1,721,081 research outputs found
Psychotic symptoms in borderline personality disorder: An update
Full text linkPurpose of review: The purpose of this article is to review the most recent literature on psychotic symptoms in borderline personality disorder (BPD). Recent findings:
Both auditory hallucinations and delusional ideation (especially paranoid delusions) are relatively common in individuals with BPD. It is still difficult to distinguish these and related phenomena in BPD from the corresponding experiences in psychotic disorders and schizophrenia, despite numerous attempts to do so. The terminology introduced to help with this effort has not been particularly useful. The presence of auditory hallucinations may affect the course of BPD negatively. Psychotic symptoms in BPD seem to be significantly related to the context (usually stressful events) and appear or intensify in response to situational crisis. The role of certain co-occurring disorders in increasing the risk of psychotic symptoms in BPD remains uncertain. Summary: Psychotic symptoms in BPD continue to be poorly understood. Further research should try to ascertain the relationships between hallucinations and delusions on one hand and the processing of trauma, emotion regulation, distress tolerance and interpersonal sensitivity on the other. Ultimately, such endeavor will contribute to developing more effective treatments for BPD
Borderline personality disorder and ageing: Myths and realities
No full textPurpose of review: Although mental health issues in ageing individuals have been receiving more attention, borderline personality disorder (BPD) in older adults and the elderly has been relatively neglected. This article aims to review the current state of knowledge about BPD in these age groups.
Recent findings: Studies have consistently reported decreasing prevalence rates of BPD among ageing individuals. This may be attributed to the ageing process itself and/or different clinical features due to which meeting the diagnostic criteria for BPD becomes more difficult. Ageing individuals with BPD often present in a way that makes them look 'atypical' compared to younger individuals with the same condition. In particular, this pertains to somewhat attenuated and less overt manifestations of impulsivity. However, the basic pattern of overall symptoms instability continues to characterize ageing individuals with BPD, in addition to depressive symptoms, feeling of emptiness, anger, unstable interpersonal relationships, turbulent responses when needs are not met, various somatic complaints and other symptoms.
Summary: Clinicians should be aware of different clinical features of BPD as patients get older. Diagnostic criteria for BPD may need to be revised to reflect this reality, allow accurate diagnosis and minimize the risk of overlooking BPD in ageing individuals
Will DSM-5 make us feel dysphoric? Conceptualisation(s) of dysphoria in the most recent classification of mental disorders
No full textAssessing situational dysphoria in borderline patients: Development and preliminary validation of the Situational Dysphoria Scale (SITDS)
Full text linkObjective: According to recent phenomenological literature, dysphoria is the psychopathological core of borderline personality disorder (BPD). It is a complex emotional state that consists of persistent tension, irritability, discontent and unhappiness, which is difficult to modulate and is associated with impulsivity. Under certain circumstances, this basic “kind” of dysphoria (“background dysphoria”) can be experienced differently, as “situational dysphoria”. The latter is a sense of pressure, an urge to act and a feeling of quasi-explosion that is mostly related to interpersonal triggers. The aim of this study was to present the process of developing a questionnaire for measuring situational dysphoria in BPD (the Situational Dysphoria Scale, SITDS) and test its psychometric properties. Method: The sample consisted of 105 borderline patients recruited from adult psychiatric outpatient services and residential inpatient communities. The SITDS was developed over several stages, with the initial version consisting of 58 items. In order to test convergent and discriminant validity, the SITDS was administered with four self-report instruments (Nepean Dysphoria Scale, Cynical Distrust Scale, Inventory of Interpersonal Problems-47 and Empathy Quotient) and one semi-structured interview (Borderline Personality Disorder Severity Index-IV). Results: The final version of SITDS, consisting of 24 items, was derived after conducting two factor analyses, a hierarchical cluster analysis and further refinement of the scale. It is divided into three clusters (Personal Events, Interpersonal Events and Environmental Events) and rated on three subscales (Internal Pressure, Urge to Act and Quasi-Explosion). This version of the SITDS demonstrated excellent internal consistency (Cronbach’s alpha value =.91) and a solid degree of convergent and discriminant validity. Conclusions: The study provides preliminary support for use of the SITDS in BPD. Further studies of psychometric properties of the SITDS are needed to support it as a tool for routine clinical practice
Models of borderline personality disorder: Recent advances and new perspectives
Full text linkPurpose of review
The purpose of this article is to review the most relevant conceptual models of borderline personality disorder (BPD), with a focus on recent developments in this area.
Recent findings
Several conceptual models have been proposed with the aim of better understanding BPD: the borderline personality organization, emotion dysregulation, reflective (mentalization) dysfunction, interpersonal hypersensitivity and hyperbolic temperament models. These models have all been supported to some extent and their common components include disorganized attachment and traumatic early experiences, emotion dysregulation, interpersonal sensitivity and difficulties with social cognition. An attempt to integrate some components of the conceptual models of BPD has resulted in an emerging new perspective, the interpersonal dysphoria model, which emphasizes dysphoria as an overarching phenomenon that connects the dispositional and situational aspects of BPD.
Summary
Various conceptual models have expanded our understanding of BPD, but it appears that further development entails theoretical integration. More research is needed to better understand interactions between various components of BPD, including the situational factors that activate symptoms of BPD. This will help develop therapeutic approaches that are more tailored to the heterogeneous psychopathology of BPD
The Feeling of Emptiness: A Review of a Complex Subjective Experience
Full text linkA feeling of emptiness is commonly encountered in clinical practice, but it is poorly understood, with incongruent approaches to its definition and possible role in various disorders. This review examines the conceptualization of the feeling of emptiness and its place in psychopathology. We found an imbalance between theoretical approaches to this phenomenon and empirical research, and argue that more studies using adequate assessment tools are needed. Based on our literature review, we propose that a feeling of emptiness is a complex, negative emotional state that is experienced in different ways by different individuals. This feeling includes a physical or bodily component, a component of aloneness or social disconnectedness, and a component of a deep sense of personal unfulfillment or lack of purpose. The feeling of emptiness is related to other emotional states (dysphoria, boredom, loneliness, and numbness) and overlaps to some extent with them. Although the feeling of emptiness is most often considered in the context of borderline personality disorder, it is also encountered in depression, narcissistic personality disorder, and schizophrenia spectrum disorders, with its features potentially varying between different conditions. The feeling of emptiness may lead to nonsuicidal self-injury and may also have an important relationship with suicidality. We conclude by offering suggestions for further research, emphasizing a need to refine the multidimensional conceptualization of the feeling of emptiness and to better understand its manifestations and relationships with other emotions within various forms of psychopathology
Reconsidering emotion dysregulation
Full text linkThis article aims to review the concept of emotion dysregulation, focusing on issues related to its definition, meanings and role in psychiatric disorders. Articles on emotion dysregulation published until May 2016 were identified through electronic database searches. Although there is no agreement about the definition of emotion dysregulation, the following five overlapping, not mutually exclusive dimensions of emotion dysregulation were identified: decreased emotional awareness, inadequate emotional reactivity, intense experience and expression of emotions, emotional rigidity and cognitive reappraisal difficulty. These dimensions characterise a number of psychiatric disorders in various proportions, with borderline personality disorder and eating disorders seemingly more affected than other conditions. The present review contributes to the literature by identifying the key components of emotion dysregulation and by showing how these permeate various forms of psychopathology. It also makes suggestions for improving research endeavours. Better understanding of the various dimensions of emotion dysregulation will have implications for clinical practice. Future research needs to address emotion dysregulation in all its multifaceted complexity so that it becomes clearer what the concept encompasses
Preliminary validation of the Interpersonal Dysphoria Model of Borderline Personality Disorder
Full text linkBackground: Borderline personality disorder (BPD) is one of the most puzzling psychiatric disorders. In order to improve its understanding and management, we have recently proposed an interpersonal dysphoria model that emphasizes the key role of the complex emotional state of dysphoria in BPD. The purpose of this study was to test the interpersonal dysphoria model using a structural equation modeling analysis. Sampling and Methods: The sample consisted of 105 patients with BPD and 105 healthy controls. A total of five self-report instruments and three semistructured interviews were administered to the participants. Results: The best-fitting structural model fit the data well in the BPD sample. Background dysphoria and negative interpersonal disposition were significant predictors of situational dysphoria, which in turn was a significant predictor of various symptoms of BPD. This model differs from the originally proposed one in terms of impaired empathy not being a component of negative interpersonal disposition and organizing and disorganizing BPD symptoms being replaced by interpersonal (abandonment fears, angry outbursts, and stormy relations)
and affective (affective shifts and emptiness) symptoms. Conclusions: Although some revision was needed, the findings provide support to the proposed model, which
needs to be further tested in a larger sample of individuals with BPD
Development, cross-cultural adaptation process and preliminary validation of the Italian version of the Nepean Dysphoria Scale
Full text linkObjectives
Dysphoria is a complex emotional state that is prevalent in the clinical setting but very vague in its precise meaning. The aim of this study was to develop and validate the Italian version of the Nepean Dysphoria Scale (NDS-I), a self-report questionnaire developed to measure the severity of dysphoria.
Methods
The NDS was translated into Italian and subjected to a cross-cultural adaptation process according to standard guidelines. The scale was then administered to 132 psychology students, together with other conceptually similar (Beck Depression Inventory II, Dysfunctional Attitude Scale - Form A, Toronto Alexithymia Scale) and conceptually different (Anxiety Sensitivity Index - 3) instruments.
Results
The NDS-I demonstrated excellent internal consistency (Cronbach alpha = 0.949). Factor analysis confirmed four factors related to irritability, discontent, interpersonal resentment and surrender. There were medium to strong correlations between the scores on the NDS-I and its subscales and the scores on the Beck Depression Inventory II, and weak to medium but still significant correlations with the scores on the other instruments.
Conclusions
The NDS-I has good psychometric properties, thus supporting the validity of the original scale. Further research in clinical samples is needed to test it as a tool for routine clinical practice
Problematic gaming, social withdrawal, and Escapism: The Compensatory-Dissociative Online Gaming (C-DOG) model
Full text linkIn this article, we critically overview existing studies on compensatory and dissociative mechanisms associated with problematic gaming, with a focus on escapism. Thus, we present a theoretical model integrating current research. In the first section, we link compensatory and dissociative processes related to gaming on a continuum that corresponds to the degree of connection/rupture between physical and virtual environments of the individual. In the second section, we discuss the strengths and limitations of existing conceptualizations and measures of escapism. We contend that escapism in gaming represents a key dimension of the compensation for difficulties in psychological needs satisfaction in the physical environment, differently from escape (avoidance) and from general immersion in video games. In the last section, we elaborate the Compensatory-Dissociative Online Gaming (C-DOG) model, which defines a set of interconnected psychological processes operationalizing the continuum between adaptive and pathological online gaming: relaxation, body-mind detachment, active escapism, escape, and dissociation. This model provides an unprecedented way to consider meaningful processes for the clinical evaluation and treatment of problematic gaming, as well as the association of problematic gaming with emerging social withdrawal conditions, such as hikikomori
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