The associated features, high rates of comorbidity and chronicity of Posttraumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD) raise questions regarding the distinctiveness of the two disorders. The present study expands upon previous literature by providing an investigation of clinical features across two groups: PTSD only and comorbid PTSD and BPD in a sample of male veterans (n=178). Results suggest that the two groups were distinct, with the comorbid group displaying higher levels of depression, hostility, alcohol use and general psychopathology. Groups did not differ on rates of personal trauma, adult sexual abuse, childhood sexual abuse, attack, accident or disaster. The two groups did differ significantly on rates of childhood violence.

Women interpersonal chronic trauma survivors are frequently misdiagnosed with borderline personality disorder (BPD) or post traumatic stress disorder (PTSD), which often results in mistreatment. Neither PTSD nor BPD adequately describes the unique character alterations observed among those exposed to prolonged early childhood trauma.  Researchers suggest survivors of interpersonal and chronic trauma should be subsumed under complex PTSD (CPTSD)(MacLean & Gallop, 2003).  The primary purpose of this study was to test the validity of complex PTSD as a construct. MANOVA, ANOVA, chi- Square, and independent samples t- Tests were utilized to test hypotheses. Results revealed that women who experienced higher frequencies of trauma met more CPTSD criteria and had higher mean base rate scores on the Major Depression, Depressive, Avoidant, Masochistic, Anxiety, PTSD, and Borderline scales of the MCMI- III than women who experienced fewer traumas. Additionally, findings suggest that the Major Depression, Depressive, Anxiety, PTSD, and Borderline scales may highlight differences among women interpersonal trauma survivors who meet five of six CPTSD criteria versus those who meet full CPTSD diagnostic criteria. Lastly, the mean Borderline scale score for women who met full CPTSD diagnostic criteria was below the cutoff for personality traits. Overall, these findings provide evidence and validation for the distinction of CPTSD from BPD and PTSD.

Bronchopulmonary dysplasia (BPD) is diagnosed in approximately 40% of extremely preterm infants, those born before 28 weeks’ gestational age, and affects roughly 10,000 to 15,000 infants annually in the United States alone. Current treatment of BPD aims to not only aid in the survival of the infant but to also minimize further lung damage and promote physiologic growth to enhance lung development and repair. As the pathogenesis of the disease is multifactorial, including pre-, peri-, and postnatal factors, treatment and prevention approaches to BPD are diverse and include both medical treatment and ventilation strategies. Late postnatal steroids (> 7 days of life) have been proven to facilitate extubation and reduce the incidence of BPD in preterm infants. However, there is evidence that the use of steroids may contribute to increased rates of neurological impairment, including increased incidence of cerebral palsy. Given these findings, the American Academy of Pediatrics (AAP) guidelines recommend against the routine use of systemic steroids in the prevention of BPD and instead argues its use should be limited to infants who are considered extremely high-risk. The aim of this study is to determine whether the use of postnatal dexamethasone decreases the risk of developing BPD in a subset of high-risk infants, those with a concomitant diagnosis of necrotizing enterocolitis or late onset sepsis. A sample size of 200 extremely preterm infants with either necrotizing enterocolitis (NEC) and/or sepsis will be enrolled in a multi-center double-blinded randomized controlled trial comparing a low-dose dexamethasone taper and saline placebo. Infants will be evaluated for the development of BPD based on respiratory support and supplemental oxygen requirement at 36 weeks’ post-menstrual age (PMA). Infants will also be evaluated for presence of neurodevelopmental outcomes at 18- to 22-months follow-up. The results of this proposed study will build the evidence base for the safety and efficacy of postnatal steroids in the prevention of BPD in a subset of high risk, extremely preterm infants. This will help to establish a more detailed characterization of infants for which the benefits of steroids outweigh the risks. The results will enable clinicians to make more informed decisions regarding the medical care of extremely preterm infants and more accurately counsel parents on the incidence of subsequent BPD development, as well as long-term morbidities.

There is a gap in the treatment of preterm infants with respiratory distress syndrome. Despite addressing surfactant insufficiency and mechanical instability, currently available exogenous surfactant does not reduce the inflammation that results from aggressive ventilation and hyperoxia. Preterm infants are also deficient in anti-oxidant and anti-inflammatory defenses. All of these factors predispose the infant to bronchopulmonary dysplasia. Recombinant human Club Cell Secretory Protein 10 (rhCC10), known to inhibit sPLA2, has been used to reduce ventilator induced lung inflammation. The long-term goal of this study is to understand the impact of rhCC10 on the pro/anti-inflammatory balance during early development. We will interrogate the link between Toll-Like Receptors (TLR 4) and rhCC10 because TLRs are integral to lung inflammation. By measuring the mRNA expression, protein, and downstream signaling activity in rhCC10 treated preterm lamb lung and then in A549 cells, an alveolar epithelial cell-like system, the anti-inflammatory effect of rhCC10 will be differentiated. This research is significant because it will improve understanding of the effect of rhCC10 on pro/anti-inflammatory regulation and provide insight regarding potential co-therapies when treating with rhCC10. / Physiology

The aim of the present study was to further understand psychological well-being (PWB) and future-directed thinking in individuals with a diagnosis of Borderline Personality Disorder (BPD). A cross-sectional mixed design was used with 24 individuals with a diagnosis of BPD and 24 community participants (Controls). Participants were measured on PWB and a measure of future-directed thinking. Future-thoughts provided by participants were also content analysed, and it was hypothesised the BPD Group would have particularly marked deficits within interpersonal future thoughts. Consistent with previous findings (MacLeod et al., 2004), BPD participants had fewer positive future-directed thoughts compared to Controls, in the absence of any differences in negative future-directed thoughts. The BPD Group had significantly lower PWB scores on all six of the Ryff Psychological Well-being dimensions. The Control Group generated significantly more positive future-directed thoughts related to Relations with Others and Recreational activities, as well as more thoughts related to Having/Raising Children than the BPD Group. The findings extend the understanding of BPD individuals by profiling their well-being and describing in more detail their future-directed thinking.

No description available.

No description available.

Bakgrund: EIPS/BPD är en psykiatrisk diagnos som karaktäriseras av ett avvikande sätt att hantera starka känslor. Personer med EIPS/BPD upplever att de stigmatiseras i vården och vårdpersonal ser patientgruppen som krävande. Berger och Luckmanns (1966/1991) socialkonstruktivistiska teori utgår från att verkligheten skapas genom socialt samspel mellan människor. Det inbegriper även konstruerandet av diagnoser och sjukdom. Syfte: Att utifrån socialkonstruktivistisk teori förstå diskursen kring EIPS/BPD-patienter hos personal inom psykiatrisk slutenvård. Metod: Kvalitativ metod med fokusgruppsintervjuer av vårdpersonal inom slutenvårdspsykiatrin. Personalen som intervjuades bestod av sjuksköterskor och skötare/undersköterskor även om läkare och kuratorer också inkluderades. Bearbetningen av intervjumaterialet gjordes med tematisk analys (Braun & Clarke, 2006) och analyserades med socialkonstruktivistisk teori av Berger & Luckmann (1966/1991). Resultat: Personalen beskrev att de flesta EIPS/BPD-patienter är unga “tjejer” och att många har olika former av självskadebeteende. Även suicidförsök beskrevs som en form av självskadebeteende av personalen, och inte grundat i äkta suicidalitet. Personalen beskrev att många med EIPS/BPD blir bättre i sin diagnos när de skaffar familj. Kunskap om patienten kom främst från andra kollegor och genom erfarenhet. Läkare beskrevs av sjuksköterskor och skötare/undersköterskor som kollegor som står utanför teamet vilket enligt dem riskerade att göra vården lidande. Vissa i personalen upplevde att de kunde ge EIPS/BPD-patienter en bra vård medan andra inte upplevde det. Slutsats: Personalen hade en typifierad bild (kategorisering för att göra mer förståelig) av patientgruppen som rörde sig utanför diagnoskriterierna för EIPS/BPD (i DSM-5 and ICD-10) och patientgruppens lidande bedömdes ibland som icke-legitimt. Den typifierade bilden av EIPS/BPD patienter sprids och reproduceras genom sekundär socialisering på arbetsplatsen. / Background: EIPS/BPD is a psychiatric diagnosis characterized by a deviant way of handling strong emotions. People with EIPS/BPD feel that they are stigmatized in healthcare and healthcare professionals see the patient group as demanding. Berger and Luckman’s (1966/1991) social constructive theory assumes that reality is created through social interaction between people, which also includes the construction of diagnoses and illness. Aim: To understand the discourse around EIPS/BPD patients among staff within psychiatric inpatient care from a social constructivist perspective. Method: Qualitative method with focus group interviews of healthcare staff within inpatient psychiatry. The processing of the interview material was done with thematic analysis (Braun & Clarke, 2006) and analyzed with social constructivist theory by Berger & Luckmann (1966/1991). Results: The staff described that most EIPS/BPD patients are young "girls" and that many have various forms of self-harming behavior. Suicide attempts were also described as a form of self-harming behavior by the staff, and not based on genuine suicidality. The staff described that many with EIPS/BPD get better in their diagnosis when they start a family. Knowledge of the patient came mainly from other colleagues and through experience. Physicians were described by nurses and assistant nurses as colleagues who stood outside the team, which, according to them, risked causing the care to suffer. Some of the staff felt that they could provide good care to EIPS/BPD patients while others did not. Conclusion: The staff had a typified image (categorization to make more understandable) of the patient group that moved outside the EIPS/BPD diagnosis criteria (in DSM-5 and ICD-10) and the suffering of the patient group was sometimes judged as non-legitimate. The typified image of EIPS/BPD patients is spread and reproduced through secondary socialization in the workplace.

Bakgrund: Tidigare forskning visar att patienter med borderline personlighetssyndrom (BPD) upplever negativa attityder och inte erbjuds den vård de behöver vid kontakt med den psykiatriska vården. Patienter med BPD uppvisar en stark emotionell smärta och känslomässig instabilitet vilket innebär att sjuksköterskan upplever svårigheter och osäkerhet vid omvårdnad av dessa patienter. Syfte: Syftet med denna litteraturstudie var att beskriva hur patienter med borderline personlighetssyndrom erfar och upplever den psykiatriska vården. Metod: En allmän litteraturstudie baserad på elva kvalitativa studier genomfördes. Resultat: Analysen resulterade i fyra kategorier: Känslor av att bli avvisad och sviken, Relationen en förutsättning, Samtalets betydelse och att bli hörd, samt Hopp om ett tillfrisknande. I resultatet framkom att det stigma och de negativa attityder som omger diagnosen BPD påverkade patienternas upplevelse av vården negativt. En bra relation till sjuksköterskan som byggde på tillit, en bra kommunikation och utgick från patientens perspektiv var viktig för att uppnå en god omvårdnad och en terapeutisk allians. Slutsats: Genom ökad kunskap om tillståndet BPD och klinisk handledning kan attityder och stigmatisering om BPD minskas. Det ökar möjligheten för sjuksköterskan att ge denna patientgrupp en positiv vårdupplevelse och en god omvårdnad.

Borderline Personlighetstörning är en psykiatrisk diagnos som definieras genom symtom som bristande impulskontroll, relationsproblem och självskadeproblem.Flera av dessa symtom är av den karaktären att de förorsakar beteenden som gör att möjligheten till att ge en god omvårdnad försvåras. Syftet med litteraturstudien var att beskriva sjuksköterskors attityder och upplevelser av att vårda patienter som lider av diagnosen BPS.Resultatet analyserades utifrån Evans (2003) modell. Studien har visat vilka utmaningar sjuksköterskan upplever i mötet med patienter med BPS när det gäller relation och omvårdnad.Sjuksköterskorna beskriver negativa attityder och upplevelser i arbetet med patienter med BPS. . Vidare har det framkommit att sjuksköterskorna har föreställningar om egenskaper av farlighet och manipulation när det gäller patienter med BPS. Ett sätt att hantera de svårigheter som finns i omvårdnadsarbetet med patientgruppen har varit att använda sig av avståndstagande från sjuksköterskornas sida, visar studien. Resultatet pekar även på att sjuksköterskorna anser att patienter med BPS har större ansvar för sitt beteende jämfört med andra patientgrupper.Sjuksköterskorna känner dock professionellt ansvar för patientgruppen och upplever en viss optimism när de gäller denna utmanande patientgrupp.För att kunna ge god omvårdnad till patienter med BPS bör sjuksköterskan ha stöd i sin professionalitet i form av behöver ett sammansvetsat och stödjande team, realistiska och tydliga mål, adekvat utbildning och fortlöpande handledning. / Program: Sjuksköterskeutbildning