Project

Borderline Personality Disorder in Adolescents and suicidal behaviors

Goal: Explore clinical, cognitive and neuronal correlates
Design and evaluate innovative therapy

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Project log

Jean-Marc Guilé
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Introduction Chart review is a low-cost, but highly informative, method to describe symptoms, treatment, and risk factors associated with borderline personality disorder (BPD) and to adapt screening and intervention to clinical reality. Previous chart review studies report more aggressiveness/anger and psychotic features in youths with BPD. They show that adverse family environment and parental psychopathology constitute important factors for BPD pathology. Objectives To examine clinical characteristics of depressed BPD adolescents (12–17 years old) outpatients according to gender and to explore variables which are associated with BPD traits. Methods A retrospective chart review using the child and adolescent version of the retrospective diagnostic instrument for borderlines was conducted on 30 depressed adolescents with BPD traits and 28 depressed patients without BPD traits. Participants who reached the retrospective diagnostic instrument for borderlines threshold for BPD were included in the BPD traits group. Comparison analyses were performed using Pearson’s Chi-square test. Associated factors were determined using regression analyses. Results BPD traits participants were characterized by higher family problems (parental psychopathology, parent disagreement/argument, and parent–child relational problem), more aggressive symptoms, and higher rates of family intervention and hospitalization. A number of familial factors (parental history of delinquency, substance use, personality disorders, having siblings, or parental disagreement/argument in boys) were associated with BPD traits. Attention seeking and problematic functioning (does not adapt well to group activities) were also associated with BPD traits. Discussion Our study stresses the need to assess BPD traits in adolescent psychiatric evaluation, especially in the presence of aggressive behaviors, family problems and attention seeking. Our results also highlight the importance of exploring family characteristics intervention in adolescents with BPD traits.
Jean-Marc Guilé
added a research item
De nombreuses etudes en neuroimagerie fonctionnelle (IRMf) menees chez les adultes presentant un trouble de personnalite limite (TPL) convergent pour identifier un patron d’activation neuronale, notamment fronto-limbique, different de celui active chez les adultes sans TPL lors des tâches de visualisation d’images emotionnelles. A ce jour, aucune etude en IRMf n’a ete realisee chez les adolescents avec TPL. Ce projet pilote vise a evaluer la faisabilite d’un protocole d’IRMf chez des adolescentes avec TPL et a identifier les regions neuronales d’interet pour les etudes de neuroimagerie chez cette population. Le projet porte sur six adolescentes euthymiques presentant un diagnostic de TPL (âge moyen : 15,8 ± 0,9 ans) et six adolescentes temoins sans diagnostic psychiatrique (âge moyen : 15,5 ± 1,2 ans). Apres l’evaluation diagnostique incluant le Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime et le Diagnostic Interview for Borderline – Revised version, les participantes ont complete une tâche d’IRMf au cours de laquelle elles devaient regarder 20 images a valence affective positive, 20 images a valence affective negative et 20 images neutres. L’etude de faisabilite montre que les participantes ont ete recrutees en 22 mois et que le protocole etait bien tolere par celles-ci. Les resultats montrent que le visionnement des scenes positives et negatives a entraine une plus grande activation de plusieurs aires limbiques ainsi que frontales, temporales et du cervelet chez le groupe TPL. Les aires limbiques et prefrontales semblent etre des regions d’interet dans l’etude du fonctionnement neuronal chez les adolescentes avec TPL.
Jean-Marc Guilé
added a project goal
Explore clinical, cognitive and neuronal correlates
Design and evaluate innovative therapy