC3575083 DOI: 10.1177/0886260511416468] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This study examined the prospective relationships among borderline personality disorder (BPD) symptoms, interpersonal problems, and types of aggressive behaviors (i.e., experiencing psychological and physical victimization and perpetrating psychological and physical aggression) in a psychiatric sample (N = 139) over the course of 2 years. We controlled for other PD symptoms and demographic variables. BPD symptoms at baseline were associated with interpersonal sensitivity, interpersonal ambivalence, interpersonal aggression, need for social approval, and lack of sociability 6 months later. In turn, interpersonal sensitivity predicted not experiencing physical aggression, interpersonal aggression predicted experiencing physical aggression and perpetrating both psychological and physical aggression, need for social approval predicted experiencing both psychological and physical aggression, and lack of sociability predicted perpetrating physical aggression 2 years later. Results demonstrated that interpersonal problems mediated the relationship between BPD and later violent behaviors. Our findings suggest the importance of distinguishing between these groups of aggressive behaviors in terms of etiological pathways, maintenance processes, and treatment interventions.
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Sansone RA, Wiederman MW. The abuse of prescription medications: borderline personality patients in psychiatric versus non-psychiatric settings. Int J Psychiatry Med 2009; 39:147-54. [PMID: 19860073 DOI: 10.2190/pm.39.2.c] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE In this study, the prevalence of prescription substance abuse among those with borderline personality symptomatology was examined in a large cohort of respondents who participated in one of 13 prior research projects. METHOD The entire cohort (N = 1039) was divided into 3 subsamples: a psychiatric sample (n = 440), a predominantly primary care sample (n = 599), and an internal medicine sample (n = 332; i.e., a well-defined subset of the predominantly primary care sample that consisted of only internal medicine outpatients seen at one location). The borderline personality scale of the Personality Diagnostic Questionnaire (PDQ), either the revised (PDQ-R) or fourth (PDQ-4) version, was used to diagnose all participants either with or without borderline personality. One item from the Self-Harm Inventory, "Have you ever intentionally, or on purpose, abused prescription medication?," was then used in the subsequent analyses. RESULTS Among the psychiatric, predominantly primary care, and internal medicine subsamples, the prevalence rates of prescription medication abuse in those diagnosed with borderline personality according to the PDQ were 46.9%, 46.2%, and 11.5%, respectively. In all subsamples, those with borderline personality were statistically significantly more likely to abuse prescription medication than those without the disorder. For example, borderline patients in the psychiatric sample were twice as likely to abuse prescription medications, in the predominantly primary care sample 4 times as likely, and in the internal medicine only sample nearly 6 times as likely. CONCLUSIONS Regardless of setting, patients with BPD are at great risk for the abuse of prescription medications.
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Affiliation(s)
- Randy A Sansone
- Wright State University and Kettering Medical Center, Ohio, USA.
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Sansone RA, Wiederman MW. Interference with wound healing: borderline patients in psychiatric versus medical settings. PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2009; 11:271-2. [PMID: 19956470 DOI: 10.4088/pcc.08l00701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Latimer S, Covic T, Cumming SR, Tennant A. Psychometric analysis of the self-harm inventory using Rasch modelling. BMC Psychiatry 2009; 9:53. [PMID: 19689823 PMCID: PMC2736947 DOI: 10.1186/1471-244x-9-53] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Accepted: 08/19/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Deliberate Self-Harm (DSH) is the intentional destruction of healthy body tissue without suicidal intent. DSH behaviours in non-clinical populations vary, and instruments containing a range of behaviours may be more informative than ones with restricted content. The Self-Harm Inventory (SHI) is a widely used measure of DSH in clinical populations (mental and physical health) and covers a broad range of behaviours (self-injury, risk taking and self-defeating acts). The test authors recommend the SHI to screen for Borderline Personality Disorder (BPD) using a cut-off score of five or more. The aim of this study was to investigate the psychometric characteristics of the SHI in non-clinical samples. METHODS The SHI was administered to a sample of 423 non-clinical participants (university students, age range 17 to 30). External validation was informed by the administration of the Depression Anxiety Stress Scales 21 (DASS-21) to a sub-sample (n = 221). Rasch analysis of the SHI was conducted to provide a stringent test of unidimensionality and to identify the DSH behaviours most likely to be endorsed at each total score. RESULTS The SHI showed adequate fit to the Rasch model and no modifications were required following checks of local response dependency, differential item functioning and unidimensionality. The scale identified gender and age differences in scores, with females and older participants reporting higher levels of DSH. SHI scores and DASS-21 scores were related. CONCLUSION The recommended cut-off point of five is likely to comprise mild forms of DSH and may not be indicative of psychopathology in a non-clinical population. Rather it may be more indicative of developmentally related risk taking behaviours while a higher cut-off point may be more suggestive of psychopathology as indicated by higher levels of depression, stress and anxiety.
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Affiliation(s)
- Shane Latimer
- School of Psychology, University of Western Sydney, Locked Bag 1797 Penrith South DC 1797 NSW, Australia
| | - Tanya Covic
- School of Psychology, University of Western Sydney, Locked Bag 1797 Penrith South DC 1797 NSW, Australia
| | - Steven R Cumming
- Faculty of Health Sciences, University of Sydney, PO Box 170 Lidcombe 1825 NSW, Australia
| | - Alan Tennant
- Faculty of Medicine and Health, Worsley Building, University of Leeds, Leeds LS2 9JT, UK
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