Community and Clinical Epidemiology of Borderline Personality Disorder

Several studies of the prevalence of Borderline Personality Disorder (BPD) in community and clinical settings have been carried out to date. Although results vary according to sampling method and assessment method, median point prevalence of BPD is roughly 1%, with higher or lower rates in certain community subpopulations. In clinical settings, BPD prevalence is around 10-12% in outpatient psychiatric clinics and 20-22% among inpatient clinics. Further research is needed to identify the prevalence and correlates of BPD in other clinical settings (e.g., primary care) and to investigate the impact of demographic variables on BPD prevalence

Does \u27Fear of Dying\u27 Indicate a More Severe Presentation of Panic Disorder?

Research suggests a relationship between the presence of fearful cognitions and panic disorder (PD) severity. With little existing evidence addressing the clinical significance of individual panic-cognitions, the current study examined presentation and impairment differences among 331 outpatients with PD according to whether they experience “fear of dying” (FOD) during panic attacks. Patients reporting FOD (n = 153) were compared to patients denying FOD (n = 178) on variables indicating PD severity (e.g., number of symptoms) and psychiatric impairment (e.g., hospitalizations). PD patients with FOD reported a greater number of panic symptoms, agoraphobia diagnoses, and were more likely to be seeking treatment primarily for PD. We found no clinical impairment or comorbidity differences between groups. Results suggest that panic attacks with FOD are related to a more acute presentation of PD. Such results substantiate past research connecting cognitive distress and PD severity and further suggest that FOD may be particularly relevant to this relationship

The Clinical Significance of Single Features of Borderline Personality Disorder: Anger, Affective Instability, Impulsivity, and Chronic Emptiness in Psychiatric Outpatients

Although dimensional models of borderline personality disorder (BPD) are consistent with findings showing that minimal levels of pathology are associated with substantial increases in psychosocial impairment, it is still unclear whether different individual BPD criteria are each clinically significant on their own. The current study uses semistructured interview data from 1,870 adults presenting for outpatient psychiatric treatment to investigate whether the BPD criteria of impulsivity, affective instability, emptiness, and anger are each related to psychosocial morbidity when met in the absence of the other eight criteria. Analyses showed that each of these criteria was associated with dysfunction in comparison with a control group meeting zero BPD criteria, but only the emptiness criterion was a marker of impairment on all indices of psychosocial morbidity: suicidality, history of suicide attempts and psychiatric hospitalizations, social and work dysfunction, Axis I comorbidity, and global functioning. Implications for the study of borderline pathology are discussed

Frame-Dragging Vortexes and Tidal Tendexes Attached to Colliding Black Holes: Visualizing the Curvature of Spacetime

When one splits spacetime into space plus time, the spacetime curvature (Weyl tensor) gets split into an "electric" part E_{jk} that describes tidal gravity and a "magnetic" part B_{jk} that describes differential dragging of inertial frames. We introduce tools for visualizing B_{jk} (frame-drag vortex lines, their vorticity, and vortexes) and E_{jk} (tidal tendex lines, their tendicity, and tendexes), and also visualizations of a black-hole horizon's (scalar) vorticity and tendicity. We use these tools to elucidate the nonlinear dynamics of curved spacetime in merging black-hole binaries.Comment: 4 pages, 5 figure

The Role of Emotion Regulation Difficulties in the Connection Between Childhood Emotional Abuse and Borderline Personality Features

In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we examined the role of emotion dysregulation as a mediator between childhood abuse and borderline personality disorder (BPD) feature severity among a sample of 964 adults presenting for treatment at an outpatient clinic. A structural equation model suggested that emotional abuse relates to BPD features both directly and through difficulties with emotion regulation, whereas physical abuse showed only a weak indirect relation with BPD features. There was no link between sexual abuse and BPD feature severity in the model. Results add specificity to etiological theories of BPD and suggest that future research in treatment should focus on developing and strengthening emotion regulation strategies in clinical populations with a history of emotional abuse. Clinicians should be sure to assess the presence of childhood emotional abuse in addition to sexual and physical abuse

Frame-Dragging Vortexes and Tidal Tendexes Attached to Colliding Black Holes: Visualizing the Curvature of Spacetime

When one splits spacetime into space plus time, the spacetime curvature (Weyl tensor) gets split into an "electric" part E_{jk} that describes tidal gravity and a "magnetic" part B_{jk} that describes differential dragging of inertial frames. We introduce tools for visualizing B_{jk} (frame-drag vortex lines, their vorticity, and vortexes) and E_{jk} (tidal tendex lines, their tendicity, and tendexes), and also visualizations of a black-hole horizon's (scalar) vorticity and tendicity. We use these tools to elucidate the nonlinear dynamics of curved spacetime in merging black-hole binaries.Comment: 4 pages, 5 figure

Visualizing Spacetime Curvature via Frame-Drag Vortexes and Tidal Tendexes I. General Theory and Weak-Gravity Applications

When one splits spacetime into space plus time, the Weyl curvature tensor (vacuum Riemann tensor) gets split into two spatial, symmetric, and trace-free (STF) tensors: (i) the Weyl tensor's so-called "electric" part or tidal field, and (ii) the Weyl tensor's so-called "magnetic" part or frame-drag field. Being STF, the tidal field and frame-drag field each have three orthogonal eigenvector fields which can be depicted by their integral curves. We call the integral curves of the tidal field's eigenvectors tendex lines, we call each tendex line's eigenvalue its tendicity, and we give the name tendex to a collection of tendex lines with large tendicity. The analogous quantities for the frame-drag field are vortex lines, their vorticities, and vortexes. We build up physical intuition into these concepts by applying them to a variety of weak-gravity phenomena: a spinning, gravitating point particle, two such particles side by side, a plane gravitational wave, a point particle with a dynamical current-quadrupole moment or dynamical mass-quadrupole moment, and a slow-motion binary system made of nonspinning point particles. [Abstract is abbreviated; full abstract also mentions additional results.]Comment: 25 pages, 20 figures, matches the published versio

Timing of Esophagectomy after Neoadjuvant Chemoradiation Therapy Affects the Incidence of Anastomotic Leaks

Background: Neoadjuvant chemoradiation therapy (nCRT) has become the standard of care for esophageal cancer patients prior to esophagectomy. However, the optimal timing for surgery after completion of nCRT remains unclear. Methods: A retrospective review was performed of patients who underwent esophagectomy with cervical anastomosis for esophageal cancer at a single institution between January 2000 and June 2015. Patients were categorized into 3 cohorts: those who did not receive nCRT prior to esophagectomy (no nCRT), those who underwent esophagectomy within 35 days after nCRT (≤35d), and those who underwent esophagectomy more than 35 days after nCRT (>35d). Results: A total of 366 esophagectomies were performed during the study period, and 348 patients met the inclusion criteria. Anastomotic leaks occurred in 11.8% of all patients included in the study (41 of 348). Within each cohort, anastomotic leaks were detected in 14.7% of patients (17 of 116) in the no nCRT cohort, 7.3% (13 of 177) in the ≤35d cohort, and 20.0% (11 of 55) in the >35d cohort (p=0.020). Significant differences in the occurrence of anastomotic leaks were observed between the no nCRT and ≤35d cohorts (p=0.044), and between the ≤35d and >35d cohorts (p=0.007). Conclusion: Esophagectomy with cervical anastomosis within 35 days of nCRT resulted in a lower percentage of anastomotic leaks

"I’ve got a sheep with three legs if anybody wants it?’" - re-visioning the rural economy

This paper reports on a study of 4CG, a cooperative enterprise located in rural Wales. 4CG operates for the good of the local economy and seeks to diversify its commercial portfolio through the creation of an online shop retailing goods and services from local suppliers. The paper compliments prior field studies focusing on rural enterprise and the challenges posed by this category of business for IT support. The current study is motivated by 4CG’s interest in setting up a local online shop and explicates the organisational issues that this venture turns upon and elaborates for broader sustainability agendas