Personality Disorder Symptomatology Research Articles

The association between minority stressors, intraminority stressors, and borderline personality disorder symptomatology among sexual minority men.

Sexual minority men are more likely to be diagnosed with borderline personality disorder compared to their heterosexual counterparts. Minority stressors have been associated with criteria for borderline personality disorder (e.g., substance use, suicidality, impulsive behaviors, and interpersonal difficulties with rejection). However, to date, there are no known studies examining the association between traditional minority and intraminority stressors and borderline personality disorder symptomatology. The purpose of the study is to examine the association between traditional and intraminority stressors and borderline personality disorder symptomatology among sexual minority men. Data were collected from 312 sexual minority men (Mage = 24.00, SD = 4.04) via Qualtrics panels across the United States. A hierarchical linear regression was conducted with borderline personality disorder symptomatology as the outcome variable. Minority stressors (i.e., internalized homophobia, sexual orientation concealment, major discrimination, and day-to-day discrimination) were entered in Step 1, and intraminority stress was entered in Step 2. In Step 1, both major and day-to-day discrimination were significantly positively associated with borderline personality disorder symptomatology. In Step 2, intraminority stress was significantly positively associated with borderline personality disorder symptomatology, and day-to-day discrimination remained significant. These findings warrant clinicians to evaluate both minority and intraminority stressors, which may be an additional risk factor in the development and/or maintenance of borderline personality disorder symptomatology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Implicit associations with non-suicidal self-injury: Examination in a clinical sample by borderline personality symptomatology.

We examine correlates and predictors for implicit associations with non-suicidal self-injury (NSSI) with the Self-Injury Implicit Association Test (SI-IAT) in a treatment-seeking sample. We also examine group differences in the SI-IAT among those with low/none, moderate and high/clinically significant borderline personality disorder (BPD) symptomatology in a treatment-seeking sample. Participants (N = 111; 58% female; 89% White; Mage = 30.25) completed the SI-IAT and self-report measures at two time points. Higher BPD symptom scores were significantly, positively correlated with implicit identification with NSSI, and predicted NSSI identity when controlling for depression indices, history of NSSI and other covariates. With Time 1 SI-IAT scores entered as a covariate, BPD scores no longer significantly predicted Time 2 SI-IAT scores. Individuals with moderate and high/clinically significant symptom counts of BPD had higher/stronger implicit associations with NSSI identity than those with no/low BPD symptoms. Individuals with symptoms of BPD may implicitly identify with NSSI more than other clinical groups; examination of implicit assessments in BPD in future research is needed to further explore implicit identification with NSSI in this patient group to further understand both cross-sectional and prospective relations.

The quest for a biological phenotype of adolescent non-suicidal self-injury: a machine-learning approach

Non-suicidal self-injury (NSSI) is a transdiagnostic psychiatric symptom with high prevalence and relevance in child and adolescent psychiatry. Therefore, it is of great interest to identify a biological phenotype associated with NSSI. The aim of the present study was to cross-sectionally investigate patterns of biological markers underlying NSSI and associated psychopathology in a sample of female patients and healthy controls. Comprehensive clinical data, saliva and blood samples, heart rate variability and pain sensitivity, were collected in n = 149 patients with NSSI and n = 40 healthy participants. Using machine-based learning, we tested the extent to which oxytocin, dehydroepiandrosterone (DHEA), beta-endorphin, free triiodothyronine (fT3), leukocytes, heart rate variability and pain sensitivity were able to classify participants regarding their clinical outcomes in NSSI, depression and borderline personality disorder symptomatology. We evaluated the predictive performance of several models (linear and logistic regression, elastic net regression, random forests, gradient boosted trees) using repeated cross-validation. With NSSI as an outcome variable, both logistic regression and machine learning models showed moderate predictive performance (Area under the Receiver Operating Characteristic Curve between 0.67 and 0.69). Predictors with the highest predictive power were low oxytocin (OR = 0.55; p = 0.002), low pain sensitivity (OR = 1.15; p = 0.021), and high leukocytes (OR = 1.67; p = 0.015). For the psychopathological outcome variables, i.e., depression and borderline personality disorder symptomatology, models including the biological variables performed not better than the null model. A combination of hormonal and inflammatory markers, as well as pain sensitivity, were able to discriminate between participants with and without NSSI disorder. Based on this dataset, however, complex machine learning models were not able to detect non-linear patterns of associations between the biological markers. These findings need replication and future research will reveal the extent to which the respective biomarkers are useful for longitudinal prediction of clinical outcomes or treatment response.

Head Injury and Antisocial Personality Features in a Sample of Juvenile Detainees

Previous research has reported high prevalence rates of head injury amongst juvenile justice involved youth and relations between head injury and different forms of offending. However, little is currently known about the extent to which head injury is associated with antisocial personality features – characteristics that are strongly correlated with adult antisocial personality disorder symptomatology. The current study aimed to address this void in the existing body of research by analyzing a longitudinal sample of juvenile detainees ( N = 881) to examine the relationship between head injury during childhood or early adolescence and a wide range of antisocial personality features in late adolescence. Results from a series of logistic regression models reveal that head injury is associated with impulsivity and aggression more than other features of antisocial personality. The implications of these results for juvenile justice intervention programming and avenues for future research are discussed.

The Pathology of Borderline Personality Disorder Symptomatology in a Nonclinical Sample: The Role of Mental Pain, Cognitive Emotion Regulation, Self-compassion, and Depression

Objectives: Patients with borderline personality disorder (BPD) often develop a certain depression that may be accompanied by “mental pain.” A negative self-concept, aversive chronic emotions, and pervasive helplessness characterize mental pain. This research aims to explore the pathology of BPD symptomatology in a nonclinical sample. Also, the role of mental pain, cognitive emotion regulation, self-compassion, and depression are assessed. Methods: Following a correlational study, 300 university students were selected via the multi-stage random cluster sampling method. The study data were collected by the personality assessment inventory-borderline features scale, Orbach and Mikulincer mental pain questionnaire, cognitive emotion regulation questionnaire, self-compassion scale (SCS-SF), and Beck depression inventory version 2. Results: Multiple regression analyses indicated that components of putting into perspective, rumination, loss of control, refocus on planning, catastrophizing, irreversibility, somatic, and isolation (ΔR2=0.507, P<0.001) significantly predicted BPD symptomatology. Discussion: The results support the biosocial model dimensions in an Iranian context. In addition, it shows a strong association between mental pain, cognitive emotion regulation, self-compassion, depression, and BPD symptoms.

Impairment in personality functioning throughout adolescence and co-development with personality traits, emotion regulation strategies, and psychopathology

The Alternative Model for Personality Disorders (AMPD) introduced in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), provides a dimensional operationalization of personality disorders and brings into account developmental tasks typical to adolescence, which makes it more suitable to apply to personality disorder symptomatology in adolescence. This study investigated the developmental course of impairment in personality functioning (IPF) in adolescence as well as trajectory classes and co-development with Big-Five personality traits, emotion regulation strategies, and psychopathological behaviors/symptoms. Data from a three-wave longitudinal study in 1480 high school students were used. Results revealed no significant linear change of IPF in the total sample. Four developmental trajectory classes emerged and classes significantly differed regarding psycho(patho)logical variables.

The effectiveness of psychological interventions for borderline personality disorder for those who misuse substances: a systematic review and narrative synthesis

Purpose This study aims to identify and critically appraise literature exploring the effectiveness of psychological interventions in improving borderline personality disorder (BPD) symptomatology for individuals who misuse substances. Design/methodology/approach Systematic searches across six databases (PsycINFO, Embase, Scopus, Medline, CINAHL and ProQuest), hand searching and citation chaining were conducted between June and August 2021. Key search terms included BPD, substance use, therapy and effect. Study and sample characteristics, interventions, outcome measures and key findings were extracted. Quality assessment and a narrative synthesis approach were used to explore strengths, limitations and relationships between and within studies. Findings Seven eligible reports were included and showed mostly adequate quality. Mixed samples, designs, outcomes, definitions and implementation varied. Treatment completion did not differ significantly between those who did and did not misuse substances. Interventions demonstrated effectiveness in relation to psychiatric symptoms, hospital admissions, self-efficacy and impulsive and self-mutilating (cutting, burning, etc.) behaviours. No effects were found for suicidal or parasuicidal (threats, preparation and attempts) behaviours. Research limitations/implications This review only considers individuals with diagnoses of BPD who are not accessing substance misuse treatment. Radically open dialectical behaviour therapy (DBT), therapeutic communities and other interventions are available as interventions for substance misuse (Beaulieu et al., 2021). Based on the findings of this review, it should not be assumed that such interventions affect substance misuse rather than BPD symptomatology. Therefore, future research might explore the effectiveness of these interventions on BPD symptomatology despite this not being the primary target for intervention. Practical implications Despite McCrone et al. (2008) noting the cost of this population’s difficulties to both themselves and services, the limited number of studies in this area is astonishing. Despite a lack of quality in the data available, there i some evidence to support the use of DBT and general psychiatric management (GPM) interventions for those with BPD and concurrent substance misuse. It is therefore of principal importance that health and social care services action Public Health England’s (2017) recommendations. Individuals with coexisting BPD and substance misuse would then receive support from any professional they see, who could then refer for psychological therapies. Originality/value Although the reports appear to show that DBT, integrated therapies and GPM may be effective for this population, conclusions cannot be drawn with high levels of confidence due to heterogeneity among studies. The findings indicate that future, high-quality research is needed to test the effects of interventions on BPD symptomatology for those who misuse substances. Randomised controlled trials with sufficient statistical power, homogeneous outcomes and standardised methodological approaches are needed.

Executive Function Deficits and Borderline Personality Disorder Symptomatology in a Nonclinical Adult Sample: A Latent Variable Analysis.

While borderline personality disorder (BPD) symptomatology has been studied extensively in clinical populations, the mechanisms underlying its manifestation in nonclinical populations remain largely understudied. One aspect of BPD symptomatology in nonclinical populations that has not been well studied is cognitive mechanisms, especially in relation to executive functions. To explore the cognitive mechanisms underlying BPD symptomatology in nonclinical populations, we analysed a large-scale dataset of 233 young adults that were administered with nine executive function tasks and BPD symptomatology assessments. Our structural equation modelling did not find any significant relations between latent factors of executive functions and the severity of BPD symptomatology. Contrary to our hypothesis, our result suggests that deficits in executive functions were not a risk factor for BPD symptomatology in the nonclinical young adult sample.

Experimental Manipulation of the BFI-2, IPIP-NEO-120, and the IPC-5.

Research assessing the relationship of the five-factor model (FFM) to personality disorder symptomatology has generally been confirmatory, with three exceptions. The exceptions have been failures to confirm associations of conscientiousness with the obsessive-compulsive personality disorder, agreeableness with dependent, and openness with schizotypal. Haigler and Widiger demonstrated empirically years ago that this was occurring because the predominant FFM measure at that time, the NEO Personality Inventory-Revised, does not include a sufficient representation of maladaptive variants of the respective FFM personality trait domains. Research since their study has continued to fail to confirm the FFM hypotheses, using other measures of the FFM. The current study extended the work of Haigler and Widiger by considering three additional FFM measures, the Big Five Inventory-2 (BFI-2), the International Item Pool-NEO-120 (IPIP-NEO-120), and the Inventory of Personal Characteristics-5 (IPC-5). Data were obtained from a community sample of adults with experience of mental health treatment. The results confirmed an improvement in the FFM-personality disorder relationships when the experimentally manipulated versions of the BFI-2, IPIP-NEO-120, and IPC-5 were used. The implications of the findings for existing and future FFM-personality disorder research are discussed.

Attentional Tendencies That Impact Emotion Regulation Success Within a Borderline Personality Disorder Framework

Emotion regulation difficulties are key to borderline personality disorder (BPD) symptomatology. Literature indicates that attentional distraction, particularly within an interpersonal context, is common in BPD. Conversely, reappraisal tactics are less prevalent. The goal of the current study was to examine whether this discrepancy is observed when individuals reporting varying levels of BPD tendencies are given the choice of a preferred emotion regulation tactic when confronted with BPD-relevant stressors. Attentional engagement patterns, affective responses, and strategy success were also examined. Participants (N = 103) reported BPD tendencies as assessed by the Personality Assessment Inventory and were instructed to choose either to "distract" or to "reappraise" in response to affective images. Results revealed more instances of failing to implement distraction among individuals with higher BPD tendencies, which was also reflected in greater fixation biases to distressing content within those images. Results are discussed in terms of the malleability of emotion regulation in BPD contexts.

Improvement in borderline personality disorder symptomatology after repetitive transcranial magnetic stimulation of the dorsomedial prefrontal cortex: preliminary results.

Objective:Current treatment for borderline personality disorder (BPD) involves psychological and pharmacological interventions. However, neuromodulation techniques such as repetitive transcranial magnetic stimulation (rTMS) may positively affect BPD symptomatology. The objective of this study was to evaluate the clinical and neuropsychological effects of rTMS on the dorsomedial prefrontal cortex (DMPFC) in BPD patients.Methods:Fourteen patients with BPD were randomized into two groups (active vs. sham) for 15 sessions of rTMS on the DMPFC. Clinical effects were measured using the Borderline Symptoms List (BSL), Clinical Global Impression Scale for BPD (CGI-BPD), Borderline Evaluation of Severity over Time (BEST), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), and Barratt’s Impulsiveness Scale (BIS). Neuropsychological effects were determined by a Stop-Signal Task (SST), the Wisconsin Card-Sorting Test (WCST), and the Iowa Gambling Test (IGT).Results:Within-group comparison showed significant differences (p < 0.05) in CGI-BPD (total score and six of nine psychopathologic domains), BEST, HDRS, HARS, and IGT scores for active modality.Conclusion:The 5 Hz-DMPFC rTMS technique was well tolerated and lessened the severity of BPD symptomatology, especially abandonment, affective issues, interpersonal relationships, suicidal behavior, anger, and paranoid ideation. Cognitive improvement was seen in decision-making. Additional studies are needed to fully evaluate the effects of rTMS on BPD symptomatology.Clinical Trial Registration:NCT03832777.

Mentalization for Offending Adult Males (MOAM): study protocol for a randomized controlled trial to evaluate mentalization-based treatment for antisocial personality disorder in male offenders on community probation

BackgroundAntisocial personality disorder (ASPD), although associated with very significant health and social burden, is an under-researched mental disorder for which clinically effective and cost-effective treatment methods are urgently needed. No intervention has been established for prevention or as the treatment of choice for this disorder. Mentalization-based treatment (MBT) is a psychotherapeutic treatment that has shown some promising preliminary results for reducing personality disorder symptomatology by specifically targeting the ability to recognize and understand the mental states of oneself and others, an ability that is compromised in people with ASPD. This paper describes the protocol of a multi-site RCT designed to test the effectiveness and cost-effectiveness of MBT for reducing aggression and alleviating the wider symptoms of ASPD in male offenders subject to probation supervision who fulfil diagnostic criteria for ASPD.MethodsThree hundred and two participants recruited from a pool of offenders subject to statutory supervision by the National Probation Service at 13 sites across the UK will be randomized on a 1:1 basis to 12 months of probation plus MBT or standard probation as usual, with follow-up to 24 months post-randomization. The primary outcome is frequency of aggressive antisocial behaviour as assessed by the Overt Aggression Scale – Modified. Secondary outcomes include violence, offending rates, alcohol use, drug use, mental health status, quality of life, and total service use costs. Data will be gathered from police and criminal justice databases, NHS record linkage, and interviews and self-report measures administered to participants. Primary analysis will be on an intent-to-treat basis; per-protocol analysis will be undertaken as secondary analysis. The primary outcome will be analysed using hierarchical mixed-effects linear regression. Secondary outcomes will be analysed using mixed-effects linear regression, mixed-effects logistic regression, and mixed-effects Poisson models for secondary outcomes depending on whether the outcome is continuous, binary, or count data. A cost-effectiveness and cost-utility analysis will be undertaken.DiscussionThis definitive, national, multi-site trial is of sufficient size to evaluate MBT to inform policymakers, service commissioners, clinicians, and service users about its potential to treat offenders with ASPD and the likely impact on the population at risk.Trial registrationISRCTN 32309003. Registered on 8 April 2016.

Identity Impairment as a Central Dimension in Personality Pathology

Section III of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes an alternative model for diagnosing personality disorders (PDs). This model highlights identity impairment as a potential criterion of all PDs, which has stimulated researchers to characterize identity functioning across PD presentations. Accordingly, the present study examined associations between dimensions of identity functioning and PD symptomatology among 242 Flemish community adults (49.2% female; Mage = 42.76, SD = 14.42). Participants completed the Self-Concept and Identity Measure (Kaufman, Cundiff, & Crowell, 2015) to assess identity functioning and the Assessment of DSM-IV Personality Disorders (Schotte, De Doncker, Vankerckhoven, Vertommen, & Cosyns, 1998) to assess dimensionally measured PDs. A correlational analysis yielded negative associations between the consolidated identity subscale and all PDs, whereas scores on both disturbed identity and lack of identity scales were positively associated with PDs. A multivariate regression analysis indicated that the consolidated identity scale did not account for unique variance in PD dimensions. Disturbed identity and lack of identity scale scores positively predicted variance in all PDs, with the lack of identity scale being the stronger predictor of symptoms of paranoid, schizotypal, and borderline PDs. Study findings generally support identity impairment as a central dimension in PD symptomatology in a Flemish community sample.

Personality disorder symptomatology in Belgian emerging adults: Associations with identity processes and statuses

ABSTRACT Individual differences in identity development are commonly captured by identity statuses, representing combinations of high and/or low scores on identity exploration and commitment processes. Although identity impairment is considered a potential diagnostic criterion of all personality disorders (PDs) in Section III of DSM-5, studies that relate identity processes or statuses to PDs are limited. The current study examined associations between identity processes and statuses, and dimensionally measured PDs among 343 Belgian emerging adults (71.4% female; M age = 22.73, SD = 2.85, age range = 18–30). Stepwise cluster analysis on the identity processes revealed six identity statuses: achievement, foreclosure, searching moratorium, troubled diffusion, carefree diffusion, and an undifferentiated status. Generally, commitment making and identification with commitment were negatively associated with PDs, whereas ruminative exploration was positively related to PDs. Individuals in troubled and carefree diffusion statuses reported the highest mean scores on PD symptomatology, whereas individuals in achievement and foreclosure statuses reported the lowest mean PD scores. The present findings suggest that individuals who appear unable to settle on identifying-defining commitments are prone to the highest levels of PD symptomatology.

Schema modes as a common mechanism of change in personality pathology and functioning: Results from a randomized controlled trial

ObjectiveWe aimed to empirically test whether schema modes are central to the change process in schema therapy, clarification-oriented psychotherapy, and treatment as usual, i.e., predictive of personality pathology, and global and social-occupational functioning. MethodA multicenter randomized controlled trial was conducted (N = 139 men, N = 181 women) over the course of three years. Repeated assessments of schema modes, personality disorder (PD) severity and functioning (controlled for concurrent PD-pathology) were analyzed using a multilevel autoregressive model. Variables were person-centered to ensure that within-person changes were analyzed. Through a process of backward elimination, the schema modes predictive of the dependent variable (i.e., PD-severity and functioning) at a later point in time were identified while controlling for concurrent dependent variable levels. Bidirectionality was tested by assessing whether dependent variables predicted later schema modes. ResultsThe Healthy Adult, Vulnerable Child, Impulsive Child, and Avoidant Protector predicted later personality pathology, with no bidirectionality observed for the first two. The Healthy Adult and Self-Aggrandizer predicted functioning at a later point in time, with no bidirectionality for Self-Aggrandizer. There was no moderation by treatment type for PD symptomatology, except for Self-Aggrandizer, which predicted functioning only in schema therapy. ConclusionsThe Healthy Adult and Vulnerable Child are central to the change process and appear to reflect common mechanisms of change. The Self-Aggrandizer might reflect a change mechanism specific for schema therapy. Our findings support the recent emphasis on these modes in schema therapy.

Mapping transitional care pathways among young people discharged from adolescent forensic medium secure units in England.

This study tracked young offenders transitioning from national adolescent forensic medium secure units to adult services in the UK within a six-month period. We used a mapping exercise to identify eligible participants moving during the study period from all national adolescent forensic medium secure units in England. Young people older than 17.5 years or those who had turned 18 years (transition boundary) and had been referred to adult and community services were included. Of the 34 patients identified, 53% moved to forensic adult inpatient services. Psychosis was the most prevalent symptom among males (29%), and emerging personality disorder symptomatology was commonly reported among females (18%) followed by learning disability (24%). The mean time for transition to adult mental-health services and community settings was eight months. There were no shared transition or discharge policies, and only two hospitals had discharge guidelines. The findings highlight the need for consistency between policy and practice among services along with the development of individualised care pathways. Future qualitative research is needed to understand and reflect on young people’s and carers’ experiences to improve transition service delivery.

Personalized models of personality disorders: using a temporal network method to understand symptomatology and daily functioning in a clinical sample

An ongoing challenge in understanding and treating personality disorders (PDs) is a significant heterogeneity in disorder expression, stemming from variability in underlying dynamic processes. These processes are commonly discussed in clinical settings, but are rarely empirically studied due to their personalized, temporal nature. The goal of the current study was to combine intensive longitudinal data collection with person-specific temporal network models to produce individualized symptom-level structures of personality pathology. These structures were then linked to traditional PD diagnoses and stress (to index daily functioning). Using about 100 daily assessments of internalizing and externalizing domains underlying PDs (i.e. negative affect, detachment, impulsivity, hostility), a temporal network mapping approach (i.e. group iterative multiple model estimation) was used to create person-specific networks of the temporal relations among domains for 91 individuals (62.6% female) with a PD. Network characteristics were then associated with traditional PD symptomatology (controlling for mean domain levels) and with daily variation in clinically-relevant phenomena (i.e. stress). Features of the person-specific networks predicted paranoid, borderline, narcissistic, and obsessive-PD symptom counts above average levels of the domains, in ways that align with clinical conceptualizations. They also predicted between-person variation in stress across days. Relations among behavioral domains thought to underlie heterogeneity in PDs were indeed associated with traditional diagnostic constructs and with daily functioning (i.e. stress) in person-specific networks. Findings highlight the importance of leveraging data and models that capture person-specific, dynamic processes, and suggest that person-specific networks may have implications for precision medicine.

2.62 PSYCHOTHERAPEUTIC INTERVENTIONS FOR ADOLESCENTS WITH SUBCLINICAL AND BORDERLINE PERSONALITY DISORDER: A SYSTEMATIC REVIEW AND META-ANALYSIS

There is growing recognition that borderline personality disorder emerges in adolescence and reaches increasing stability in early adulthood. Although the efficacy of psychotherapy in adults with borderline personality disorder is well-established, it is unclear whether psychotherapy is effective for adolescents with borderline personality disorder symptomatology. Here, the authors conduct a systematic review and meta-analysis of RCTs to assess the efficacy of psychotherapies in adolescents with borderline personality disorder symptomatology.

Psychotherapies for Adolescents with Subclinical and Borderline Personality Disorder: A Systematic Review and Meta-Analysis

Evidence regarding the efficacy of psychotherapy in adolescents with borderline personality disorder (BPD) symptomatology has not been previously synthesized. To conduct a systematic review and meta-analysis of the randomized controlled trials (RCTs) in order to assess the efficacy of psychotherapies in adolescents with BPD symptomatology. Seven electronic databases were systematically searched using the search terms BPD, adolescent, and psychotherapy from database inception to July 2019. Titles/abstracts and full-texts were screened by one reviewer; discrepancies were resolved via consensus. We extracted data on BPD symptomatology, including BPD symptoms, suicide attempts, nonsuicidal self-injury, general psychopathology, functional recovery, and treatment retention. Data were pooled using random-effects models. Of 536 papers, seven trials (643 participants) were eligible. Psychotherapy led to significant short-term improvements in BPD symptomatology posttreatment (g = -0.89 [-1.75, -0.02]) but not in follow-up (g = 0.06 [-0.26, 0.39]). There was no significant difference in treatment retention between the experimental and control groups overall (odds ratio [OR] 1.02, 95% confidence interval [CI], 0.92 to 1.12, I 2 = 52%). Psychotherapy reduced the frequency of nonsuicidal self-injury (OR = 0.34, 95% CI, 0.16 to 0.74) but not suicide attempts (OR = 1.03, 95% CI, 0.46 to 2.30). There is a growing variety of psychotherapeutic interventions for adolescents with BPD symptomatology that appears feasible and effective in the short term, but efficacy is not retained in follow-up-particularly for frequency of suicide attempts.

Borderline personality disorder symptoms and exposure to violence as risk factors for opioid use in adulthood

Borderline personality disorder and exposure to violence are both risk factors for opioid use. While past research has identified these relationships, there has yet to be any study which investigates the potential that exposure to violence may help explain the relationship between borderline personality disorder symptoms and opioid use as a mediator. The present study used data from the Pathways to Desistance study to test these proposed relationships. Results indicated that greater levels of borderline personality disorder symptoms were associated with increased opioid use frequency. However, when exposure to violence variables were included in the model, the magnitude of this effect was attenuated by more than 20% and reduced to non-significance. These results indicate the importance of identifying and treating borderline personality disorder symptomatology and to provide increased oversight of the environments which juvenile offenders are exposed to upon reentry. Doing so may help to address the opioid crisis in the United States.