Comorbidity of Borderline Personality Disorder

Shah, Ravi; Zanarini, Mary C.

doi:10.1016/j.psc.2018.07.009

Cited by 145 publications

(86 citation statements)

References 40 publications

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“…Second, our patient sample reported high rates of psychiatric comorbidities. While high rates of axis I comorbidities are a common finding in the literature [55] and thus emphasize the representativeness of our sample, it also questions the specificity of our results for BPD, especially since our study lacks a clinical control group. The absence of a clinical control group therefore precludes any inferences regarding the BPD-specific nature of our findings.…”

Section: Discussionmentioning

confidence: 81%

An eye-tracking study of interpersonal threat sensitivity and adverse childhood experiences in borderline personality disorder

Seitz

Leitenstorfer

Krauch

et al. 2021

bord personal disord emot dysregul

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Background Previous eye-tracking studies provide preliminary evidence for a hypersensitivity to negative, potentially threatening interpersonal cues in borderline personality disorder (BPD). From an etiological point of view, such interpersonal threat hypersensitivity might be explained by a biological vulnerability along with a history of early life adversities. The objective of the current study was to investigate interpersonal threat hypersensitivity and its association with adverse childhood experiences (ACE) in patients with BPD employing eye-tracking technology. Methods We examined a sample of 46 unmedicated, adult female patients with BPD and 25 healthy female volunteers, matched on age and intelligence, with a well-established emotion classification paradigm with angry, fearful, happy, and neutral facial expressions. ACE were assessed retrospectively with the Childhood Trauma Questionnaire. Results Patients as compared to healthy volunteers reflexively directed their gaze more quickly towards the eyes of emotional and neutral faces and did not adapt their fixation patterns according to the facial expression presented. Misclassifying emotional and neutral faces as angry correlated positively with the patients’ self-reported ACE. Conclusions Building on and extending earlier findings, our results are likely to suggest a visual hypervigilance towards the eyes of emotional and neutral facial expressions and a childhood trauma-related anger bias in patients with BPD. Given the lack of a clinical control group, the question whether these findings are specific for BPD has to remain open. Thus, further research is needed to elucidate the specificity of altered visual attention allocation and the role of ACE in anger recognition in patients with BPD.

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Section: Discussionmentioning

confidence: 81%

An eye-tracking study of interpersonal threat sensitivity and adverse childhood experiences in borderline personality disorder

Seitz

Leitenstorfer

Krauch

et al. 2021

bord personal disord emot dysregul

View full text Add to dashboard Cite

show abstract

“…Borderline Personality Disorder occurs in 1–2% of the general population, usually begin during adolescence before the age of thirty, and more than two‐third of the diagnosed patients are females . BPD has high rates of comorbidity in cross‐sectional and longitudinal studies . According to the ICD‐10 classification system, BPD is categorized as part of emotional unstable personality disorder (ICD‐10 F60.3x).…”

Section: Introductionmentioning

confidence: 99%

Societal costs of Borderline Personality Disorders: a matched‐controlled nationwide study of patients and spouses

Hastrup

Jennum

Ibsen

et al. 2019

Acta Psychiatr Scand

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Objective Information on societal cost of patients with Borderline Personality Disorder (BPD) and spouses is limited. The aim was to investigate factual societal costs before and after initial BPD diagnosis. Method A register‐based cohort study of 2756 patients with incident BPD (ICD F60.3) with spouses and 11 024 matched controls, during 2002–2016. Results Total direct healthcare costs and lost productivity costs amounted €40 441 for patients with BPD, which was more than 16 times higher than the matched controls. Somatic and psychiatric health care costs and costs of lost productivity were increased during 5 years before initial diagnosis of BPD. Before and after initial diagnosis, health care costs and lost productivity were increased among spouses of patients with BPD. Conclusion Patients with BPD differed substantially from the general population with respect to all included costs. The study documented a significant burden on their spouses. Besides the early onset of BPD, which implies that patients are affected before they finish school and enter labor market, the neurocognitive impairment and fundamental symptoms of BPD, e.g. unstable, intense relationships, impulsivity, and lack of stable sense of self together with psychiatric and somatic comorbidity are part of explanation of the excess costs of BPD.

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“…This statement finds it support in studies showing increased comorbidity between social anxiety and BPD [135], and that social anxiety plays a moderating role in adult depression [136]. Furthermore, maladaptive perfectionism in primary school children has been found to be related to increased levels of internalizing as well as externalizing behaviour [137], and precursors of SAD, such as self-criticism and avoidance behaviour may be reinforced by parenting [129].…”

Section: Social Anxiety Disordermentioning

confidence: 82%

Treatment Refractory Internalizing Behaviour Across Disorders: An Aetiological Model for Severe Emotion Dysregulation in Adolescence

Herpers

Neumann

2020

Child Psychiatry Hum Dev

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Auto-aggressive behaviour, especially treatment refractory suicidality in adolescents with psychiatric disorders, may be challenging to clinicians. In search of therapeutic possibilities, we have integrated current opinions regarding causality and interdependency of suicidality and auto-aggressive behaviour across disorders within the HiTOP framework. We propose a developmental model regarding these unsettling behaviours in youths that may help to guide future directions for research and interventions. We argue that the interdependent development of biologic factors, attachment, moral reasoning and emotion regulation in an overprotective environment may lead to social anxiety and later during development to emotion dysregulation and severe internalizing behaviour disorders. To optimize treatment efficacy for both internalizing and externalizing behaviour, we emphasize the importance transdiagnostic interventions, such as addressing non-compliance, restoration of trust between parents and their child, and limitation of avoidance behaviour. These may be seen as higher order interventions within the HiTOP framework.

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Comorbidity of Borderline Personality Disorder

Cited by 145 publications

References 40 publications

An eye-tracking study of interpersonal threat sensitivity and adverse childhood experiences in borderline personality disorder

An eye-tracking study of interpersonal threat sensitivity and adverse childhood experiences in borderline personality disorder

Societal costs of Borderline Personality Disorders: a matched‐controlled nationwide study of patients and spouses

Treatment Refractory Internalizing Behaviour Across Disorders: An Aetiological Model for Severe Emotion Dysregulation in Adolescence

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