Personality Disorder Traits Research Articles

“Am I safe enough for you now?” BPD and the forced erasure of personal identity

AbstractIn this paper, I explore a number of issues related to a life lived with borderline personality disorder (BPD). Primarily, I am interested in discussing how one unwillingly changes their personal identity by forced medicating—demanded by others implicitly and explicitly. My motivation is something deep and invasive in me. I want to know, I have always wanted to know, why others want me to not be Me so badly. I have thought about this question for years, and though others may simply chalk it up to just one of the standard paranoid or narcissistic traits of borderline personality disorder, there is something more to this question that many of us agonize over most of our lives. There is a deeply normative component to this question that extends beyond the mere fear of abandonment; it is tied to a desire by others to erase—literally—who we are for their own comfort. In this sense, then, I invite you to travel along a path of what it can mean to be a BPDer, from a narrative, phenomenological, and cognitive lived, embodied perspective. My purpose is to show that the treatments for us that others desire cannot avoid (and usually do not want to avoid) the unraveling of who we really are. Whether we want to or not, we give up our self to keep other people with us. And for many, this is too much to ask, and can be one, though not the only, reason suicide and self‐harm seem to be necessary recourses. One in 10 people with BPD commit suicide. So this is a serious matter, indeed.

Dialectical Behavior and Social Rhythm Therapy for Comorbid Bipolar Disorder and Borderline Personality Disorder.

Bipolar disorder and borderline personality disorder commonly co-occur. Each disorder is associated with substantial morbidity and mortality, which are worsened by co-occurrence of the disorders. Emotional dysregulation, suicidality, and disrupted circadian rhythm are key aspects of psychopathology associated with both conditions. A novel psychotherapy combining elements of two evidence-based treatments (i.e., dialectical behavior therapy [DBT] for borderline personality disorder and social rhythm therapy [SRT] for bipolar disorder) is described. Unlike either treatment alone, the new therapy, called dialectical behavior and social rhythm therapy (DBSRT), targets all three disease-relevant processes and therefore may represent a promising new approach to treatment for individuals with these two conditions. DBSRT may also have utility for individuals with overlapping characteristics of bipolar disorder and borderline personality disorder or for those whose illness manifestation includes a mix of bipolar and borderline personality disorder traits. Strategies associated with DBSRT are described, and a brief case vignette illustrates its application.

An investigation of the relationship between female rape myths, child sexual abuse myths and personality disorders

ABSTRACT Given high prevalence rates internationally for female rape and CSA and a gap in the literature regarding personality characteristics of those more likely to endorse these myths, this research sought to examine female rape myths versus child sexual abuse (CSA) myth acceptances as a function of the participants’ maladaptive personality traits and sexual trauma history. 469 adults (61.4% female, 36.5% male, M age range 35–44 years old) participated, endorsing significantly higher rates of acceptance of female rape myths than CSA myths. Sexual trauma history was unrelated to either myth. Higher scores on Antisocial, Narcissistic and Sadistic Personality Disorder scales were significantly correlated with higher rates of acceptance of both myths. Multiple regression analyses determined that higher scores on Narcissistic and Sadistic personality scales uniquely predicted both higher CSA and female rape myth acceptance. The results offer implications for more effective communications to combat false beliefs about CSA and sexual assault. PRACTICE IMPACT STATEMENT The results may have implications for interventions targeting false beliefs about CSA and sexual assault. Our research focuses on personality disorder traits, leading to possible implications for individuals with these traits or disorders, as they are diagnoseable and therefore can be treatable. Interventions targeting these myths generally may not be as effective for someone with these personality disorders, so this research suggests perhaps modified protocols can be created to help destigmatise CSA and rape survivors in these populations.

Love is a losing game: Capacity for love mediates the relationship between the vulnerable dark triad and love styles

Although loving relationships form part of everyday life, the contribution of personality to the dynamics of these relationships remains relatively unexamined. Research has yet to demonstrate how individuals high in vulnerable Dark Triad (DT) traits behave in such relationships. Across three studies, we compare capacity for love and love styles in vulnerable DT individuals and those high in primary psychopathy and grandiose narcissism. In study 1 (N = 128), reduced capacity for love explained relationships between primary psychopathy, and love styles of agape (selfless), eros (passionate), pragma (logical) and storge (friendship), although no effects were found for secondary psychopathy or vulnerable narcissism. In study 2 (N = 274), contrasting findings emerged in that reduced capacity for love partially mediated relationships between borderline personality disorder traits, agape and eros, only, yet indrirect effects were not observed for primary psychopathy, secondary psychopathy and associated love styles. In study 3 (N = 197), reduced capacity for love partially explained the relationship between vulnerable narcissism and agape, eros, ludus and storge, but not those between grandiose narcissism and related love styles. Findings demonstrate how vulnerable DT traits differ across psychological and behavioural domains compared to primary psychopathy and grandiose narcissism.

Personality disorder traits, maladaptive schemas, modes and coping styles in participants with complex dissociative disorders, borderline personality disorder and avoidant personality disorder.

The schema mode model offers a new conceptualisation of complex dissociative disorders (CDD) as it explains shifts between identities as shifts between schema modes. Furthermore, in this model CDD is conceived as personality pathology, incorporating core features of personality disorders. This study tested the assumptions of this schema mode model of CDD. Questionnaires measuring personality disorder traits, schemas, schema modes and coping styles were filled out by patients with CDD, borderline personality disorder and avoidant personality disorder (N = 210), and their scores on the various constructs were compared. Participants with CDD were characterised by specific schizoid, schizotypal, borderline and avoidant personality traits and early maladaptive schemas in the domains of disconnection and rejection and over-vigilance and inhibition. The most pronounced schema modes were the dysfunctional parent modes, avoidant coping modes and the vulnerable child mode. For coping styles, no differences were found between the diagnostic groups. On all outcome measures participants with CDD scored at the level of personality disorders and showed a unique pattern different from participants with borderline and avoidant personality disorder. This suggests that CDD shows features akin to a personality disorder. A clinical implication is that an adapted form of schema therapy might present a viable treatment option for CDD.

Mother–child interactions in adolescents with borderline personality disorder traits and the impact of early life maltreatment

BackgroundEarly detection and intervention of borderline personality disorder (BPD) in adolescence has become a public health priority. Theoretical models emphasize the role of social interactions and transgenerational mechanisms in the development of the disorder suggesting a closer look at caregiver-child relationships.MethodsThe current study investigated mother-adolescent interactions and their association with adolescent BPD traits by using a case–control design. Thirty-eight adolescent patients with ≥ 3 BPD traits and their mothers (BPD-G) were investigated in contrast to 35 healthy control dyads (HC-G). Maternal, adolescent and dyadic behavior was coded using the Coding Interactive Behavior Manual (CIB) during two interactions: a fun day planning and a stress paradigm. Additional effects of maternal and/or adolescent early life maltreatment (ELM) on behavior were also explored.ResultsBPD-G displayed a significantly lower quality of maternal, adolescent and dyadic behavior than the HC-G during both interactions. Maternal and adolescent behavior was predicted by BPD traits alone, whilst dyadic behavior was also influenced by general adolescent psychopathology. Exploratory analyses of CIB subscales showed that whilst HC-G increased their reciprocal behavior during stress compared to the fun day planning, BPD-G dyads decreased it. Maternal ELM did not differ between groups or have any effect on behavior. Adolescent ELM was correlated with behavioral outcome variables, but did not explain behavioral outcomes above and beyond the effect of clinical status.Discussion/ConclusionOur data suggest a stronger focus on parent–child interactions in BPD-specific therapies to enhance long-term treatment outcomes in adolescent BPD patients. Further research employing study designs that allow the analyses of bidirectional transactions (e.g. longitudinal design, behavioral microcoding) is needed.

Autistic traits and borderline personality disorder traits are positively correlated in UK and US adult men and women

Co-occurrence of autism and borderline personality disorder (BPD) has been reported and may be more prevalent in women than men. However, the association between these conditions remains poorly understood, as does that between traits found throughout the general population. We present two studies which measured self-reported autistic traits (Autism Spectrum Quotient [AQ]) and BPD traits (McLean Screening Instrument for Borderline Personality Disorder [MSI-BPD]) in UK (N = 695) and US (N = 700) adults. As predicted, autistic and BPD traits correlated positively in both samples. However, there were no significant sex differences in the correlation strength. In the UK sample, the association between autistic traits (AQ total score) and BPD traits was no longer significant once current anxiety and depression symptoms (Hospital Anxiety and Depression Scale [HADS]) were controlled for. However, AQ subscales for Details/Patterns and Communication/Mindreading (but not Social Skills) remained significantly associated with MSI-BPD scores in the US sample. Our findings suggest that an overrepresentation of autistic women in patient populations with BPD may not be explained by traits of these conditions co-occurring to a greater degree in women than men. They also suggest that although both conditions are associated with elevated levels of anxiety and depression, BPD traits remain independently associated with specific domains of autistic traits.

Evaluation of a 36-item measure of ICD-11 and DSM-5 personality disorder trait domains and facets in Russian inpatients.

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and International Classification of Diseases 11th revision (ICD-11) have introduced a new dimensional approach to personality disorder (PD) classification that relies on the global level of PD severity and individual expressions of personality dysfunction in terms of specified trait domains (i.e., negative affectivity, detachment, antagonism, disinhibition, anankastia, and psychoticism). This study sought to evaluate the psychometric qualities of the DSM-5 and ICD-11 trait domains and facets in 570 Russian psychiatric inpatients using the Modified 36-Item Personality Inventory for DSM-5 and ICD-11 Brief Form Plus-Modified (PID5BF + M). The expected six-factor structure of the DSM-5 and ICD-11 trait domains was replicated using exploratory factor analysis. The six domain scores showed expected convergence with normal five-factor model scores, and the 18 subfacets showed acceptable scale reliability. Our findings overall support the psychometric properties of the six PID5BF + M domain scores and 18 subfacet scores covering both the ICD-11 and the DSM-5 trait models. Consequently, clinicians and researchers in Russian-speaking mental health services are now able to perform a combined and facet-level assessment of the DSM-5 and ICD-11 trait models in a feasible and psychometrically sound manner. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Personality disorders traits, interpersonal problems and emotion dysregulation as predictors of Facebook addiction

ABSTRACT Background Some empirical data suggest that Facebook Addiction (FA) is underlined by difficulties in emotion regulation. We aimed to investigate the role played by personality disorder traits, interpersonal problems and emotion dysregulation in FA. Methods We administered to a sample of community participants (N = 270; 78.5% females; M age = 41 years, SD = 14.05), the Bergen Facebook Addiction Scale (BFAS), the Personality Inventory Index for DSM-5 (PID-5), the Difficulties in Emotion Regulation Scale (DERS) and the Interpersonal Problem Index-47 (IPI-47). Results Controlling for age and gender, we found that the IPI Aggression subscale, the Negative Affectivity domain of the PID-5 and the DERS Total score positively and significantly predicted BFAS scores. Moreover, results showed that emotion dysregulation partially mediated the relationship between personality disorder traits and FA severity whereas interpersonal problems moderated the direct relationship between pathological personality and FA severity. Conclusions Our results shed light on the complex pattern of relationships between these variables.

Adolescent borderline personality traits and dyadic behavior shape mother-adolescent cortisol synchrony

BackgroundAssociations between parent and child cortisol levels (“cortisol synchrony”) are often reported and positive synchrony may mark dyadic regulation on a physiological level. Although dyadic behavior during interaction and adolescent borderline personality disorder (BPD) traits are linked with individual and dyadic regulatory capacities, little is known about how both factors influence parent-adolescent cortisol synchrony. We hypothesized that cortisol synchrony would differ depending on behavioral synchrony, i.e., smooth reciprocal dyadic interaction patterns, adolescent BPD traits, and their interactions.MethodsMultilevel state-trait modeling was implemented to investigate associations between concurrent mother-adolescent state cortisol and mother-adolescent average cortisol levels in a community sample of 76 mother-adolescent dyads. Three saliva samples were collected across interaction paradigms. Behavioral synchrony was observed, and adolescent BPD traits were evaluated using clinical interviews.ResultsFirst, behavioral synchrony and absence of BPD traits were linked with positive associations between adolescent and maternal state cortisol (positive synchrony), BPD traits with negative associations (negative synchrony). When interaction effects were examined, results were more nuanced. In low-risk dyads (higher behavioral synchrony, no BPD traits) asynchrony was found. When risk (BPD traits) and resource (higher behavioral synchrony) were combined, synchrony was positive. Lastly, in high-risk dyads (lower behavioral synchrony, adolescent BPD traits), negative synchrony was observed. Average adolescent and maternal cortisol levels were consistently positively associated in dyads with higher risk.ConclusionsPositive dyadic interaction patterns are associated with positive state cortisol synchrony in mother-adolescent dyads and could buffer the effect of BPD traits, possibly supporting the process of physiological regulation.

Cluster-b personality disorder traits and impulsivity: Indirect associations with alcohol use severity through positive alcohol expectancies.

Prior theory and research suggest that both Cluster-B personality pathology and trait impulsivity are indirectly associated with alcohol use through positive alcohol expectancies. Yet, no prior study has investigated whether features of each of the Cluster-B personality disorders (PDs) (i.e., antisocial, borderline, histrionic, and narcissistic) and rash impulsiveness are indirectly associated with alcohol use severity through positive alcohol expectancies. In a cross-sectional design, social drinkers (N = 200; 51% female; Mage = 26 years) completed self-report measures of trait (rash) impulsivity, Cluster-B personality disorder (PD) traits, positive alcohol expectancies, and alcohol use severity. Simple and serial mediation analyses were used to test positive alcohol expectancies and the association between trait impulsivity and alcohol expectancies as potential mediators of personality disorder trait relations with alcohol use severity. Simple mediation analyses evidenced that trait impulsivity and traits specific to each of the Cluster-B (PDs) were indirectly associated with alcohol use severity through positive alcohol expectancies. Serial mediation analyses further evidenced that the Cluster-B (PD) traits were indirectly associated with alcohol use severity via positive alcohol expectancies both uniquely from and together with trait impulsivity. Current findings are novel and suggest that positive alcohol expectancies may be important to connecting the rashly impulsive aspects of Cluster-B (PDs) with greater alcohol use severity. However, current findings also suggest that features of the Cluster-B (PDs) probably increase risk for alcohol use disorder due to other reasons (e.g., other aspects of personality or forms of impulsivity). (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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.

Impact of personality dysfunction on interdisciplinary treatment team working alliance in an inpatient psychiatric population.

Cluster B personality disorders (PDs) share specific traits that can result in interpersonal conflict. As therapeutic working alliance has a strong relationship with improved outcomes, there is interest in understanding the relationship between PDs, working alliance, and clinical outcomes. This is especially compelling in inpatient populations, where symptoms are severe, and patients are working with a treatment team. The aims of this study were to (a) assess whether higher team working alliance is associated with lower depressive symptoms, (b) assess whether patients with Cluster B PD traits have worse working alliance with their team than patients without those Cluster B PD traits, and (c) assess whether higher team working alliance is associated with lower depressive symptoms when Cluster B PD traits are present. Team working alliance was measured at baseline and at discharge for 3,406 inpatients at a psychiatric hospital. Improved team working alliance was associated with lower depression scores at discharge. Patients with borderline personality disorder traits had worse team working alliance, whereas patients with narcissistic personality disorder and antisocial personality disorder traits had similar working alliance scores as other patients. Borderline personality disorder and antisocial personality disorder traits moderated the association between team working alliance and depressive symptoms differently. Findings suggest that team working alliance works similarly to therapist working alliance. Of clinical importance is the finding that team working alliance and its relationship with depression symptoms differ based on Cluster B PD traits, and the importance of strong working alliance regardless of interpersonal challenges due to personality pathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Child versus adolescent borderline personality disorder traits: Frequency, psychosocial correlates, and observed mother-child interactions.

Research has established the diagnostic validity of borderline personality disorder (BPD) in adolescence. The roots of BPD often lie in childhood; however, significantly less is known about the presence and correlates of BPD traits in school-age children and whether these are comparable with those observed in adolescents. Trained psychologists administered the Childhood Interview for Borderline Personality Disorder in a cohort of 14-year-old adolescents (n = 76) and a cohort of 9-year-old children (n = 70). We compared the prevalence of BPD traits in both cohorts and investigated common psychosocial correlates (comorbidity, impaired quality of life, emotional/behavioral problems, maternal distress, and observed mother-child interaction). Children and adolescents showed no significant differences regarding the type and frequency of BPD traits. In both cohorts, BPD traits were associated with comorbidity, emotional and behavioral problems, and lower quality of life. In contrast to adolescents, children's BPD traits were not significantly related to maternal distress and showed less relations to interaction patterns. Negative maternal and dyadic behavior were associated with more BPD traits in adolescents during a conflict discussion but not during fun day planning. Our study suggests that BPD traits in children are similarly frequent as in adolescents and accompanied by psychosocial impairment. However, age-related differences were revealed, mostly indicating weaker associations with the mother-child relationship. Mother-child interaction patterns in youth seem to be especially relevant during conflict discussion and provide a target for intervention. Our study provides preliminary support for potential early detection of BPD pathology among children and encourages further study of its life span perspective. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Attachment, Emotion Regulation and Physiological Reactivity in middle-childhood: a pilot study

IntroductionAttachment, as an interpersonal motivational system, is the relational ground that allows emotions to be regulated through action on the Autonomic Nervous System resulting in better psychological outcomes during middle childhood. Emotion dysregulation and autonomic function are often connected to psychiatric symptoms observed in adolescence (e.g. borderline personality disorder traits) and thus middle childhood becomes a critical age for psychopathological trajectories.ObjectivesExamine the relationship between child’s attachment and both psychological and physiological emotional regulation.Methods20 children (Mage = 10.7, SD = 1.25; 65% males) were recruited from general population. Attachment was measured through the Child Attachment Interview (CAI), while emotional regulation was assessed with a multimethod approach, using questionnaires i.e. How I Feel (HIF) and Positive and Negative Affect (PANAS), and physiological measurements i.e. Heart Rate Variability (ratio between High Frequency and Low Frequency, HF/LF, labeled as the child’s sympathovagal balance) and Heart Rate (Beats Per Minute, BPM, as an index of physiological reactivity).ResultsStatistically significant correlations emerged between the HIF-Control scale and the Mother and Father Dismissal CAI scale, the PANAS-Negative Affect scale and the Mother and Father Preoccupied Anger CAI scale. Moreover, there was a non-significant but moderate effect (rs > .30) between HF/LF and the Emotional Openness and the Resolution scales of the CAI, and between BPM and the Emotional Openness scale.ConclusionsDespite the small sample size, more secure children are able to connect with their emotions and properly use them in solving relational problems. Consequently, they are likely to succeed in understanding and regulating emotions as they manage to find more adaptive strategies their own. On the contrary, the presence of dismissal or anger (insecure attachment) towards parents would appear to lead to higher levels of psycho-physiological dysregulation, a core feature of Borderline Personality Disorder dimensions starting to emerge later in adolescence. Future studies should consider physiological dysregulation as an additional factor linked to psychopathological developmental trajectories.Disclosure of InterestNone Declared

Parental attitudes and intensification of borderline personality traits: the mediational role of self-control and identity integration.

The aim of this paper is to analyze the relationship between parental attitudes, selfcontrol, identity integration, and traits of borderline personality disorder (BPD) in a non-clinical sample of adults. Additionally, it will examine the role of self-control and identity integration as direct predictors of BPD, and as potential mediators of the association between parental attitudes and BPD traits. The study involved a group of 162 adults drawn from the general population. The study participants were asked to complete the Questionnaire of Retrospective Assessment of Parental Attitudes (KPR-Roc) by Plopa, one subscale of the Lifestyle Questionnaire 05/SK by Trzebińska, subscale Identity Integration of the Multidimensional Self-Esteem Inventory (MSEI) by O'Brien and Epstein in a Polish adaptation by Fecenec, and the Self-Control Scale (SCS) by Tangney et al. in the adaptation by Kwapis and Bartczuk. The results demonstrated a significant correlation of self-control and identity integration with parental attitudes (except from an excessively protective attitude presented by the mother and father), as well as negative correlations of both identity integration and self-control with BPD traits. Structural modeling analysis revealed that the mother's inconsequent attitude and identity integration have a direct impact on BPD traits, whereas the mother's excessively demanding attitude and self-control influence BPD traits only indirectly. An inconsequent father's attitude influences BPD traits in both direct and indirect ways. Self-control and identity integration are the mediators of the relationship between a mother's excessively demanding attitude and a father's inconsequent attitude with BPD traits. The impact of self - control on BPD traits is mediated by identity integration. Parental attitudes of both the mother and father are associated with selfcontrol, identity integration and BPD traits. Self-control and identity integration mediate the influence of the selected parental attitudes on BPD traits.

Borderline personality disorder traits and rates of NSSI during the COVID-19 pandemic: An initial investigation

Objective: The current study evaluated frequency of nonsuicidal self-injury (NSSI) and associated maladaptive traits between three time periods: pre-pandemic, early pandemic, and later pandemic. Participants: Two college student samples (n = 362; n = 337) were collected via two online studies. Method: Participants completed measures assessing maladaptive borderline personality traits, engagement in NSSI over the past month, and reasons for and types of NSSI engaged in across the lifetime. Results: Results demonstrated a stable and potentially a slight increase in general rates of NSSI over the course of the pandemic. Further, specific maladaptive traits that underly borderline personality disorder (i.e., despondence, fragility, self-disturbance, and anxious-uncertainty) were related to engagement in NSSI 1-month post COVID. Conclusion: The study highlights the need for added interventions that might reach at risk populations during these heightened periods of stress.

The relationship between personality type, and menstrual patterns and neuropsychological performance in young women

Introduction: Personality type describes the configuration of personality traits which represents an individual. We have explored the association between personality type, menstrual pattern and associated symptoms, neuropsychological function, and quality of life of young healthy females. Material and methods: Menstrual patterns and presence of premenstrual syndrome (PMS) and primary dysmenorrhea (PD) were assessed using standard tools. Personality type was determined using the Personality Type A/B Inventory questionnaire. The presence and severity of depression, anxiety, stress, insomnia and sleepiness were evaluated using other validated questionnaires. Results: Of the 179 females in the population sample, 38.6% were Type A personality and 61.4% were Type B personality. There was no significant difference in the mean age of women with menarche menstrual pattern, presence of PMS and PD between subjects with Type A or Type B personality. The women with a Type B personality performed better than women with a Type A personality for most of the cognitive ability tasks. Moreover, women with a Type A personality had a higher score for depression and stress, and a lower score for mental health compared to Type B group (p < 0.05). Logistic regression analyses showed that individuals with a Type A personality were more likely than women with a Type B personality to have cognitive impairment (OR = 3.5, 95% CI: 1.8–6.7), depressive mood (OR = 1.9; 95% CI: 1.05–3.6), stress reaction (OR = 3.6; 95% CI:1.8–7.4), and lower quality of life (OR = 3.7, 95% CI: 1.6–8.7). Conclusions: There was no significant relationship between personality type and menstrual pattern or menstrual-associated complications. Type A personality had a greater degree of personality disorder traits including lower cognitive performance, decreased mental quality of life, as well as higher depression, and stress.

Borderline personality traits are differently associated with postpartum psychosis and postpartum depression episodes in women with bipolar disorder

BackgroundWomen with bipolar disorder have approximately 40 %–50 % chance of having a perinatal bipolar recurrence. Knowing the factors associated will be beneficial for the prediction and prevention of episodes. We aim to establish if borderline personality disorder traits, as measured by the BEST (Borderline Evaluation of Severity over Time) scale, are associated with perinatal psychiatric outcomes. MethodsWe recruited women with bipolar disorder as part of the BDRN (Bipolar Disorder Research Network) study. Women were interviewed and we collected their demographic and clinical information. Participants subsequently completed the BEST questionnaire. We analysed the association of BEST scores with lifetime presence/absence of perinatal bipolar relapse and, employing multinomial logistic regression, with different subtypes of perinatal outcomes: postpartum psychosis; postpartum depression, and other episodes. ResultsIn our sample of 807, although there was no significant association between the BEST total score and perinatal episodes as a whole (adjustedOR 1.01 CI95% [0.99, 1.03], p = 0.204), we found significant differing associations with different subtypes of episodes. Women scoring highly on BEST were less likely to experience a postpartum psychotic episode (RRR 0.96 CI95% [0.94, 0.99], p = 0.005) but more likely to experience a non-psychotic depressive episode (RRR 1.03 CI95% [1.01, 1.05], p = 0.007) than no relapse. LimitationsThis study is limited by its cross-sectional design and self-report nature of BEST. ConclusionsIn women with bipolar disorder, borderline traits differentiate the risk of postpartum depression and postpartum psychosis, emphasise the importance of considering risk factors for these perinatal episodes separately, and may help individualise the risk for women in the perinatal period.

Does gambling differ in people with a minority sexual orientation?

Gambling is common and there is growing concern about its public health implications. Little is known about how gambling differs in people with minority sexual identities. We sought to understand whether lesbian, gay, and bisexual (LGB) individuals differ from non-LGB individuals in terms of gambling and associated characteristics. A total of 534 participants age 18 to 29 who gambled at least 5 times in the preceding year undertook clinical and neurocognitive evaluations. Those who identified as LGB were compared to heterosexuals on clinical and cognitive measures. Overall, 51 participants (9.6%) identified as LGB. These individuals showed significantly higher levels of problem gambling, suicide risk, substance use disorders, traits of obsessive-compulsive personality disorder (OCPD), higher errors on a set-shifting task, and higher rates of family history of addiction. These results indicate that individuals with minority sexual orientations may be at higher risk of experiencing problem gambling and associated factors, such as increased suicidality, OCPD traits, and some degree of cognitive differences. Future studies should establish whether these associations also exist in clinical samples of people with full gambling disorder. Large-scale longitudinal research in neglected minority groups is needed to further explore these associations.