The impact of childhood trauma on Adolescent Depressive Symptoms: the Chain Mediating role of borderline personality traits and self-control.

BACKGROUND: The adolescent depression associated with childhood trauma has been confirmed, but the underlying mechanisms remain unclear. This study aims to explore the chain-mediated role of borderline personality traits and self-control in the relationship between childhood trauma and adolescent depression. METHODS: A cross-sectional study was conducted on 2,664 students from a senior high school through online questionnaires from October to December 2022 in Henan, China. Childhood Trauma Questionnaire-Short Form, Borderline Personality Dimension of Personality Diagnostic Questionnaire-4, Self-Control Scale, and Children's Depression Inventory were used to measure childhood trauma, borderline personality traits, and self-control. RESULTS: The prevalence of depression in adolescents was 21.17%, while the prevalence of borderline personality was 12.00%. childhood trauma (r = 0.50, p < 0.001) and borderline personality traits (r = 0.60, p < 0.001) were positively correlated with adolescent depressive symptoms, while self-control was negatively correlated with depressive symptoms (r = - 0.50, p < 0.001). Borderline personality traits and Self-control both play a mediating role in childhood trauma and depressive symptoms, and the mediating effect values are 0.116 (95%CI = [0.098, 0.137]), and 0.022 (95%CI = [0.012, 0.032]) respectively. The chain mediating effect of borderline personality traits and self-control on the relationship between childhood trauma and depressive symptoms was significant (effect value: 0.034, 95%CI = [0.028, 0.042]). CONCLUSIONS: Childhood trauma can predict depressive symptoms in adolescents due to the formation of borderline personality traits and the reduction of self-control. These findings are important for understanding the formation of personality traits, self-control abilities and coping strategies shaped by traumatic experiences in adolescents.

Borderline personality traits mediate the relationship between negative life events and nonsuicidal self-injury in a clinical sample with youth depression.

BACKGROUND: Borderline personality traits play a significant role in nonsuicidal self-injury (NSSI), particularly in depressed youths. NSSI is also highly correlated with negative life events. This research aimed to explore the connections between negative life events, borderline personality traits, and NSSI. METHODS: The study included 338 depressed youth aged 13 to 25 years. Self-reported measures and clinical interviews were utilized to evaluate the depressive symptoms, borderline personality traits, negative life events, and NSSI behaviours of these participants. Identifying variables linked to NSSI was the aim of our analysis, and we also conducted a mediation analysis to look into the influence of borderline traits on the connection between negative life events and NSSI. RESULTS: Of the 338 depressed youth, approximately 59.47% (201/338) displayed NSSI, which was associated with greater clinical severity. Borderline traits had an independent influence on NSSI and it partially explained the connection between negative life events and NSSI, even when accounting for depression symptoms. Depressed youth who were more vulnerable to NSSI behaviours often experienced negative life events such as interpersonal relationships, academic pressure, being punished, and loss. CONCLUSIONS: Our research suggests that depressed youth who experience more negative life events are more likely to experience NSSI, and negative life events indirectly influence nonsuicidal self-injury through borderline personality traits. Implementing interventions focused on mitigating borderline symptoms could be a promising therapeutic approach for addressing NSSI in young people.

Association Between Suicidal Behaviour and Cannabis and Tranquilizer use, Depression, Aggression and Other Borderline Personality Traits Among Students in Sincelejo, Colombia.

OBJECTIVE: This objective of this study is to examine the association between suicidal behaviour and substance use, depression, aggressiveness and borderline personality traits among adolescents from Sincelejo, a rural city in the north of Colombia. METHODS: This cross sectional study included 352 participants selected by purposive sampling, from a public and a private school located in Sincelejo, Sucre district, in the north of Colombia. Students ages ranged from 12 to 18 years old (mean, 15.09±1.82). The participants completed three screening tools: a socio-demographic questionnaire, a screening instrument to collect information related to the frequency of use of some substances, such as tobacco and cannabis, and a self-report inventory to assess various personality and psychopathology domains. A series of t-tests, ANOVA and linear regression analyses were conducted. RESULTS: Physical aggression (t=7.74; p <0.01), cognitive depression (t=5.03; p <0.01), affective depression (t=8.24; p <0.01), affective instability (t=3.46; p <0.01), few social relationships (t=3.36; p <0.01), self-harm (t=3.45; p<.01), cannabis and tranquilizer use (t=2.83; p <0.05; and t=2.37; p <0.05) had a significant independent relationship with suicidal behaviour. Aggression (t=2.59; p <0.05), components of depression (t=9.03; p <0.01) and borderline personality traits (t=4.12; p <0.01) also predicted suicidal behaviour. CONCLUSIONS: More longitudinal studies are needed in this area to identify the causal relations between the factors studied and the suicidal behaviour of young people in Sincelejo.

Childhood emotional abuse and alcohol use disorders in a national Nepali women sample: The mediating role of borderline personality traits.

While many studies have found an association between childhood emotional abuse and alcohol use disorders (AUD) during adulthood, underlying psychological mechanisms linking the two remain inadequately understood. Drawing on the developmental psychopathology perspective, this study examined the relationship between childhood emotional abuse and AUD during adulthood with a national sample of women in Nepal (N = 1,100, M age = 37.73), focusing on the mediating role of borderline personality traits. Mediation analyses were performed using the Karlson-Holm-Breen (KHB) method and bootstrapping confidence intervals. Results indicated that Nepali women's borderline personality traits significantly mediated the relationship between childhood emotional abuse and AUD. Hence, emotional abuse in childhood increases the risk for AUD during adulthood for Nepali women by increasing the risk of borderline personality traits. Findings underscore the necessity of continued emphasis on developing and implementing early interventions for childhood emotional abuse and therapeutic interventions for borderline personality traits in reducing AUD among vulnerable women in Nepal.

Association Between Suicidal Behaviour and Cannabis and Tranquilizer use, Depression, Aggression and Other Borderline Personality Traits Among Students in Sincelejo, Colombia

Objective: This objective of this study is to examine the association between suicidal behaviour and substance use, depression, aggressiveness and borderline personality traits among adolescents from Sincelejo, a rural city in the north of Colombia. Methods: This cross sectional study included 352 participants selected by purposive sampling, from a public and a private school located in Sincelejo, Sucre district, in the north of Colombia. Students ages ranged from 12 to 18 years old (mean, 15.09 ± 1.82). The participants completed three screening tools: a socio-demographic questionnaire, a screening instrument to collect information related to the frequency of use of some substances, such as tobacco and cannabis, and a self-report inventory to assess various personality and psychopathology domains. A series of t-tests, ANOVA and linear regression analyses were conducted. Results: Physical aggression (t = 7.74; p < 0.01), cognitive depression (t = 5.03; p < 0.01), affective depression (t = 8.24; p <0.01), affective instability (t = 3.46; p <0.01), few social relationships (t = 3.36; p < 0.01), self-harm (t = 3.45; p< .01), cannabis and tranquilizer use (t = 2.83; p < 0.05; and t = 2.37; p <0.05) had a significant independent relationship with suicidal behaviour. Aggression (t = 2.59; p <0.05), components of depression (t = 9.03; p <0.01) and borderline personality traits (t = 4.12; p <0.01) also predicted suicidal behaviour. Conclusions: More longitudinal studies are needed in this area to identify the causal relations between the factors studied and the suicidal behaviour of young people in Sincelejo.

Objetivo: El objetivo de este estudio es examinar la asociación del comportamiento suicida con el consumo de sustancias, síntomas depresivos, agresividad y rasgos de personalidad límite en adolescentes de Sincelejo (Sucre), una ciudad rural del norte de Colombia. Métodos: Este estudio transversal incluyó a 352 participantes seleccionados por muestreo intencional de una escuela pública y privada ubicada en Sincelejo, distrito de Sucre, en el norte de Colombia. Las edades de los estudiantes oscilaron entre los 12 y los 18 anos (media, 15,09 ± 1,82). Los participantes completaron 3 instrumentos de cribado: uno de datos sociodemográficos, uno sobre consumo de algunas sustancias, tales como tabaco y cannabis, y su frecuencia y un instrumento de autoinforme para evaluar varios dominios de la personalidad y algunas psicopatologías. Se realizaron una serie de pruebas de la t, ANOVA y análisis de regresión lineal. Resultados: La agresión física (t = 7,74; p <0,01), el componente cognitivo de la depresión (t = 5,03; p <0,01), el componente afectivo de la depresión (t = 8,24; p <0,01), la inestabilidad afectiva (t = 3,46, p < 0,01), las pocas relaciones sociales (t = 3,36, p < 0,01), las autolesiones (p <0,01; t = 3,45, p <0,01), el cannabis (t = 2,83; p <0,05) y la toma de tranquilizantes (t = 2,37; p <0,05), se asociaron con el comportamiento suicida. La agresión (t = 2,59; p <0,05), los componentes de la depresión (t = 9,03; p <0,01) y los rasgos de personalidad límite (t = 4,12, p <0,01) predijeron el comportamiento suicida. Conclusiones: Se requieren más estudios longitudinales en esta área con el fin de identificar las relaciones causales entre los factores estudiados y el comportamiento suicida de los jóvenes en Sincelejo.

The effectiveness of a day hospital mentalization-based therapy programme for adolescents with borderline personality traits: Findings from Touchstone-Child and Adolescent Mental Health Service.

BACKGROUND: Individuals with borderline personality disorder (BPD) are at a substantial risk of harm to themselves and others, experience high levels of functional impairment and typically are high users of tertiary healthcare to address their mental health concerns. As indicators for BPD typically emerge in adolescence, a day therapy service in Bentley, Western Australia, Touchstone Child and Adolescent Mental Health Service (CAMHS), was developed as an intensive intervention for adolescents with indicators for BPD and its associated symptomology. Touchstone utilizes mentalization-based therapy (MBT) in a therapeutic community setting, where the current study sought to document the anecdotal outcomes using the data provided at Touchstone, to enable a greater understanding of this treatment approach for adolescents with indicators for BPD. METHOD: Forty-six participants attended the Touchstone programme between 2015 and 2020. The programme involved 6 months of MBT (group and individual), occupational therapy, education and creative therapies. Measures of self-injury, mood and emergency department presentations were collected pre- and post-programme. RESULTS: Results indicate that participants show a reduction in non-suicidal acts and thoughts, as well as a reduction in negative moods and feelings from pre-Touchstone to post-Touchstone. There is also a decrease in participant presentation to tertiary emergency departments for mental health concerns. CONCLUSIONS: The current study shows evidence for the efficacy of Touchstone as an MBT therapeutic community intervention to reduce symptoms of emerging BPD and effectively reduce presentations to emergency departments for mental health presentations, alleviating pressure on tertiary hospitals and reducing economic impact of adolescents within this demographic.

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.

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

BACKGROUND: Women 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. METHODS: We 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. RESULTS: In 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. LIMITATIONS: This study is limited by its cross-sectional design and self-report nature of BEST. CONCLUSIONS: In 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.

Social cognition and depression in adolescent girls.

BACKGROUND AND OBJECTIVES: Depression has been associated with alterations in social functioning. Decoding and understanding others' mental states and adaptive reasoning are important for social functioning. This study examined theory of mind (ToM) and socio-moral reasoning (SMR) in adolescent girls with and without depression. Within the depression group, we examined associations between relevant clinical features (depression severity, anxiety symptoms and borderline personality traits) and ToM and SMR. METHODS: A cross-sectional study was conducted, whereby 43 adolescent girls (mean age = 16.19, SD = 1.24) meeting full or subthreshold criteria for depression and 40 adolescent girls (mean age = 15.44, SD = 1.24) with no psychiatric diagnosis were recruited. ToM was assessed using the Movie for the Assessment of Social Cognition; SMR was evaluated via the Socio-Moral Reasoning Aptitude Level task. RESULTS: Analyses of covariance indicated that adolescents with depression did not differ from controls in ToM abilities but showed lower socio-maturity scores on the SMR task. This difference disappeared after controlling for the number of words used to justify responses. Amongst adolescents with depression, multiple linear regression analyses revealed that higher levels of borderline personality traits were associated with lower levels of mentalization (ToM task), and more severe depressive symptoms were associated with lower socio-moral maturity stages (SMR task) LIMITATIONS: Directional associations were not studied, and the sample included only girls. CONCLUSIONS: Findings may help to explain clinical heterogeneity in social cognitive functioning observed in individuals with depression.

Association Between Suicidal Behaviour and Cannabis and Tranquilizer use, Depression, Aggression and Other Borderline Personality Traits Among Students in Sincelejo, Colombia.

OBJECTIVE: This objective of this study is to examine the association between suicidal behaviour and substance use, depression, aggressiveness and borderline personality traits among adolescents from Sincelejo, a rural city in the north of Colombia. METHODS: This cross sectional study included 352 participants selected by purposive sampling, from a public and a private school located in Sincelejo, Sucre district, in the north of Colombia. Students ages ranged from 12 to 18 years old (mean, 15.09±1.82). The participants completed three screening tools: a socio-demographic questionnaire, a screening instrument to collect information related to the frequency of use of some substances, such as tobacco and cannabis, and a self-report inventory to assess various personality and psychopathology domains. A series of t-tests, ANOVA and linear regression analyses were conducted. RESULTS: Physical aggression (t=7.74; p <0.01), cognitive depression (t=5.03; p <0.01), affective depression (t=8.24; p <0.01), affective instability (t=3.46; p <0.01), few social relationships (t=3.36; p <0.01), self-harm (t=3.45; p<.01), cannabis and tranquilizer use (t=2.83; p <0.05; and t=2.37; p <0.05) had a significant independent relationship with suicidal behaviour. Aggression (t=2.59; p <0.05), components of depression (t=9.03; p <0.01) and borderline personality traits (t=4.12; p <0.01) also predicted suicidal behaviour. CONCLUSIONS: More longitudinal studies are needed in this area to identify the causal relations between the factors studied and the suicidal behaviour of young people in Sincelejo.

[The moderating effect of dispositional mindfulness in the relationship between depressive symptoms, borderline personality traits and suicidal ideation among young adults]. / L'effet modérateur de la pleine conscience dispositionnelle dans la relation entre symptomatologie dépressive, troubles de la personnalité limite et idéations suicidaires chez le jeune adulte.

OBJECTIVES: The aim of the study was to evaluate the influence of dispositional mindfulness on suicidal ideation and its moderating effect on the relationships between depressive symptoms and borderline personality traits, and suicidal ideation. METHODS: A sample of 1034 students from France (818 women, mean age=20.1±2; 216 men, mean age=20.6±2.2) completed the Five Facets Mindfulness Questionnaire-Short Form (FFMQ-SF), assessing dispositional mindfulness, the Patient Health Questionnaire-9 (PHQ-9) assessing depression symptoms; the borderline personality disorder scale of the Personality Disorder Questionnaire-4th Edition (PDQ-4), and the three-item scale measuring suicidal ideation proposed by Garrison et al. (1991). RESULTS: At least occasional wish to kill oneself was reported by 11% of men and 10% of women. Thirty-eight percent of men and 47% of women had moderate to severe depressive symptoms (P<.001). The mean borderline personality traits score for women was higher than for men (33.44±10.56 versus 31.48±10.35; P=.02), and the mean dispositional mindfulness score for men was higher than for women (77.99±12.3 versus 73.4±12.1; P<.001). In order to explore the role of mindfulness as a moderator between depressive symptoms/borderline traits and the wish to kill oneself, multiple regression analyses were performed separately by gender according to the method of Hayes (2013). To assess whether the presence of dispositional mindfulness decreased the risk for persons with depressive symptoms/borderline personality traits to have suicidal ideation, the effect of the interaction between these disorders and dispositional mindfulness was tested by introducing in a second regression the cross product of these two variables. To assert moderation we had to observe that the interaction explained an additional part of the variance of suicidal ideation. For men, in the first multiple regression analysis, the FFMQ-SF score and PHQ-9 score both explained 32% of the variance of suicidal ideation (R2=.32, s.e.=1.42). In the second analysis, the prediction level of depressive symptoms and dispositional mindfulness scores had decreased. The interaction between dispositional mindfulness and depressive symptoms was a significant predictor in the second stage (ß=-.26; t=-4.48, P<.001), accounting for an additional 6% of the variance of suicidal ideation (R2=.38, s.e.=1.36). For women, in the first multiple regression analysis, the FFMQ-SF score and PHQ-9 score both explained 25% of the variance of suicidal ideation (R2=.25, s.e.=1.29). In the second analysis, the prediction level of depressive symptoms and dispositional mindfulness scores had slightly decreased. The interaction between dispositional mindfulness and depressive symptoms was a significant predictor in the second stage (ß=-.16; t=-5.34, P<.001), accounting for an additional 3% of the variance of suicidal ideation (R2=.28, s.e.=1.26). For men, in the first multiple regression analysis, the FFMQ-SF score and PDQ-4 subscale score both explained 23% of the variance of suicidal ideation (R2=.23, s.e.=1.51). In the second analysis, the prediction level of borderline personality traits and dispositional mindfulness scores had decreased. The interaction between dispositional mindfulness and borderline personality traits was a significant predictor in the second stage (ß=-.27; t=-4.68, P<.001), accounting for an additional 7% of the variance of suicidal ideation (R2=.30, s.e.=1.44). For women, in the first multiple regression analysis, the FFMQ-SF score and PDQ-4 subscale score both explained 24% of the variance of suicidal ideation (R2=.24, s.e.=1.30). In the second analysis, the prediction level of borderline personality traits and dispositional mindfulness scores remained the same. The interaction between dispositional mindfulness and borderline personality traits was a significant predictor in the second stage (ß=-.19; t=-6.30, P<.001) accounting for an additional 3% of the variance of suicidal ideation (R2=.27, s.e.=1.27). CONCLUSIONS: Dispositional mindfulness appeared to be a moderator between depressive symptoms/borderline personality traits and the wish to kill oneself in both genders. This finding is relevant for prevention and therapy and suggests that mindfulness may be important and useful to reduce suicidal ideation and prevent suicidal attempts in young adults.

Panic-Focused Reflective Functioning and Comorbid Borderline Traits as Predictors of Change in Quality of Object Relations in Panic Disorder Treatments.

OBJECTIVE: To investigate whether (a) baseline levels of panic-specific reflection function (PSRF; i.e. patients' capacity to reflect on their panic symptoms) and improvement in this capacity over treatment; (b) baseline borderline personality disorder (BPD) traits and pre-post treatment improvement in BPD traits predict change in patients' quality of object relations. METHOD: A subsample of 102 patients diagnosed with panic disorder from a larger randomized controlled trial received either Cognitive-Behavioral Therapy or Panic-Focused Psychodynamic Psychotherapy. We investigated whether baseline levels and change in both PSRF and BPD traits (as measured by the SCID-II) predicted pre-post change in quality of object relations (QOR), while controlling for pre-post treatment change in panic symptoms assessed by the Panic Disorder Severity Scale. RESULTS: In both treatments, higher baseline levels of PSRF and lower levels of BPD traits, as well as pre-post decrease in BPD traits, predicted improvement in QOR when controlling for symptomatic change. CONCLUSIONS: The findings suggest that reduction in comorbid BPD traits can facilitate improvement in patients' quality of object relations even in brief symptom-focused psychotherapies. Additionally, patients with higher baseline levels of symptom-focused reflective function and lower BPD traits are more likely to demonstrate interpersonal change over the course of psychotherapy for panic disorder. Finally, our study highlights the importance of examining therapeutic change beyond reduction in symptoms, particularly in domains of interpersonal functioning.

The Sense of Commitment in Individuals With Borderline Personality Traits in a Non-clinical Population.

This is the first study to test the hypothesis that individuals' sense of commitment in joint activities and relationships may be influenced by personality traits characteristic of borderline personality disorder (BPD). This study consisted of 3 online experiments implemented via Amazon Mechanical Turk. Participants were presented with videos (Experiment 1) or vignettes (Experiments 2, 3) describing situations in which everyday commitments were violated. Participants then reported their perceptions, interpretations, and affective and behavioral responses to those situations. Participants' BPD traits (BPDt) were assessed using the short form of the Five-Factor Borderline Inventory on the basis of which they were divided into two groups: High and Low BPDt. The results revealed that participants with High BPD traits were less optimistic about others acting in accordance with an implicit sense of commitment (Experiment 1), although there was no difference between groups when the commitment was explicitly stated (Experiment 3). Participants in the High BPDt group also reported heightened emotional responses (Experiments 1-3) and less adaptive behavioral responses (Experiments 1, 3) to perceived or anticipated violations of commitment. Our findings suggest that high levels of BPD traits may give rise to a difficulty in adapting one's social expectations and behavior in light of interpersonal commitments and in a manner that is calibrated to the social norms in the community. Future research should investigate to what extent a disturbed sense of commitment may contribute to the difficulties in interpersonal functioning experienced by many individuals with a clinical diagnosis of BPD.

Cannabis use and suicidal ideations in high-school students.

BACKGROUND: The association of cannabis use and suicidal ideations in adolescents has been inconsistent. This discrepancy may reflect differences in controlled confounders. In particular, no study has controlled for personality disorder traits linked to both cannabis use and suicidality such as borderline and psychopathic personality traits. METHOD: Participants were 972 high-school students who completed questionnaires assessing cannabis use, suicidal ideations, depressive symptoms, social anxiety symptoms, and borderline and psychopathic personality traits. RESULTS: Cannabis use was not a significant independent predictor of suicidal ideations after adjustment for confounding personality traits in the total sample and in the subsample of cannabis users.

Borderline Personality Disorder and Religion: A perspective from a Muslim country.

BACKGROUND: There are still many unanswered questions about psychological and social factors that may affect the development and treatment of borderline personality disorder (BPD). Religion/spirituality (R/S) is a factor that could influence the lives of people with BPD. OBJECTIVE: The aim of this study was to evaluate the relationship between religiosity, religious attendance and borderline personality traits. METHOD: Four hundred twenty- nine medical students of Tehran University of medical sciences participated in this study, and their information on demographics, responses to the Duke University Religion Index (DUREL), and the Structured Clinical Interview for DSM-IV Axis II Disorders (the self-administered section on BPD) was obtained. RESULTS: The total score of SCID-II questionnaire and the number of positive borderline personality characteristics on the SCID-II were inversely related with the DUREL total score and individual DUREL items. Those with higher levels of borderline personality traits had lower total DUREL score and lower DUREL subscale scores. CONCLUSION: Religiosity and religious attendance are negatively correlated with borderline personality traits, especially with anger, instability of mood, feeling of emptiness and self-harming behaviors. These findings are important for understanding the causes of BPD and in developing treatments for this disorder.

Recurrent suicide attempts in patients with depressive and anxiety disorders: the role of borderline personality traits.

BACKGROUND: The presence of a comorbid borderline personality disorder (BPD) may be associated with an increase of suicidal behaviors in patients with depressive and anxiety disorders. The aim of this study is to examine the role of borderline personality traits on recurrent suicide attempts. METHODS: The Netherlands Study on Depression and Anxiety included 1838 respondents with lifetime depressive and/or anxiety disorders, of whom 309 reported at least one previous suicide attempt. A univariable negative binomial regression analysis was performed to examine the association between comorbid borderline personality traits and suicide attempts. Univariable and multivariable negative binomial regression analyses were performed to identify risk factors for the number of recurrent suicide attempts in four clusters (type and severity of axis-I disorders, BPD traits, determinants of suicide attempts and socio-demographics). RESULTS: In the total sample the suicide attempt rate ratio increased with 33% for every unit increase in BPD traits. A lifetime diagnosis of dysthymia and comorbid BPD traits, especially the symptoms anger and fights, were independently and significantly associated with recurrent suicide attempts in the final model (n=309). LIMITATIONS: The screening of personality disorders was added to the NESDA assessments at the 4-year follow-up for the first time. Therefore we were not able to examine the influence of comorbid BPD traits on suicide attempts over time. CONCLUSIONS: Persons with a lifetime diagnosis of dysthymia combined with borderline personality traits especially difficulties in coping with anger seemed to be at high risk for recurrent suicide attempts. For clinical practice, it is recommended to screen for comorbid borderline personality traits and to strengthen the patient's coping skills with regard to anger.