2017
2017 BPD literature
Pharmacopsychiatry, 2017 Jan;50(1):26-31
“Doxazosin, an alpha-1-adrenergic-receptor antagonists, for nightmares in patients with PTSD (post traumatic stress disorder) and/or BPD (borderline personality disorder): a chart review”
“Doxazosin might improve trauma associated nightmares and more general sleep parameters in patients with PTSD and BPD.”
Tijdschr Psychiatr. 2017;59(12):750‑758.
“Inpatient dialectical behaviour therapy for borderline personality disorder: effect on symptoms, coping, attachment and quality of life”
“We conclude that patients diagnosed with BPD may benefit from an inpatient DBT (group) program. Improvements in attachment style during inpatient treatment may contribute to this benefit.”
J Psychiatry Neurosci. 2017 Dec 13;43(1):170132.
“Assessing the marks of change: how psychotherapy alters the brain structure in women with borderline personality disorder.”
“We found that DBT increased grey matter volume of brain regions that are critically implicated in emotion regulation and higher‑order functions…”
Psychiatry Res. 2018 Feb;260:313‑317
“Substance‑induced psychotic symptoms in Borderline Personality Disorder among substance use disorder samples in Spain.”
“The most prevalent drug consumed was cocaine (67%) followed by cannabis (47.3%) and then alcohol (39.6%). A total of 62.8% people with BPD registered substance‑induced psychosis symptoms in their lifetime.”
Borderline Personal Disord Emot Dysregul. 2017 Dec 7;4:25
“A prospective, longitudinal, study of men with borderline personality disorder with and without comorbid antisocial personality disorder.”
“BPD comorbid with ASPD (antisocial personality disorder) was associated with violent criminal offending in adolescence and most strongly in adulthood, elevated levels of psychopathic traits, and childhood disruptive behaviour. BPD showed similar characteristics but to a much less degree.”
J Pers Disord. 2017 Nov 9:1‑1
“Substance Use in Youth With Borderline Personality Disorder.”
“Alcohol dependence, daily tobacco use, and use of illicit substances in the past month were between four and nine times more prevalent in the BPD group than in the general population. Similarly, the prevalence of substance use was disproportionately higher in youth with BPD than in matched controls.”
Early Interv Psychiatry. 2019 Jun;13(3):502‑508
“Sexuality and sexual health among female youth with borderline personality disorder pathology”
“BPD pathology in youth is associated with poor sexual health and safety, and uncertainty in sexual identity formation”
Evid Based Ment Health. 2017 Nov;20(4):123‑127
“Adjunctive avatar therapy for mentalization‑based treatment of borderline personality disorder: a mixed‑methods feasibility study”
“…avatar‑MBT (mentalization based treatment) may be a viable option to enhance existing BPD treatment …”
Acta Psychiatr Scand. 2017 Dec;136(6):637‑647
“Hemispheric asymmetry of the frontolimbic cortex in young adults with borderline personality disorder”
“Patients with BPD have greater frontolimbic asymmetry than healthy individuals”
Clin Psychol Psychother. 2018 Mar;25(2):188‑194
“Anger and depressive ruminations as predictors of dysregulated behaviours in borderline personality disorder”
“Anger and depressive ruminations were found to be significantly associated to, respectively, self‑harm and aggression, beyond the variance accounted by emotional dysregulation.”
Borderline Personal Disord Emot Dysregul. 2017 Sep 29;4:20
“Frontal EEG asymmetry in borderline personality disorder is associated with alexithymia (the inability to recognize or describe one’s own emotions)”
“Our findings reveal that lower right frontal EEG asymmetry is associated with alexithymia in patients with BPD. This finding is in accordance with neurophysiological models of alexithymia that implicate a right hemisphere impairment in emotion processing, and could suggest frontal EEG asymmetry as a potential biomarker of relevant psychopathology in these patients.”
J Affect Disord. 2017 Sep;219:80‑85
“Risk of stroke among patients with borderline personality disorder: A nationwide longitudinal study”
“Patients with BPD had an elevated vulnerability to subsequent stroke and ischemic stroke compared to those without BPD.”
Personal Ment Health. 2017 May;11(2):91‑100
“The neurobiology of social deficits in female patients with borderline personality disorder: The importance of oxytocin”
“we did not find lower serum oxytocin levels in the BPD group. However, BPD patients in a romantic relationship had higher levels of serum oxytocin than single BPD patients.”
Neurosci Biobehav Rev. 2017 Feb;73:48‑67
“The sleep phenotype of Borderline Personality Disorder: A systematic review and meta‑analysis”
“BPD is associated with comparable sleep disturbances to those observed in depression. These disturbances are not solely attributable to comorbid depression. Given growing evidence that sleep disturbance may exacerbate emotional dysregulation and suicide risk, treatments for BPD should explicitly address sleep problems.”
Personal Ment Health. 2017 Feb;11(1):14‑22
“How do mothers with borderline personality disorder mentalize when interacting with their infants?”
“…mothers with BPD also appear more likely to misread their infants’ mental states.”
J Abnorm Child Psychol. 2017 Jan;45(1):193‑206
“Sleep Problems in Childhood and Borderline Personality Disorder Symptoms in Early Adolescence”
“These findings tentatively support that childhood nightmares may potentially increase the risk of BPD symptoms in early adolescence via a number of aetiological pathways.”
J Pers Disord. 2017 Apr;31(2):273‑288
“Facing the Problem: Impaired Emotion Recognition During Multimodal Social Information Processing in Borderline Personality Disorder”
“In line with the major body of facial emotion recognition studies, we conclude that deficits in the interpretation of facial expressions lead to the difficulties observed in multimodal emotion processing in BPD.”
PLoS One. 2017 Sep 8;12(9):e0184447
“The overlap between autistic spectrum conditions (ASC) and borderline personality disorder”
“BPD patients have elevated autistic traits and a strong drive to systemize, suggesting an overlap between BPD and ASC.”
2018
BPD literature 2018
Encephale. 2018 Feb;44(1):46‑51
“The effects of oxytocin on social cognition in borderline personality disorder”
“There was no current evidence for the interest of oxytocin in enhancing affective and cognitive empathy in borderline personality disorder”
J Pers Disord. 2018 Oct;32(5):694‑708
“Substance Misuse Is Associated With Increased Psychiatric Severity Among Treatment‑Seeking Individuals With Borderline Personality Disorder”
“Over half (58.5%) of individuals entering treatment were currently misusing substances. Substance misuse was associated with more legal and employment problems, greater mood disturbance, impulsivity, and psychiatric severity… For the majority of patients (58%), there was little change in substance misuse post‑treatment.”
(Note: they didn’t specify treatment, clearly successfully treating the BPD medically lowers substance abuse)
Aust N Z J Psychiatry. 2018 Feb;52(2):117‑128
“Borderline personality disorder and polycystic ovary syndrome: A review of the literature”
“Overall, the literature shows women with borderline personality disorder to have higher than expected serum androgen levels and incidence of polycystic ovaries”
PLoS One. 2017 Sep 8;12(9):e0184447
“The overlap between autistic spectrum conditions (ASC) and borderline personality disorder”
“BPD patients have elevated autistic traits and a strong drive to systemize, suggesting an overlap between BPD and ASC.”
Braz J Psychiatry. 2018 Jan‑Mar;40(1):97‑104
“Clinical improvement in patients with borderline personality disorder after treatment with repetitive transcranial magnetic stimulation: preliminary results”
“Both protocols produced global improvement in severity and symptoms of BPD, particularly in impulsiveness, affective instability, and anger.”
J Pers Disord. 2018 Jun;32(3):414‑420
“High Prevalence of Physical Pain Among Treatment‑Seeking Individuals With Borderline Personality Disorder”
In this study 89% of those with BPD had chronic pain. 30% of all patients seeking pain relief have the BPD.
Actas Esp Psiquiatr. 2018 Nov;46(6):226‑33
“Factors predicting early dropout from dialectical behaviour therapy in individuals with borderline personality disorder”
Cocaine use and eating disorders are common causes of dropping out of therapy.
J Psychiatry Neurosci. 2018 May;43(3):171‑181
“Assessing the marks of change: how psychotherapy alters the brain structure in women with borderline personality disorder”
“We found that DBT increased grey matter volume of brain regions that are critically implicated in emotion regulation and higher‑order functions”
Compr Psychiatry. 2018 Jul;84:15‑21
“The relation of borderline personality disorder to aggression, victimization, and institutional misconduct among prisoners”
“Among prisoners with MDD (major depressive disorder), those with a BPD diagnosis have increased risk of psychological aggression and disciplinary infractions during incarceration.”
Health Technol Assess. 2018 Apr;22(17):1‑68
“Lamotrigine (Lamictal) for people with borderline personality disorder: a RCT (randomized control trial).”
“The addition of lamotrigine to the usual care of people with BPD was not found to be clinically effective or provide a cost‑effective use of resources.”
CNS Drugs. 2018 Feb;32(2):179‑187
“Effect of the Glutamate NMDA Receptor Antagonist Memantine as Adjunctive Treatment in Borderline Personality Disorder: An Exploratory, Randomised, Double‑Blind, Placebo‑Controlled Trial”
“Memantine at a 20‑mg daily dose is a well tolerated drug that can improve BPD symptomatology and may be a promising novel therapeutic for its treatment. ”
Acta Psychiatr Scand. 2018 Mar;137(3):206‑215
“Psychosocial stress differentially affects emotional empathy in women with borderline personality disorder and healthy controls”
“The current finding provides first evidence that stress differentially affects emotional empathy in patients with BPD and healthy individuals such that patients with BPD showed reduced emotional empathy compared to healthy women after stress.”
Clin Drug Investig. 2018 Apr;38(4):367‑372
“Combination of Omega‑3 Fatty Acids and Valproic Acid in Treatment of Borderline Personality Disorder: A Follow‑Up Study”
“Combined therapy with omega‑3 fatty acids showed long‑lasting effects after discontinuation in terms of anger control.”
Psychopathology. 2018;51(2):76‑82
“Behavioral and Neurobiological Correlates of Disturbed Emotion Processing in Borderline Personality Disorder.”
“Neurobiologically, threat hypersensitivity has been related to increased and prolonged amygdala responses, while deficient emotion regulation was associated with reduced prefrontal inhibition of the amygdala.”
Behav Res Ther. 2018 May;104:44‑50
“The unique contribution of acceptance without judgment in predicting nonsuicidal self‑injury (NSSI) after 20‑weeks of dialectical behaviour therapy group skills training”
“There was a significant effect of DBT skills training on NSSI.”
Arch Suicide Res. 2019 Jan‑Mar;23(1):82‑99
“The Effectiveness of Dialectical Behavior Therapy Skills Training Group (DBTSTG) vs. Cognitive Therapy Group (CTG) on Reducing Depression and Suicide Attempts for Borderline Personality Disorder in Taiwan.”
“Both groups had similar reductions in suicide reattempts and depression after the intervention and 6‑month follow‑ups. However, the CTG showed improvements in cognitive errors, but the DBTSTG revealed increases in acceptance and decreases in suppression scores.”
Fortschr Neurol Psychiatr. 2019 Feb;87(1):32‑38
“[Attention‑deficit/hyperactivity disorder (ADHD) in adult psychiatry: Data on 12‑month prevalence, risk factors and comorbidity].”
“The 12‑month prevalence of ADHD was 59.0 % (severe symptomatology: 33.1 %), high rates of comorbid disorders (92.9 % depression, 5.1 % bipolar disorder, 28.6 % anxiety disorder, 30.6 % emotional unstable (Borderline) personality disorder, 31.6 % avoidant personality disorder, 18.4 % dependent personality disorder, 25.5 % combined personality disorder, 10.2 % obsessive‑compulsive personality disorder, 26.5 % PTSD, 25.5 % restless legs syndrome, 24.5 % adiposity, 11.2 % eating disorder, 45.9 % learning difficulty, 51.0 % nicotine dependency, 4.1 % alcohol dependency, 7.1 % illegal substance dependency), risk factors for ADHD, a high genetic risk (72.4 %) and problems in psychosocial functioning.”
J Pers Disord. 2019 Feb;33(1):82‑100
“10‑Year Outcome of Suicidal Behavior in Borderline Personality Disorder”
“Core symptoms of BPD, substance abuse, and alcohol use disorders decreased significantly; however, major depressive disorder (MDD) remained constant at 50%”
PLoS One. 2018 Feb 21;13(2):e0191946.
“Abnormalities in gray matter volume in patients with borderline personality disorder and their relation to lifetime depression: A VBM study”
“According to this study, BPD is characterized by a restricted pattern of cortical volume reduction involving the dorsolateral frontal cortex and the medial frontal cortex, both areas of potential relevance for the clinical features of the disorder. Previous findings concerning reduced hippocampus and amygdala volume in the disorder are not supported. Brain structural findings in BPD do not appear to be explainable on the basis of history of associated lifetime major depression.”
Acta Psychiatr Scand. 2018 Mar;137(3):206‑215
“Psychosocial stress differentially affects emotional empathy in women with borderline personality disorder and healthy controls”
“The current finding provides first evidence that stress differentially affects emotional empathy in patients with BPD and healthy individuals such that patients with BPD showed reduced emotional empathy compared to healthy women after stress. Given the strong impact of stress on acute psychopathology in patients with BPD, such a response may exacerbate interpersonal conflicts in stress contexts and may be an important target for therapeutic interventions.”
Psychiatry Res. 2018 Apr;262:40‑45
“Description and prediction of time‑to‑attainment of excellent recovery for borderline patients followed prospectively for 20 years.”
“Thirty‑nine percent of borderline patients and 73% of personality‑disordered comparison subjects met our operationalized definition of excellent recovery (concurrent remission of borderline or another primary personality disorder, good social and full‑time vocational functioning, and absence of an axis I disorder associated decreased social and/or vocational functioning). Five variables formed our multivariate predictive model of excellent recovery for borderline patients: higher IQ, good childhood work history, good adult vocational record, lower trait neuroticism, and higher trait agreeableness. The results of this study suggest that complete recovery is difficult for borderline patients to achieve even over long periods of time.”
Encephale. 2018 Feb;44(1):46‑51
“The effects of oxytocin on social cognition in borderline personality disorder”
“In patients with borderline personality disorder, oxytocin had a beneficial impact on recognition and discrimination of emotions and on hypervigilance towards social threats. However, oxytocin could hinder trust and cooperation.”
J Psychiatry Neurosci. 2018 Jan 12;43(2):170102
“Neural correlates of emotional action control in anger‑prone women with borderline personality disorder.”
“The results indicate reduced lateral prefrontal‑amygdala communication during emotional action control in anger‑prone women with BPD.”
Clin Drug Investig. 2018 Apr;38(4):367‑372
“Combination of Omega‑3 Fatty Acids and Valproic Acid in Treatment of Borderline Personality Disorder: A Follow‑Up Study”
“Combined therapy with omega‑3 fatty acids showed long‑lasting effects after discontinuation in terms of anger control.”
Arch Womens Ment Health. 2018 Jun;21(3):375‑382
“Oxytocin and parenting behavior among impoverished mothers with low vs. high early life stress.”
“For mothers with low Adverse Childhood Experiences (ACE), higher oxytocin secretion was associated with more positive parenting. For mothers with high ACEs, higher oxytocin secretion was associated with lower levels of positive parenting. Oxytocin may be operating differently for mothers who experienced harsh early social environments, supporting more defensive behaviors and harsh parenting than anxiolytic and prosocial behaviors.”
{Note: this shows oxytocin isn’t the panacea many of us hoped would help borderlines}
Clin Psychol Psychother. 2018 Mar;25(2):188‑194
“Anger and depressive ruminations as predictors of dysregulated behaviours in borderline personality disorder”
“Anger and depressive ruminations were found to be significantly associated to, respectively, self‑harm and aggression, beyond the variance accounted by emotional dysregulation.”
J Affect Disord. 2018 Jan 15;226:85‑91
“Screening for attention‑deficit/hyperactivity disorder in borderline personality disorder”
“The prevalence of adult ADHD was of 32.4%”
(Note: 46% of borderlines got it from ADHD, which contradicts this study. Certainly everyone with BPD should be screened for ADHD. I do.)
Personal Ment Health. 2018 Feb;12(1):49‑58
“Estimating the prevalence of borderline personality disorder in mothers involved in youth protection services (YPS).”
“results revealed that 48.9% of mothers with BPD had a history of being followed by YPS in their childhood.”
J Affect Disord. 2018 Jan 1;225:723‑732
“Reduced white matter integrity in borderline personality disorder: A diffusion tensor imaging study”
“Our results suggested that hypo‑metabolism in a front‑limbic network dysfunction is characterized by the cingulum and a front‑occipital network dysfunction characterized by the occipital lobe, while an occipital‑temporal network dysfunction characterized by the inferior longitudinal fasciculus.”
Depress Anxiety. 2018 Jan;35(1):50‑57
“Endogenous oxytocin is associated with the experience of compassion and recalled upbringing in Borderline Personality Disorder.”
“BPD patients had significantly lower oxytocin plasma levels than healthy controls”
Clin Psychol Psychother. 2018 Jan;25(1):e51‑e59
“Different aspects of emotional intelligence of borderline personality disorder”
“Our findings suggest that BPD patients have the ability to regulate emotions effectively, but they subjectively experience deficits in emotion regulation and therefore may not use this ability when they need it.”
J Clin Psychiatry. 2018 May/Jun;79(3)
“Randomized Controlled Trial of Web‑Based Psychoeducation for Women With Borderline Personality Disorder”
“Taken together, these results suggest that internet‑based psychoeducation is an effective form of early treatment for reducing the symptom severity of borderline personality disorder for periods up to 1 year.”
Braz J Psychiatry. 2018 Jan‑Mar;40(1):97‑104
“Clinical improvement in patients with borderline personality disorder after treatment with repetitive transcranial magnetic stimulation: preliminary results.”
“ protocols produced global improvement in severity and symptoms of BPD, particularly in impulsiveness, affective instability, and anger.”
Eur Arch Psychiatry Clin Neurosci. 2018 Jun;268(4):401‑415
“Reduced amygdala reactivity and impaired working memory during dissociation in borderline personality disorder”
“Altered activity in areas associated with emotion processing, memory, and self‑referential processes may contribute to dissociative states in BPD”
Eur Arch Psychiatry Clin Neurosci. 2018 Jun;268(4):417‑427
“Amygdala structure and aggressiveness in borderline personality disorder”
“regions of the left superficial and laterobasal amygdala of male BPD patients were positively associated with aggressiveness”
2019
BPD literature 2019
Neurosci Biobehav Rev. 2019 Jan;96:316‑334
“Hypothalamic‑pituitary‑adrenal axis functioning in borderline personality disorder: A meta‑analysis”
“BPD patients displayed elevated continuous cortisol output and blunted cortisol following psychosocial challenges.”
J Pers Disord. 2019 Jun;33(3):394‑412
“Effects of a Painful Stimulus on Stress Regulation in Male Patients With Borderline Personality Disorder: A Pilot Study”
“This data showed that nonsuicidal self‑injury can reduce arousal and aggression in male BPD.”
(Another study that self mutilation “works” for BPD dysphoria, but self injury itself causes a myriad of problems).
J Pers Disord. 2019 Feb;33(1):82‑100
“10‑Year Outcome of Suicidal Behavior in Borderline Personality Disorder”
“ In the 10‑year interval, 46.6% attempted suicide.”