Borderline personality disorder and mood spectrum

Several lines of evidence have raised the question of whether Borderline Personality Disorder (BPD) is an independent disease entity or it might be better conceptualized as belonging to the spectrum of mood disorders. This study explores a wide array of lifetime mood features (mood, cognitions, energy, and rhythmicity and vegetative functions) in patients with BP and mood disorders. The sample consisted of 25 BPD patients who did not meet the criteria for bipolar disorders, 16 bipolar disorders patients who did not meet the criteria for BPD, 19 unipolar patients who did not meet the criteria for BPD, and 30 non-clinical subjects. Clinical diagnoses were determined by administering the structured clinical interviews for DSM-IV disorders. The Mood Spectrum Self-Report (MOODS-SR) was used for measuring lifetime mood phenomenology. Clinical subjects displayed higher mean scores than normal subjects in all domains of the MOODS-SR, and BPD patients displayed higher scores than unipolar patients in the Mood and Cognition depressive subdomains. Differences between patients with BP and bipolar disorders on MOODS psychopathology did not attain statistical significance for any (sub)domain considered. The results of this study are consistent with previous findings suggesting the importance of mood dysregulations in patients with BPD.     

Borderline personality disorder and childhood trauma: Evidence for a causal relationship

The debate over whether childhood trauma is a causative factor in the development of borderline personality disorder continues in the literature despite decades of research. This review examines this body of literature published from 1995 through 2007 to assess the strength of evidence for such a causal relationship. A unique conceptual approach was used, as we considered the literature in the context of Hill’s classic criteria for demonstrating causation. Results of this review suggest that evidence supports the causal relationship, particularly if the relationship is considered as part of a multifactorial etiologic model. Directions for future research and clinical implications are discussed.     

Borderline attributions

Borderline personality disorder is characterized as an identity disturbance or pathology of the self-structure. The author employs concepts from deconstruction philosophy and object relations theory to explore how persons with borderline personality disorder attempt to generate meaning, eliminate ambiguity, and maintain idealizations by assigning polarized attributions of value, agency, and motivation to their experiences. The author proposes that these binary attributions interact to form multiple, discrete self-structures or states of being. Each state is characterized by stereotyped expectations for self and other and patterns of relatedness that are self-perpetuating. The author delineates four common states, labeled as helpless victim, guilty perpetrator, angry victim, and demigod perpetrator, and suggests treatment strategies to deconstruct each state and to facilitate the development of an integrated and differentiated self.     

Borderline Disorders:

No abstract available for this article.     

10 Borderline cases

Summary The concept of pseudoneurotic schizophrenia is discussed, and 10 cases, with histories of borderline development, are presented. The material contained in Hoch and Polatin's paper on pseudoneurotic schizophrenia is abstracted, and the symptomatology of pseudoneurotic schizophrenia is discussed. Basic problems in the approach to schizophrenia are mentioned and the environmental factors stressed. Piotrowski and Lewis' formula alpha is discussed. The necessity of a careful total evaluation of each case is stressed in making the diagnosis of pseudoneurotic schizophrenia. The interpretation is advanced that pseudoneurotic schizophrenia is a fluid transition stage from the psychoneurotic to the schizophrenic type of reaction.     

Intellectual disability and its relationship to autism spectrum disorders

Intellectual disability (ID) and autism spectrum disorders (ASDs) covary at very high rates. Similarly, greater severity of one of these two disorders appears to have effects on the other disorder on a host of factors. A good deal of research has appeared on the topic with respect to nosology, prevalence, adaptive functioning, challenging behaviors, and comorbid psychopathology. The purpose of this paper was to provide a critical review and status report on the research published on these topics. Current status and future directions for better understanding these two covarying disorders was reviewed along with a discussion of relevant strengths and weaknesses of the current body of research.     

Seizures and epilepsy and their relationship to autism spectrum disorders

Autism spectrum disorders (ASD) are serious neurodevelopmental disorders which often co-occur with intellectual disabilities. A disorder which is strongly correlated with both of these disabilities are seizures and epilepsy. The purpose of this review was to provide an overview of available research on seizures and epilepsy in the ASD population and to provide a status report on recent trends in research. Among these topics are prevalence, nosology, etiology, and autistic regression. Strengths and weaknesses of the current, available literature are discussed.     

Borderline personality organization and dissociation

The relationship between Kernberg's psychodynamic model of personality organization (PO) and dissociation has not yet been explored. Seventy-two nonclinical subjects and 222 psychiatric patients completed the Dissociative Experiences Scale and the Inventory of Personality Organization. Its Reality Testing subscale emerged as the most important predictor for all facets of dissociation. Discussing our results in the framework of Fonagy and coworkers' model of mentalization, we suggest that dissociation may reflect the preoedipal "pretend" mode of psychic functioning while impaired reality testing and psychotic experiences might be indicative of the "psychic equivalent" mode.     

Borderline adolescents under hospitalization conditions

The problem of borderline states is recently attracting interest in the entire psychiatric world. The paper deals with the problem of diagnosis and therapy of borderline states during adolescence, in particular under conditions of hospitalization. In the first part the author discusses problems which are associated with the diagnosis of borderline states in general and in adolescence in particular. The specificity of adolescence makes the diagnosis of typical traits of the described syndrome difficult. It is also a question whether it is correct to speak of borderline conditions at this early age. The second part deals with contemporary trends in the treatment of borderline states, again with special emphasis on adolescence. Attention is drawn to the fact that psychotherapy in the treatment of borderline states is irreplaceable; it must be, however, implemented with adherence to special regulations (supportive psychotherapy). Hospitalization is then an important modification of therapeutic possibilities and practices. The paper is concluded by an illustrative case-history of a borderline adolescent who was repeatedly hospitalized. Gradually a more accurate diagnosis was elaborated and optimal therapy was sought which involved various pitfalls.