Disturbed body schema, perceptual body image, and attitudinal body image in patients with borderline personality disorder

BackgroundBorderline personality disorder (BPD) is a severe mental disorder that affects attitudes toward the body. However, whether this condition also affects body schema and perceptual body image remains unclear. Previous questionnaire-based studies found dissatisfaction with one's body in patients with BPD. In addition to attitudinal body image, our study investigates whether body schema and perceptual body image are disturbed in patients with BPD.MethodOur study included 31 patients diagnosed with BPD (25 women) and 30 healthy individuals (19 women) (Mage = 29 for both groups). The SCID-5-PD interview was used to determine personality disorder. Attitudinal body image was measured using the Body Attitude Test (BAT) factors. Body schema and perceptual body image were measured by two conditions of a body representation task, the body portraying method (BPM).ResultsBPD patients achieved higher scores in all three BAT factors and were more susceptible to misinformation in both conditions of BPM. Based on the results, BPD patients appear to have more negative attitudes toward their bodies and worse perceptual body image and body schema.ConclusionThe novel finding of our study is that, besides the previously found attitudinal dissatisfaction with the body, individuals with BPD also show disturbances at the levels of body schema and perceptual body image. Our findings concerning disturbances in body schema and perceptual body need further research into their etiological factors and provide new therapeutic targets for the treatment of BPD

Reliability and validity of the Hungarian version of the Personality Inventory for DSM-5 (PID-5)

Objectives and methodsIn order to assess the internal consistency, fit indexes, test-retest reliability, and validity of the Personality Inventory for the DSM-5 (PID-5) and its associations with age, gender, and education, 471 non-clinical (69,6% female; mean age: 37,63) and 314 clinical participants (69,7% female, mean age: 37,41) were administered the Hungarian translation of the PID-5, as well as the SCL-90-R and the SCID-II Personality Questionnaire.ResultsWe found that; (a) temporal consistency of the Hungarian PID-5 was confirmed by one-month test-retest reliability analysis, (b) validity of the PID-5 instrument is acceptable in the clinical and the non-clinical sample as well, based on significant correlations with SCID-II and SCL-90-R, (c) PID-5 facets' and domains' associations with gender, age, and level of education are in accordance with previous findings.ConclusionThese findings support that the Hungarian PID-5 is a reliable and valid instrument for both clinical and non-clinical populations

How many causal pathways must symptoms form before we call them a borderline? A hierarchical network model of borderline personality disorder

Borderline personality disorder (BPD) is characterized by impulsivity, emotion dysregulation, disturbed relationships, and identity disturbances. Despite the known variable co-occurrence of BPD symptoms, the possible causal relationships are not well understood. We addressed this by creating a hierarchical network model of BPD, which identifies the most likely acyclic causal pathways that are driving BPD development. Cross-sectional data was obtained from the Structured Clinical Interview-II (SCID-II), and possible causal relationships between symptoms were identified from conditional independence relations. The symptoms’ hierarchy values, assessing their role in causal pathways, was determined by a random walk-based algorithm. By analyzing the directed network of BPD symptoms, it was found that symptoms in initial stages of causal pathways were abandonment, physical fights, impulsivity, suicidal threats, identity disturbances, and affective instability. Based on the assessed role symptoms play in causal pathways of BPD development, specific symptoms can be targeted during early diagnosis and clinical assessment

How many causal pathways must symptoms form before we call them a borderline? A hierarchical network model of borderline personality disorder

Borderline personality disorder (BPD) is characterized by impulsivity, emotion dysregulation, disturbed relationships, and identity disturbances. Despite the known variable co-occurrence of BPD symptoms, the possible causal relationships are not well understood. We addressed this by creating a hierarchical network model of BPD, which identifies the most likely acyclic causal pathways that are driving BPD development. Cross-sectional data was obtained from the Structured Clinical Interview-II (SCID-II), and possible causal relationships between symptoms were identified from conditional independence relations. The symptoms’ hierarchy values, assessing their role in causal pathways, was determined by a random walk-based algorithm. By analyzing the directed network of BPD symptoms, it was found that symptoms in initial stages of causal pathways were abandonment, physical fights, impulsivity, suicidal threats, identity disturbances, and affective instability. Based on the assessed role symptoms play in causal pathways of BPD development, specific symptoms can be targeted during early diagnosis and clinical assessment

Measuring post-traumatic stress disorder and complex post-traumatic stress disorder using the International Trauma Questionnaire: results from a Hungarian clinical and non-clinical sample

Background: The 11th revision of the International Classification of Diseases (ICD-11) simplified the description of post-traumatic stress disorder (PTSD) and also introduced a new trauma-related diagnosis called complex post-traumatic stress disorder (CPTSD). CPTSD is linked to earlier, prolonged interpersonal trauma, and is characterized by a broader range of symptoms, in addition to the core PTSD symptoms. The International Trauma Questionnaire (ITQ) has been developed to assess the new diagnostic criteria. Objectives: The primary aim of our study was to test the factor structure of the ITQ in a clinical and a non-clinical Hungarian sample. We also examined whether the degree of traumatization or the type of trauma experienced was associated with meeting the criteria for PTSD or CPTSD, or with the severity of PTSD or disturbances in self-organization (DSO) symptoms, in both samples. Method: A trauma-exposed heterogeneous clinical sample (N = 176) and a non-clinical sample (N = 229) filled out the ITQ and a modified version of the Life Events Checklist (LEC-5). The factor structure of the ITQ was tested by examining the model fit of seven competing confirmatory factor analysis models. Results: A two-factor second-order model with a second-order PTSD factor (measured by three first-order factors) and a DSO factor (measured directly by six symptoms) had the best fit to the data in both samples if an error correlation was allowed between negative self-concept items. Those in the clinical group who reported more interpersonal and childhood trauma experienced more PTSD and DSO symptoms. Also, there were significant, positive, and weak associations between the total number of different traumas and PTSD and DSO factor scores in both samples. Conclusion: ITQ was found to be a reliable tool to differentiate between PTSD and CPTSD, two related but distinct constructs in a clinical and a non-clinical trauma-exposed sample in Hungary

Early Maladaptive Schema-Related Impairment and Co-Occurring Current Major Depressive Episode-Related Enhancement of Mental State Decoding Ability in Borderline Personality Disorder.

Disturbed interpersonal relationships specific to borderline personality disorder (BPD) suggest biased processing of social information. The goal of this study was to examine alterations in mental state decoding (MSD) and their associations with early maladaptive schemas (EMS) that may lead to the misinterpretation of incoming information. In addition, the authors' aim was to evaluate the effects of a co-occurring current major depressive episode (MDE) on the MSD performance of BPD patients. Seventy-eight BPD patients (34 with MDE) and 76 matched healthy controls (HC) were assessed for Reading the Mind in the Eyes Test (RMET) and the level of EMS. The authors found that impairment in the total RMET performance, as well as specific impairment regarding the recognition of positive and neutral items, was associated with EMS, and enhanced vigilance to negative mental states was characteristic to BPD with MDE. Results suggest that MSD ability is altered in two independent ways in BPD

Moral injury in psychiatric patients with personality and other clinical disorders: development, psychometric properties, and validity of the Moral Injury Events Scale–Civilian Version

Background: Moral injury emerges when someone perpetrates, fails to prevent, or witnesses acts that violate their own moral or ethical code. Nash et al. [(2013). Psychometric evaluation of the moral injury events scale. Military Medicine, 178(6), 646–652] developed a short measure, the Moral Injury Events Scale (MIES) to facilitate the empirical study of moral injury in the military. Our study aimed to develop a civilian version of the measure (MIES–CV) and examine its psychometric properties in a sample of psychiatric inpatients . Methods: In this cross-sectional study, the sample comprised 240 adult patients (71.7% female) with a mean age of 31.57 (SD = 11.69). The most common diagnoses in the sample were anxiety disorders (58.3%), depressive disorders (53.8%), and borderline personality disorder (39.6%). Participants were diagnosed using structured clinical interviews and filled out psychological questionnaires. Results: Exploratory factor analysis suggested that Nash et al.’s model (Perceived Transgressions, Perceived Betrayals) represents the data well. This two-factor solution showed an excellent fit in the confirmatory factor analysis, as well. Meaningful associations were observed between moral injury and psychopathology dimensions, shame, reflective functioning, well-being, and resilience. The Perceived Betrayals factor was a significant predictor of bipolar disorders, PTSD, paranoid personality disorder, borderline personality disorder, and avoidant personality disorder. Conclusions: Our study demonstrated that this broad version of the MIES is a valid measure of moral injury that can be applied to psychiatric patients