Suicidal imagery in borderline personality disorder and major depressive disorder

A better understanding of suicidal behavior is important to detect suicidality in at-risk populations such as patients with Borderline Personality Disorder (BPD), Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD). Suicidal tendencies are clinically assessed by verbal thoughts rather than specifically asking about mental images. This study examines whether imagery and verbal thoughts about suicide occur and differ between patients with BPD with and without comorbid PTSD compared to patients with MDD (clinical controls). All patient groups experienced suicide-related images. Patients with BPD with comorbid PTSD reported significantly more vivid images than patients with MDD. Severity of suicidal ideation, number of previous suicide attempts and childhood traumata were significantly associated with suicidal imagery across all patient groups. We demonstrate for the first time that suicide-related mental imagery occurs in BPD and is associated with suicidal ideation. This highlight the importance of assessing mental imagery-related to suicide in clinical practice

Does cortisol modulate emotion recognition and empathy?

INTRODUCTION: Emotion recognition and empathy are important aspects in the interaction and understanding of other people's behaviors and feelings. The Human environment comprises of stressful situations that impact social interactions on a daily basis. Aim of the study was to examine the effects of the stress hormone cortisol on emotion recognition and empathy. METHODS: In this placebo-controlled study, 40 healthy men and 40 healthy women (mean age 24.5 years) received either 10mg of hydrocortisone or placebo. We used the Multifaceted Empathy Test to measure emotional and cognitive empathy. Furthermore, we examined emotion recognition from facial expressions, which contained two emotions (anger and sadness) and two emotion intensities (40% and 80%). RESULTS: We did not find a main effect for treatment or sex on either empathy or emotion recognition but a sexxemotion interaction on emotion recognition. The main result was a four-way-interaction on emotion recognition including treatment, sex, emotion and task difficulty. At 40% task difficulty, women recognized angry faces better than men in the placebo condition. Furthermore, in the placebo condition, men recognized sadness better than anger. At 80% task difficulty, men and women performed equally well in recognizing sad faces but men performed worse compared to women with regard to angry faces. CONCLUSION: Apparently, our results did not support the hypothesis that increases in cortisol concentration alone influence empathy and emotion recognition in healthy young individuals. However, sex and task difficulty appear to be important variables in emotion recognition from facial expressions