Aggressive behavior and self-harm in Borderline Personality Disorder: The role of impulsivity and emotion dysregulation in a sample of outpatients

Terzi, Laura; Martino, Francesca; Berardi, Domenico; Bortolotti, Biancamaria; Sasdelli, Anna; Menchetti, Marco

doi:10.1016/j.psychres.2017.01.011

Cited by 46 publications

(30 citation statements)

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“…Diagnoses were analysed both on the level of main and secondary diagnoses. In addition, we included the comorbidities addiction and psychosis (F1 and F2) and addiction and personality disorder (F1 and F6) in our analyses, because these were previously shown to be associated with increased risks for aggression, suicide and self-harm, involuntary admissions and containment measures [30–32]. Metric data (age and length of in-patient stay) were analysed by means of ANOVA and t-tests on the unweighted sample ( n = 5764).…”

Section: Methodsmentioning

confidence: 99%

A retrospective analysis of determinants of involuntary psychiatric in-patient treatment

et al. 2019

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Background The purpose of our study was to identify predictors of a high risk of involuntary psychiatric in-patient treatment. Methods We carried out a detailed analysis of the 1773 mental health records of all the persons treated as in-patients under the PsychKG NRW (Mental Health Act for the state of North Rhine-Westphalia, Germany) in a metropolitan region of Germany (the City of Cologne) in 2011. 3991 mental health records of voluntary in-patients from the same hospitals served as a control group. We extracted medical, sociodemographic and socioeconomic data from these records. Apart from descriptive statistics, we used a prediction model employing chi-squared automatic interaction detection (CHAID). Results Among involuntary patients, organic mental disorders (ICD10: F0) and schizophrenia and other psychotic disorders (ICD10: F2) were overrepresented. Patients treated as in-patients against their will were on average older, they were more often retired and had a migratory background. The Exhaustive CHAID analysis confirmed the main diagnosis to be the strongest predictor of involuntary in-patient psychiatric treatment. Other predictors were the absence of outpatient treatment prior to admission, admission outside of regular service hours and migratory background. The highest risk of involuntary treatment was associated with patients with organic mental disorders (ICD 10: F0) who were married or widowed and patients with non-organic psychotic disorders (ICD10: F2) or mental retardation (ICD10: F7) in combination with a migratory background. Also, referrals from general hospitals were frequently encountered. Conclusions We identified modifiable risk factors for involuntary psychiatric in-patient treatment. This implies that preventive measures may be feasible and should be implemented to reduce the rate of involuntary psychiatric in-patient treatment. This may include efforts to establish crisis resolution teams to improve out-patient treatment, train general hospital staff in deescalation techniques, and develop special programs for patients with a migratory background.

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Section: Methodsmentioning

confidence: 99%

A retrospective analysis of determinants of involuntary psychiatric in-patient treatment

et al. 2019

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“…Emotion dysregulation is also closely related to impulsiveness, another core domain of BPD (Cackowski et al, 2014;Gratz et al, 2009;van Zutphen, Siep, Jacob, Goebel, & Arntz, 2015). For instance, self-destructive behavior is seen as an impulsive attempt to regulate emotional distress (Linehan, 1993a;Terzi et al, 2017;Tragesser et al, 2007). This indicates the presence of a phenomenological overlap between emotion dysregulation and impulsiveness.…”

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confidence: 99%

Interpersonal Problems in Borderline Personality Disorder: Associations With Mentalizing, Emotion Regulation, and Impulsiveness

Euler

Nolte

Constantinou

et al. 2021

Journal of Personality Disorders

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Interpersonal problems are a core symptom of borderline personality disorder (BPD). This study investigated the relationship between emotion dysregulation, impulsiveness, and impaired mentalizing in the context of predicting interpersonal problems in BPD. A total of 210 patients with BPD completed the Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale (BIS-11), Reflective Functioning Questionnaire (RFQ), and Inventory of Interpersonal Problems (IIP-32). The authors conducted three path models, with either mentalizing, emotion regulation, or impulsiveness as the exogenous variable. Emotion dysregulation and attentional impulsiveness predicted interpersonal problems directly, whereas hypomentalizing predicted interpersonal problems only indirectly throughout emotion dysregulation and attentional impulsiveness. The results suggest that these domains contribute significantly to interpersonal problems in BPD. Moreover, hypomentalizing might affect on interpersonal problems via its effect on impulsiveness and emotion regulation. The authors argue that focusing on emotion regulation and mentalizing in BPD treatments might have interlinked beneficial effects on interpersonal problems.

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“…Identifying emotions is the key to successful therapy, independently from the type of treatment (Derks et al., 2016; McMain et al., 2013). To consider negative and positive affects dysregulation could make it possible to limit the risk of dysfunctional behaviour (Terzi et al., 2017) and social rejection (Chester et al., 2017). Further research is needed to examine this issue in BPD.…”

Section: Introductionmentioning

confidence: 99%

Impulsivity issues in borderline personality disorder and it's links with insight: the role of urgency

Martin

Del-Monte

Graziani

2019

Heliyon

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Impulsivity plays a major role in a wide range of disorders including Borderline Personality Disorder. Another crucial clinical dimension is insight. This clinical dimension is linked with symptomatology and treatment issue. The present study aims to investigate the impact of positive and negative urgency on insight in Borderline Personality Disorder. Methods: We recruited eighty-one women with Borderline Personality Disorder and assessed insight level and impulsivity scores using the Beck Cognitive insight scale and the UPPS-short form scale. Results: Our results showed interesting links between positive urgency and insight quality. Conclusion: Negative emotions play a fundamental role for the insight quality, but positive emotions are surprisingly related to clinical insight. We discuss the possible therapeutical impact of this results on treatment adaptation.

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Aggressive behavior and self-harm in Borderline Personality Disorder: The role of impulsivity and emotion dysregulation in a sample of outpatients

Cited by 46 publications

References 54 publications

A retrospective analysis of determinants of involuntary psychiatric in-patient treatment

A retrospective analysis of determinants of involuntary psychiatric in-patient treatment

Interpersonal Problems in Borderline Personality Disorder: Associations With Mentalizing, Emotion Regulation, and Impulsiveness

Impulsivity issues in borderline personality disorder and it's links with insight: the role of urgency

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