Suicidality in Borderline Personality Disorder

Paris, Joel

doi:10.3390/medicina55060223

Cited by 150 publications

(143 citation statements)

References 42 publications

(50 reference statements)

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“…Borderline personality disorder (BPD) is a pervasive, debilitating psychological condition found in 28.5% of clinical populations and between 0.8% and 1.6% among community samples [ 1 , 2 ]. BPD is often regarded as the most lethal form of mental illness and the most severe personality disorder [ 3 ], where completed suicides are estimated between 8.5% and 10% [ 4 , 5 ]. Such patients are considered high treatment utilizers as they consume extensive treatment resources, and a large proportion return to therapy after termination of the initial treatment [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Schema therapy for borderline personality disorder: A qualitative study of patients’ perceptions

et al. 2018

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Schema therapy (ST) has been found to be effective in the treatment of borderline personality disorder (BPD). However very little is known about how the therapy is experienced by individuals with BPD including which specific elements of ST are helpful or unhelpful from their perspectives. The aim of this study is to explore BPD patients’ experiences of receiving ST, in intensive group or combined group-individual format. Qualitative data were collected through semi-structured interviews with 36 individuals with a primary diagnosis of BPD (78% females) who received ST for at least 12 months. Participants were recruited as part of an international, multicenter randomized controlled trial (RCT). Interview data (11 Australian, 12 Dutch, 13 German) were analyzed following the procedures of qualitative content analysis. Patients’ perceptions of the benefits gained in ST included improved self-understanding, and better awareness and management of their own emotional processes. While some aspects of ST, such as experiential techniques were perceived as emotionally confronting, patient narratives informed that this was necessary. Some recommendations for improved implementation of ST include the necessary adjunct of individual sessions to group ST and early discussion of therapy termination. Implications of the findings are also discussed, in particular the avenues for assessing the suitability of patients for group ST; management of group conflict and the optimal format for delivering treatment in the intensive group versus combined group-individual formats.

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Section: Introductionmentioning

confidence: 99%

Schema therapy for borderline personality disorder: A qualitative study of patients’ perceptions

et al. 2018

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“…Nevertheless, suicide attempts are just one symptom of suicidality and patients not conducting SA may still have frequent suicidal ideations or occupy with death and suicide in the internet and exchange suicide methods in social media (27). Indeed, SA typically occur in a circumscribed (early) phase during the course of BPD (28), whereas suicide ideations tend to persist over years (29). Fatally, it also turned out that highest suicide rates occur later in the course of the illness and follow long courses of unsuccessful treatment (30), meaning that patients are not at their highest risk of suicide when they are young and frequent visitors to the emergency room (29).…”

Section: Can Suicidality In Borderline Bementioning

confidence: 99%

“…Indeed, SA typically occur in a circumscribed (early) phase during the course of BPD (28), whereas suicide ideations tend to persist over years (29). Fatally, it also turned out that highest suicide rates occur later in the course of the illness and follow long courses of unsuccessful treatment (30), meaning that patients are not at their highest risk of suicide when they are young and frequent visitors to the emergency room (29). Thus, working in therapy with chronic suicidality (beyond management of NSSI and SA) appears to be mandatory in order to prevent later suicides.…”

Section: Can Suicidality In Borderline Bementioning

confidence: 99%

Function and Psychotherapy of Chronic Suicidality in Borderline Personality Disorder: Using the Reinforcement Model of Suicidality

Hennings

2020

Front. Psychiatry

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Although great advancements in evidence-based therapies, chronic suicidal patients with borderline personality disorder (BPD) still challenge our mental health system. While BPD patients continue suffering from distress and aversive emotions, therapists and relatives feel often stunned and helpless when confronted with suicidality resulting in interruption of therapies, repeated presentations to emergency rooms and referrals to hospitals. Reviewing the current knowledge of the functions and background of non-suicidal selfinjury, we learned that reinforcement mechanisms play an important role to understand why individuals act in deliberate self-mutilation. While individual motives for non-suicidal self-injury and suicidal behavior including suicidal ideations can differ, the principle mechanisms appear to be transferrable. Elucidating the individual motives and function of suicidal behavior is an important therapeutic step, giving us access to very central maladaptive schemes and false believes that we need to address in order to reduce chronic suicidality in BPD patients. This Perspective article aims to give a better idea of what is behind and what are the differences between non-suicidal self-injury, suicidal ideations and suicide attempts. It further integrates recent developments of behavioral science in a reinforcement model of suicidality that can provide therapists a practical armamentarium in their work with chronic suicidal clients.

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“…People with a diagnosis of BPD also represent a high risk group for suicidality (i.e., suicidal thoughts, selfharm, suicide attempts), with approximately 10% of people with BPD dying by suicide [12].…”

Section: Introductionmentioning

confidence: 99%

Structural stigma and its impact on healthcare for consumers diagnosed with Borderline Personality Disorder: protocol for a scoping review

Klein

Fairweather‐Schmidt

Lawn

et al. 2020

Preprint

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BackgroundStructural stigma in health systems experienced by consumers diagnosed with Borderline Personality Disorder (BPD), is a widespread phenomenon that causes health inequities and harm for this population. Structural stigma in this context relates to organisational practices, cultural norms, and institutional policies that limits consumers’ access to health services, quality of care, and health and well-being. BPD is a mental illness with high morbidity and mortality, characterised by instability in interpersonal relationships, self-image, and emotional and behavioral deregulation, which stem from significant traumatic childhood/life events, and/or biological etiologies. This scoping review aims to explore the literature on structural stigma in health systems specific to BPD, and to provide an overview of the impact of stigma on healthcare services for BPD consumers, and their carers/families.MethodsThis scoping review will follow the Joanna Briggs Institute (JBI) guidelines. The search strategy was developed and tested using PsycINFO. A comprehensive search will be conducted across PsycINFO, MEDLINE, CINAHL, Scopus, ProQuest, Cochrane library and JBI Evidence-Based databases; as well as a grey literature search using Google search engine. Studies will be screened by title, abstract and full text articles, by separate reviewers against the eligibility criteria. Selected full text articles will be accessed against the inclusion criteria. Quantitative and qualitative data will be extracted from the selected full text articles. A narrative summary of findings will then be conducted and presented in accordance with the JBI guidelines for scoping reviews, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 checklist. Quality appraisal of the included articles will be assessed using the Mixed Methods Appraisal Tool (MMAT) 2018 version.DiscussionThis review is anticipated to enhance both identification and understanding of those structures in health systems (i.e., policies, cultural norms, and practices), that manifest and perpetuate stigma experienced by consumers with BPD, and their carers/families. The findings can be used to inform future research, policy and practice relating to stigma reduction strategies that can be adopted to improve the provision of BPD-responsive services and care for this population.Scoping review registrationThis scoping review was submitted for registration in Open for Science Framework on 11th June 2020.

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Suicidality in Borderline Personality Disorder

Cited by 150 publications

References 42 publications

Schema therapy for borderline personality disorder: A qualitative study of patients’ perceptions

Schema therapy for borderline personality disorder: A qualitative study of patients’ perceptions

Function and Psychotherapy of Chronic Suicidality in Borderline Personality Disorder: Using the Reinforcement Model of Suicidality

Structural stigma and its impact on healthcare for consumers diagnosed with Borderline Personality Disorder: protocol for a scoping review

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