Borderline Personality Disorder Features Research Articles

Relationship between borderline personality features, emotion regulation, and non-suicidal self-injury in depressed adolescents: a cross-sectional study

ObjectiveNon-suicidal self-injury (NSSI) is common among adolescents and has been linked to mental disorders and suicide in addition to physical injuries. According to the empirical avoidance model, adolescents with NSSI have stronger emotional affect and poorer emotional regulation than those without NSSI, and these constitute core features of borderline personality disorder (BPD). The relationship between borderline personality features, emotional regulation, and NSSI in the population is unclear. This study explored these associations to provide a theoretical basis for the treatment of NSSI in the future.MethodsDepressed adolescents (n = 1192) were evaluated using Chinese versions of the Function Assessment of Self-mutilation Scale, Emotional Regulation Questionnaire for Children and Adolescents, and Borderline Personality Features Scale for Children.ResultsThe majority of depressed adolescents (71.3%, 850/1192) had demonstrated NSSI in the past year, with cutting or scratching being the most common form (57.4%). Pearson correlation analysis with NSSI as a fixed factor (NSSI = 1, no NSSI = 2) revealed a negative correlation between NSSI and borderline personality features (r = -0.314, P < 0.01) but a positive correlation between NSSI and emotional regulation capacity (r = 0.159, P < 0.01), which was positively correlated with the expression suppression dimension (r = 0.079, p < 0.01); however, there was no significant correlation between the cognitive reappraisal dimension and expression suppression (r = 0.022, p > 0.05). The occurrence of NSSI was also positively correlated with borderline personality features in general (r = 0.314, p < 0.01). These results were statistically significant. Emotional regulation played a mediating role between borderline personality traits and NSSI in adolescents with depression (effect value = 0.151).ConclusionBorderline personality features and emotional regulation ability were significantly correlated with NSSI in depressed adolescents. Borderline personality symptoms not only directly influenced NSSI risk in adolescents with depression, but also indirectly influenced NSSI risk through emotional regulation.

A systematic review and meta-analysis of digital interventions targeted at individuals with borderline personality disorder (BPD), emotionally unstable personality disorder (EUPD), and related symptoms.

The present review investigates the impact of digital interventions for individuals with features of borderline personality disorder(BPD)/emotional unstable personality disorder(EUPD) as digital interventions show promise as therapeutic tools in underserved groups. BPD/EUPD features are identified as clinically relevant, yet previous reviews on the use of digital interventions fail to include subthreshold symptomatology. Five online databases were searched for terminology in three categories: BPD/EUPD and related symptoms, mental-health interventions, and digital technology. Additionally, four relevant journals and two trial registers were searched for additional papers meeting the inclusion criteria. Twelve articles met all inclusion criteria. Meta-analyses revealed statistically significant differences in symptom measures between intervention and control groups at postintervention and decreases in BPD/EUPD symptomatology and well-being from pre- to postintervention. Service users' engagement, satisfaction, and acceptability of interventions were high. Results support the previous literature on the value of using digital interventions in populations with BPD/EUPD. Overall, it was identified that digital interventions show promise for successful implementation with this population.

Trajectories of adaptive and disturbed identity dimensions in adolescence: developmental associations with self-esteem, resilience, symptoms of depression, and borderline personality disorder features.

To advance our understanding of adolescents' identity formation and how it may play into their psychological functioning, this study investigated developmental trajectory classes of adaptive and disturbed dimensions of identity formation, and whether adolescents belonging to different trajectory classes develop differently on self-esteem, resilience, symptoms of depression, and borderline personality disorder (BPD) features. Three-wave longitudinal data from 2,123 Flemish adolescents was used (54.2% girls; Mage = 14.64, range = 12-18 at T1). Results pointed to four trajectory classes of identity formation: adaptive identity, identity progression, identity regression, and diffused identity. The adaptive identity class presented with stable high levels of self-esteem and resilience, and stable low levels of symptoms of depression and BPD, whereas opposite results were obtained for the diffused identity class. The identity progression class reported an increase in self-esteem and resilience as well as a decrease in symptoms of depression and BPD, whereas opposite results were obtained for the identity regression class. These results emphasize that adaptive and disturbed dimensions of identity formation are closely related to markers of well-being and psychopathology among adolescents, and could help identify adolescents with an increased risk for negative psychological functioning or increased opportunity for positive psychological functioning.

Alteration of surface morphology and core features in adolescents with borderline personality disorder

BackgroundAccurate early diagnosis of adolescent borderline personality disorder (BPD) is critical for prompt treatment. The aim of this study was to assess the alteration of brain surface morphology and to evaluate its relationship with core features in adolescent BPD. MethodsA total of 52 adolescents with BPD aged 12–17 years and 39 age- and sex-matched healthy controls (HCs) were prospectively enrolled into the study. Brain magnetic resonance imaging (MRI) was obtained with both 3D-T1 weighted structural sequence and resting-state functional data. The structural data was analyzed for surface morphology parameters including the local gyrification index (LGI), mean curvature and surface area. The functional MRI data was analyzed for seed-based functional connectivity (FC). Correlative analysis of surface morphology and core features of adolescent BPD was performed. ResultsAdolescents with BPD showed the following altered surface morphology in the limbic-cortical circuit when compared to the HCs: (1) reduced LGI in the left fusiform and right superior temporal gyrus; (2) reduced mean curvature in the left precentral gyrus and right rostral anterior cingulate cortex, and increased mean curvature in the bilateral pericalcarine; and (3) reduced surface area in the left paracentral gyrus, left pars triangularis, right insula and right lateral orbitofrontal gyrus (P < 0.05, FWE correction). In addition, these brain regions with altered surface morphology were significantly correlated with several core features including the mood instability, self-identity problems, and non-suicidal self-injury behavior in adolescents with BPD (P < 0.05). Furthermore, there was enhanced functional connectivity among these altered brain regions within the limbic-cortical circuit (voxel P < 0.001, cluster P < 0.05, FWE corrected). ConclusionsAdolescents with BPD had significant alterations of brain surface morphology in the limbic-cortical circuit, which was correlated with core BPD features. These results implicated the surface morphology parameters and FC alterations may potentially serve as neuroimaging biomarkers for adolescents with BPD.

Level of identity diffusion in patients with borderline, narcissistic, avoidant and other specified personality disorder

Traditional conceptions of personality disorder (PD) view severe identity disturbance as a defining characteristic of borderline personality disorder (BPD). In the alternative DSM-5 model for PDs (AMPD) and in the outlined substantial changes to PD diagnostics in ICD-11, disturbances in self and identity are elevated from a specific diagnostic criterion for BPD to a defining criterion for PD in general. In line with Kernberg’s theory of personality organization (PO), it is expected that although identity disturbance may be characteristic of most or all PDs, severe identity diffusion is a more pronounced and defining characteristic of BPD and possibly other PDs organized on a borderline level (BPO). Here, we examined the level of identity disturbance in SCID-diagnosed patients with BPD, narcissistic PD (NPD), avoidant PD (AVPD), comorbid BPD with NPD and AVDP, as well as other specified PD (PD-OT). We found that measures of identity diffusion were higher in BPD and NPD patients compared with patients diagnosed with AVPD. Hierarchical multiple regression analyses showed that number of SCID criteria met for BPD and NPD predicted level of identity diffusion when gender, age and general symptomatology were controlled for, whereas number of SCID criteria met for AVPD did not. The presented data support severe identity diffusion as a prominent characteristic of BPD with possible implications for how we should differentiate BPD from other PDs. The findings are discussed in relation to Kernberg’s model and the AMPD.

The Role of the Hippocampus in Borderline Personality Disorder: Structural and Functional Abnormalities

This review article discusses the structural and functional abnormalities observed in the hippocampus of individuals with borderline personality disorder (BPD). The hippocampus plays a critical role in regulating emotions and memories, which has been implicated in the pathophysiology of BPD. The review summarizes the findings from various studies that have used neuroimaging techniques to investigate the hippocampus in BPD. The results suggest that individuals with BPD exhibit reduced hippocampal volume, altered hippocampal activation patterns, and disrupted connectivity with other brain regions. These abnormalities have been linked to several clinical features of BPD, including emotional dysregulation, impulsivity, and unstable self-image. The review also discusses potential mechanisms underlying these abnormalities, such as childhood trauma and chronic stress. Overall, this review highlights the importance of the hippocampus in the etiology of BPD and emphasizes the need for further research to understand its role in this complex disorder fully.

The impact of a combined mentalisation-based therapy and therapeutic community programme for adolescents with borderline personality disorder traits on service utilisation in Western Australia.

This study assessed the effect of a mentalisation-based therapy (MBT) treatment programme on the utilisation of Western Australian public hospitals for mental health presentations over an 18-month period. Hospital data included the number of visits to the emergency department (ED), the number of inpatient admissions to hospital and length of stay of the admissions. Participants included 76 adolescents aged 13-17 years old, who presented with borderline personality disorder (BPD) traits. The Touchstone treatment programme is a time-limited intensive programme that utilises MBT in the context of a therapeutic community. Hospital data for the participants were collected and analysed from three time points; 6 months prior to attending the programme, during the 6-month programme (active treatment) and 6 months after the programme. Results found a statistically significant decrease in hospital utilisation from pre to post programme, with a decline in ED visits, inpatient admissions and admission length of stay. This study presents promising preliminary evidence for the effectiveness of an intensive MBT programme as an intervention for adolescents with BPD features and has significant implications for the public health system in terms of providing effective community-based treatment for this difficult to treat population as well as reducing pressure on tertiary care.

Adverse childhood experiences mediate the negative association between borderline personality disorder symptoms and plasma oxytocin

BackgroundInterpersonal dysfunction is a core symptom of borderline personality disorder (BPD) and may be closely linked to adverse childhood experiences. According to a recent model on the pathology of BPD, the neuropeptide oxytocin might play an important role in the development and maintenance of the disorder. However, so far, only few studies with small adult samples have reported reduced baseline oxytocin levels in BPD that may be linked to adverse childhood experiences.MethodsWe examined baseline plasma oxytocin levels in 131 female patients with BPD and 124 non-BPD female controls across a large age span (12–50 years). Additionally, 113 female patients with less than five DSM-IV BPD features were included to examine the association between plasma oxytocin levels and the number of fulfilled BPD criteria. We also explored associations between plasma oxytocin and adverse childhood experiences as well as depressive symptoms in BPD.ResultsPatients with BPD had reduced plasma oxytocin levels compared to non-BPD controls and this was independent of age. Plasma oxytocin was negatively associated with the number of fulfilled BPD criteria. The exploratory regression model revealed no association between plasma oxytocin and depressive symptoms but an association between plasma oxytocin and adverse childhood experiences, which in fact mediated the relationship between BPD criteria und plasma oxytocin.ConclusionIn a large sample of individuals with BPD across a large age span, our results replicate and extend previous reports of reduced plasma oxytocin levels that might be related to adverse childhood experiences thus providing further evidence for a prominent role of oxytocin in BPD.

The role of youths' cardiac autonomic balance and parental responses to youth emotion in vulnerability to borderline personality disorder development.

Developmental models of borderline personality disorder (BPD) emphasize the effects of youths' biological vulnerabilities and their experiences of parental responses to emotion, as well as the interaction between these two elements. The current study evaluated the independent and interactive effects of two indices of autonomic nervous system response and parental responses to youth negative emotions on severity and exacerbation of youths' BPD features during the transition to adolescence. The sample consisted of 162 psychiatric youth (10-14 years; 47.2% female) and their parents. At baseline, youth and their parents completed a lab-based conflict discussion during which parasympathetic and sympathetic nervous system response were measured and indices of sympathetic-parasympathetic balance and coactivation/coinhibition were calculated. Youth also reported on supportive and non-supportive parental responses. At baseline and after 9 months, youth self-reported on their BPD features. Results demonstrated that shifting toward sympathetic dominance independently predicted exacerbation of BPD across 9 months. Additionally, fewer experiences of supportive parental responses and more non-supportive parental responses were associated with greater severity of BPD features in youth. This study highlights the role of autonomic response to parent-child conflict as well as the significance of parental responses to youth emotion for the development of BPD during this developmental window.

Relationship Dysfunction in Couples When One Partner Is Diagnosed with Borderline Personality Disorder: Findings from a Pilot Study.

Relationship dysfunction-marked by frequent conflicts-is one of the hallmark features of borderline personality disorder (BPD). However, the BPD couple as a dyad and partner-related features have rarely been taken into account. The aim of the present study was to investigate hormonal, personality, and relationship relevant factors, such as relationship satisfaction, attachment, and trauma in both partners within a dyad where one partner is diagnosed with BPD. The total sample consisted of 26 heterosexual couples. All studies were conducted at 2 p.m. Primary outcomes: Neo-Five-Factor-Inventory, Childhood Trauma Questionnaire, Experiences in Close Relationships Scale. Secondary outcomes: Problem List, Partnership Questionnaire, Questionnaire for Assessing Dyadic Coping. Upon questionnaire completion, one saliva sample was taken via passive drool to assess baseline cortisol and testosterone levels. Results showed that females with BPD have higher scores on childhood maltreatment, dysfunctional attachment styles, and neuroticism than mentally healthy females. Furthermore, they have more relationship-related problems and are less satisfied in their romantic relationship. Male partners of women with BPD showed lower testosterone levels, higher levels of childhood maltreatment, dysfunctional attachment styles, neuroticism, and openness compared with the healthy control partners. Furthermore, childhood trauma, neuroticism as well as dysfunctional attachment styles displayed a significant positive correlation with relationship-related problems. Traumatic childhood experiences, insecure attachment styles as well as neurotic personality characteristics contribute to increased relationship disruptions in couples. Relevant hormonal and psychosocial parameters in BPD partners should be taken into account when treating females with BPD.

Inflammatory and oxidative endophenotypes in borderline personality disorder: A biomarker cluster analysis

Objectives This study is designed to search for aggrupation of inflammatory/oxidative biomarker alterations in borderline personality disorder (BPD) and their association with phenotypic features. Methodology Inflammatory/nitrosative proteins were measures in plasma and peripheral blood mononuclear cells obtained from BPD patients. Patients were assessed on different clinical dimensions of BPD. Oxidative damage was tested by measuring TBARS, nitrites, catalase, GPx and SOD. Protein expression of IκBα, NFκB, iNOS, COX-2, PPARγ, Keap1, NQO1, Nrf2 and α7nAChR was also determined. Western blot and ELISA were used for measurements and a cluster analysis of inflammatory/oxidative biomarkers alterations was performed to investigate subgroups of patients with similar alterations and its relationship with clinical features of BPD. Results 69 patients were included in the study. Two inflammatory/nitrosative clusters of patients were found: Cluster 1 patients showed significantly higher levels of GPx, IκBα, keap1, NQO1, PPARγ, α7nAChR and Nrf2 than cluster 2 patients. These patients had significantly longer duration of illness, milder anxiety symptoms and lower prescription of antipsychotic drugs than cluster 2. Conclusions Two clusters of BPD patients according to the inflammatory/nitrosative profiles were identified. Cluster 1 had increased antioxidant and anti-inflammatory biomarkers and was characterised by greater chronicity of illness but less acute symptomatic severity.

Emotion regulation strategies in borderline personality disorder: a meta-analysis

ABSTRACT Objectives Many theoretical models pinpoint emotional dysregulation not only as a symptom of borderline personality disorder (BPD) but also as a component in the development and maintenance of the disorder. In this meta-analysis, results from studies that examined the association between emotion regulation strategies and BPD symptoms were systematically analysed. Design A quantitative meta-analysis approach was used to systematically assess previous research studies and conduct subgroup and meta-regression analysis to test for theoretical, methodological and demographic moderating variables. Results Emotion regulation strategies are significantly and largely associated with BPD symptoms. Negative associations were found between BPD symptoms and acceptance (r = −.558), mindfulness (r = −.581) and reappraisal (r = −.303) and positive associations were found between BPD symptoms and avoidance (r = .528), distraction (r = .336), rumination (r = .551) and suppression (r = .449). As heterogeneity was high, moderating variables (clinical status, type of reporting, comorbidity control, type of population, mean age, percentage of females) were also investigated. Conclusion The findings highlight the need for active involvement of emotion regulation in explaining BPD psychopathology, as well as promoting interventions focused on individual emotion regulation strategies. KEY POINTS What is already known about this topic: (1) The biosocial model of BPD and dialectical behaviour therapy focuses on emotion dysregulation as a core characteristic of BPD. (2) Emotional dysregulation is a core feature of BPD and is strongly involved in the appearance and maintenance of BPD pathology. (3) Emotional regulation difficulties in BPD are also well reflected in the diagnostic criteria according to DSM-5 (APA, 2013). What this topic adds: (1) In the present review, acceptance and mindfulness are considered different emotion regulation strategies. (2) Problem solving is not seen as an emotion regulation strategy because it refers to meta-cognitive processes of dealing with emotions and does not target direct attempts to regulate emotions. (3) Psychological treatments that target the reduction of BPD associated symptoms should continue to focus on emotional dysregulation as a core component of BPD psychopathology.

Interpersonal emotion regulation in the context of social networks: A focus on borderline personality disorder.

Interpersonal emotion regulation (IER) involves modulating one's emotions through social contact. Considering the extensive emotional and interpersonal difficulties associated with borderline personality disorder (BPD), it is particularly relevant to the study of IER. We examined the frequency and efficacy of IER in relation to BPD features, as well as perceived characteristics of the social network partners utilized for IER, among 149 participants. We found that BPD features were unrelated to the frequency of using IER but negatively related to the perceived efficacy of IER and perceived willingness of partners to assist in IER. Furthermore, BPD features attenuated the relation between partner closeness and both the likelihood of being an IER partner (vs. a non-IER partner) and the frequency of going to that partner for IER (partner-IER-frequency). Additionally, there was an inverse relation between relationship quality and frequency of seeking IER from a partner at higher levels of BPD features, whereas there was no association between quality and frequency of IER at lower levels of BPD features. Finally, BPD features attenuated the relation between partner centrality and the likelihood of being an IER partner. Finding that those with elevated BPD features go to less central and close others for IER, even though there is no association between IER frequency and BPD features, bolsters our understanding of the intersection of interpersonal and emotional functioning and may provide future avenues for intervention. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Borderline personality disorder; a psycho-analytic perspective

Introduction: Borderline personality disorder is one of the most common personality disorders and it is associated with functional impairments. This article clarifies the use of psychodynamic formulations in understanding an 18-year-old lady diagnosed with Borderline personality disorder.&#x0D; Case report: An 18-year-old female experiencing a mass of symptoms including depression, feeling lonely, self-blaming, confusion, inability to work, impulsivity, mood swings, relationship problems, and difficulty in thinking clearly. Rapid Mental State Examination revealed an obese body build, with long dark hair and a wide black framed medical glass. She looked anxious and tired. Her cognitive functions were. She showed evidence of the crucial features of borderline personality disorder. The therapist offered biweekly sessions with the client to listen to her story which took three sessions (each one of 45 minutes) to figure out her worries and life difficulties, during these sessions therapist tried to prove to her that she was listened to and she was welcomed to speak as loud and as clear as she wanted. This made her feel confident to speak and made her make a promise to commit to the therapeutic processes in the 4th session. So far, the plan was to have overall 14 therapeutic sessions.&#x0D; Conclusion: Dealing with the delicate cases of borderline personality disorder is one of the most challenging and therapist-exhausting situations using the psychodynamic interview is an effective way in helping cases of borderline personality disorder.

A Psychosis Superspectrum in Borderline Personality Disorder?

Introduction The innermost relationship of the borderline concept and psychosis has been historically intertwined and can be traced back to the 20th century, but remarkably, to date, they have not been the focus of many empirical studies. Likewise, the contributions of empirical research on the DSM-5 dimensional approach to this topic are also uncommon. Objectives In this study the framework of psychosis superspectrum were put closely in relation to both DSM-5 psychoticism/detachment domains, personality traits and psychopathological symptoms features in borderline personality disorder (PD). Methods A cross-sectional study of a borderline PD sample of 58 participants (Mage=39.76 years, SD=11.37; Mschooling=9 years), mainly male (58.5%). Self-reported assessment: PID-5; BSI; NEO-FFI. A multiple linear regression was computed. Results In borderline PD, the PID-5 disinhibition (β=.51), BSI psychoticism (β=.43), BSI depression (β=-.24) and NEO neuroticism (β=.29) predicted psychosis superspectrum, explaining 94% of the variance. Also, stands out as a complement that, the BSI psychoticism was predicted by PID-5 detachment and PID-5 psychoticism, explaining 82% of the variance. Conclusions Evidence appears to be emerging for the underlying psychosis superspectrum trough borderline PD. There is a closer dialogue between the state-of-art view of a dimensional pathological personality-symptoms and the borderline pathology. Disclosure of Interest None Declared

Object constancy in adolescents with borderline personality disorder pathology.

Persistent, interpersonal difficulties are a core feature of borderline personality disorder (BPD). Theories propose that these may result from an insufficient object constancy, for example, the insufficient capacity to maintain feelings of closeness (FC) toward a person when he or she is absent. Based on this assumption, this study examined whether FC toward the mother or the best friend were more dependent on previous contact in adolescents with BPD pathology compared with healthy controls. In addition, the influence of different contact modes was explored. N = 52 female adolescents aged 14 to 18 years (n = 24 with ≥ 5 BPD symptoms [full-threshold BPD], n = 10 with 1-4 BPD symptoms [subthreshold BPD], n = 18 healthy controls) completed up to 12 e-diaries a day on 2 consecutive weekends. Using multilevel mixed-effect regression analyses, we found that the more BPD symptoms a patient fulfilled, the more dependent were FC toward the best friend on actual contact. In contrast, BPD pathology did not influence the dependency of the FC toward the mother on actual contact. Finally, the mode of contact seems to matter: The more BPD symptoms a patient met, the more was the FC toward the best friend dependent on personal compared with written or no contact, whereas phone or written contact was no different from no contact. The present findings partially support the theory of an insufficient object constancy in BPD that seems to become apparent in adolescence mainly in relationships with peers. Replication of the findings, particularly with regard to the impact of mode of contact, in larger samples is required. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Protective Community Norms and Mental Health Risks for Severe Physical Abuse: Lessons From a Nationally Representative Study of Ghana.

Although it has become axiomatic to quote an African proverb in discussions of child well-being, attempts to draw concrete and positive lessons from how African communities respond to and mitigate child maltreatment are comparatively few. This study tested the hypothesis that the collective value of Abiriwatia in Ghana, which supports legitimate norms of community obligations to care for children, could be protective against physical abuse. It also examined the claim that knowledge of the familial situation of community members, generated through Abiriwatia, may help them to act to mitigate the risk of caregiver's borderline personality disorder (BPD) features. We obtained a nationally representative sample of 1,100 female caregivers from 22 Ghanaian settlements and tested the hypotheses using multilevel models. Controlling for community-level physical abuse, living in a community with high levels of Abiriwatia childcare and community authority values is associated with lower levels of very severe physical abuse, and Abiriwatia childcare may mitigate risk from the caregiver's BPD features. Within Ghana, encouraging positive and protective aspects of traditional Ghanaian values and working to reinstate respect for these values may have positive outcomes for children. Interventions to reduce child maltreatment should be developed with reference to Abiriwatia childcare values.

Experiences of dialectical behaviour therapy for adolescents: A qualitative analysis.

To explore how former patients in dialectical behaviour therapy for adolescents (DBT-A) experience their treatment, and specifically if there were aspects of the treatment that they retrospectively identify as particularly meaningful, helpful or unhelpful. From a larger sample of 75 former DBT-A patients 19 were selected for a qualitative semi-structured interview study. Young adults (N=19; 18 females, one male), who as adolescents had been enrolled in DBT-A due to self-harming behaviours and features of borderline personality disorder, were interviewed up to 8 years (median 6.0; min 1.3; max 8.2) after end of treatment, at mean age 23 years (SD 2.5). Reflexive thematic analysis was implemented. Six key themes were revealed; (1) The need to be seen, listened to and believed in, (2) the importance of teamwork between patient and therapist, (3) the value of group and structure, (4) therapy as lifesaving and life-changing, (5) the risks of feeling misplaced and (6) the risks of abrupt endings. A trusting relationship with the therapist promoted commitment and motivation for treatment. This relationship was facilitated by the therapist showing explicit care and belief in the patient's own competence in changing their destructive behaviours. Meeting peers in group skill training offered a salient form of validation and was reported to be of particular value. The format of meeting peers and the importance of the dialectical therapeutic stance need to be studied further. Not all youth experienced DBT-A as suitable and the need for sufficient treatment dose was emphasized.

Altered gray matter volume and functional connectivity in adolescent borderline personality disorder with non-suicidal self-injury behavior.

Non-suicidal self-injury (NSSI) behavior is one of the characteristics of borderline personality disorder (BPD) in adolescents. Prior studies have shown that adolescents with BPD may have a unique pattern of brain alterations. The purpose of this study was to investigate the alterations in brain structure and function including gray matter volume and resting-state functional connectivity in adolescents with BPD, and to assess the association between NSSI behavior and brain changes on neuroimaging in adolescents with BPD. 53 adolescents with BPD aged 12-17years and 39 age-gender matched healthy controls (HCs) were enrolled into this study. Brain magnetic resonance imaging (MRI) was acquired with both 3D-T1 weighted structural imaging and resting-state functional imaging. Voxel-based morphometry (VBM) analysis for gray matter volume and seed-based functional connectivity (FC) analysis were performed for assessing gray matter volume and FC. Clinical assessment for NSSI, mood, and depression was also obtained. Correlative analysis of gray matter alterations with self-injury or mood scales were performed. There were reductions of gray matter volume in the limbic-cortical circuit and default mode network in adolescents with BPD as compared to HCs (FWE P < 0.05, cluster size ≥ 1000). The diminished gray matter volumes in the left putamen and left middle occipital gyrus were negatively correlated with NSSI in adolescents with BPD (r = -0.277 and P = 0.045, r = -0.422 and P = 0.002, respectively). Furthermore, there were alterations of FC in these two regions with diminished gray matter volumes (voxel P < 0.001, cluster P < 0.05, FWE corrected). Our results suggest that diminished gray matter volume of the limbic-cortical circuit and default mode network may be an important neural correlate in adolescent BPD. In addition, the reduced gray matter volume and the altered functional connectivity may be associated with NSSI behavior in adolescents with BPD.

Borderline Personality Disorder Patients With Suicidal Tendencies: A Case Study

A personality disorder known as borderline personality disorder (BPD) tend to have negative effects on individuals who have it. Negative emotional symptoms, poor impulse control/impulsivity, unstable interpersonal relationship patterns, and high suicidal tendencies are characteristics of BPD. Based on the findings of the assessment that was conducted, this study aims to describe the psychological dynamics of BPD patients who are at risk of suicide. The participant is a female with BPD who is 23 years old. A case study approach is used in the qualitative research method to more thoroughly document individual conditions. The process of gathering data involved observation, interviews, and administering psychological tests, including the BAUM, DAP, and HTP graphic tests, the DASS (Depression Anxiety Stress Scale) and the recording of daily activities in journals. The study's findings demonstrated that the participants had significant personality traits, such as unstable emotional states, high impulsivity, dependence on others, and suicidal thoughts followed by attempts. Due to the interaction of biological, psychological, social, and spiritual factors, there is a high risk of suicide. This is influenced by the past experiences, specifically the separation of the participants' parents when they were young, lack of support from significant others and environmental stressors. Each of these elements portrays a more complete picture of the person's psychological dynamics.