Borderline personality disorder (BPD) is a severe and debilitating mental disorder that is over-represented within the criminal legal system (CLS), with 15-29.5% of individuals in the CLS meeting criteria. However, little research has examined mechanisms leading to criminal involvement within this population. Potential mechanisms include positive/negative emotion dysregulation and internalized shame, which (aside from positive emotion dysregulation) have been linked to criminal involvement in other populations. Research has yet to examine these constructs as mechanisms explaining criminal involvement among individuals with BPD. This study examined positive/negative emotion dysregulation and internalized shame as mechanisms of the relationship between BPD and criminal involvement. Adults (N = 93) currently incarcerated in jail who are identified as having a current or prior mental health concern were invited to participate in the study. Measures include the addiction severity index (ASI) examining criminal involvement, the original and positive versions of the difficulties in emotion regulation scale (DERS; DERS-P), and the internalized shame scale (ISS). At the bivariate level, BPD symptoms were significantly correlated with negative emotion dysregulation (total score) and several subscales (clarity, goals, impulse, strategies), as well as internalized shame and criminal involvement. Negative emotion dysregulation and internalized shame were unrelated to criminal involvement, and there was no evidence of mediation through these constructs. These bivariate results are consistent with other literature, but future research is needed to examine relevant variables that could explicate the relationship between BPD symptoms and criminal involvement.

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Borderline personality disorder (BPD) and schizotypal personality disorder (SPD) are both characterized by inflexible and pervasive behavioral patterns that frequently lead to significant functional impairment. Although considerable research has been conducted on the biological and phenotypic aspects of these disorders, researching, diagnosing, and treating them remains a challenge, primarily due to the difficulties associated with the categorical nature of current diagnostic methods (Skodol and Bender, 2009) which, in turn, results in significant within-group heterogeneity and between-group co-occurrence. Given the relative paucity of research comparing aspects of these disorders with one another, the current study aimed to evaluate overlapping and differentiating aspects of BPD and SPD by examining the integrity of a brain region frequently implicated in both disorders, the cingulum. The current study used a 3T Siemens scanner to acquire structural and diffusion tensor imaging in age-, sex-, and education-matched groups of 28 adults with BPD, 32 adults with SPD, and 36 healthy control participants (HC). The anterior and posterior cingulate were manually traced on all participants and then volume and fractional anisotropy (FA) comparisons were conducted across the groups for the left and right anterior and posterior cingulate. Compared with HC, SPD patients had smaller relative cingulate white matter volume and BPD patients had marginally significantly smaller relative cingulate white matter volume, and the two patient groups did not differ from one another. With regard to FA findings, a spectrum pattern emerged, such that the BPD group had significantly lower FA in the posterior cingulum relative to controls, whereas the SPD group also had lower FA in this region but did not differ from HC. The BPD group had marginally lower FA in dorsal aspects of the anterior cingulum when compared with HC, and the SPD patients did not differ from HC or BPD individuals. In summary, the current study provides evidence of aberrant connectivity of the cingulum in BPD patients, but not SPD patients, compared with HC individuals. Consistent with prior work, overall results suggest potential involvement of cingulum in BPD symptomatology. / Psychology

No description available.

Both borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) are associated with emotion dysfunction and often co-occur. Emotional reactivity is also evident in some studies in BPD and PTSD. Despite the frequent co-occurrence of these diagnoses, only a few studies have examined the independent and joint effects of BPD and PTSD on emotional functioning. Some data suggest that co-occurring PTSD may drive discordance between domains of emotional reactivity in BPD, dampening physiological reactivity but increasing subjective reactivity. Low reliance on acceptance-based emotion regulation may also account for this divergence. The current study examined the independent and interactive effects of BPD and PTSD on emotional reactivity, regulation, and concordance across physiological and subjective measures. We also examined the role of acceptance in driving concordance across physiological and subjective measures. Participants (N = 195) underwent a diagnostic interview and completed a computerized task including neutral and negative emotion inductions. We examined subjective and physiological outcomes after both inductions. Linear regressions were used to examine relationships between diagnostic group and self-reported reactivity and regulation outcomes, as well the mediating role of acceptance on discordance. Multilevel models were used to examine the associations between diagnostic criteria and time on reactivity and regulation outcomes. We found that BPD and BPDxPTSD, but not PTSD, were significantly associated with greater difficulty regulating and accepting emotions. No significant differences in physiological reactivity and regulation were present across diagnostic groups, and acceptance was not found as a mediator between diagnostic groups and discordance indices. We discuss possible interpretations of our reactivity and regulation findings. Investigating BPD and PTSD’s association with reactivity and regulation, along with the role of emotional acceptance on these outcomes, will extend our understanding of diagnostic profiles and potentially pinpoint how acceptance can be utilized to influence emotional concordance.

Childhood trauma experiences (sexual abuse, physical abuse, witnessed violence, and early separation experiences) and family environment characteristics were assessed via questionnaire from a sample of depressed borderline (N=17) and depressed nonborderline (N=19) female inpatients. Significantly more borderline individuals than nonborderlines gave histories of sexual abuse (76%) and physical abuse (93%) and these traumatic experiences were more severe in nature as demonstrated by significantly greater composite scores. While the presence of witnessed violence did not differentiate the two groups, borderline individuals witnessed violence more frequently than nonborderline individuals if there was violence in the home. Early separation experiences were relatively common in both groups suggesting that these experiences may be associated with both BPD and depression. The BPD group was also distinctive on family environment measures, evidencing significantly less family cohesiveness and expressiveness and significantly more conflict and control. The two groups were similar on indices of current stressors, typically associated with onset of depression, providing more support for the role of childhood trauma in the etiology of BPD. / Master of Science

Text in English / Psychologists-in-training are often presented with textbook definitions and descriptions of individuals presenting with psychopathologies. A major challenge for such texts is to effectively convey the relational issues and interpersonal dynamics of the mental disorders. The current study explores the role of film in enhancing intern clinical psychologists’ understanding of borderline personality disorder by specifically utilising the films Sylvia and Black Butterflies. A qualitative, phenomenological study was conducted with 15 clinical psychology interns at a tertiary psychiatric hospital in Gauteng, South Africa. The collected data consisted of responses to open-ended questionnaires and semi-structured interviews and was analysed according to an interpretive phenomenological analysis. Although the analysis was conducted inductively, the researcher also made deductive inferences from the data based on contemplations about the link between archetypes and images and learning and archetypal experiences. The importance of and connection to 21st-century learning skills, the creative learning spiral and a pedagogy of play were also taken into consideration while analysing the data. The findings of the current study suggest the ability of the two films to draw one in and to cause one to emotionally connect with the characters. Furthermore, films form an opportunity for trainees to practice psychodynamic formulations and not only focus on biological reductionisms of the disorder. / Psychology / M.A. (Psychology)

Résumé : Problématique : Le trouble de la personnalité limite (TPL) est une condition psychiatrique touchant environ 1 % de la population et 20 % de la clientèle recevant des services en psychiatrie (Gunderson et Links, 2008). L’un des domaines du fonctionnement dans la vie quotidienne le plus touché chez cette population est le travail (Gunderson et al., 2011; Larivière et al., 2010; Zanarini et al., 2012). À notre connaissance, aucune étude n’a décrit de façon approfondie la participation au travail des personnes présentant un TPL. Objectif : L’objectif général de cette étude vise à identifier et à décrire les obstacles, les facilitateurs de même que les solutions possibles de la participation au travail des personnes présentant un TPL selon leur point de vue et celui de leurs intervenants. Méthodologie : Une étude de cas multiples a été utilisée (Yin, 2009). Neuf cas ont été étudiés selon trois contextes socioprofessionnels de la participation au travail : A. Réintégration (personne en invalidité), B. Retour (personne en absence maladie) et C. Maintien au travail. Pour chacun des contextes, trois dyades incluant une personne avec un TPL (âgée de 18 à 55 ans) et son intervenant soutenant la participation au travail ont été interviewées. Résultats: Les résultats qualitatifs (n = 18) ont démontré que la participation au travail des personnes présentant un TPL est influencée par des facteurs individuels (p. ex., la réaction face à la pression et aux relations de travail, la régulation émotionnelle) ainsi que des facteurs liés aux acteurs et procédures des systèmes de l’assurance, organisationnel et de la santé (p. ex., la collaboration et la communication entre les acteurs, l’alliance de travail entre les acteurs et la personne présentant un TPL, les mesures d’accommodement et de soutien naturel dans le milieu de travail). Conclusions et implication clinique : Cette étude met en lumière le défi important et spécifique que représente la participation au travail pour les personnes présentant un TPL. Elle implique des facteurs personnels et environnementaux qui doivent être considérés par tous les acteurs impliqués (les utilisateurs de services, les professionnels de la santé, les assureurs et les employeurs). Les programmes de réadaptation au travail actuels devraient être bonifiés et coordonnés adéquatement avec les thérapies spécialisées afin d’aborder de manière optimale les enjeux liés à la participation au travail des personnes présentant un TPL. / Abstract : Background: Borderline personality disorder (BPD) affects around 1% of the population and 20% of psychiatric service users (Gunderson & Links, 2008). Recent studies show that work participation is the most impaired occupational domain and should be prioritized in rehabilitation (Gunderson et al., 2011; Larivière et al., 2010; Zanarini et al., 2012). However, to our knowledge, no study has examined in depth the specific issues regarding work participation for people with BPD. Objective: The overall purpose of this study was to identify and describe barriers and facilitators as well as possible solutions for enabling work participation of individuals with a borderline personality disorder (BPD) from their perspective and the perspective of their service providers. Methods: Using a qualitative multiple case study design (Yin, 2009), three contexts of work participation were considered: 1) work (re) integration, 2) return to work (after a sick leave), and 3) job tenure. Within each context, three dyads including an individual with BPD (aged 18 to 55) and their service provider supporting work participation were met for individual interviews. Results: Qualitative results (n = 18) showed that individual factors (e.g., reaction towards pressure and relationships at work, regulation of emotions) and factors related to stakeholders and procedures from insurance, organizational and health systems (e.g., poor collaboration and communication between stakeholders, working alliance between individuals with BPD and stakeholders, work accommodations and natural support in the workplace) influenced work participation of individuals with BPD. Conclusions and implication for practice: This study highlights that work participation presents specific challenges for individuals with BPD, including several personal and environmental factors to be considered by all stakeholders (service users, health care professionals, insurers and employers). Current work rehabilitation programs need to be improved to address more optimally the work participation issues of individuals with BPD and be well coordinated with current specialized psychotherapies.

Assignment (MA)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: Adherence to medical regimes and the difficulties associated with patient adherence are well documented. Furthermore, non-adherence with prescribed medication is ubiquitous. Regarding HIV, strict adherence to combination highly active antiretroviral therapy regimes is a prerequisite for immunological reconstitution. Certain factors have been identified as predicting non-adherence. However, the role of personality variables on adherence has been neglected, specifically with regards to personality pathology. Moreover, there is a high rate of comorbidity between HIV and Axis II disorders, including BPD. Despite controversy, the DSM-IV-TR identifies nine fundamental criteria required for the diagnosis of BPD to be made. These criteria are considered separately in an attempt to elucidate their potential role on non-adherence. Clinically, it is likely that the criteria interact to create a gestalt effect, further complicating adherence. / AFRIKAANSE OPSOMMING: Patient voldoening ter mediese aanbevele en die probleme geassosier daarmee is goed gedokumenteer. En verder is dit allerdags dat patlente nie met hul voorgeskrewe medikasie voldoen nie. In verband met MIV, streng voldoening tot HAART is a voorvereiste vir immunologiese hersamestelling. Sekere faktore is geidentifiseer wat voldoening en die teenoorgestelde daarvan voorspel. Alhoewel, die rei van persoonlikheid veranderlikes op voldoening is nie in ag geneem nie, spesifiek in verband met persoonlikheid patologie. Bowenal, is daar n hoe frekwensie van komorbiditeit tussen MIV en As II steurings, insluitend BPO. Ten spyte van kontroversie, die OSM-IV-TR identifiseer nege fundementele kriteria, waarvan vyf teenwoordig moet wees vir n diagnose van BPO. Hierdie kriteria word individueel bespreek in n poging om hulle impak op patiente voldoening te illustreer. Klinies is dit heel moontlik dat daar interaksie is tussen die kriteria wat n gestalt effek sal skep, wat voldoening weer verder sal kompliseer.

People with Borderline Personality Disorder (BPD) have a particular difficulty in forming and maintaining close relationships. The Relational Affective Model (Mizen, 2014) proposes that intimate relationships activate claustro-agoraphobic anxieties as the person alternately seeks and flees emotional closeness. The therapeutic relationship is a specialised kind of intimate relationship in which claustro-agoraphobic anxieties are likely to be activated in a process which psychoanalysis understands as transference. The understanding and working through of this transference is the mutative factor proposed in psychodynamic therapies. This study explored participants' mental representation of the internal psychic space of the other. Ten people with a diagnosis of BPD were asked to describe themselves and significant others, including their therapist in order to understand more about (1) their mental representations of the internal space of the other; (2) their relationship with their therapist with reference to internal space. and (3) the implications for the Relational Affective Model and clinical understanding of BPD. Using a mixed qualitative methodology four broad but distinct ways of describing internal space states emerged: positive, negative, nondescript and merged, which I have termed Alpha, Omega, Non-Alpha and Merged. Case study analyses for the four participants who provided interviews at the beginning and end of their treatment were conducted to attempt to highlight any changes in the internal space states identified. A thematic analysis of therapist descriptions indicated participants were positively engaged with their therapist. Negative internal space (Omega) descriptions of self and mother did not transfer to the relationship with the therapist in the early stages of therapy. The implications for the Relational Affective Model are considered.