Le suicide chez les patients présentant des troubles de la personnalité limite

Les patients qui souffrent de troubles liés à la personnalité limite (PL) représentent un défi clinique principalement en raison de leur tendance chronique au suicide. La recherche menée sur les résultats à long terme montre qu'environ 10% des patients présentant des troubles de la PL finiront par réussir leur suicide, mais qu'il reste difficile de prédire lesquels sont le plus à risque. Il n'existe encore aucune preuve qu'on puisse prévenir le suicide grâce à un traitement. Des recommandations cliniques suggèrent que la prévention du suicide ne devrait pas être la préoccupation centrale de la thérapie pour ces patients.Patients with borderline personality disorder present a clinical challenge, largely because of their chronic suicidality. Long-term outcome research shows that about 10 per cent of borderline patients will eventually complete suicide, but that is difficult to predict which patients are at highest risk. There is no evidence at present that treatment prevents suicide. Clinical recommendations are made, suggesting that suicide prevention should not be the major priority of therapy of these patients

Succès et échecs dans le traitement de patients souffrant de troubles de la personnalité limite

Cet article examine les principales options de traitement de patients souffrant de troubles de la personnalité limite. Les interventions pharmacologiques sont de valeur marginale et l'hospitalisation ne s'est pas révélée valable pour la prévention du suicide chez cette population. La psychothérapie psychodynamique n'a pas fait ses preuves non plus, mais la thérapie dialectique comportementale produit une amélioration symptomatique. Les patients souffrant de ce trouble présentent plusieurs difficultés en thérapie, particulièrement une tendance chronique au suicide. Les futurs traitements pourraient faire appel à une médication améliorée jointe à une thérapie cognitive.This paper reviews the main treatment options for patients with borderline personality disorder. Pharmacological interventions are of marginal value, and hospitalization has not been shown to prevent suicide in this population. Psychodynamic psychotherapy has not been proven to be effective, but dialectical behavior therapy yields symptomatic improvement. Borderline patients present many special difficulties in therapy, particularly their chronic suicidality. Future developments in treatment could involve improved drug treatment combined with cognitive therapy

Traumatisme et trouble de la personnalité limite

Le présent article passe en revue Timportant corpus de preuves empiriques amassées au sujet du rapport qu'il est possible d'établir entre certaines expériences traumatiques subies durant l'enfance et l'installation des troubles de la personnalité dite limite ou « borderline » chez l'adulte. Les connaissances accumulées à ce jour nous indiquent qu'un traumatisme subi durant l'enfance est l'un des nombreux facteurs de risque à l'égard des personnalités limites, mais qu'il ne saurait en être le principal facteur étiologique.This article reviews a large body of empirical evidence concerning the relationship between traumatic experiences in childhood and the development of borderline personality disorder (BPD) in adulthood. Our present state of knowledge indicates that childhood trauma is one of several risks for BPD, but is by no means the main etiological factor accounting for the development of this disorder

Every countable model of set theory embeds into its own constructible universe

The main theorem of this article is that every countable model of set theory M, including every well-founded model, is isomorphic to a submodel of its own constructible universe. In other words, there is an embedding $j:M\to L^M$ that is elementary for quantifier-free assertions. The proof uses universal digraph combinatorics, including an acyclic version of the countable random digraph, which I call the countable random Q-graded digraph, and higher analogues arising as uncountable Fraisse limits, leading to the hypnagogic digraph, a set-homogeneous, class-universal, surreal-numbers-graded acyclic class digraph, closely connected with the surreal numbers. The proof shows that $L^M$ contains a submodel that is a universal acyclic digraph of rank $Ord^M$. The method of proof also establishes that the countable models of set theory are linearly pre-ordered by embeddability: for any two countable models of set theory, one of them is isomorphic to a submodel of the other. Indeed, they are pre-well-ordered by embedability in order-type exactly $\omega_1+1$. Specifically, the countable well-founded models are ordered by embeddability in accordance with the heights of their ordinals; every shorter model embeds into every taller model; every model of set theory $M$ is universal for all countable well-founded binary relations of rank at most $Ord^M$; and every ill-founded model of set theory is universal for all countable acyclic binary relations. Finally, strengthening a classical theorem of Ressayre, the same proof method shows that if $M$ is any nonstandard model of PA, then every countable model of set theory---in particular, every model of ZFC---is isomorphic to a submodel of the hereditarily finite sets $HF^M$ of $M$. Indeed, $HF^M$ is universal for all countable acyclic binary relations.Comment: 25 pages, 2 figures. Questions and commentary can be made at http://jdh.hamkins.org/every-model-embeds-into-own-constructible-universe. (v2 adds a reference and makes minor corrections) (v3 includes further changes, and removes the previous theorem 15, which was incorrect.

Differential susceptibility to the environment and borderline personality disorder

Evolutionary models of psychopathology can shed light on gene-environment interactions. Differential susceptibility to the environment means that heritable traits can have positive or negative effects, depending on environmental context. Thus, traits that increase risk for mental disorders when the environment is negative can be adaptive when the environment is positive. This model can be applied to borderline personality disorder, with predictors such as emotional dysregulation and impulsivity seen as temperamental variations leading to negative effects in an unfavorable environment but to positive effects in a favorable environment. This model may also be useful in conceptualizing the mechanisms of effective therapy for borderline personality disorder

Haren: A Framework for Ad-Hoc Thread Scheduling Policies for Data Streaming Applications

In modern Stream Processing Engines (SPEs), numerous diverse applications, which can differ in aspects such as cost, criticality or latency sensitivity, can co-exist in the same computing node. When these differences need to be considered to control the performance of each application, custom scheduling of operators to threads is of key importance (e.g., when a smart vehicle needs to ensure that safety-critical applications always have access to computational power, while other applications are given lower, variable priorities).Many solutions have been proposed regarding schedulers that allocate threads to operators to optimize specific metrics (e.g., latency) but there is still lack of a tool that allows arbitrarily complex scheduling strategies to be seamlessly plugged on top of an SPE. We propose Haren to fill this gap. More specifically, we (1) formalize the thread scheduling problem in stream processing in a general way, allowing to define ad-hoc scheduling policies, (2) identify the bottlenecks and the opportunities of scheduling in stream processing, (3) distill a compact interface to connect Haren with SPEs, enabling rapid testing of various scheduling policies, (4) illustrate the usability of the framework by integrating it into an actual SPE and (5) provide a thorough evaluation. As we show, Haren makes it is possible to adapt the use of computational resources over time to meet the goals of a variety of scheduling policies

Does fish larval dispersal differ between high and low latitudes?

Author Posting. © The Author(s), 2013. This is the author's version of the work. It is posted here by permission of The Royal Society for personal use, not for redistribution. The definitive version was published in Proceedings of the Royal Society B Biological Sciences 280 (2013): 20130327, doi:10.1098/rspb.2013.0327.Several factors lead to expectations that the scale of larval dispersal and population connectivity of marine animals differs with latitude. We examine this expectation for demersal shorefishes, including relevant mechanisms, assumptions, and evidence. We explore latitudinal differences in: 1) biological (e.g., species composition, spawning mode, pelagic larval duration (PLD)), 2) physical (e.g., water movement, habitat fragmentation), and 3) biophysical factors (primarily temperature, which could strongly affect development, swimming ability, or feeding). Latitudinal differences exist in taxonomic composition, habitat fragmentation, temperature, and larval swimming, and each could influence larval dispersal. Nevertheless, clear evidence for latitudinal differences in larval dispersal at the level of broad faunas is lacking. For example, PLD is strongly influenced by taxon, habitat, and geographic region, but no independent latitudinal trend is present in published PLD values. Any trends in larval dispersal may be obscured by a lack of appropriate information, or use of ‘off the shelf’ information that is biased with regard to the species assemblages in areas of concern. Biases may also be introduced from latitudinal differences in taxa or spawning modes, as well as limited latitudinal sampling. We suggest research to make progress on the question of latitudinal trends in larval dispersal.TK was supported by the Norwegian Research Council through project MENUII #190286. JML was supported by ARC Discovery Grant DP110100695. JEC and RRW were supported by the Partnership for the Interdisciplinary Study of Coastal Oceans, funded by The David and Lucille Packard Foundation and the Gordon and Betty Moore Foundation.2014-03-2

The clustering of galaxies in the SDSS-III Baryon Oscillation Spectroscopic Survey: Baryon Acoustic Oscillations in the Data Release 9 Spectroscopic Galaxy Sample

We present measurements of galaxy clustering from the Baryon Oscillation Spectroscopic Survey (BOSS), which is part of the Sloan Digital Sky Survey III (SDSS-III). These use the Data Release 9 (DR9) CMASS sample, which contains 264,283 massive galaxies covering 3275 square degrees with an effective redshift z=0.57 and redshift range 0.43 < z < 0.7. Assuming a concordance Lambda-CDM cosmological model, this sample covers an effective volume of 2.2 Gpc^3, and represents the largest sample of the Universe ever surveyed at this density, n = 3 x 10^-4 h^-3 Mpc^3. We measure the angle-averaged galaxy correlation function and power spectrum, including density-field reconstruction of the baryon acoustic oscillation (BAO) feature. The acoustic features are detected at a significance of 5\sigma in both the correlation function and power spectrum. Combining with the SDSS-II Luminous Red Galaxy Sample, the detection significance increases to 6.7\sigma. Fitting for the position of the acoustic features measures the distance to z=0.57 relative to the sound horizon DV /rs = 13.67 +/- 0.22 at z=0.57. Assuming a fiducial sound horizon of 153.19 Mpc, which matches cosmic microwave background constraints, this corresponds to a distance DV(z=0.57) = 2094 +/- 34 Mpc. At 1.7 per cent, this is the most precise distance constraint ever obtained from a galaxy survey. We place this result alongside previous BAO measurements in a cosmological distance ladder and find excellent agreement with the current supernova measurements. We use these distance measurements to constrain various cosmological models, finding continuing support for a flat Universe with a cosmological constant.Comment: 33 page

The six most essential questions in psychiatric diagnosis: A pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances