A Latent Profile Analysis of Suicidal and Self-Injurious Behavior, Other Dysregulated Behaviors, and Borderline Personality Disorder Symptoms

Those with borderline personality disorder (BPD) exhibit many dysregulated behaviors, such as non-suicidal self-injury (NSSI), dysregulated eating, and substance use. The purpose of this study was to examine BPD symptoms and levels of these dysregulated behaviors with latent profile analysis, which allows for the empirical investigation of distinct behaviors patterns among those with BPD. A non-clinical student sample was screened for elevated BPD symptoms (N=128, age =18.75 years [SD=1.05], 76.8% female) and used in mixture modeling analyses. Results supported five profiles from the sample, primarily distinguished by suicidality and NSSI: a low BPD-low dysregulated behavior profile, a low BPD profile with elevated suicidality, a low BPD profile with elevated NSSI, a high-BPD with low NSSI and somewhat elevated suicidality, and a high-BPD profile with high NSSI and low suicidality. Follow-up analyses indicated that other dysregulated behaviors did little to distinguish between those with high BPD symptoms. There were also important difference in motivational functions for NSSI between two of the profiles: those with high or low BPD symptoms who self-injured frequently. These findings are relevant to the ongoing debate about the existence of a NSSI disorder distinct from BPD

Exploration of emotion regulation experiences associated with borderline personality features in a non-clinical sample

Background Emotion dysregulation is a core feature associated with borderline personality features (BPF). Little research has explored how individuals with high levels of BPF regulate their emotions. This study aimed to explore how individuals with high versus low levels of BPF compare on the strategies they use to regulate emotions and in their experiences of emotion regulation. Methods Twenty-nine university students were recruited and assessed for the presence of BPF using self-report questionnaires. Each participant took part in a semi-structured interview about their experiences of emotion regulation. All interview transcripts then underwent thematic analysis. In addition chi square analyses were conducted to explore the association between level of BPF (High vs Low) and each qualitative theme identified. Results Findings indicated similarities in the types of emotion regulation strategies used by the high and low-BPF groups. However, the groups differed in their experiences and thought processes surrounding emotion regulation. High-BPF participants were found to describe a need to communicate negative emotions with others and demonstrated difficulty maintaining attention on positive experiences. In addition there was a trend towards High-BPF participants demonstrating less forward-planning in emotion regulation. Conclusions This study provides insights into some of the unique aspects of emotion regulation in individuals with high BPF that may make emotion regulation attempts less successful

Identifying suicide and self-harm research priorities in North West England: a Delphi study

Background: Understanding and effectively managing self-harm and suicide requires collaborative research between stakeholders focused on shared priorities. Aims: To develop a consensus about suicide and self-harm research priorities in the North-West of England using the Delphi method. Method: Items for the Delphi survey were generated through group discussions at a workshop with 88 stakeholders and subsequent thematic analysis of key themes. Forty-four participants who were experts-by-experience, researchers, and clinicians based within health services including third sector organisations completed the Delphi survey. Results: A three-round survey reached consensus on 55 research priority items identifying key priorities in each of the following groups: offenders, children and young people, self-harm in community settings, and crisis care in the community. Limitation: The pool of delegates at the workshop and subsequent self-selection into the Delphi may have introduced bias into the study. Conclusion: The current paper highlights specific actionable priorities were identified in four areas that can be used to inform research efforts and future policy and practice, based on shared areas of perceived importance and concern. Future work is needed to confirm the significance of these priority areas, including the use of evidence synthesis approaches to ascertain the extent to which these priorities have already been investigated and where gaps in understanding remain

Reasons for non-suicidal self-harm in adult male offenders with and without borderline personality traits

The presented study aimed to advance understanding of the reasons for non-suicidal self-harm (NSSH) in adult male offenders, with and without borderline personality traits. 179 offenders completed self-report measures of NSSH and other clinical constructs, with 42 being identified as having self-harmed. Results were consistent with past research and supported the relative importance of intrapersonal over interpersonal functions, but also highlight that self-harm is performed rarely for one type of reason. The results also show that the presence of borderline personality traits increases the likelihood of endorsing a range of interpersonal reasons. These findings highlight the importance of understanding the range of reasons for engaging in NSSH to help manage the behaviour within the priso

Humor styles influence the perception of depression-related internet memes in depression

symptom normalisation, research highlights possible benefits of depressive internet memes for depressed individuals. We examined whether individuals experiencing depressive symptoms would differ from controls in their interpretation of internet memes related to depression, whilst incorporating the mediating role of humour style. N=78 individuals with self-reported depressive symptoms (24 on CES-D) and 67 controls (23) rated the emotional valance, humour, relatability, shareability, and mood-improving potential of 32 depressive and control memes (depicting neutral/positive social commentaries). Measures of depression and humour style were also completed. Perceived humour, relatability, shareability and mood-improving potential of depressive, but not control, memes were greater amongst individuals displaying depressive symptoms. However, differential ratings of humour, shareability and relatability were mediated by the extent of ones self-defeating humour style. These outcomes further evidence benefits of interacting with depression-related internet memes for those with depression

Intrapersonal and interpersonal functions as pathways to future self-harm repetition and suicide attempts

Background: Research has identified functions of non-suicidal self-harm/self-injury (NSSH) but whether functions change over time, from adolescence to early adulthood, or predict the continuation of the behaviour prospectively remains unclear. This study aimed to prospectively explore whether intrapersonal and interpersonal NSSH functions in adolescence predict repetition of self-harm (regardless of suicidal intent) and incident suicide attempts in early adulthood. Methods: Participants were 528 individuals with NSSH at age 16 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based birth cohort in the UK. Descriptive statistics were used to explore changes in functions over time from age 16 to 21, and logistic regression used to examine associations between NSSH functions and repeat self-harm and suicide attempts at age 21, 24 and 25 years. Findings: The majority of 16-year-olds with NSSH endorsed intrapersonal (e.g., affect regulatory) functions only (73% at 16 years and 64% at 21 years). Just under half of adolescents (42%) and three quarters of 21 years olds reported more than one function simultaneously. A greater number of intrapersonal functions at 16 years independently predicted future repetition of self-harm at ages 21-25 years, over and above interpersonal functions (OR=1.46, 95% CI 1.06 to 2.01). Interpersonal functions during adolescence did not predict repeat self-harm or suicide attempts in adulthood. Discussion: Our findings suggest that intrapersonal but not interpersonal NSSH functions are a prospective risk factor for future self-harm and might also predict incident suicide attempts. The results highlight the central role of underlying affective difficulties and motivations in self-harm maintenance

Associate Psychological Practitioners (APPs) in Primary Care: Modelling the Impact

Background: The ‘Associate Psychological Practitioner’ (APP) is an innovative new role that expands the psychological workforce and addresses the rising demand for mental health services in England, yet the impact of this role on NHS workforce capacity has yet to be modelled. Aim: We modelled the impact of the APP role in Primary Care in terms of additional capacity to provide mental health care and the impact on General Practitioner (GP) capacity within the sector. Method: Workforce experts of the NHS Workforce Repository and Planning Tool (WRaPT) team used a modelling tool to determine future state scenarios of APPs working across all Primary Care Networks (PCNs) within a region, and the associated change on the baseline workforce. Modelling was based on Lancashire and South Cumbria, a large geographical area in North-West England that includes 41 PCNs. Assumptions used in the modelling included identifying the patient population and workforce in scope, documenting the activity undertaken by APPs, and considering the future state scenarios for modelling. Findings: With regards to generating additional capacity, having 1 APP in each of the 41 PCNs in Lancashire and South Cumbria could provide 53,000 brief intervention appointments of 45 minutes each, thereby diverting these appointments away from the GP; and up to 48 people could benefit from attending Group and Wellbeing sessions over a year with 1 APP working with another Primary Care colleague, that is, 384 group intervention sessions delivered. In relation to GP capacity, 1 APP (if placed across a PCN, or within multiple practices) could free up at least 1,665 General Practitioner appointments within one year, which could lead to potential cost savings. These findings can be used to underpin decision making in respect of training future cohorts of APPs and contribute to wider workforce planning in primary care