&lt;p&gt;Manifestation of Borderline Personality Symptomatology in Chronic Pain Patients Under Stress: An Understated and Exacerbated Consequence of the COVID-19 Crisis&lt;/p&gt;

Shapiro, Hannah; Kulich, Ronald J.; Schatman, Michael E

doi:10.2147/jpr.s264761

Cited by 9 publications

(10 citation statements)

References 78 publications

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“…We might have expected BPD patients in particular to experience a dramatic deterioration in terms of their individual psychological symptoms in the context of the health crisis and the accompanying lockdown restrictions. However, our findings show that patients with the disorder likely reacted to the situation in much the same way as the population as a whole, reporting symptoms of anxiety and depression, as well as high levels of stress (Choi, 2020;Lakeman & Crighton, 2020;Pakpour & Griffiths, 2020;Shapiro et al, 2020;Yao et al, 2020) and difficulties with social relations as a result of social isolation (Frías et al, 2020). In fact, our exploratory study corroborates previous studies (Frías et al, 2020;Salamin et al, 2020) as during lockdown most of the patients' psychopathological symptoms seem to be stable.…”

Section: Discussionmentioning

confidence: 66%

“…In addition to the increasing levels of stress, the subjective loss of agency and control in the face of these circumstances experienced by people with BPD might generate greater difficulty in affective and emotional regulation, possibly triggering impulsive, and risky behavior (Pakpour & Griffiths, 2020;Shapiro et al, 2020;Ventura Wurman et al, 2020). Furthermore, social distancing has created obstacles to interpersonal relationships and contributed to the feeling of social isolation (Frías et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Exploring the psychological impact of COVID-19 on adolescents with borderline personality disorder and their mothers: A focus group study

Puigdesens

Roca

Ferrer

et al. 2021

Clin Child Psychol Psychiatry

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The aim of this study was to explore the impact of the coronavirus pandemic on adolescents diagnosed with Borderline Personality Disorder (BPD) and their mothers. This exploratory study used a qualitative focus group approach. This study’s sample group consisted in nine participants: five adolescents diagnosed with BPD and their four mothers. Patients were recruited from a specialized BPD outpatient unit of a university hospital psychiatry department. The results are divided into two main areas, the first regarding the lockdown period and the second examining the period of gradual relaxation of lockdown restrictions. The results show that the adolescents had difficulties in the management of their interpersonal relationships, especially in striking a balance between individual and family space, as well as in communication, cohesion, and family dynamics. During the COVID lockdown, adolescents experienced a stabilization of psychopathological symptoms, but these symptoms worsened when the lockdown restrictions were lifted. Nevertheless, they reported having learned and implemented self-care strategies. The findings are discussed in terms of both individual and family impact, shedding light on some of the challenges precipitated by the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Exploring the psychological impact of COVID-19 on adolescents with borderline personality disorder and their mothers: A focus group study

Puigdesens

Roca

Ferrer

et al. 2021

Clin Child Psychol Psychiatry

View full text Add to dashboard Cite

show abstract

“…During the COVID-19 pandemic, a high incidence of psychological distress and symptoms have also been observed, including mental health disorders, posttraumatic stress disorder, psychosomatic disorders, and substance abuse [ 88 , 89 , 90 ].…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, individual and societal disruption associated with COVID-19 are likely to increase their likelihood of emergence [ 89 , 92 ]. Moreover, while the prevalence of Borderline Personality Disorder is inordinately high among chronic pain patients, the severity of the disorder itself is likely to be increased during the COVID-19 outbreak [ 93 ].…”

Section: Resultsmentioning

confidence: 99%

Practical Advices for Treating Chronic Pain in the Time of COVID-19: A Narrative Review Focusing on Interventional Techniques

Bianco

Papa

Schatman

et al. 2021

JCM

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Background: Since the management of chronic pain has become even more challenging secondary to the occurrence of SARS-CoV-2 outbreaks, we developed an exhaustive narrative review of the scientific literature, providing practical advices regarding the management of chronic pain in patients with suspected, presumed, or confirmed SARS-CoV-2 infection. We focused particularly on interventional procedures, where physicians are in closer contact with patients. Methods: Narrative Review of the most relevant articles published between June and December of 2020 that focused on the treatment of chronic pain in COVID-19 patients. Results: Careful triage of patients is mandatory in order to avoid overcrowding of hospital spaces. Telemedicine could represent a promising tool to replace in-person visits and as a screening tool prior to admitting patients to hospitals. Opioid medications can affect the immune response, and therefore, care should be taken prior to initiating new treatments and increasing dosages. Epidural steroids should be avoided or limited to the lowest effective dose. Non urgent interventional procedures such as spinal cord stimulation and intrathecal pumps should be postponed. The use of personal protective equipment and disinfectants represent an important component of the strategy to prevent viral spread to operators and cross-infection between patients due to the SARS-CoV-2 outbreaks.

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“…In fact, a spokesman for the Tulsa Police Department noted that the gunman was “very deliberate about this”, as he only killed the physician he held responsible for his condition and those who “got in his way”, choosing to spare the life of a receptionist who was cowering at his feet (Captain Richard Meulenberg, personal communication, June 24, 2022). In a 2020 article on the manifestations of borderline personality symptomatology in chronic pain patients under stress, Shapiro, Kulich and Schatman noted that based on a diathesis-stress model, those suffering from Borderline Personality Disorders can potentially not manifest symptoms until the stress of chronic pain and its sequelae “pushes them over the edge.” 12 Given the findings of a review article by Sansone and Sansone in which the average prevalence of Borderline Personality Disorder among samples of pain patients was 30% 13 and that borderline personality pathology has been found to increase the likelihood of homicidal ideation by 1557%, 14 the risk of violence that pain care providers are currently experiencing cannot be overstated. This risk is, of course, exacerbated by the ease of access to semi-automatic weapons in the United States, a country in which the number of guns privately owned is considerably higher than the actual population, with 1.2 guns per capita.…”

mentioning

confidence: 99%

Violence Against Pain Care Providers: The Frightening Future of American Pain Medicine?

Schatman¹,

Kooharian²,

Guerrero³

2022

JPR

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On June 1 st , 2022, a lone gunman, Michael Louis, walked into a medical office building in Tulsa, OK, and with a semiautomatic rifle and a semi-automatic handgun, shot and killed 4 people prior to turning his gun on himself and taking his own life. This was the 233 rd mass shooting in the United States in the first half of 2022, 1 and given the nation's ongoing mass shooting epidemic, the story's national interest waned quickly. Coverage by Tulsa's leading daily newspaper, Tulsa World, continued, however, providing additional details of the tragic incident. 2 Readers may be questioning the relevance of yet another mass shooting in the United States to the international pain community. The assailant, Mr. Louis, suffered from chronic low back pain, and among the victims were the orthopedic surgeon, Dr. Preston Phillips, who had performed a spinal fusion from L3 to S1 on the patient on May 19th, as well as another physician. According to Tulsa World, Mr. Louis was discharged from the hospital on May 24 th , subsequent to which he experienced ongoing pain for which he blamed Dr. Phillips. Tulsa police reported that they found a letter from the assailant stating that he blamed his surgeon for his ongoing pain and that he intended to kill him, as well as anyone else who got in his way. Mr. Louis reportedly contacted Dr. Phillips on numerous occasions between his discharge from the hospital and his final appointment with the surgeon on May 31 st . Although it was reported that Mr. Louis was distressed by his pain following his surgery, police reports indicate that he was also extremely unhappy regarding a number of functional deficits with which he was left post-operatively (Captain Richard Meulenberg, personal communication, June 24, 2022).Reports from a number of media outlets were rife with assumptions and inaccuracies regarding the cause of Mr. Louis's rampage. For example, the libertarian think tank, the Cato Institute, published a commentary in Reason less than a week following the shootings. 3 In the commentary, the authors (both of whom are surgeons) claimed that "America's Failed Opioid Policy Drove the Tulsa Shooter to Violence". Another less-than-mainstream media source assigned blame to an Oklahoma state law that limits opioid prescribing to 7 days post-operatively. 4 This claim is misleading, at best. According to the 2018 state law, 5 initial prescription of post-operative Schedule II opioids is limited to 7 days, although the physician has the right to subsequently refill the prescription following the 7-day period. The speculation on social media regarding the relationship between Dr. Phiillips' alleged failure to provide adequate opioid analgesia and the mass shooting tragedy was even more irresponsible and rife with unsubstantiated claims than that of the mainstream media, tabloids and blogs, which is hardly surprising. 6 According to a source from the Tulsa Police Department, there is no evidence that the mass shooting was necessarily related to a failure to provide the perpetrator with adequate opio...

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<p>Manifestation of Borderline Personality Symptomatology in Chronic Pain Patients Under Stress: An Understated and Exacerbated Consequence of the COVID-19 Crisis</p>

Cited by 9 publications

References 78 publications

Exploring the psychological impact of COVID-19 on adolescents with borderline personality disorder and their mothers: A focus group study

Exploring the psychological impact of COVID-19 on adolescents with borderline personality disorder and their mothers: A focus group study

Practical Advices for Treating Chronic Pain in the Time of COVID-19: A Narrative Review Focusing on Interventional Techniques

Violence Against Pain Care Providers: The Frightening Future of American Pain Medicine?

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