Exploratory comparison of auditory verbal hallucinations and other psychotic symptoms among youth with borderline personality disorder or schizophrenia spectrum disorder

Abstract

Objective: This study explored phenomenological aspects of auditory verbal hallucinations (AVH) and other psychotic symptoms among youth with borderline personality disorder (BPD).Methods: Sixty-eight outpatients, aged 15 to 25 years, were categorized into three groups according to their primary Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnosis and AVH symptom profile; BPD + AVH (n = 23), schizophrenia spectrum disorder (SZ) + AVH (n = 22) and BPD with no AVH (n = 23).Results: No differences in AVH were found between BPD + AVH and SZ + AVH. Compared with SZ + AVH, BPD + AVH scored lower on delusions and difficulty in abstract thinking and higher on hostility. BPD + AVH reported more severe self-harm, paranoid ideation, dissociation, anxiety and stress than BPD no AVH.Conclusions: This study replicates, in a sample of youth, the finding from studies of adults that AVH in BPD are indistinguishable from those in SZ, when assessed with the Psychotic Symptom Rating Scales (PSYRATS). Clinicians should specifically enquire about AVH among youth with BPD. When present, AVH appear to be an indicator of a more severe form of BPD. K E Y W O R D Sadolescence, hearing voices, psychiatry, psychotic symptoms, schizophrenia, young adulthood

Testing the Interpersonal-Cognitive Model of Auditory Verbal Hallucinations in Youths with Either Early-Stage Borderline Personality Disorder or First-Episode Schizophrenia Spectrum Disorder

“…Following a transdiagnostic approach toward understanding and treating distressing voices, we recently explored AVH in a sample of outpatient youths with BPD compared with those with a schizophrenia spectrum disorder (SZ). The main findings that emerged from the study are that: (1) AVH in youths with BPD are phenomenologically indistinguishable from those in SZ [28] and (2) both negative appraisals of voices and negative voice content predicted more severe depression, regardless of the diagnosis (BPD vs. SZ), while AVH severity (i.e., frequency, duration, location, and loudness) was not correlated with depression [29]. Using the same sample [28,29], the aim of the current study was to better understand the role of interpersonal schemata within the relationship between appraisals of voices and depression in young voice hearers, whose identity is still developing.…”

“…All of the participants were fluent in English. The sample is the same as reported in Cavelti et al [28,29]. Two participants did not complete the questionnaires and were excluded from the analyses reported here.…”

Preliminary Evidence for the Cognitive Model of Auditory Verbal Hallucinations in Youth With Borderline Personality Disorder

“…Forty-three help-seeking youth, aged 15–25 years, with AVH, who were diagnosed with either BPD (BPD+AVH; n = 23) or schizophrenia spectrum disorder (SZ) (SZ+AVH, n = 20) according to the Diagnostic and Statistical Manual of Mental Disorders , 5th Edition (DSM-5) (31) and were fluent in English, participated in the study. They constituted a subsample of a study that has been reported elsewhere (30). Two participants from the original SZ+AVH group ( n = 22) did not complete the questionnaires, and were thus excluded from these analyses.…”

“…In order to examine whether beliefs, emotions, and behaviors associated with AVH in youth with BPD differed from those in youth with SZ and AVH (exploratory aim 1 and Hypothesis 1), group comparisons were performed using the Mann–Whitney U test for the BAVQ-R subscales and the DASS-21 subscales, as well as the t -test for independent samples for the VRS. Group comparisons of the PSYRATS-AH items have been reported elsewhere (30).…”

“…In a recent study, our group explored AVH in a sample of outpatient youth (15 to 25 years of age) with BPD and found that they were similar to those in youth with schizophrenia spectrum disorder (SZ) with regard to physical (frequency, duration, location, loudness), cognitive (beliefs regarding origin of voices, disruption to life, controllability), and emotional (negative content, distress) characteristics (30). Using this same sample, the current study aimed to investigate whether beliefs, emotions, and behaviors associated with AVH in youth with BPD are similar to or different from those in youth with schizophrenia spectrum disorder (exploratory aim 1).…”