Researchers have previously identified substance use and borderline personality disorder as factors that increase risk for suicidal thoughts and behaviors. This study explored the relationship between these factors in samples of students and individuals seeking outpatient treatment. Supplemental data collected via the internet (MTurk) also looked at experiential avoidance (EA) with the Avoidance and Fusion Questionnaire for Youth. The Structured Clinical Interview for the DSM-IV, Alcohol Use Disorders Identification Test, Scale for Suicide Ideation, and Personality Assessment Inventory- Borderline Features Scale elicited information regarding severity and/or frequency of substance use, suicidal thoughts, and borderline features respectively. Additionally, the Psychiatric Diagnostic Screening Questionnaire was administered to the UNT sample. The UNT sample analyses indicate substance use moderates, strengthening, the relationship between borderline features and current suicidal thoughts. However, severity of suicidal thoughts was lower for individuals high in both borderline features and substance use disorder symptoms compared to those low in borderline features and high in substance use symptoms. The MTurk sample analyses suggest substance use functions as a mediator. A robust relationship existed between substance use severity and EA, showing substance use as a behavioral marker for EA. In conclusion, concurrent treatment of substance use and borderline personality features would be beneficial in reducing risk for suicidal thoughts. Further investigation into the role and utility of addressing EA is warranted.

Individuals with borderline personality disorder (BPD) experience severe and pervasive disturbances in the development of attachment relationships, identity, and emotion regulation. Given these deficits, mothers diagnosed with BPD are likely to experience significant difficulties in parenting their children. The present study examined the effect of maternal BPD and borderline personality features on emotional availability in interactions between mothers with BPD and their 4- to 7-year-old children. In a low socioeconomic status (SES) sample of n = 35 children of mothers diagnosed with BPD and n = 35 normative comparisons, groups were compared on maternal and child emotional availability, and self-reported maternal borderline personality features were assessed across the sample as a whole. No significant differences in emotional availability were found between groups. Across the sample as whole, however, maternal borderline personality features of affective instability, identity disturbance, negative relationships, and self-harm were significantly correlated with maternal intrusiveness and maternal hostility. Maternal borderline personality features of affective instability and negative relationships were significantly associated with maternal sensitivity, child responsiveness, and child involvement. Results are discussed in terms of putative precursors to BPD and preventive interventions.

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2007 / Thesis submitted in partial fulfillment for the degree of Master of Social Work. Includes bibliographical references (leaves 102-108).

Thesis (H. Sc. D.)--University of Sydney, 2008. / Title from title screen (viewed 11 March 2009). Submitted in fulfilment of the requirements for the degree of Doctor of Health Sciences to the School of Behavioural and Community Health Sciences, Faculty of Health Sciences. Includes bibliographical references. Also available in print form.

Thesis (M.A.)--The University of North Carolina at Greensboro, 2008. / Directed by Rosemery Nelson-Gray; submitted to the Dept. of Psychology. Title from PDF t.p. (viewed Apr. 13, 2010). Includes bibliographical references (p. 32-42).

M.A. (Clinical Psychology) / The relatively rapidly development of cognitive-behavioural approaches to various psychological conditions, has prompted clinicians and researchers to investigate the borderline personality disorder more thoroughly. Research has evidenced the uniqueness of the borderline personality disorder in terms of description, etiology and therefore treatment. of the various treatments proposed, the cognitive-behavioural approaches appear to be most effective. Latest developments in this area emphasize cognitive factors such as content-specitic cognitions and Early Maladaptive Schemas. These factors are important tor psychotherapeutic purposes. A hypothesis was formulated which stated broadly that cognitive-behavioural approaches would result in equal treatment efficacy, whether process(schema) or content based, and investigated in the context of a pilot clinical trial with tour subjects. Apart from measures for depression and cognitive processes in the BPD, a depth-of-processing task and a schema questionnaire were utilized in investigation or the hypothesis. These measures, in addition to CB interventions, were applied to a small group or carefully selected BPD's, with a secondary diagnosis or depression. Findings supported the basic hypothesis of the study, and demonstrated that cognitive-behavioural approaches of either content or process typos are equally etricacious in treatment of the borderline porsonality disorder.

Introduction: Borderline personality disorder (BPD) is a severe psychiatric disorder characterized by emotion dysregulation, interpersonal dysfunction, and poor impulse control. Little research has investigated BPD in the context of major life events. The perinatal period (pregnancy until 12 months postpartum) is an important milestone that involves major role transitions and novel challenges. This thesis examined the associations between borderline personality features (BPF) and depressive and generalized anxiety symptoms in a sample of treatment-seeking perinatal women. Methods: 74 perinatal women were recruited from the Women’s Health Concerns Clinic (WHCC) at St. Joseph’s Healthcare Hamilton, Canada, and enrolled in the WHCC Registry study. Participants were sent online intake questionnaires to collect data about demographic, personality, and other psychosocial variables. They also completed three self-report mental health measures: the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), the Edinburgh Postnatal Depression Scale (EPDS), and the Generalized Anxiety Disorder Scale (GAD-7). Logistic regression was used to determine whether a positive MSI-BPD screen (score ≥ 7) was associated with a higher likelihood of screening positive on the EPDS or GAD-7 (score ≥ 13). Results: A positive screen on the MSI-BPD was significantly associated with an almost eighteen-fold increase in the odds of screening positive on the EPDS in our treatment-seeking perinatal sample (OR 17.84, 95% CI[2.11, 218.80], p<0.05). A positive screen on the MSI-BPD was not associated with higher odds of screening positive on the GAD-7, rather only childhood trauma and a positive screen on the EPDS emerged as significant predictor variables. Our findings may reflect the greater symptomatic overlap observed between BPD and perinatal depression as well as the comparatively lower comorbidity observed between GAD and BPD in non-perinatal research. Conclusions and Future Directions: The use of self-report measures, low statistical power, and a treatment-seeking sample are limitations to consider when interpreting our findings. To our knowledge, this research study offers one of the first explorations into the relationship between BPD and generalized anxiety symptoms during the perinatal period. Future research should aim to better characterize perinatal BPD and investigate its relationship with other mental health conditions. / Thesis / Master of Science (MSc) / The perinatal period (pregnancy until 12 months postpartum) represents a time of heightened vulnerability to poor mental health. Prior research has mainly focused on perinatal depression and anxiety, while perinatal personality disorders have received comparably less attention. Borderline personality disorder (BPD) is a severe psychiatric disorder associated with diminished ability to regulate emotions, disturbances in self-image, troubled interpersonal relationships, and impulsive behaviour. This thesis investigated the relationship between self-reported borderline personality features (BPF) and depressive and generalized anxiety symptoms in a sample of perinatal women seeking treatment at a psychiatric clinic. We hope that this research sheds light on the nature of perinatal BPD, as well as its associations with other mental health conditions, to improve both immediate and multi-generational maternal and infant well-being.

In 2003, Winter, Watson, Gillman-Smith, Gilbert and Acton criticised the DSM-IV’s psychiatric conceptualisation of BPD, proposing a set of alternative descriptions based on Kelly’s (1955) Personal Construct Psychology (PCP) and diagnostic constructs. According to Winter et al. (2003), PCP offers not only a less “pre-emptive” stance towards BPD but is more clinically useful given its intrinsic implications for treatment. This correlational research study aimed to determine whether BPD symptomatology is associated with these proposed characteristics of construing. In addition, it was hypothesised that those with a belief that BPD was a part of their identity and untreatable would display higher levels of hopelessness. Ten participants with an existing diagnosis of BPD completed the following measures: a) Personal Construct Inventory (PCI; Chambers & O’Day, 1984); b) Millon Clinical Multiaxial Inventory, Third Edition, (MCMI-III, Millon, 1994); and c) Beck Hopelessness Scale (BHS; Beck & Steer, 1988). Participants were also asked to complete a repertory grid and a Likert Scale indicating the extent of their belief that: a) BPD is an intrinsic part of them; and b) BPD is a treatable condition. Two of the participants are presented as case examples. The most significant finding related to the hypothesis that greater BPD symptomatology would be associated with a higher degree of change in self-construction over time (‘slot-rattling’). Contrary to our prediction, similarity of construing of the elements ‘Me Now’ and ‘Me in the Past’ was correlated with greater BPD symptomatology. This may indicate a belief among participants that they are unable to change or may represent Kellian hostility. Construing one’s mother and father similarly to one’s therapist was associated with greater BPD symptomatology, as was construing one’s father and partner similarly, suggesting, as hypothesised, that those diagnosed with BPD tend to construe current relationships in the same terms as early relationships. Pre-emptive construing and poorly elaborated self-construction were also found to be associated with increased BPD symptoms as predicted. Content analyses performed on elicited constructs revealed that emotion regulation is the most salient area for participants. While the majority of participants considered that BPD was a part of their identity, most were uncertain as to whether BPD is treatable although these findings were not significantly correlated with levels of hopelessness. Participants’ feedback about their experiences of being diagnosed with BPD raises important ethical questions. Further hypotheses are generated based on the study findings and suggestions are made for a revision of the way in which psychological distress is conceptualized, with a particular emphasis on the utility of the PCP approach towards BPD. Clinical implications, limitations of the study and possibilities for further research are discussed.

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.

This study investigated the discharge practice of a Community Mental Health Team (CMHT) by examining records (electronic and file) of clients discharged between April 2005 and March 2006. Out of a total of 211 discharged clients a random sample of 20 clients was selected to examine the extent to which records and reasons for discharge adhere to current CMHT policies and guidelines. In addition, a sample of clients who had been engaged by the CMHT for 6 months or less was compared to a sample of clients who have been engaged for 1 year or longer to establish whether these differed in sociodemographic characteristics, diagnoses and extent of service provision. The majority of clients discharged during the specified period consisted of clients engaged for 6 months or less. The sampling process revealed that a proportion of these included clients seen for one-off assessments or duty calls, indicating that there is room for improvement to clarify referral criteria (e.g. to GPs) and the role of the CMHT. Similarly, the examination of recording practice also revealed room for improvement in the closing of care packages electronically and inclusion of required information in discharge letters. Almost 50% of clients in the sample were discharged following a decline of any further intervention the reasons for which it will be important to investigate in the form of an audit or survey of service user’s views. Clients engaged for 6 months or less and 1 year or longer seemed to differ mostly in terms of employment rates, diagnosis and previous inpatient admission and mental health act sections. The findings are discussed in relation to the limitations of this study, implications for the service and further research.