The Incremental Validity of Borderline Personality Disorder Relative to Major Depressive Disorder for Suicidal Ideation and Deliberate Self-Harm in Adolescents

Journal of personality disorders (Impact Factor: 3.08). 12/2012; 26(6):927-38. DOI: 10.1521/pedi.2012.26.6.927
Source: PubMed


Few studies have examined the relation between suicide-related behaviors and Borderline Personality Disorder (BPD) in adolescent samples. The current study investigated the incremental validity of BPD relative to Major Depressive Disorder (MDD) for suicide-related behaviors in a psychiatric sample of adolescents at the cross-sectional level of analysis. The sample included N = 156 consecutive admissions (55.1% female; M age = 15.47; SD = 1.41), to the adolescent treatment program of an inpatient treatment facility. Of the sample 19.2% (n = 30) met criteria for BPD on the Child Interview for DSM-IV Borderline Personality Disorder and 39.1% (n = 61) met criteria for MDD on the Computerized Diagnostic Interview Schedule for Children-IV. Results showed that BPD conferred additional risk for suicidal ideation and deliberate self-harm. Our findings support the clinical impression that BPD should be evaluated in inpatient samples of adolescents either through intake interviews or more structured assessments.

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Available from: Carla Sharp, Jan 21, 2014
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    • "Also, it seems that bipolar disorders are related more to the impulsivity and aggressive behavior (Nabuco et al., 2009). In this field, Researchers like Leung, Lai, Yu & Fu (2012), Segal et al., (2012), Black et al.(2004), Sharp et al.(2012) and Soltaninejad et al.(2013) concluded that the borderline personality disorders and their characteristics such as hopelessness, impulsivity, emotional instability and interpersonal turmoil are significantly related to suicide and suicidal ideation and non-suicidal self-injury behavior. Among psychiatric disorders, depression with 58% has allocated the highest rates of suicide risk (Zare &Sayadi, 2009). "
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    ABSTRACT: The research aim was investigating the relationship between personality styles of autonomy and sociotropy, and suicidal behavior at Zahedan University of medical sciences' medical students. This was a descriptive correlational study. The population consisted of all medical students at Zahedan University of Medical Sciences internship period 2002-2003. The number of samples was 102 patients, including 47 males and 55 females. To collect information, the personal style inventory (PSI) with 48 items. Twenty four items to assess sociotropy, 24 items to assess autonomy, and to measure suicide the suicidal subscale (MMPI) with 21 items were used. The two scales had the content validity and for the reliability used Cronbach a. So the reliability of the personality styles is 0.84 and the reliability of the suicidal subscales is 0.83. Data were analyzed using Pearson's correlation methods. The results showed that there is an inverse and significant relation between autonomic style and trends of suicide in men (P = 0.02, r = -0.43), but no association between sociotropy and suicidal tendencies were observed in men. There was no significant relationship between autonomy and sociotropy personality styles and tendency towards suicide in women.
    Preview · Article · Oct 2015 · Global journal of health science
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    • "Adequate concurrent validity, and sensitivity and specificity of BPD severity scores to clinicians' diagnosis have been demonstrated for the IPDE-BOR. Further, this questionnaire has been validated for use in adolescent samples (Chanen et al., 2008; Sharp et al., 2012; Stepp, Burke, Hipwell, & Loeber, 2011; Stepp, Pilkonis, Hipwell, Loeber, & Stouthamer-Loeber, 2010). In this sample, the average score during the age 16 assessment was 2.96, the median score was 3, and scores ranged from 0 to 9. The upper quartile of our sample had an average score of 4, which is in the clinically significant range (Smith, Muir, & Blackwood, 2005; Stepp, Burke, Hipwell, & Loeber, 2011). "
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    ABSTRACT: Developmental theories of borderline personality disorder (BPD) posit that transactions between child characteristics and adverse environments, especially those in the context of the parent-child relationship, shape and maintain symptoms of the disorder over time. However, very little empirical work has investigated the role of parenting and parent-child transactions that may predict BPD severity over time. We examined maternal and dyadic affective behaviors during a mother-adolescent conflict discussion task as predictors of the course of BPD severity scores across 3 years in a diverse, at-risk sample of girls (N = 74) oversampled for affective instability and their biological mothers. Adolescent girls completed a structured conflict discussion task with their mothers at age 16. Girls' self-reported BPD severity scores were assessed annually from ages 15 to 17. Mother-adolescent interactions were coded using a global rating system of maternal and dyadic affective behaviors. Results from multilevel linear mixed models indicated that positive maternal affective behavior (i.e., supportive/validating behavior, communication skills, autonomy-promoting behavior, and positive affect) and positive dyadic affective behaviors (i.e., satisfaction and positive escalation) were associated with decreases in girls' BPD severity scores over time. Dyadic negative escalation was associated with higher overall levels of BPD severity scores, but negative maternal affective behavior (i.e., negative affect, dominance, conflict, and denial) was not. These findings suggest that the mother-daughter context is an important protective factor in shaping the course of BPD severity scores during adolescence and may be valuable in assessment, intervention, and prevention efforts. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Full-text · Article · Mar 2014 · Personality Disorders: Theory, Research, and Treatment
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    • "High rate of DSH is usually found in patients with personality disorders (most of all, borderline disorder). This has clinical implications because patients with Axis II disorder comorbidity are clinically different from patients with major depression alone and borderline personality disorder can confer additional risk for suicidal ideation and DSH [26]. For this reason we stratified the randomisation, in order to have an equal distribution of treatment regimens in the two subgroups. "
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    ABSTRACT: Data on therapeutic interventions following deliberate self harm (DSH) in patients with treatment-resistant depression (TRD) are very scant and there is no unanimous consensus on the best pharmacological option for these patients. There is some evidence that lithium treatment might be effective in reducing the risk of completed suicide in adult patients with unipolar affective disorders, however no clear cut results have been found so far. The primary aim of the present study is to assess whether adding lithium to standard therapy is an effective treatment strategy to reduce the risk of suicidal behaviour in long term treatment of people with TRD and previous history of DSH.Methods/ design: We will carry out a randomised, parallel group, assessor-blinded superiority clinical trial. Adults with a diagnosis of major depression, an episode of DSH in the previous 12 months and inadequate response to at least two antidepressants given sequentially at an adequate dose for an adequate time for the current depressive episode will be allocated to add lithium to current therapy (intervention arm) or not (control arm). Following randomisation, treatment is to be taken daily for 1 year unless some clear reason to stop develops. Suicide completion and acts of DSH during the 12 months of follow-up will constitute the composite primary outcome. To preserve outcome assessor blindness, an independent adjudicating committee, blind to treatment allocation, will anonymously review all outcome events. The results of this study should indicate whether lithium treatment is associated with lower risk of completed suicide and DSH in adult patients with treatment resistant unipolar depression, who recently attempted suicide.Trial registration: identifier: NCT00927550 (
    Full-text · Article · Aug 2013 · BMC Psychiatry
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