Reasons for suicide attempts and nonsuicidal self-injury in women with borderline personality disorder.

Department of Psychology, University of Washington, Seattle 98195-1525, USA.
Journal of Abnormal Psychology (Impact Factor: 4.86). 03/2002; 111(1):198-202. DOI: 10.1037/0021-843X.111.1.198
Source: PubMed

ABSTRACT Self-reported reasons for suicide attempts and nonsuicidal self-injury were examined using the Parasuicide History Interview within a sample of chronically suicidal women meeting criteria for borderline personality disorder (N = 75). Overall, reasons given for suicide attempts differed from reasons for nonsuicidal self-injury. Nonsuicidal acts were more often reported as intended to express anger, punish oneself, generate normal feelings, and distract oneself, whereas suicide attempts were more often reported as intended to make others better off. Almost all participants reported that both types of parasuicide were intended to relieve negative emotions. It is likely that suicidal and nonsuicidal parasuicide have multiple intents and functions.

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    ABSTRACT: Extant research indicates that dissociation may act as a risk factor for non-suicidal self-injury (NSSI), but the data are mixed. In this study, 75 university and community females, aged 18-35, were assessed for rates of normative, clinical, and severely clinical dissociation, as well as for NSSI. Significant differences in normative dissociation were found between the control group and the group reporting a history of NSSI. Additionally, normative dissociation - but not clinical or severely clinical dissociation - was found to be significantly associated with NSSI in this sample. Considering this finding in the context of existing literature, the authors propose a quartile risk model of dissociation and NSSI as a new approach to the influences of levels of dissociation on NSSI risk.
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    ABSTRACT: Dialectical behaviour therapy (DBT)-informed skills training for borderline personality disorder (BPD) aims at the development of specific emotion regulation skills in patients, particularly with regard to the regulation of problematic anger. While the effects of dialectical behaviour skills training have been shown, their processes of change are rarely examined. Neacsiu, Rizvi and Linehan (2010) found that patient's self-reported use of emotion regulation skills was a mediator of therapeutic change in these treatments; however, they found no effect for problematic anger. From an integrative perspective on anger (Pascual-Leone & Greenberg, 2007; Pascual-Leone & Paivio, 2013), there are several forms of anger, varying in their degree of therapeutic productivity. The present add-on randomized controlled trial included n = 41 patients with BPD (n = 21 DBT-informed skills training versus n = 20 treatment as usual). The first study examined the outcome of the DBT-informed skills training encompassing basic components of training in mindfulness, distress tolerance, interpersonal effectiveness and emotion regulation. Results showed that symptom reduction was significantly greater in the DBT-informed skills training, compared with the treatment as usual. The second study used process assessment, for which all patient completers underwent a 50-min-long psychological interview both early and late in treatment, which was rated using the Classification of Affective Meaning States. DBT-informed skills training produced increased levels of primary 'assertive' anger, as compared with the treatment as usual, whereas no effect was found for 'rejecting' secondary anger. Most importantly, we showed that changes in assertive anger mediated the reported symptom reduction, in particular in patient's social roles. We discuss these results in the context of underlying mechanisms of change in DBT skills group treatments, in particular towards developing more productive forms of anger in this patient population. Copyright © 2015 John Wiley & Sons, Ltd. A 20-session dialectical behaviour therapy (DBT)-informed skills training is a promising adjunct intervention for patients with borderline personality disorder, in particular for reducing problems related to social role. Increases in assertive anger mediate the effects of DBT-informed skills training, whereas rejecting anger remains unchanged over the course of treatment. Short-term objectives for intervention might involve the specific increase of assertive anger in BPD, by using DBT-informed skills training; long-term objectives for intervention might involve a specific decrease of rejecting anger in BPD. Copyright © 2015 John Wiley & Sons, Ltd.
    Clinical Psychology & Psychotherapy 04/2015; DOI:10.1002/cpp.1956 · 2.59 Impact Factor
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Jun 2, 2014