Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

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Background Emotional dysregulation seems to be a core feature of Borderline Personality Disorders (BPD). In addition, recent research in the adolescent population has shown that suicidal behaviours have been associated with maladaptive strategies of emotion regulation. Methods This study examined the relative contributions of emotional dysregulation to suicide attempt history in a clinical sample of borderline adolescents. Data were analyzed from 85 participants of the Collaborative European Research Network on Borderline Personality Disorder. Participants completed measures of BPD traits and symptoms, suicide behaviours, emotional dysregulation, attachment styles and lifetime depressive disorders. Results In an SEM model, lifetime depressive disorders and insecure attachment styles have a significant direct effect on lifetime suicide attempt, but only lifetime depressive disorders have an indirect effect through emotion dysregulation. The results suggest that emotional dysregulation has a mediating role in suicide attempts among BPD adolescents. Conclusions These findings call for the development of interventions targeting the role of emotion dysregulation in effectively predicting and preventing suicidality in borderline adolescents.

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Background The COVID-19 pandemic had led to severe education disruption in many countries, including for medical students (MS). We aimed to evaluate MS mental health in France and search for a difference depending on studies’ years and clinical activities. Methods In a cross-sectional, survey-based study during the first confinement, 668 (8.35%) MS were compared to 7 336 non-medical students (non-MS) (91.65%). The PHQ-9 (≥10), the GAD-7 (≥8), and the IES-R (≥26) were collected to assess depressive, anxiety, and distress symptoms. Multivariable logistic regression analyses were performed. Results MS reported significant psychological distress (depressive symptoms: 38.17%, anxiety: 38.77% and distress: 36.83%). Compared to non-MS, they reported less significant depressive (OR, 0.80; 95% CI, 0.67-0.91; P = .007) and distress symptoms (OR, 0.73; 95% CI, 0.62-0.87; P < .001), after taking into account potential confounding variables including COVID-19 diagnosis. First year-MS reported higher rates of significant psychological distress than MS with clinical activities. Moreover, depressive symptoms’ rates were higher among MS with COVID-19 diagnosis (OR, 2.61; 95% CI, 1.21-6.13; P = .016). Conclusions Special attention should be offered to first year-MS and MS with COVID-19 diagnosis. Systematic companionship could be implemented for first year MS, and systematic psychiatric/psychological consultations for students with COVID-19 diagnosis.

Within the European Research Network on BPD (EURNET-BPD; n = 85 BPD adolescents, n = 84 healthy controls, aged 13–19), this study explored the combination of three types of adversity—maltreatment, stressful life events (early separation from parents, parental suicide attempt, parental chronic disease) and parental bonding—as predictors of BPD, on a criteria-based approach. Results indicated that cumulative traumatic experiences largely characterize borderline adolescent's history; and, in the multivariate regression models, all adversity experiences were likely to contribute to BPD symptoms. The role of emotional abuse, parental suicide attempt, and a decrease in paternal level of care were particularly prominent. Moreover, adversities combinations were different for each criterion, suggesting that specific sets of traumatic experiences are leading to BPD. These findings argue for a further criteria-based exploration of trauma in borderline patients, as well as a more accurate and efficient prevention.

Background The study examines the psychometric properties of the French version of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) created by M. Zanarini to screen borderline personality disorder in clinical and non-clinical populations. Method In this multicentric longitudinal study from the European Network on Borderline Personality Disorder, a sample of 84 adolescent patients from five psychiatric centres and 85 matched controls without psychiatric comorbidity completed the MSI-BPD, French version, and were interviewed with the Structured Interview for DSM-IV Personality (SIDP-IV), in order to assess the presence or absence of borderline personality disorder. Results The MSI-BPD showed excellent internal consistency (α = 0.87 [0.84;0.90]). Compared to the semi-structured reference interview (SIDP-IV), the MSI-BPD showed substantial congruent validity (AUC = 0.93, CI 95%: 0.90–0.97). The optimal cut-off point in the present study was 5 or more, as it had relatively high sensitivity (0.87) and specificity (0.85). In our sample, the cut-off point (7 or more) proposed by the original developers of the MSI-BPD showed high specificity (0.95) but low sensitivity (0.63). Conclusions The French version of the MSI-BPD is now available, and its psychometric properties are satisfactory. The French version of the MSI-PBD can be used as a screening tool for borderline personality disorder, for clinical purposes or in research studies.

Cet article expose l'intérêt du Multimorph, outil expérimental évaluant les performances de traitement dynamique de visages émotionnels par le morphing. La version présentée ici permet de voir évoluer lentement et continuellement un visage de la neutralité à l'une des six émotions de base pleinement exprimée (colère, dégoût, joie, peur, surprise et tristesse). L'intérêt du Multimorph est analysé à partir d'une revue des études utilisant ce paradigme dans la mesure des capacités de reconnaissance émotionnelle faciale. L'exemple de la personnalité borderline à l'adolescence est développé, afin d'en analyser les corrélats clinico-expérimentaux. Les limites et les perspectives du Multimorph sont ensuite discutées. Abstract An increasing interest in the study of facial emotion recognition in many psychiatric disorders has emerged over the past few years. The morphing technique allowed opening new Page 2 of 10 A c c e p t e d M a n u s c r i p t 2 perspectives in experimentation, by using dynamic expressions of emotions, such as in the Multimorph task. Based on a literature review, we present here the interest of the Multimorph task. It includes 36 trials where a neutral (0 %) face expresses increasing degrees of emotional intensity, slowly changing to a full-blend (100 %) emotion. Then, the example of borderline personality disorder in adolescence is developed, to examine how the observed pattern of results could account for the reported clinical characteristics. Limitations and prospects of the Multimorph are further discussed.