Recent developments in psychosocial interventions for borderline personality disorder [version 1; peer review: 3 approved]

Borderline personality disorder (BPD) is a serious psychiatric disorder that affects multiple symptomatic domains and is associated with an increased risk of suicidality. Several empirically supported treatments for BPD have been developed in recent years for adults with BPD. More recent work has focused on tailoring or applying (or both) these existing treatments to specific patient populations, including patients with certain types of comorbidity (for example, BPD and post-traumatic stress disorder or antisocial personality disorder) and younger patients. Other work has involved developing treatments and models of treatment delivery that address concerns related to access of care. Relatedly, new adjunctive and technology-assisted interventions have been developed, adding to the growing repertoire of treatment options for these patients. Advances in the last several years address specific treatment needs and offer cost-efficient options for this diverse patient population

The incremental validity of borderline personality disorder relative to major depressive disorder for suicidal ideation and deliberate self-harm in adolescents

Few studies have examined the relation between suicide-related behaviors and Borderline Personality Disorder (BPD) in adolescent samples. The current study investigated the incremental validity of BPD relative to Major Depressive Disorder (MDD) for suicide-related behaviors in a psychiatric sample of adolescents at the cross-sectional level of analysis. The sample included N = 156 consecutive admissions (55.1% female; M age = 15.47; SD = 1.41), to the adolescent treatment program of an inpatient treatment facility. Of the sample 19.2% (n = 30) met criteria for BPD on the Child Interview for DSM-IV Borderline Personality Disorder and 39.1% (n = 61) met criteria for MDD on the Computerized Diagnostic Interview Schedule for Children-IV. Results showed that BPD conferred additional risk for suicidal ideation and deliberate self-harm. Our findings support the clinical impression that BPD should be evaluated in inpatient samples of adolescents either through intake interviews or more structured assessments

The Contributions of Neuroticism and Childhood Maltreatment to Hyperbolic Temperament

Zanarini and colleagues have proposed that hyperbolic temperament, involving a preponderance of negative emotions and cognitions combined with a need for those dysphoric inner states to be validated and understood, underlies borderline symptomatology. This study examined neuroticism and childhood maltreatment as predictors of hyperbolic features measured 10 years later in a clinical sample. Neuroticism and childhood maltreatment were significant and independent predictors of prospective hyperbolic temperament. These findings expand upon the hyperbolic temperament model of borderline phenomenology by depicting its developmental antecedents

Five-factor trait instability in borderline relative to other personality disorders.

Borderline Personality Disorder (BPD) is related to five-factor model (FFM) traits and can be characterized as involving psychological and behavioral instability. A previous study comparing the FFM trait stability across individuals with borderline and other personality disorders found that the BPD group tended to have lower stability, particularly on neuroticism and conscientiousness and the overall configuration of FFM profiles over 6 years, suggesting that associated psychological and behavioral variability may be due to trait variability. The current study was designed to test the degree to which these findings replicate in another sample using different diagnostic and trait measures and extending the measurement period to 10 years. Results are consistent with previous findings in showing lower differential (rank-order) stability on conscientiousness, greater mean-level decreases on neuroticism, lower individual-level stability on conscientiousness, and lower ipsative stability of trait profile configurations among those with BPD. However, unlike the previous study, no differences were observed for differential or individual-level neuroticism or mean-level conscientiousness. Overall, findings show that the instability characteristic of BPD extends into typically stable personality traits, and that it does so with some specificity in terms of which traits are affected and how instability manifests