Adverse childhood experiences (ACEs) and adult mental health were explored in a sample of urban Aboriginal ( n = 83) and non-Aboriginal ( n = 89) women. Childhood sexual abuse (CSA) was associated with negative home environments, teenage pregnancy, lifetime suicide attempts, and treatment seeking. Aboriginal women with CSA witnessed higher levels of physical/sexual abuse of family members. The severity of current psychological distress was associated with a history of childhood neglect. The results indicate that CSA rarely occurs in isolation, and that multiple ACEs are strongly associated with suicide attempts and treatment seeking in adulthood. Future studies should focus on the role of CSA in suicidality, as well as familial, community, and cultural protective factors.

The present study examined mechanisms of change in dialectical behavior therapy (DBT) skills group and positive psychotherapy (PPT) group intervention, two treatments that have previously been shown to be effective at reducing symptoms of BPD and depression over a 12-week treatment protocol within the context of a college counseling center (Uliaszek et al., 2016). The present study is secondary data analysis of that trial. We hypothesized that change in dysfunctional coping skills use would be a specific mechanism for DBT, while change in functional coping skills use and therapeutic alliance would be mechanisms of change for both treatments. Fifty-four participants completed self-report and interview-based assessments at pretreatment, weeks 3, 6, 9, and posttreatment. Path models examined the predictive power of the mechanisms in predicting outcome; the moderating effect of group membership was also explored. Dysfunctional coping skills use across the course of treatment was a significant mechanism of change for BPD and depression for the DBT group, but not the PPT group. Conversely, therapeutic alliance was a significant mechanism of change for the PPT group, but not the DBT group. Findings highlight the importance of each mechanism during mid-to late-treatment specifically.

Despite high prevalence rates of concurrent borderline personality disorder (BPD) and substance use disorders (SUDs), little is known about the impact of substance misuse on the presentation of BPD. Sixty-five individuals with BPD were assessed at intake and at 3- and 6-month follow-up. Assessment included validated instruments such as the Addiction Severity Index and the Revised Symptom Checklist (SCL-90-R). Over half (58.5%) of individuals entering treatment were currently misusing substances. Substance misuse was associated with more legal and employment problems, greater mood disturbance, impulsivity, and psychiatric severity, including almost all SCL-90-R subscales. For the majority of patients (58%), there was little change in substance misuse post-treatment. The high prevalence of substance misuse and its association with psychiatric severity among individuals with BPD suggest that substance misuse should be a targeted behavior during treatment, and further specialized interventions are needed for individuals with comorbid BPD and SUD.

BackgroundPrevious research has illustrated a relationship between emotion dysregulation and suicidal ideation, both cross-sectionally and longitudinally. However, it is not yet understood how this relationship manifests. The aim of this study was to explore if two beliefs about suicide, (1) suicide as a way to escape from emotional pain and (2) suicide as a solution to a problem, moderate the relationship between emotion dysregulation and suicidal ideation.MethodsOne hundred one community participants completed questionnaires examining emotion dysregulation, suicidal ideation, and beliefs in the functions of suicide. Inclusion criteria were used to over-sample individuals within the community experiencing higher levels of suicidal ideation and emotion dysregulation. Hierarchical linear regressions with interaction terms were used to assess moderation effects. The moderating role of beliefs in the function of suicide was examined both cross-sectionally and longitudinally.ResultsSuicide as an escape significantly moderated the relationship between global emotion dysregulation and suicidal ideation cross-sectionally, while it moderated the relationship between a facet of emotion dysregulation and suicidal ideation longitudinally. Greater endorsement of this belief resulted in a stronger relationship between emotion dysregulation and suicidal ideation. The function of suicide as a solution to a problem did not moderate the emotion dysregulation-suicidal ideation relationship.ConclusionsThese findings underscore the importance of not only addressing emotion dysregulation but also addressing the underlying belief that suicide is an escape in individuals who experience both emotion dysregulation and suicidal ideation. Intervention efforts to address belief in suicide as an escape along with emotion dysregulation are delineated.