Borderline Personality Disorder

Question 1

Lieb and colleagues (2008) suggest that

Answer 1

Clinical signs of BPD:

• emotion dysregulation
• impulsive aggression
• repeated self injurious behaviour
• chronic suicidal tendencies

Casual factors:
genetics
adverse childhood events such as physical and sexual abuse

Question 2

BPD is a serious mental health disorder affecting 1–6% of the general population

Answer 2

(Grant et al., 2008)

Question 3

what are the co-morbid sex differences for BPD

Answer 3

men = substance abuse, women = eating disorder

Question 4

• Investigated affect regulation in 50 BPD and 50 non-BPD patients using 24-hour psychophysiological ambulatory monitoring.
• BPD patients reported more negative emotions, fewer
  positive emotions, and greater intensity of negative but not positive emotions.
• Nonmedicated BPD tended to show higher levels of high-frequency heart rate
  variability.

Answer 4

Ebner et al. (2004)

Question 5

Herpertz and colleagues (2001)

Answer 5

• 6 female bpd patients and 6 HCs
• BPD had elevated BOLD in the amygdala on both sides and activation medial and inferolateral PFC
• Suggest enhanced amygdala activation reflects intense and subsiding emotions even in response to low level stressors

Question 6

Treatment with DBT has been shown to reduced suicide attempts and deaths (????)

Answer 6

(Linehan et al., 2006)

Question 7

e Psychotherapies, most notably dialectical behavior therapy and psychodynamic approaches, are effective for borderline symptoms and related problems

Answer 7

(Cristea et al., 2017) a systematic review

Question 8

• Clinical trial
• Men with BPD and antisocial behaviours
• 12 months DBT for 30 men
• Significant reduction in dysfunctional beaviours incl self-harm, verbal and physical aggression
• Pps reported high satisfaction with treatment and maintined improvement at 1 year follow up.
• Could be an effective alternative for men with BPD and antisocial behaviour

Answer 8

(Wetterborg et al., 2018)

Question 9

Navarro-Haro and colleagues (2018) found

Answer 9

Compared CBT and DBT for co-morbid BPD and eating disorder
118 women with co-morbidity
DBT showed greater decrease in dysfunctional behaviours used to regulate emotions
DBT greater decrease in self-harm, depressive symptoms
DBT greater increase of cognitive reappraisal and global functioning
Supports standard DBT for co-morbid BPD.

Question 10

Volume reduction in hippocampus and amygdala.

• dysfunction of fronto-limbic network (PFC and limbic system)
• Amygdala volume reduction may be a specific feature of BPD.
• dysfunction of network may contribute to most of BPD symptoms (????)

Answer 10

Schmahl and Bremner (2006)

Question 11

Friberg and colleagues (2014) conducted a meta analysis and found

Answer 11

• that PD’s had high comorbidity with BD, MDD and DYS.

- highest comorbidity with DYS.

Question 12

Zanarini and colleagues (1998) found

Answer 12

• high degree of comorbdity in BPD

- comrbid with Anx Dis, Mood Dis, PTSD, substance abuse (male), eating disorders (female)

Question 13

• High comorbidity of BPD with psychiatric disorders

- conducted in Taiwan = cross cultural support (????)

Answer 13

(Shen et al., 2017)

Question 14

Lieb et al., 2004 stated…

Answer 14

emotion regulation is the core of BPD symptomology.

Question 15

• a meta analysis
• found a dysfunction in the DLPFC and limbic regions which are hallmark features of BPD
• consistent with evidence that BPD is an emotion dysregulation disorder

Answer 15

Schulze and colleagues (2016)