2011:
BPD Medical Literature 2011
J Pers Disord 2011 Dec;25(6):782-8
“The relationship between BPD (borderline personality disorder) and the number of sexual partners”
Individuals with BPD have had approximately twice as many sexual partners compared to those without BPD.
Harefuah 2011 Apr;150(4):349-52, 419
“BPD (borderline personality disorder) and bipolar II disorder – similarities and differences”
“…BPD patients show increased sensitivity to negative emotional states.”
J Abnorm Psychol Epub Dec 12, 2011
“The covariation of trait anger and borderline personality: a bivariate twin-siblings study”
The authors found a 54% correlation of “trait anger” that was genetic.
Int J Psychiatry Clin Pract Epub 2011 Aug 31
“Religion/spirituality status and borderline personality symptomatology among outpatients in an internal medicine clinic”
“This suggests that individuals with borderline personality symptomatology have lower overall levels of religious/spirituality than individuals without this type of psychopathology.”
Int J Psychiatry Clin Pract Epub 2011 Jul 11 (from the UK)
“Medication for BPD (borderline personality disorder): a survey at a secure hospital”
“Clozapine was … the most likely to lead to a major improvement in target symptoms. Other psychotropics were generally rated as resulting in minor improvement or no change.”
(This study of 79 patients shows some of the problems with pharmacological studies. There is no “borderline drug” – combinations are needed. There are a number of studies showing medications can be of help. Clozaril is a very problematic and expensive drug that requires very frequent blood monitoring)
Psychother Psychosom Epub 2011 Nov 22
“Higher executive control and visual memory performance predict treatment completion in BPD (borderline personality disorder)”
“In the treatment of outpatients with BPD, better executive control and visual memory performance predict more weeks in treatment. (they are more likely to complete a treatment course
J Pers Disord 2011 Oct;25(5): 715-21
“Reactivity to sensations in BPD (borderline personality disorder): a preliminary study”
Individuals with BPD have a heightened reactivity to sounds. (This is particularly true when dysphoric – “stop yelling at me” is commonly said to mate, even when the mate isn’t yelling.)
Eat Weight Disord J011 Jun;16(2):e81-5
“eating disorder symptoms and borderline personality symptomatology”
“Specific eating disorder symptoms, alone, may predict for borderline personality symptomatology.”
Drug Alcohol Depend 2012 Feb 1;121 (1-2):970`01. Epub 2011 Sep9
“The impact of BPD (borderline personality disorder) on residential substance abuse treatment dropout among men.”
“Patients with BPD were significantly more likely to prematurely dropout of treatment.”
Presse Med 2012 Feb;41(2): e63-75
“Polysomnographic studies on sleep in adult borderline personality disorder”
Borderlines have decreased onset delay of REM sleep and an increased REM density. Decreased total sleep time and efficiency.
Psychiatry Res 2011 Nov 30;190(1):126-321 Ebut 2011 Aug 27
“History of suicide attempt in male substance-dependent inpatients and relationship to borderline personality features, anger, hostility and aggression.
“…to reduce the risk of suicide attempt among substance dependent patients, anger must be the target of evaluation and treatment among those with borderline personality features.
J Pers Disord 2011 Aug;25(4):432-47
“dissociation predicts poor response to Dialectical Behavior Therapy in female patients with BPD (borderline personality disorder).”
J Affect Disord 2011 Nov;134(1-3_:410-5 Epub 2011 Jun 08
“Orbitofrontal dysfunction related to depressive symptomatology in subjects with BPD (borderline personality disorder).
“Abnormal functioning at orbitofrontal areas in BPD could be related to the presence of affective symptomatology and is associated with greater functional deterioration of patients.
Compr Psychiatry 2012 Apr;53(3):230-7 Epub 2-11 <au 31
“Affective lability in bipolar disorder and BPD (borderline personality disorder)” (Dr. Zanarini)
Patients with bipolar had significantly higher score on euthymia elation subscale, borderlines had less frequent affective shifts between euthymia-elation and depression-elation. Borderlines shifted more from euthymia-anxiety, euthymia anger, anxiety depression, and depression-anxiety.
Acta Psychiatr Scand 2011 Nov;124(5):349-56 Doi:10.1111/j.1600-0447.2011.01717.x. Epub 2011 May 12 August 3, 2018 Dr. Zanarini
“The 10 Year course of PTSD in borderline patient and axis II comparison subject.
“…the results of this study suggest that PTSD is not a chronic disorder for the majority of borderline patients. They also suggest a strong relationship between sexual adversity and the course of PTSD among patients with BPD.
Psychoneuroendocrinology 2011 Oct;36(9): 1418-21. Epub 2011 May 4
“Oxytocin administration attenuates stress reactivity in BPD: a pilot study.”
“Results suggest that oxytocin may have a beneficial impact on emotional regulation on BPD.”
2012
2012 Literature
Compr Psychiatry 2012 Jan;53(1):39-47
“Symptomatic overlap between attention-deficit/hyperactivity disorder and BPD (borderline personality disorder) in women: the role of temperament and character traits.”
“Contrary to patients with combined ADHD and BPD symptoms, patients with only symptoms of ADHD showed normal character development and thus an absence of a personality disorder.”
Compr Psychiatry 2012 Feb;53(2):176-80
“The relationship between illegal behaviors and borderline personality symptoms among internal medicine outpatients.”
Aggravated and simple assault, disorderly conduct, driving under the influence, drug abuse violations, and public intoxication were significantly more common in young males with BPD, especially when correlated with alcohol/substance abuse.
J Abnorm Child Psychol 2012 Jan;40(1):7-20
“Trajectories of attention deficit hyperactivity disorder and oppositional defiant disorder as precursors of borderline personality disorder symptoms in adolescent girls”
“…higher levels of ADHD and ODD scores at age 8 uniquely predicted BPD symptoms at age 14.”
Presse Med 2012 Feb;41(2):e63-75
“Polysomnographic studies on sleep in adult BPD (borderline personality disorder)”
Those with BPD had a decreased onset delay of rapid eye movements (REM) sleep and an increased REM density. BPD shares some findings with major depression including increase in onset latency, decreased total sleep time and efficiency.
Psychiatr Genet, 2012 FEb;22(1):15-24
“Interaction between tryptophan hydroxylase I polymorphisms and childhood abuse is associated with increased risk for BPD (borderline personality disorder) in adulthood”
Individuals with some variations in TPH1 gene are more susceptible to developing BPD from childhood abuse.
Int Clin Psychopharmacol 2012 Jan;27(1):61-8
“Evaluation of naltrexone for dissociative symptoms in BPD (borderline personality disorder)”
In this small study naltrexone 50 or 200mg/day lowered dissociative symptoms.
Curr Opin Psychiatry, 2012 Jan;25(1):52-8
“Clinical psychopharmacology of BPD (borderline personality disorder): an update on the available evidence in light of the DSM-5″
The author recommends omega-3, anticonvulsants, and atypical antipsychotic agents in treating specific DSM-5 BPD traits, “notably disinhibition, antagonism, and some aspects of negative affectivity.” Personally I’m baffled why the author didn’t include Prozac (fluoxetine) – which has been shown to markedly reduce anger, these studies were decades ago and no study has shown Prozac (fluoxetine) to be ineffective for anger.
Psychother Psychosom 2012;81(1):38-43
“Higher executive control and visual memory performance predict treatment completion in BPD (borderline personality disorder)”
“In the treatment of outpatients with BPD, better executive control and visual memory performance predict more weeks in treatment.”
J Abnorm Psychol, 2012 May;121(2):458-66
“The covariation of trait anger and borderline personality: a bivariate twin-siblings study”
“A shared genetic risk factor is thus one of the explanations for the covariation of borderline personality and trait anger.”
Brain Struct Func, 2012 Oct;217(4):767-82
“Brain structure and function in borderline personality disorder”
Many findings including reductions in the hippocampi and amygdalae of BPD patients, exaggerated amygdala activity in BPD patients when confronted with emotion-related stimulus, and negative correlations between increases in left amygdalar ereatine and reductions in amygdalar volume, reductions in absolute N-acetylaspartate concentration in the dorsolateral prefrontal cortex and increases in glutamate concentration in the anterior cingulate cortices of BPD patients.
Psychosom Res, 2012 Feb;72(2):147-52
“Alexithymia in adolescents with borderline personality disorder”
“BPD adolescents are characterized by alexithymia” (difficulty in identifying and describing self emotions).
Alcohol Clin Exp Res, 2012 Jul;36(7):1188-95
“Borderline personality symptoms in short-term and long-term abstinent alcohol dependence.”
BPD symptoms didn’t impair short term abstinence, but long term abstinence in women was more difficult when they had anger-associated symptoms and abandonment avoidance symptoms.
J Psychiatr Res, 2012 Apr;46(4):516-25
“Structural brain abnormalities and suicidal behavior in borderline personality disorder”
“High lethality attempters had significant decreases in right mid-superior temporal gyrus, right middle inferior orbitofrontal gyrus, right insular cortex, left fusiform gyrus, left lingual gyrus and right parahippocampal gyrus compared to low lethality attempters.”
J Child Psychol Psychiatry, 2012 Aug;53(8):846-55
“Bullied by peers in childhood and borderline personality symptoms at 11 years of age: a prospective study.”
“Intentional harm inflicted by peers is a precursor or marker on the trajectory towards the development of BPD symptoms…”
Psychol Med, 2012 Oct;42(10):2181-92
“Influence of emotional distraction on working memory performance in borderline personality disorder”
“Our findings suggest hyper-responsiveness to emotionally distracting pictures in BPD patients that negatively affects working memory performance. This stresses the important of emotional dysregulation in the context of cognitive functioning. Moreover, our findings suggest that dissociative states have a dampening effect on neural reactivity during emotional challenge in BPD.”
Eur Arch Psychiatry Clin Neurosci, 2012 Dec;262(8):677-85
“Orbitofrontal cortex and impulsivity in borderline personality disorder: an MRI study of baseline brain perfusion.”
“…dysfunction of medial and lateral regions of the orbitofrontal cortex could specifically mediate symptoms of impulsivity in BPD.”
Psychoneuroendocrinology, 2012 Oct;37(10):1659-68
“Associations of childhood trauma with hypothalamic-pituitary-adrenal (HPA) function in borderline personality disorder and major depression”
“HPA dysfunctions appear to be related rather to childhood trauma than to psychopathology in adulthood. Exposure to childhood trauma may contribute to long-lasting alterations in HPA activity and might enhance the risk for development of later mental disorder.”
J Pers Disord, 2012 APr;26(2):238-54
“Childhood abuse in Chinese patients with borderline personality disorder”
“…maternal physical abuse is as strong a predictor of BPD in China as sexual abuse, a finding not replicated in North America.”
J Affect Disord, 2012 Jul;139(2):149-53
“Microstructural white matter damage at orbitofrontal areas in borderline personality disorder”
“…behavioral symptoms of BPD patients might be associated to damage at the connectivity tracts in (the orbitofrontal) areas.”
Behav Res Ther, 2012 Jun;50(6):381-6
“Treating PTSD in suicidal and self-injuring women with borderline personality disorder: development and preliminary evaluation of Dialectical Behavior Therapy Prolonged Exposure Protocol”
“…the results indicate that this integrated BPD and PTSD treatment is feasible to implement within one year of treatment, highly acceptable to patients and therapist, safe to administer, and shows promise as an effective intervention for PTSD in this complex and high-risk patient population.”
Psychiatry Res, 2012 Mar 31;201(3):245-52
“Amygdala and hippocampal volume reductions as candidate endophenotypes for borderline personality disorder: a meta-analysis of magnetic resonance imagine studies.”
“These findings suggest modest volume reductions of the amygdala and hippocampus bilaterally in BPD which cannot be attributed to illness state or comorbid psychopathology.”
Aust N Z J Psychiatry, 2012 Apr;46(4):327-39
“borderline personality disorder and bipolar affective disorder. Spectra or specter? A review”
“This review concludes that bipolar affective disorders and borderline personality disorder are separate disorders…”
J Clin Psychopharmacol, 2012 Jun;32(3):398-402
“Open-label treatment with olanzapine for patients with borderline personality disorder”
“…these results suggest that continued therapy with olanzapine (Zyprexa) may sustain and build upon improvements seen with acute olanzapine treatment of patients with BPD.”
Biol Psychiatry, 2012 Sep 15;72(6):448-56
“Potentiated amygdala response to repeated emotional pictures in borderline personality disorder
“…BPD patients … may benefit from treatments targeting emotion recognition.”
Am J Psychiatry, 2012 Jun,169(6):6650-61
“Dialectical Behavior Therapy compared with general psychiatric management for borderline personality disorder: clinical outcomes and functioning over a 2 year follow up.”
There was no significant difference in outcome with both approaches.
Child Maltreat, 2012 May,17(2):182-90
“Borderline personality disorder features and history of childhood maltreatment in mothers involved with child protective services.”
“BPD features rather than maltreatment history per se predicted maternal involvement with child protective services, controlling for alcohol and drug use predictors.”
Neuropsychology, 2012 Jul;26(4):473-82
“Response inhibition deficits in unaffected first-degree relatives of patients with borderline personality disorder”
“These findings suggest that response inhibition deficits are pronounced in some BPD relatives, may be heritable between siblings…”
PloS One, 2012;7(5):e37464
‘Methadone-mediated autonomic functioning of male patients with heroin dependence: the influence of borderline personality pattern.”
“Borderline personality individuals how increased sympathetic activity and decreased parasympathetic activity compared to other personalities after taking methadone. The results support the hypothesis that there is an interaction between borderline personality and autonomic modulation.”
Am J Psychiatry, 2012 May;169(5):476-83
“Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and axis II comparison subjects: a 16 year prospective follow up study”
“Our results suggest that sustained symptomatic remission is substantially more common than sustained recovery from borderline personality disorder and that sustained remissions and recoveries are substantially more difficult for individuals with borderline personality disorder to attain and maintain than for individuals with other forms of personality disorder.”
CNS Spectr, 2012 Jun;17(2):70-5
“Amygdalar volume in borderline personality disorder with and without comorbid post-traumatic stress disorder: a meta-analysis”
“This meta-analysis suggests that amygdalar volumes are reduced in patients with BPD. This pattern is confirmed in BPD patients without PTSD, but not in BPD patients with PTSD, raising the possibility that reduced amygdalar volume in BPD patients cannot be explained by comorbid PTSD.”
Int J Psychiatry Clin Pract, 2012 Sep;16(3):197-204
“Training emotional intelligence (EI) improves both EI and depressive symptoms in inpatients with borderline personality disorder and depression.”
“For inpatients suffering from BPD and depression, regular skill training in EI can be successfully implemented and leads to improvements both in EI and depression.”
J Affect Disord, 2012 Dec 20;143(1-3):261-4
“Executive functioning among patients with borderline personality disorder and their relatives.”
“…executive dysfunctions do not appear to be markers of familial vulnerability for BPD.”
J Pers Disord, 2012 Oct;26(5):660-75
“Empathy and alexithymia in borderline personality disorder: clinical and laboratory measures.”
“BPD patients are highly responsive to the feelings of others, BU they are impaired in identifying/describing feelings and in taking the perspective of others.”
Bipolar Disord, 2012 Dec;14(856-62)
“Sustained unemployment in psychiatric outpatients with bipolar depression compared to major depressive disorder with comorbid borderline personality disorder”
“Both bipolar disorder and borderline personality disorder were associated with impaired occupational functioning and thus carry a significant public health burden. Efforts to improve detection of borderline personality disorder in depressed patients might be as important as the recognition of bipolar disorder.”
Ann Clin Psychiatry, 2012 Nov;24(4):255-60
“Efficacy of extended-release divalproex combined with “condensed” Dialectical Behavior Therapy for individuals with borderline personality disorder”
“Although the patients had a decrease in symptoms during the study, there was no advantage observed for (Depakote) divalproex ER and Dialectical Behavior Therapy over placebo and DBT”
(note: this is consistent with my experience, Tegretol (carbamazepine) is markedly superior to Depakote (valproic acid or valproate) and has medical evidence of effectiveness.”
J Pers Disord, 2012 Dec;26(6):927-38
“The incremental validity of borderline personality disorder relative to major depressive disorder for suicidal ideation and deliberate self- harm in adolescents”
“Our findings support the clinical impression that BPD should be evaluated in inpatient samples of adolescents either through intake interviews or more structured assessments.”
J Pers Disord, 2012 Dec;26(6):939-55
“What does sadness mean to BPD patients?”
“The results suggest … that sadness … is a non-mentalized experience that should not be conceptualized as sadness proper
2013
2013 Medical Literature
Soc Cogn Affect Neurosci, 2013 Jun:8(5):531-7
“Neuronal correlates of social cognition in BPD (borderline personality disorder)”
“This activation pattern seems to reflect an enhanced emotional approach in the processing of social stimuli in BPD that allow good performance in standardized social-cognitive tasks, but might be the basis of social-cognitive deficits in real-life social interactions.”
World J Biol Psychiatry, 2013 Feb;14(1):45-56
“Reduced deactivation in reward circuitry and midline structures during emotion processing in BPD (borderline personality disorder)”
“Altered emotion processing in BPD patients is likely to affect the reward system. More basic deficits in reward circuitry and other midline regions level of resting state activity may contribute to this effect.”
(Another biological abnormality in BPD based on function MRI testing)
World J Biol Psychiatry, 2013 May;14(4):307-18.
“Medial prefrontal dysfunction and prolonged amygdala response during instructed fear processing in BPD (borderline personality disorder)”
“Prolonged amygdala response and a functional disconnection between ventral and dorsal mPFC (medial prefrontal cortex).”
(Another biological abnormality in BPD based on function MRI testing)
Personal Disord. 2013 Jan;4(1):15-22
“An item response theory analysis of the DSM IV BPD (borderline personality disorder) criteria in a population based sample of 11-12 year old children.”
“Despite the controversy associated with applying the borderline construct to youth (11-12 year olds), the current findings provide psychometric evidence in favor of doing so.”
(The BPD begins at puberty, when the limbic system goes into “hyperdrive.” In my experience, any early pubertal signs such as hair growth, voice changes, body odor, are sufficient to establish the diagnosis – as long as BPD criteria are met).)
Personal Disord, 2013 Apr;4(2)152-9
“Borderline personality pathology and chronic health problems in later adulthood: the mediating role of obesity.”
“BPD is associated with many negative physical health outcomes, including increased risk for serious chronic diseases such as diabetes, heart disease and arthritis. BPD is also linked with obesity, a condition that is strongly related to many of the same physical health problems.”
(I screen all morbidly obese patients for the BPD. This study illustrates the importance of treating BPD successfully medically to reduce the risk of serious health problems subsequently.)
J Abnorm Psychol, 2013 Feb;122(1):180-94
“Tests of a direct effect of childhood abuse on adult borderline personality disorder traits: a longitudinal discordant twin design”
Twin studies show that childhood abuse is not a strong predictor of future BPD. Genetic influences are a stronger predictor.
(In my experience, untreated ADHD causes ~50% of BPD cases. Genetics alone only accounts for ~20%. Childhood sexual abuse is a strong predictor of BPD.)
Eur Arch Psychiatry Clin Neurosci, 2013 Apr;263(3):205-13
“Prevalence of the metabolic syndrome in patients with BPD: results from a cross sectional study.”
“Our results demonstrate and increased (metabolic syndrome) rate, (diabetes and prediabetes) and lipid (cholesterol and triglycerides) metabolism in patients with BPD.”
Psychopathology, 2013;46(1):55-62
“Axis I and II comorbidity and psychosocial functioning in female adolescents with BPD”
“Adolescent BPD in females is accompanied by high rates of psychiatric comorbidity and poor psychosocial functioning. This underscores the need for diagnosis of BPD at its early stages, in order to facilitate appropriate interventions.”
(I could not possibly agree more).
J Psychiatry Neurosci, 2013 Mar;38(2):129-37
“Morphometric differences in central stress-regulating structures between women with and without BPD.”
“Our findings provide new evidence for grey matter alterations in the hypothalamus and replicate previously reported decrements in hippocampal volume in patients with BPD.”
J Pers Disord, 2013 Dec;27(6):806-19
“Maternal transmission of BPD symptoms in the community based Greifswald Family Study.”
“…maternal BPD symptoms and depression … were significant predictors of a number of BPD criteria that the offspring met (during adolescence). In sum, the authors’ findings provide evidence for familial aggregation of BPD symptoms and heightened levels of general psychopathology in offspring of mothers with high levels of BPD features, pointing to the need for providing early intervention for this high-risk group.”
J Pers Disord, 2013 Oct;27(5):680-96
“Circadian sleep-wake cycles, well being and light therapy in BPD”
“Individuals with BPD frequently suffer from sleep disturbances.” “Although general depression scores and borderline symptoms did not change, daytime alertness improved with morning light therapy.”
Psychopathology, 2013;46(3):172-5
“Axis II comorbidity of BPD in adolescents”
According to the Structured Interview for DSM-IV Disorders of Personality, adolescents with BPD have the following comorbid personality disorders:
OCPD 35.3% antisocial 22.4%, avoidant 21.2%, dependent 11.8%, paranoid 9.4%. Antisocial was more common in males (45.5%) than in women (19%).
Psychopathology, 2013;46(4):217-24
“Enhanced detection of emotional facial expressions in BPD”
“The participants with BPD performed significantly better in the detection of positive and negative expressions compared to the healthy controls. False alarm rates did not differ significantly between the two groups. The BPD participants showed an enhanced detection of emotional expressions that might be related to the emotional disturbances they experience.”
J Psychiatry Neurosci, 2013 May;38(3):164-72
“Emotional modulation of motor response inhibition in women with BPD: a functional MRI study”
“Our findings are consistent with the view that a disturbed amygdala-prefrontal network in patients with BPD is compensated by a subcortical loop involving the subthalamic nucleus, leading to normal behavioral inhibition in these patients.”
Community Ment Health, J, 2013 Dec;49(6):643-8
“Its us that have to deal with it seven days a week”: carers and BPD”
“It seems carers of those with a diagnosis of BPD are continuing to be overlooked by mental health services, and subsequently require more support to Ensure their own well-being.”
Psychiatry Res, 2013 Apr 30;206(2-3):278-81
“Borderline symptoms and suicidal / self injury in late adolescence: prospectively observed relationship correlates in infancy and childhood.”
“Maternal withdrawal in infancy was a significant predictor of both borderline symptoms and suicidality/self-injury in late adolescence. Disorganized controlling child behavior at age 8 contributed independently to the prediction of borderline symptoms. The effect of maternal withdrawal was independent of, and additive to, variability explained by severity of childhood abuse. Borderline symptoms and suicidality/self-injury may be preceded developmentally by disturbed interactions as early as 18 months of age.”
Psychiatry Res, 2013 Aug 30;213(2):83-91
“Structural brain features of borderline personality and bipolar disorders.”
“Although BPD and bipolar show a considerable overlap in (gray matter) changes, the topography of alterations is more consistent with the separate conditions hypothesis…”
Psychol Med, 2013 Sep;43(9):1953-63
“Facial emotion recognition in BPD”
“Patients with BPD have difficulties recognizing specific negative emotions in faces and may misattribute emotions to faces depicting neutral expressions.”
Psychol Med, 2013 Mar;43(3):495-505
“Effects of cortisol on memory in women with borderline personality disorder: role of co-morbid post-traumatic stress disorder and major depression”
“The present results demonstrate beneficial effects of acute cortisol elevations on hippocampal-mediated memory processes in BPD. The absence of these effects in patients with comorbid major depressive disorder suggest that these patients differ from other BPD patients in terms of their sensitivity to glucocorticoids.”
Curr Opin Psychiatry, 2013 Jan;26(1):90-6
“Neurocognitive profiles of people with borderline personality disorder”
“Frontolimbic structural and functional abnormalities underlie the broad array of cognitive abnormalities in BPD.”
(Some individuals with BPD have cognitive abnormalities, but in my experience it is no more common than the general population. I would like to see this study repeated in individuals treated with Prozac (fluoxetine), Tegretol (carbamazepine) and as needed Haldol (haloperidol), along with treating those with comorbid ADHD with an effective dose of a stimulant like methylphenidate or Adderall.”
Horm Behav, 2013 Mar;63(3):424-9
“Reduced plasma oxytocin levels in female patients with borderline personality disorder”
“Women diagnosed with BPD had significantly reduced oxytocin concentrations…plasma oxytocin correlated negatively with experiences of childhood trauma, in particular with emotional neglect and abuse.”
(Oxytocin is strongly correlated with degree of outgoingness in personality and is largely responsible for maternal infant bonding. Nasal oxytocin helps many individuals with BPD, but its not available in the US.)
Psychol Med, 2013 Jun;43(6):1279-91
“Prenatal adversity: a risk factor in borderline personality disorder?”
“Borderline patients were significantly more often exposed to adverse intrauterine conditions, such as prenatal tobacco exposure, medical complications, prenatal maternal traumatic stress, familial conflicts, low social support and partnership problems during pregnancy. Logistical regression analyses revealed that the reported prenatal risk factors accounted for 25.7% of the variance in BPD.”
Am J Psychiatry, 2013 Jan 1;170(1):111-20
“Defense mechanisms reported by patients with borderline personality disorder and axis II comparison subjects over 16 years of prospective follow-up: description and prediction of recovery.”
“Borderline patients had significantly lower scores than axis II comparison subjects on one mature defense mechanism (suppression) and significantly higher scores on seven of the other 18 defenses studied. … Taken together, these results suggest that the longitudinal defensive functioning of borderline patients is distance and improves substantially over time. They also suggest that immature defenses are the best predictor of time to recovery.”
Clin J Pain, 2013 Jun:29(6):527-32
“Associations between pain conditions and borderline personality disorder symptoms: findings from the National Comorbidity Survey Replication.”
“This is the first study to demonstrate that BPD symptoms are positively associated with chronic spinal pain, severe/frequent headaches, and other chronic pain conditions…”
Scand J Psychol, 2013 Aug;54(4):300-12
“Altered sleep in borderline personality disorder in relation to the core dimensions of psychopathology.”
“We show that disturbed sleep including sleep fragmentation, alterations in slow wave sleep and REM sleep, and dysphoric dreaming are prevalent symptoms in BPD.” “…a stronger emphasis on sleep disturbances would enrich the treatment protocols of BPD.”
J Pers Disord, 2013 Aug:27(4):442-56
“Rejection sensitivity is a mediator between borderline personality disorder features and facial trust appraisal.”
“…interpersonal difficulties (abandonment fears, instability in close relationships) may be influenced by the propensity to interpret neutral social stimuli (e.g. nonemotional faces) as untrustworthy.”
Psychiatry Res, 2013 Jul 30;213(1):1-10
“Magnetic resonance imaging in patients with borderline personality disorder: a study of volumetric abnormalities”
Females with BPD showed reductions in the sizes of left hippocampal head, body, and tail, and the right hippocampal tail, as well as caudate and dorsolateral prefrontal cortex.
Psychiatry Res, 2013 Jul 30;213(1):18-23
“Childhood abuse is associated with structural impairment in the ventrolateral prefrontal cortex and aggressiveness in patients with borderline personality disorder”
“Volume reduction and functional impairment in areas of the prefrontal cortex have been found in BPD, particularly in patients with a Hx of childhood abuse. …Our results suggest that a history of childhood abuse may lead to increased aggression mediated by an impairment of the right ventrolateral prefrontal cortex.”
Innov Clin Neurosci, 2013 Apr;10(4):36-40
“The relationship between borderline personality and obesity.”
“Findings appear to support the association between impulsive personality pathology and impulsive eating pathology, and underscore that a significant minority of obese individuals may suffer from borderline personality disorder.”
Neurol Sci, 2013 May:34 Suppl
“Personality traits, personality disorders and migraine, a review”
“…borderline personality disorder, in particular, is associated with increased negative impact of migraine, risk for medication overuse, and poor response to (migraine) treatment.”
Psychopathology, 2014;47(1):10-6
“Longitudinal transmission pathways of borderline personality disorder symptoms: from mother to child?”
“The data of the current study imply that the transmission of borderline symptoms from mother to child is mediated by maladaptive mother-child interactions.”
J Pers Disord, 2013 Aug;274(4):427-41
“Borderline personality disorder features and risk for prescription opioid use disorders.”
“The authors conclude that individuals with more pronounced BPD features may be at risk for use and dependence on prescription opioids, and that this association may be primarily associated with the impulsivity features of BPD.”
J Consult Clin Psychol, 2013 Oct;81(5):941-7
“Chronic sleep disturbances and borderline personality disorder symptoms”
“…BPD symptoms are aggravated by poor sleep and lead to higher levels of functional impairment. Sleep in patients with BPD should be routinely assessed, and ameliorating chronic sleep problems may enhance treatment by improving emotion regulation and implementation of therapeutic skills.”
Psychother Psychosom Med Psychol, 2014 Feb;64(2):63-9
“Tattoos and piercings: motives for body modification in women suffering from borderline symptomatology.”
“…for people with borderline tendency body modification may serve as a coping strategy similar to self injury.”
(20 years ago the literature implied that most women with tattoos have BPD, this is no longer the case due to societal changes. Self-mutilation has become “popular” among teens, the difference is self mutilation relieves emotional pain (dysphoria) and doesn’t hurt in those with BPD, those without BPD experience pain when self mutilation)
J Pers Disord, 2013 Dec;27(6):783-94
“Reasons for self-mutilation reported by borderline patients over 16 years of prospective follow up.”
“The results of this study suggest that borderline patients with a more extensive history of self-mutilation are best distinguished from those with a less extensive history of self-harm that are motivated, at least in par, by dysphoric inner states.”
Curr Pain Headache Rep, 2013 Aug;17(8):350
“Borderline personality disorder and chronic pain: a practical approach to evaluation and treatment.”
While 6% of the population has the BPD, 30% of the chronic pain population has the BPD.
Personal Disord, 2014 Apr;5(2): 164-71
“Somatosensory processing and borderline personality disorder: pain perception and a signal detection analysis of proprioception and exteroceptive sensitivity.”
“Finding are consistent with (but do not prove) a specific dysfunction in the pain specific mechanism of sensitive and perception in BPD, perhaps one that does not disturb the other somatosensory modalities.”
J Psychiatr Res, 2013 Oct;47(10)
“The relationship of chronic medical illnesses, poor health-related lifestyle choices, and health care utilization to recovery status in borderline patients over a decade of prospective follow up”
“Over a decade of prospective follow up, failure to recover from BPD seems to be associated with a heightened risk of chronic medical illnesses, poor health-related lifestyle choices, and costly health services utilization”
J Psychiatr Res, 2013 Oct;47(10):1507-13
“Differences between older and younger adults with borderline personality disorder on clinical presentation and impairment.”
“Older adults were more likely to endorse chronic emptiness, and less likely to endorse impulsivity, self harm and affective instability (mood swings). Older adults also reported fewer substance use disorders, more lifetime hospitalizations and higher social impairment.”
Can J Psychiatry, 2013 Jul;58(7):402-8
“Omega-3 fatty acid supplementation in adolescents with borderline personality disorder and ultra-high risk criteria for psychosis: a post hoc subgroup analysis of a double-blind, randomized controlled trial.”
“…long chain n-3polyunsaturated fatty acids correlated positively with psychosocial functioning and negatively with psychopathology compared to placebo.”
(We need a study of borderlines on effective medication with and without omega-3 fatty acid supplementation)
Psychiatry Res, 2013 Dec 15;210(2):505-9
“Increased attempts to suppress negative and positive emotions in borderline personality disorder”
“BPD patients reported increased attempts to suppress both negative and positive emotions.”
Child Abuse Negl, 2013 Nov;37(11):1030-3
“Perceptions of childhood caretakers and borderline symptomatology.”
“In this primary care sample, participants with borderline personality symptomatology perceived parents more negatively than those without such symptomatology.”
Am J Psychoyther, 2013;67(2):153-64
“The borderline mother and her child: a couple at risk”
“The author concludes that psychiatry should consider prepartum screening for BPD and if necessary, early … intervention.”
(There are much better outcomes when mothers with BPD are treated medically while pregnant and in the post partum period. Relationship with baby’s father is improved. Mother is less likely to act impulsively or self destructively, and will be a more effective mother.)
J Clin Psychiatry, 2013 Jul;74(7):675-84
“Lamotrigine in psychiatric disorders”
“Data are limited but promising (for use of Lamictal (lamotrigine)) in borderline personality disorder”
Hum Psychopharmacol, 2013 Aug 16
“Oxytocin influences avoidant reactions to social threat in adults with borderline personality disorder”
“Adult patients with BPD show an avoidant response to social threat, a reaction that is linked with traumatic experiences during childhood. This response pattern is altered by oxytocin, possibly by reducing stress and inhibiting social withdrawal from distressing social stimuli.”
J Can Acad Child Adolesc Psychiatry 2013 Aug;22(3):206-11
“Reliability and validity of borderline personality disorder in hospitalized adolescents.”
“Overall, finding suggest that BPD can be reliably and validly diagnosed in adolescents as young as 12-14 years old.
Am J Psychiatry 2013 Oct 1;170(10):1169-77
“Oxytocin and reduction of social threat hypersensitivity in women with borderline personality disorder”
“Borderline patients exhibit a hypersensitivity to social threat in early, reflexive stages of information processing. Oxytocin may decrease social threat hypersensitivity and thus reduce anger and aggressive behavior in borderline personality disorder or other psychiatric disorders with enhanced threat driven reactive aggression.”
Psychiatry Res 2013 Dec 30;210(3):980-5
“Hostility and childhood sexual abuse as predictors of suicidal behavior in borderline personality disorder”
“Our results support previous findings indicating that high levels of hostility and having suffered sexual abuse during childhood lead to an increased risk for suicidal behavior in BPD.”
Psychopathology 2014;47(2):101-10
“Facial reactions during emotion recognition in borderline personality disorder: a facial electromyography study.”
“These results do not support the view that facial recognition in BPD is impaired or that there is a general hypersensitivity to the emotional state of others. Instead, they suggest a negativity bias in BPD, expressed by reduced facial responding to positive social signals and increased facial responding to negative social signals. This is a pattern of facial reactions that might contribute to the social interactions frequently reported by patients with this disorder.”
Int J Methods Psychiatr Res, 2014 Sep 11.
“The international ADHD in substance use disorders prevalence study: background, methods and study population.”
3558 subjects from 10 countries with substance abuse were evaluated for ADHD. 40.9% had ADHD.
(~ 50 % of adults with ADHD have BPD and vice versa)
JAMA Psychiatry 2013 Nov,70(11):1206-14
“Structure of genetic and environmental risk factors for symptoms of DSM-IV borderline personality disorder”
Criteria 2 (unstable relationships) has a strong genetic factor, environmental factors are more important for the other criteria.”
Int J Psychiatry Clin Pract, 2013 Jun;18(2):150-2
“Borderline personality symptomatology and legal charges related to drugs”
“The criminal behaviors of assault and disorderly conduct observed in BPD appear to be related, at least in part, to comorbid substance abuse.”
Ther Adv Psychopharmacol 2013 Oct;3(5):272-4
“Clozapine for self-injurious behavior in individuals with borderline personality disorder”
“Clozapine appears to be efficacious in the management of chronic suicidality, self injurious behaviors and aggression in patients with severe BPD.”
Dialogues Clin Neurosci 2013 Jun;15(2):155-69
“The relationship between borderline personality disorder and bipolar disorder”
10% of those with BPD also had bipolar I, 10% had bipolar II. 20% of those with bipolar II also had BPD, compared to 10% of those with bipolar I. “…other axis I disorders such as major depression, substance abuse and PTSD (post traumatic stress disorder) are also more commonly diagnosed in patients with BPD than is bipolar disorder. These findings challenge the notion that BPD is part of the bipolar spectrum.”
Australas Psychiatry epub Nov 4
“Reputation and science: examining the effectiveness of DBT in the treatment of borderline personality disorder”
“DBT has built an impressive reputation within psychology and psychiatry as an effective treatment for deliberate self harm and chronic suicidal behaviors in patients with BPD. However, when each of the randomized controlled trials that comprise this evidence base is examined carefully, the actual results are less convincing about DBT’s positive reputation.”
J Psychiatr Ment Health Nur 2013 Nov 5
“DBT (dialectical behavior therapy) in the treatment of borderline personality disorder”
“Two recent Cochrane reviews conclude that DBT does benefit those with BPD.”
J Nerv Ment Dis 2013 Feb;201(2):99-104
“Borderline personality disorder and emotional intelligence”
“These results suggest that BPD is associated with emotional understanding deficits, whereas temporary severity of BPD is associated with emotion regulation deficits.”
J Nerv Ment Dis 2013 Feb;201(2): 130-5
“The effects of borderline personality disorder and panic disorder on suicide attempts and the associated influence of affective dysregulation in the general population.”
It has been previously shown that the combination of BPD and panic disorder has a significantly higher risk of suicide than either illness alone. This study showed suicide attempts “were greatly decreased after controlling for affective dysregulation (mood swings.) These findings emphasize the importance of affective dysregulation individuals with BPD in relation to suicide attempts.”
J Psychosom Res 2013 APr;74(4):278-82
“Relationship between sleep disturbance and recovery in patients with borderline personality disorder”
“These results demonstrate an association between subjective sleep disturbance and recovery status among BPD patients.”
Tijdschr Psychaitr 2013;55(3):165-75 (from Holland)
“Short-term dialectical behavior therapy for borderline personality disorder”
“Short-term inpatient DBT had a positive effect on borderline problems. (Para)suicidal behavior, however, was not reduced significantly.”
J Pers Disord, 2013 APr;27:252-9
“Borderline personality disorder and mental healthcare service use among adolescents.”
This study from Europe showed that “patients who had received psychotherapy did not differ on any psychopathological variables from those who did not receive psychotherapy.”
J Relig Health, 2013 Sep,52(3);974-80
“The relationship between forgiveness and borderline personality symptomatology.”
There were numerous aspects of forgiveness that were significantly lower in individuals with the borderline personality disorder.
Am J Psychiatry, 2013 Jun 1;170(6):671-9
“Cognitive experiences reported by patients with borderline personality disorder and axis II comparison subjects: a 16-year prospective follow-up study.”
“Disturbed cognitions are common in patients with borderline personality disorder and are distinguishing for the disorder. They also decline substantially over time but remain a problem, particularly those of a nonpsychotic nature.”
J Nerv Ment Dis, 2013 Dec;201(12):1027-34
“Phenomenology of borderline personality disorder: the role of race and socioeconomic status.”
African American borderlines had more severe lack of anger control and few suicidal behaviors.
Personal Ment Health, 2013 Aug;7(3):181-90
“Post-traumatic stress disorder and the outcome of dialectical behavior therapy for borderline personality disorder”
“Patients with comorbid PTSD had a poorer outcome from dialectical behavior therapy than those with BPD alone.”
Prim Care Companion CNS Disord, 2013;15(5)
“Pain and pain catastrophizing among internal medicine outpatients with borderline personality symptomatology: a cross-sectional self-report survey”
“Regardless of the measure used, individuals with borderline personality disorder symptomatology consistently demonstrated higher pain scores at all time points, as well as higher levels of pain catastrophizing.”
Acta Psychiatr Scand, 2013 Dec 6
“Regional cortical thinning may be a biological marker for borderline personality disorder”
“…(cortical thinning) may partly be related to interpersonal dysfunction in patients with BPD. The pattern of thinning may represent a potential biological marker for BPD.”
more of 2013
JAMA Psychiatry 2013 Nov,70(11):1206-14
“Structure of genetic and environmental risk factors for symptoms of DSM-IV borderline personality disorder”
Criteria 2 (unstable relationships) has a strong genetic factor, environmental factors are more important for the other criteria.”
Int J Psychiatry Clin Pract, 2013 Jun;18(2):150-2
“Borderline personality symptomatology and legal charges related to drugs”
“The criminal behaviors of assault and disorderly conduct observed in BPD appear to be related, at least in part, to comorbid substance abuse.”
Ther Adv Psychopharmacol 2013 Oct;3(5):272-4
“Clozapine for self-injurious behavior in individuals with borderline personality disorder”
“Clozapine appears to be efficacious in the management of chronic suicidality, self injurious behaviors and aggression in patients with severe BPD.”
Dialogues Clin Neurosci 2013 Jun;15(2):155-69
“The relationship between borderline personality disorder and bipolar disorder”
10% of those with BPD also had bipolar I, 10% had bipolar II. 20% of those with bipolar II also had BPD, compared to 10% of those with bipolar I. “…other axis I disorders such as major depression, substance abuse and PTSD (post traumatic stress disorder) are also more commonly diagnosed in patients with BPD than is bipolar disorder. These findings challenge the notion that BPD is part of the bipolar spectrum.”
Australas Psychiatry epub Nov 4
“Reputation and science: examining the effectiveness of DBT in the treatment of borderline personality disorder”
“DBT has built an impressive reputation within psychology and psychiatry as an effective treatment for deliberate self harm and chronic suicidal behaviors in patients with BPD. However, when each of the randomized controlled trials that comprise this evidence base is examined carefully, the actual results are less convincing about DBT’s positive reputation.”
J Psychiatr Ment Health Nur 2013 Nov 5
“DBT (dialectical behavior therapy) in the treatment of borderline personality disorder”
“Two recent Cochrane reviews conclude that DBT does benefit those with BPD.”
J Nerv Ment Dis 2013 Feb;201(2):99-104
“Borderline personality disorder and emotional intelligence”
“These results suggest that BPD is associated with emotional understanding deficits, whereas temporary severity of BPD is associated with emotion regulation deficits.”
J Nerv Ment Dis 2013 Feb;201(2): 130-5
“The effects of borderline personality disorder and panic disorder on suicide attempts and the associated influence of affective dysregulation in the general population.”
It has been previously shown that the combination of BPD and panic disorder has a significantly higher risk of suicide than either illness alone. This study showed suicide attempts “were greatly decreased after controlling for affective dysregulation (mood swings.) These findings emphasize the importance of affective dysregulation individuals with BPD in relation to suicide attempts.”
J Psychosom Res 2013 APr;74(4):278-82
“Relationship between sleep disturbance and recovery in patients with borderline personality disorder”
“These results demonstrate an association between subjective sleep disturbance and recovery status among BPD patients.”
Tijdschr Psychaitr 2013;55(3):165-75 (from Holland)
“Short-term dialectical behavior therapy for borderline personality disorder”
“Short-term inpatient DBT had a positive effect on borderline problems. (Para)suicidal behavior, however, was not reduced significantly.”
J Pers Disord, 2013 APr;27:252-9
“Borderline personality disorder and mental healthcare service use among adolescents.”
This study from Europe showed that “patients who had received psychotherapy did not differ on any psychopathological variables from those who did not receive psychotherapy.”
J Relig Health, 2013 Sep,52(3);974-80
“The relationship between forgiveness and borderline personality symptomatology.”
There were numerous aspects of forgiveness that were significantly lower in individuals with the borderline personality disorder.
Am J Psychiatry, 2013 Jun 1;170(6):671-9
“Cognitive experiences reported by patients with borderline personality disorder and axis II comparison subjects: a 16-year prospective follow-up study.”
“Disturbed cognitions are common in patients with borderline personality disorder and are distinguishing for the disorder. They also decline substantially over time but remain a problem, particularly those of a nonpsychotic nature.”
J Nerv Ment Dis, 2013 Dec;201(12):1027-34
“Phenomenology of borderline personality disorder: the role of race and socioeconomic status.”
African American borderlines had more severe lack of anger control and few suicidal behaviors.
Personal Ment Health, 2013 Aug;7(3):181-90
“Post-traumatic stress disorder and the outcome of dialectical behavior therapy for borderline personality disorder”
“Patients with comorbid PTSD had a poorer outcome from dialectical behavior therapy than those with BPD alone.”
Prim Care Companion CNS Disord, 2013;15(5)
“Pain and pain catastrophizing among internal medicine outpatients with borderline personality symptomatology: a cross-sectional self-report survey”
“Regardless of the measure used, individuals with borderline personality disorder symptomatology consistently demonstrated higher pain scores at all time points, as well as higher levels of pain catastrophizing.”
Acta Psychiatr Scand, 2013 Dec 6
“Regional cortical thinning may be a biological marker for borderline personality disorder”
“…(cortical thinning) may partly be related to interpersonal dysfunction in patients with BPD. The pattern of thinning may represent a potential biological marker for BPD.”
2014
Int J Methods Psychiatr Res, 2014 Sep 11.
“The international ADHD in substance use disorders prevalence study: background, methods and study population.”
3558 subjects from 10 countries with substance abuse were evaluated for ADHD. 40.9% had ADHD.
(~ 50 % of adults with ADHD have BPD and vice versa)
Personal Ment Health, 2014 May;8(2):143-50
“Comparison of affective instability in borderline personality disorder and bipolar disorder using a self-report measure.”
“The affective instability associated with symptoms of BPD and bipolar disorder has different profiles, particularly with respect to frequency. Borderline affective instability appears more interpersonal than the affective instability associated with bipolar symptoms.”
Psychopathology, 2014:47(3):148-57
“Susceptibility to distraction by social cues in borderline personality disorder”
“Findings of the present study suggest increased susceptibility to distracting (negatively arousing) social cues in individuals with BPD, which might interfere with cognitive functioning.”
J Pers Disord, 2014 Jun;28(3);365-78
“Association between genetic polymorphisms in the serotonergic system and comorbid personality disorders among patients with first-episode depression”
“The study adds evidence to the effect of the serotonin transporter gene specifically on cluster B personality disorders (including the BPD).”
Personal Disord. 2014 Apr.5(2);178-85
“EEG asymmetry in borderline personality disorder and depression following rejection.”
Faced with rejection, borderlines showed greater right cortical activation.
Neuropsychobiology, 2014;69(1);19-24
“Diazepam binding inhibitor and dehydroepiandrosterone sulfate plasma levels in borderline personality disorder adolescents.
“Our results indicate that a dysfunction of the neurosteroid system might be operative in BPD…”
Behav Res Ther, 2014 Feb;53;47-54
“Impact of dialectical behavior therapy versus community treatment by experts on emotional experience, expression, and acceptance in borderline personality disorder”
“…DBT has unique effects on improving the expression of anger and experiential avoidance.”
2015
2015 BPD literature
J Pers Disord, 2015 Jun,29(3):408-17
“The relationship between childhood adversity and dysphoric inner states among borderline patients followed prospectively for 10 years.”
“Significant predictors of dysphoric states included emotional abuse, verbal abuse, physical abuse, sexual abuse, emotional withdrawal, inconsistent treatment, denial of patient’s feelings, lack of a real relationship, placing patient in parental role, and failure to protect patient.
J Pers Disord, 2015 Apr;29(2):261-74
“Food consumption as affect modulation in borderline personality.”
“…women with borderline personality characteristics may be at elevated risk for developing problems with binge eating, because consuming larger quantities of food appeared to have a tempering effect on their negative mood and feelings of sadness.”
Int J Psychiatry Med, 2015;48(4):317-24
“Neurochemical alterations associated with borderline personality disorder”
There is a reduced amount of N-acetylaspartate in patients with BPD.
Behav Cogn Psychother, 2015 Nov;43(6):676-91
“A service evaluation of a 1 year Dialectical Behavior Therapy programme for women with borderline personality disorder in a low secure unit.”
“Engagement in 1 years’s treatment was associated with significant reduction in risk behaviors…”
J Pers Disord, 2015 Feb;29(1):62-70
“The course of marriage/sustained cohabitation and parenthood among borderline patients followed prospectively for 16 years.”
“…the results of this study suggest that stable functioning as a spouse/partner and as a parent are strongly associated with recovery status for borderline patients.”
Psychol Psychother, 2015 Mar;88(1):71-86
“Changing from a traditional psychodynamic treatment programme to mentalization-based treatment for patients with borderline personality disorder – does it make a difference?”
“MBT (mentalization-based treatment) is an effective treatment for patients with BPD. MBT can successfully be implemented in therapeutic settings outside United Kingdom and may be more beneficial than psychodynamic treatment programmes for BPD patients.”
Eur Child Adolesc Psychiatry, 2015 Mar;24(3):351-7
“Pain perception in female adolescents with borderline personality disorder”
“These findings are in line with previous findings in adult BPD patients concerning lower pain sensitivity as compared to healthy controls. This provides support for the idea that disturbed pain processing is not only a consequence of chronic BPD but is already present in early stages of BPD.” (This was in response to pain from heat trauma)
J Pers Disord, 2015 Apr;29(2):177-92
“Oxytocin receptor gene variation and differential susceptibility to family environment in predicting youth borderline symptoms.”
The “A-allele” of the oxytocin receptor gene had high levels of BPD symptoms under negative family conditions.
Psychol Med, 2015 Apr;45(5): 1025-37
“Prospective associations between prenatal adversities and borderline personality disorder at 11-12 years”
Maternal alcohol and tobacco consumption, anxiety and depression were significantly associated with BPD by age 11-12.
Child Abuse Negl, 2015 Jan;39:147-55
“An examination of the relationship between childhood emotional abuse and borderline personality disorder features: the role of difficulties with emotion regulation.”
“…frequency of childhood emotional abuse (and not sexual or physical abuse) was uniquely associated with BPD feature severity.”
J Affect Disord, 2015 Jan 1,170:104-11
“Different impulsivity profiles in borderline personality disorder and bipolar II disorder”
This study implied that individuals with BPD are impulsive at all mood states, bipolar II only with depressed mood and childhood trauma history. (I suspect the increased impulsivity when feeling well with BPD is comorbid ADHD)
J Pers Disord, 2015 Oct;29(5):610-26
“Lack of breast-feeding: a potential risk factor in the multifactorial genesis of borderline personality disorder and impaired maternal bonding.”
Infants that were breast fed has less than half the amount of BPD risk.
J Behav Ther Exp Psychiatry, 2015 Mar;46:85-92
“Remembering rejection: specificity and linguistic styles of autobiographical memories in borderline personality disorder and depression.”
“…patients with BPD showed a higher self-focus, used more anger-related words, referred more frequently to social environments, and rated memories of rejection as more relevant for today’s life.”
Psychoneuroendocrinology, 2015 Jan;51:282-95
“Effects of cortisol on cognition in major depressive disorder, PTSD (post traumatic stress disorder) and borderline personality disorder” 2014 Curt Richter Award Winner
Patients with PTSD and BPD had enhanced sensitivity to cortisol.
Encephale, 2015 Apr;41(2):115-22
“Mental health service utilization among BPD (borderline personality disorder) patients inpatient”
In this study 32% of psychiatrically hospitalized patients had the BPD.
Eur Psychiatry, 2015 Feb;30(2):221-7
“Abnormalities in cortical gray matter density in borderline personality disorder”
“BPD patients feature specific morphology of the cerebral structures involved in cognitive and emotional processing and social cognition/mentalization”
J Affect Disord, 2015 Mar 15;174:650-7
“Specificity of abnormal brain volume in major depressive disorder: a comparison with BPD (borderline personality disorder)”
Anterior cingulate cortex volume decreases were more common in major depression, amygdala volume loss is more pronounced in BPD.
Personal Disord, 2015 Jan;6(1):53-63
“Daily shame and hostile irritability in adolescent girls with borderline personality disorder symptoms.”
Guilt was not associated with hostile irritability in girls, shame may be a key clinical target in the treatment of anger-related difficulties among adolescent girls with BPD symptoms.
Psychol Med, 2015;45(9):1955-64
“Impulsivity in borderline personality disorder”
“…choice impulsivity but not motor impulsivity is a core feature of BPD.”
Personal Disord, 2015 Apr;6(2):107-16
“Executive functions and social cognition in highly lethal self-injuring patients with borderline personality disorder”
“…patients with BPD that engage in more physically damaging self-injurious behaviors may have greater difficulties with behavioral control and employ less efficient problem solving strategies. Problems in facial emotion recognition and discrimination may contribute to interpersonal difficulties in patients with BPD who self-injure.”
Genes Brain Behav, 2015 Feb;14(2):177-88
“Borderline personality disorder and childhood maltreatment: a genome-wide methylation analysis”
Some genes make individuals more susceptible to childhood maltreatment.
Atten Defic Hyperact Disord, 2015 Sep,7(3):199-209
“Addition of methylphenidate to intensive dialectical behavior therapy for patients suffering from comorbid borderline personality disorder and ADHD: a naturalistic study”
“This study outlines the importance of systematically screening BPD patients for ADHD, since a methylphenidate based treatment will improve the symptoms of patients who are comorbid for BPD and ADHD. …the more severe the ADHD symptoms, the greater the chance for the patient of being treated.”
Psychiatry Res, 2015 Mar 30,226(1):284-8
“Combined treatment of borderline personality disorder with interpersonal psychotherapy and pharmacotherapy: predictors of response.”
“Patients with more severe BPD psychopathology and with a higher degree of core symptoms such as fear of abandonment, affective instability, and identity disturbance have a better change to improve with combined therapy with fluoxetine and interpersonal psychotherapy adapted to BPD.”
Neuroimage Clin, 2015 Feb 7;7:476-81
“White matter integrity and its association with affective and interpersonal symptoms in borderline personality disorder”
Deficits in the fornix and cingulum within the fronto-limbic connections were related to severity of symptoms…”
J Pers Disord. 2015 Dec;29(6):839-46
“Attributional “tunnel vision” in patients with borderline personality disorder”
“…”trapped” thinking might contribute to interpersonal problems in BPD patients…”
Psychol Med, 2015 Aug;45(11):2237-51
“Clinical and psychosocial outcomes of borderline personality disorder in childhood and adolescence: a systematic review.”
“These findings provide some support for the clinical utility of the BPD phenotype in younger populations, and suggest that an early intervention approach may be warranted.”
JAMA Psychiatry, 2015 May;72(5):475-82
“Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis.”
“Interventions that include DBT skills training are more effective than DBT without skills training, and standard DBT may be superior in some areas.”
Psychiatry Res, 2015 Jun 30;227(2-3):253-7
“Thyroid hormones and adult interpersonal violence among women with borderline personality disorder”
Elevated T3 levels can be associated with violent/aggressive behavior in both men and women.
Int J Psychiatry Med. 2015;49(3):169-75
“Increased serum prolactin in borderline personality disorder”
In this small study individuals with the BPD had higher levels of the pituitary hormone prolactin.
Biol Psychiatry, 2016 Jan 15;79(2):97-106
“Neural Correlates of Disturbed Emotion processing in borderline personality disorder: A multimodal Meta-Analysis”
“…dysfunctional dorsolateral, prefrontal and limbic brain regions are a hallmark feature of BPD”
Br J Psychiatry, 2016 Jul;207(1):79-80
“Hedonic and disgust taste perception in borderline personality disorder and depression.”
“Juice disgust ratings were related to self-disgust in BPD, suggesting close links between abnormal sensory processing and self-identity in BPD.”
J Consult Clin Psychol, 2015 Jun;83(3):643-8
“Self-harm and suicidal behavior in borderline personality disorder with and without bulimia nervosa”
“The presence of a concurrent diagnosis of bulimia nervosa among women with BPD is significantly and uniquely associated with recent suicidal ideation, and self-harm behavior and suicide attempts during treatment… Co-occurring bulimia nervosa appears to represent a significant marker for immediate life-threatening behaviors in women seeking treatment for BPD.”
Int J Psychiatry Med, 2015;49(4):237-44
“Pituitary volumes of patients with borderline personality disorder are not changed.”
Despite the information that prolactin levels are higher in individuals with BPD, the size of the pituitary gland is the same in individuals with and without BPD.
Psychol Med, 2015 Nov;45(15)3171-80
“Structural alterations in white-matter tracts connecting (para-) limbic and prefrontal brain regions in borderline personality disorder.”
Abnormalities in the “uncinate fasciculus indicates distinct white-matter alterations in BPD, presumably due to stress-induced myelin degeneration in the aftermath of stressful life events.
J Clin Psychiatry, 2015 Nov;76(11):1529-34
“Interactions of borderline personality disorder and anxiety disorders over 10 years.”
“BPD negatively affects the course of the generalized anxiety disorder, social phobia and post traumatic stress disorder. In contrast, the anxiety disorders, aside from PTSD, had little effect on BPD course.”
Int Clin Psychopharmacol, 2015;30(6)338-41
“Effectiveness of long-acting paliperidone palmitate in borderline personality disorder”
“The treatment decreased impulsive disruptive behaviors and improved general functioning. An acceptable tolerance was observed. The average weight gain was clinically irrelevant despite being statistically significant.”
PloS One, 2015 Aug 4;10(8):e0133693
“Pain processing after social exclusion and its relation to rejection sensitivity in borderline personality disorder”
“…BPD patients differed from healthy controls in their neural processing of physical pain depending on the preceding social situation. Rejection sensitivity further modulated the impact of social exclusion on neural pain processing in BPD but not in healthy controls.”
Compr Psychiatry, 2015 Oct;62:63-70
“Borderline personality disorder: prevalence and psychiatric comorbidity among male offenders on probation in Sweden.”
“BPD affected one fifth of probationers and was related to serious mental ill-health known to affect recidivism risk.”
2016
2016 BPD Literature
Eur Psychiatry, 2016 Jan;31:29-36
“Characterizing adult attention deficit hyperactive disorder and comorbid borderline personality disorder: ADHD symptoms, psychopathology, cognitive functioning and psychosocial factors”
“Comorbid ADHD and BPD is characterized by more symptoms of impulsivity, additional psychopathology, comparatively lower intellectual and attentional functioning and increased psychosocial difficulties.”
Womens Health Issues, 2016 Mar-Apr;26(2):190-5
“Effect of borderline personality disorder on obstetrical and neonatal outcomes”
“BPD is associated with several adverse obstetrical and neonatal outcomes”
Depress Anxiety, 2016 Jan;33(1):45-55
“Methylation of serotonin receptor 3A in ADHD, borderline personality disorder, and bipolar disorders: link with severity of the disorders and childhood maltreatment.”
“This study shows that epigenetic modification of the 5HT3A (serotonin 3 A) receptor is involved in the mechanism underlying the relationship between maltreatment in childhood and the severity of several psychiatric disorders in adulthood.”
Psychiatry Clin Neurosci, 2016 Jan;70(1):51-61
“Frontolimbic neural circuit changes in emotional processing and inhibitory control associated with clinical improvement following transference focused psychotherapy in borderline personality disorder”
Transference focused psychotherapy alters frontolimbic circuitry.
Biol Psychiatry Cogn Neurosci Neuroimaging, 2016 Jul;1(4):335-344
“Electrocortical reactivity during self-referential processing in female youth with BPD (borderline personality disorder)”
Females with BPD “endorsed, recalled, and recognized fewer positive and more negative words.” They had faster reaction times to endorse negative versus positive words.
“…these findings show that females with BPD process negative self-relevant information differently than healthy females.”
Ind Psychiatry J. 2016 Jan-Jun;25(1):101-106
“Childhood sexual abuse in adult patients with BPD (borderline personality disorder)”
In this small study, 44.4% of individuals with BPD reported a history of childhood sexual abuse.
Neurosci Biobehav Rev, 2017 Feb;73:48-67
“The sleep phenotype of BPD (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.”
Br J Clin Psychol 2017 Mar;56(1):1-15
“exploring the effectiveness of combined mentalization-based group therapy and dialectical behavior therapy (DBT) for inpatients with BPD (borderline personality disorder) – a pilot study”
“Mentalization based treatment in combination with DBT may improve certain aspects of social cognitive skills and attachment security, as compared to DBT alone”
Personal Ment Health, 2016 Nov;10(4):285-292
“Description and prediction of the income status of borderline patients over 10 years of prospective follow up”
“BPD patients show enduring lowered economic functioning. Their economic functioning seems to be negatively affected by childhood emotional, verbal and/or physical abuse but positively affected by years of education and IQ.”
Front Pediatr, 2016 Sep 21;4:87
“Familial and clinical correlates in depressed adolescents with BPD (borderline personality disorder) traits”
Parental history of delinquency, substance use, personality disorders, having siblings, parental arguments, attention seeking and an inability to adapt well to group activities were all associated with BPD traits.
Acta Psychiatr Scand, 2016 Dec, 134(6):504-510
“The international mood network (IMN) nosology project: differentiating borderline personality from bipolar illness.”
“In a mood disorder clinic setting, manic criteria and episodic mood course distinguished bipolar illness from BPD (borderline personality disorder)”.
Acta Psychiatr Scand, 2016 Dec, 134(6):494-503
“Abnormal white matter structural connectivity in treatment-naive young adults with BPD (borderline personality disorder)”
Abnormalities were seen in the limbic system and corpus callosum suggesting abnormal maturation of white matter structures in mechanism of BPD.
Early Interv Psychiatry, 2016 Sep 1. Doi: 10.1111/eip.12364
“Risk stratification for the early diagnosis of BPD (borderline personality disorder) using psychiatric co-morbidities.”
“Most psychiatric disorders were more common in BPD patients than in the control subjects.” These diagnoses include depression, bipolar, anxiety, substance use, other personality disorders, sleep disorder, mental retardation and ADHD.
Borderline Personal Disord Emot Dysregul. 2016 Aug 1;3:7. Doi: 10.1186/s40479-016-0042-4
“The impact of posttraumatic stress disorder on the symptomatology of BPD (borderline personality disorder)”
The addition of PTSD to BPD results in more mood swings, intrusions, dissociation, suicide attempts and self mutilation compared to those with only BPD.
PloS One, 2016 Jul 28;11(7):e0160056. doi: 10,1371/journal.prone.09160056
“Differences in facial emotion recognition between first episode psychosis, BPD (borderline personality disorder) and healthy controls.”
BPD (borderline personality disorder) and first episode of psychosis patients have problems in recognizing neutral faces more than controls. They also tend to over-report negative emotions in recognition of happy faces.
Encephale, 2017 Aug;43(4):340-345. doi: 10.1016/j.encop.2016.02.020
“Mentalization based treatment and BPD (borderline personality disorder)”
“Effectiveness of mentalization based treatment in treating borderline disorder has been shown in several studies with short and long term benefits.” Benefits were seen in adolescents and adults.
J Psychiatr Prac. 2016 Jul;22(4):270-82
‘The effect of borderline personality pathology on outcome of cognitive behavior therapy”
“…patients with borderline personality pathology did demonstrate a greater response to cognitive behavioral therapy than other patients in terms of improvement on several measures of symptoms”
Psychoneuroendocrinology. 2016 Sep;71:176-9.
“Increased hair testosterone but unaltered hair cortisol in female patients with BPD (borderline personality disorder)”
In this study it was shown that females with BPD have a higher testosterone level, which may partially explain the sexual indiscretions some borderlines experience. Cortisol wasn’t raised.
Neuropsychopharmacology. 2016 Oct;41(11):2697-703
“White matter integrity reductions in Intermittent explosive disorder”
Intermittent explosive disorder (IED) is basically the BPD without the chronic unprovoked mood swings and anger, everything else is the same. “…IED was associated with lower white matter integrity in long range connections between the frontal and temporoparietal regions.”
Clin Psychopharmacol Neurosci, 2016 May 31;14(2):226-8
“Use of Clozapine for BPD (borderline personality disorder): a case report”
Clozaril (clozapine) is a dangerous but very effective antipsychotic medication that requires intense monitoring. In this study it was effective in managing suicide attempts and self injurious behavior. Further study was recommended.
Front Behav Neurosci. 2016 Feb 23;10-12
“Increased prevalence of intermittent rhythmic delta or theta activity in the electroencephalograms (EEG’s) of patients with BPD (borderline personality disorder)”
“In this blinded retrospective case-control study, we were able to confirm an increased prevalence of pathological EEG findings.
Tijdschr Psychiatr. 2016;58(2):122-9
“Auditory verbal hallucinations in patients with BPD (borderline personality disorder)”
27% of those with BPD experience auditory visual hallucinations that are indistinguishable from schizophrenia.
Depress Anxiety. 2016 Jun;33(6):520-30
“Effectiveness of dialectical behavior therapy (DBT) versus collaborative assessment and management of suicidality (CAMS) treatment for reduction of self-harm in adults with borderline personality traits and disorder – a randomized observer-blinded clinical trial”
“In adults with borderline personality traits and disorder and a recent suicide attempt, DBT does not seem superior compared with CAMS for reduction of number of self-harm or suicide attempts.”
Womens health issues, 2016 Mar-Apr;26(2):190-5
“Effect of BPD (borderline personality disorder) on obstetrical and neonatal outcomes.”
“BPD is associated with several adverse obstetrical and neonatal outcomes.” Prozac, BuSpar, Haldol are very low risk medications for pregnancy and breast feeding. Tegretol can cause birth defects early on, although I’ve followed many patients through their delivery taking Tegretol (carbamazepine). Adderall is low risk as well, but the woman will need to switch to Ritalin mid pregnancy to keep the baby from withdrawing on delivery. Raging and psychosis cause massive damage to their partners and I’ve seen many borderlines have their husband leave or have an affair because of how hostile and difficult the BPD can be to deal with. Being a single parent because of not treating the BPD during pregnancy is not a good outcome.
Am J Psychiatry, 2016 May 1;173(5):491-8
“Ultra-low-dose buprenorphine as a time limited treatment for severe suicidal ideation: a randomized controlled trial.”
The use of very low sublingual (under the tongue) buprenorphine doses wass associated with decreased suicidal ideation in severely suicidal patients without substance abuse. What’s being missed in the opioid abuse epidemic is that many opioids “treat” psychiatric symptoms, so patients use whatever treatment they can. Prozac (fluoxetine), Tegretol (carbamazepine), sometimes with the addition of Zyprexa (olanzapine) can markedly reduce suicidality. If the patient is already on Prozac (fluoxetine) and Tegretol (carbamazepine), a single 3mg dose of Risperdal (risperidone) usually works very well but takes a day to work.
Personal Disord, 2016 Jan;7(1):72-79
“What’s in a face? Mentalizing the BPD (borderline personality disorder) based on dynamically changing facial expressions.”
“Results showed (a) that BPD patients were as accurate in their first, but less accurate in their full emotion recognition than normal controls, (b) a trend for BPD patient to respond (to mentalization) more slowly than normal controls, and (c) no significant difference in overall level of confidence between BPD patients and normal controls. Mood and psychotropic medication did not influence these results. Exposure to trauma in BPD patients, however, was negatively related to accuracy at full expression.”
Personal Disord, 2016 Apr;7(2):159-68
“Confidence in facial recognition in borderline personality disorder”
“Patients with BPD rated the intensity of happiness in happy faces lower than did controls, but did not differ in regard to the assessment of angry or ambiguous facial stimuli or the rating of anger.”
Depress Anxiety, 2016 Jan;33(1):45-55
“Methylation of serotonin receptor 3A in ADHD, borderline personality and bipolar disorders: link with severity of the disorders and childhood maltreatment.”
“This study shows that epigenetic modification of the 5-HT3A R is involved in the mechanism underlying the relationship between maltreatment in childhood and the severity of several psychiatric disorders in adulthood.”
Eur Arch Psychiatry Clin Neurosci, 2016 Jun;266(4):307-16
“The role of hypothalamus-pituitary-adrenal (HPA) genes and childhood trauma in borderline personality disorder”
“Our findings suggest a contribution of HPA axis genetic variants to BPD pathogenesis and reinforce the hypothesis of the modulating effect of childhood trauma in the development of this disorder.”
Biol Psychiatry, 2016 Jan 15;79(2):97-106
“Neural correlates of disturbed emotion processing in BPD: a multimodal meta-analysis.”
“Results strengthen the assumption that dysfunctional dorsolateral prefrontal and limbic brain regions are a hallmark feature of BPD and therefore are consistent with the conceptualization of BPD as an emotion dysregulation disorder.”
Biol Psychiatry, 2016 Jan 15;79(2):117-26
“Elevated Monoamine Oxidase-A distribution volume in BPD (borderline personality disorder) is associated with severity across mood symptoms, suicidality and cognition.”
“These results suggest that elevated MAO (monoamine oxidase) is associated with multiple indicators of BPD severity, including BPD symptomatology, mood symptoms, suicidality and neurocognitive impairment.” (Note: MAO inhibitors have been shown to improve rejection sensitivity in those with BPD, but these medications are not safe for this population)
Personal Disord, 2016 Apr;7(2):159-68
“Confidence in facial emotion recognition in borderline personality disorder”
“Our findings suggest alterations in the processing of positive social stimuli that affect both the experience of the emotional intensity and the confidence subjects experience during their assessment.
The link to loneliness and social rejection sensitivity points to the necessity to target these alterations in psychotherapeutical interventions.”