Article
Psychology, Multidisciplinary
Catherine Winsper
Summary: This article provides an overview of the current literature on the course and outcomes of BPD, discussing age of onset, prognosis, recovery in youth and adult populations, as well as prospective studies on adolescent BPD in community populations. The review also includes studies on older populations to explore how BPD manifests in middle to old age, and concludes by bringing together research strands across the lifespan for future research directions.
CURRENT OPINION IN PSYCHOLOGY
(2021)
Review
Medicine, General & Internal
Tina Wu, Jennifer Hu, Dimitry Davydow, Heather Huang, Margaret Spottswood, Hsiang Huang
Summary: Borderline personality disorder is a common mental health diagnosis observed in the primary care population and is associated with various challenges in diagnosis and treatment. This article aims to describe the impact of BPD in primary care, review current knowledge, and provide evidence-based treatment approaches for these patients.
FRONTIERS IN MEDICINE
(2022)
Article
Psychiatry
L. R. Magni, C. Ferrari, S. Barlati, M. E. Ridolfi, E. Prunetti, G. Vanni, M. Bateni, G. Diaferia, A. Macis, S. Meloni, G. Perna, G. Occhialini, A. Vita, G. Rossi, R. Rossi
Summary: Most BPD patients receive medication rather than psychotherapy, despite international guidelines recommending psychotherapy as the primary treatment. The prescription of medication does not fully depend on the severity of the disorder, and is only partially influenced by comorbidity. This study highlights the need for more rigorous research to better understand BPD treatment management.
PSYCHIATRY RESEARCH
(2021)
Article
Psychiatry
Odette de Wilde Brand, Sharon Clarke, Arnoud Arntz
Summary: Patients benefited from using the BPDSI-IV by gaining insight into their borderline personality disorder symptoms and feeling more understood by therapists. Therapists preferred the BPDSI-IV over other ROM instruments because of its disorder-specific nature, which provides insight into the patient's treatment course. Positive experiences of both patients and therapists suggest that using a disorder-specific ROM instrument like the BPDSI-IV is valuable and promising for evaluating treatment in healthcare institutions.
Article
Psychiatry
Kevork Danayan, Noah Chisamore, Nelson B. Rodrigues, Joshua D. Di Vincenzo, Shakila Meshkat, Zoe Doyle, Rodrigo Mansur, Lee Phan, Farhan Fancy, Edmond Chau, Aniqa Tabassum, Kevin Kratiuk, Anil Arekapudi, Kayla M. Teopiz, Roger S. McIntyre, Joshua D. Rosenblat
Summary: Borderline personality disorder (BPD) is often comorbid with mood disorders, particularly treatment-resistant depression (TRD), and this comorbidity is associated with poor response to antidepressants. This study aimed to evaluate the effectiveness of intravenous ketamine in a TRD population with comorbid BPD. The results showed that patients with TRD and comorbid BPD receiving ketamine experienced significant improvement in symptoms of depression, borderline personality, suicidality, and anxiety, with no significant difference between the BPD-positive and BPD-negative groups.
PSYCHIATRY RESEARCH
(2023)
Article
Psychology, Clinical
Timothy A. Allen, Alexandre Y. Dombrovski, Paul H. Soloff, Michael N. Hallquist
Summary: There is more evidence for stress generation than for stress-induced decompensation in individuals with borderline personality disorder (BPD). Antagonism and disinhibition are the externalizing dimensions driving stress generation in BPD.
PSYCHOLOGICAL MEDICINE
(2022)
Article
Clinical Neurology
J. Lumikukka Socada, John J. Soderholm, Tom Rosenstrom, Jesper Ekelund, Erkki Isometsa
Summary: This study investigated the prevalence, severity, co-occurrence, and overlap of manic symptoms and borderline personality features in unipolar and bipolar major depressive episodes. The results showed that the presence of mixed and borderline features in MDEs is common, with differences in diagnosis-specific features among different subcohorts. The study highlighted the impact of hypomania on perceived BPD features and the correlation between manic symptoms and borderline features.
JOURNAL OF AFFECTIVE DISORDERS
(2021)
Article
Psychology, Multidisciplinary
Veronica Guillen, Sara Bolo, Sara Fonseca-Baeza, Sandra Perez, Joaquin Garcia-Alandete, Cristina Botella, Jose Heliodoro Marco
Summary: This study aimed to explore the clinical symptomatology in parents of people diagnosed with Borderline Personality Disorder (BPD) and compare them with a sample of people without a relative with a personality disorder. The results showed that parents of people with BPD exhibited greater depressive and anxious symptomatology, higher levels of expressed emotion, and worse quality of life. Additionally, a high percentage of these parents (50%) met the diagnostic criteria for different personality disorders.
FRONTIERS IN PSYCHOLOGY
(2023)
Article
Clinical Neurology
Karen Kelley, Maggie Walgren, Hilary L. DeShong
Summary: This study found that anger rumination is the strongest predictor of both antisocial and borderline symptoms, while worry negatively predicts antisocial symptoms. Rumination and worry explain far more variance in borderline symptoms compared to antisocial symptoms.
JOURNAL OF AFFECTIVE DISORDERS
(2021)
Article
Psychology, Multidisciplinary
Benjamin Otto, Lisa Kokkelink, Martin Brune
Summary: The study found that BPD patients had higher scores on the fast Pace-of-Life Syndrome (PoLS), were more aggressive, experienced more chronic stress, and had more severe childhood adversity. Childhood trauma predicted PoLS, which in turn predicted allostatic load (AL).
FRONTIERS IN PSYCHOLOGY
(2021)
Review
Psychology, Clinical
Arnoud Arntz, Kyra Mensink, Wouter R. R. Cox, Rogier E. J. Verhoef, Arnold A. P. van Emmerik, Sophie A. A. Rameckers, Theresa Badenbach, Raoul P. P. P. Grasman
Summary: Dropout is a significant problem in psychotherapy for borderline personality disorder (BPD). This study found that dropout rates were highest in the first quarter of treatment. Schema therapy had the lowest overall dropout rate, while mentalization-based treatment had the lowest dropout rate in the first two quarters. Individual therapy had the lowest dropout rate, while group therapy had the highest rate, with combined formats in-between. Other variables such as age or substance-use exclusion criteria were not associated with dropout.
PSYCHOLOGICAL MEDICINE
(2023)
Article
Clinical Neurology
Joana Henriques-Calado, Bruno Goncalves, Catarina Marques, Marco Paulino, Joao Gama Marques, Jaime Gracio, Rute Pires
Summary: This study aims to identify the best set of predictors to differentiate between borderline personality disorder and bipolar spectrum disorders. The results indicate that the major common discriminants of borderline PD across the bipolar spectrum are unusual beliefs & experiences, paranoid ideation, obsession-compulsion and extraversion. Depressivity and impulsivity traits display the greatest predictive value in the differential diagnosis.
JOURNAL OF AFFECTIVE DISORDERS
(2021)
Review
Clinical Neurology
Alessandro Ceresa, Cecilia Maria Esposito, Massimiliano Buoli
Summary: When BPD coexists with MDD, treatment response is generally poorer, making clinical management challenging. The combination of SSRI and psychotherapy may be an effective treatment option, with further research needed to confirm these findings.
JOURNAL OF AFFECTIVE DISORDERS
(2021)
Article
Psychology, Clinical
Mark Zimmerman, Caroline Balling, Iwona Chelminski, Kristy Dalrymple
Summary: Patients with both bipolar disorder and BPD exhibit more severe psychosocial morbidity compared to those with only one of these disorders.
PSYCHOLOGICAL MEDICINE
(2021)
Article
Psychiatry
Chuanjun Zhuo, Guangdong Chen, Chongguang Lin, Feng Jia, Lei Yang, Qiuyu Zhang, Jiayue Chen, Hongjun Tian, Deguo Jiang
Summary: This study assessed the validity and reliability of the Chinese version of the BPFSC-SF and found it to be a valid and reliable tool for assessing adolescent Chinese patients with BPD.
FRONTIERS IN PSYCHIATRY
(2022)
Article
Geriatrics & Gerontology
Erol Ekiz, Arjan C. Videler, Sebastiaan P. J. van Alphen
Summary: The purpose of this study was to develop an individually tailored, non-pharmacological treatment model, the Cognitive Model for Behavioral Interventions (CoMBI), for patients with Behavioral and Psychological Symptoms of Dementia (BPSD) and comorbid maladaptive personality traits (CMPT), and to explore its feasibility and effectiveness. The CoMBI model was implemented in two geriatric psychiatric inpatient wards in the Netherlands and demonstrated significant decrease in challenging behaviors, showing its potential as a feasible treatment model for patients with BPSD and CMPT. Focusing on personality and associated core needs could have a key role in the non-pharmacological treatment of the elderly with BPSD.
CLINICAL GERONTOLOGIST
(2022)
Article
Neurosciences
Julie Schulkens, Nina Bergs, Theo Ingenhoven, Erlene Rosowsky, Sebastiaan van Alphen, Sjacko Sobczak
Summary: This study used the Delphi method to reach consensus among 18 international experts on the use of SSRIs for older adults with BPD, resulting in agreement on 11 statements. The findings suggest a potential role for SSRIs in addressing affective instability in older adults with BPD, with further investigation needed.
CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE
(2021)
Meeting Abstract
Psychiatry
Jarinne de Jong, Lars De Vroege, Arjan C. Videler, Willem J. Kop
JOURNAL OF PSYCHOSOMATIC RESEARCH
(2021)
Article
Geriatrics & Gerontology
Machteld A. Ouwens, Arjan C. Videler, Sebastiaan P. J. van Alphen
Summary: This paper presents a novel approach for selecting psychological treatment levels for older adults with borderline personality disorder (BPD). It illustrates the specific presentation of BPD symptoms in later life through three clinical cases. By combining the clinical staging model for BPD and psychotherapeutic treatment levels for older adults with personality disorders, a more accurate treatment selection for older adults with BPD can be achieved.
CLINICAL GERONTOLOGIST
(2022)
Article
Geriatrics & Gerontology
Gina Rossi, Arjan C. Videler, Sebastiaan P. J. van Alphen
Summary: Diagnosing personality disorders in older adults requires the use of the ICD-11 and DSM-5 models, and a separate assessment of traits and severity.
AGING & MENTAL HEALTH
(2023)
Letter
Clinical Neurology
Timothy L. van Dijl, Diederik Smit, Arjan C. Videler, Willem J. Kop
JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES
(2022)
Review
Psychiatry
Erol Ekiz, Sebastiaan P. J. van Alphen, Machteld A. Ouwens, Jamie van de Paar, Arjan C. Videler
Summary: Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment program for patients with borderline personality disorder (BPD), aiming to improve symptoms and quality of life through teaching emotion regulation and behavior management skills. Results indicated that STEPPS is associated with reduced BPD symptoms, improved quality of life, and decreased depressive symptoms, although the effects on impulsivity and suicidal behaviors are mixed. High attrition rates may limit the generalizability of the findings, highlighting the need for further research.
PERSONALITY AND MENTAL HEALTH
(2023)
Article
Psychology, Clinical
Erol Ekiz, Arjan C. Videler, Machteld A. Ouwens, Sebastiaan P. J. van Alphen
Summary: Based on the preliminary findings of this study, STEPPS appears to be a feasible treatment program for older adults with personality disorders and emotion regulation difficulties. However, adaptations to the program may be needed in order to better fit the needs of older adults.
BEHAVIOURAL AND COGNITIVE PSYCHOTHERAPY
(2023)
Article
Psychiatry
Lars de Vroege, Jarinne E. Woudstra-de Jong, Arjan C. Videler, Willem J. Kop
Summary: This study investigates the association between personality factors (neuroticism, extraversion, openness, agreeableness, and conscientiousness) with cognitive functioning in patients with SSRD. Results show that neuroticism, extraversion, and low openness are associated with lower cognitive functioning (particularly planning and visual memory) in patients with SSRD, which remains significant after taking depressive symptoms into account.
JOURNAL OF PSYCHOSOMATIC RESEARCH
(2022)
Article
Psychology, Clinical
Erol Ekiz, Sebastiaan P. J. van Alphen, Annemiek M. E. L. Melssen, Machteld A. Ouwens, Arjan C. Videler
Summary: This study investigated the applicability of STEPPS therapy in older adults with personality disorder and found that adjustments at both content and process levels are needed to enhance its feasibility and efficacy in later life.
CLINICAL PSYCHOLOGIST
(2023)
Article
Psychology, Clinical
David A. Khasho, Sebastiaan P. J. van Alphen, Machteld A. Ouwens, Arnoud Arntz, Sylvia M. J. Heijnen-Kohl, Arjan C. Videler
Summary: This study aimed to investigate the effectiveness of schema therapy (ST) in treating older adults with borderline personality disorder (BPD). A multiple baseline case series design was used, with five BPD patients aged 66 on average. After a baseline phase, patients received weekly ST sessions for a year, followed by six months of follow-up sessions. The results showed that ST significantly reduced the credibility of negative core beliefs and all participants achieved remission from their BPD diagnosis.
CLINICAL PSYCHOLOGY & PSYCHOTHERAPY
(2023)
Article
Psychology, Clinical
A. C. Videler, K. A. van Beest, M. A. Ouwens, G. Rossi, R. J. J. van Royen, S. P. J. van Alphen
Summary: The study investigated the effects of group schema therapy on older adults with personality disorders, finding that the adapted treatment protocol did not show significant improvement in symptomatic distress or early maladaptive schemas. Older patients with personality disorders may benefit from more intensive treatment, possibly including a combination of group therapy and individual sessions.
COGNITIVE BEHAVIOUR THERAPIST
(2021)
Article
Medicine, Research & Experimental
L. van Donzel, M. A. Ouwens, S. P. J. van Alphen, S. Bouwmeester, A. C. Videler
Summary: Schema therapy has been shown to be effective psychotherapy for personality disorders in adults, with recent studies indicating its feasibility and effectiveness in older adults. Adjusting case conceptualisation, modifying experiential techniques, utilizing patient wisdom, and reactivating positive schemas are suggested strategies to enhance the efficacy of ST in older populations.
CONTEMPORARY CLINICAL TRIALS COMMUNICATIONS
(2021)
Article
Psychology, Clinical
Barbera E. van Reijswoud, Inge Debast, Arjan C. Videler, Gina Rossi, Jill Lobbestael, Daniel L. Segal, Sebastiaan P. J. van Alphen
Summary: The study examined the psychometric properties of SIPP-SF in assessing maladaptive personality functioning among older adult outpatients. Results showed that the tool demonstrated good internal reliability in evaluating participants with personality disorders, and had high correlations with other assessment instruments.
JOURNAL OF PERSONALITY ASSESSMENT
(2021)
Article
Psychology, Clinical
Arjan C. Videler, Rita J. J. van Royen, Marjolein J. H. Legra, Machteld A. Ouwens
BEHAVIOURAL AND COGNITIVE PSYCHOTHERAPY
(2020)