Components of event-related potentials and borderline personality disorder: a meta-analysis.

Background: Borderline personality disorder (BPD) is characterized by symptoms associated with difficulties in emotion regulation, altered self-image, impulsivity, and instability in personal relationships. A relationship has been found between BPD symptoms and altered neuropsychological processes. Studies of event-related potentials (ERP) measured with electroencephalogram (EEG) have found neural correlates related to BPD symptoms. Of note is the P300 component, considered a potential mental health biomarker for trauma-associated disorders. However, no meta-analysis has been found to demonstrate this relationship.Objectives: To evaluate the relationship between the P300 component and BPD symptoms. To evaluate the relationship of other ERP components with BPD symptoms.Methods: The method and procedure were adjusted to the PRISMA checklist. The search was performed in three databases: WOS, Scopus and PubMed. A Random Effects Model was used to perform the analysis of the studies. In addition, a meta-regression was performed with % women, Gini and GDP. Finally, a descriptive analysis of the main results found between P300, other ERP components (LPP, P100 and ERN/Ne) and BPD symptoms was performed.Results: From a review of 485 articles, a meta-analysis was performed with six articles that met the inclusion criteria. A moderate, positive relationship was found between the P300 component and BPD symptoms (REM = .489; p < .001). It was not possible to perform meta-analyses for other ERP components (LPP, P100 and ERN/Ne) due to the low number of articles found.Conclusion: The idea that P300 could be considered for use as a biomarker to identify altered neural correlates in BPD is reinforced. In addition, a moderating effect of inequality (Gini) was detected.

The P300 component of event-related potentials could be considered for use as a possible biomarker to identify altered neural correlates in Borderline Personality Disorder.There is support for the proposition that an altered P300 would be present in disorders related to exposure to traumatic events.P300 could be used to evaluate the therapeutic processes associated with the clinical symptoms of Borderline Personality Disorder.

Preliminary Investigation of the Psychometric Properties of the Parent Version of the Borderline Personality Features Scale for Children (BPFS-P).

There is growing evidence that features of borderline personality disorder (BPD) emerge in childhood and present long-term risk for the development of BPD. Thus, valid and reliable assessments of BPD features in childhood are needed. This study examined the psychometric properties of the parent version of the Borderline Personality Features Scale for Children (BPFS-P) in a large, representative sample (N = 1,050; 51.5% male; Mage = 8.42, SD = 2.31; Agerange = 5 to 12 years). The factor structure of the BPFS-P was examined, and measurement invariance was tested across child age and sex as well as caregiver informant sex. Additionally, the unique contribution of the identified factors of the BPFS-P to overall impairment and need for treatment beyond co-occurring dimensions of additional psychopathology was examined. A one factor structure was identified, which demonstrated measurement invariance across child sex and age as well as caregiver informant sex. BPD features measured with the BPFS-P contributed unique variance to explaining overall impairment and need for treatment. These findings point to the potential of the BPFS-P to break new ground in identifying youth at risk for BPD.

The association between neurocognitive functioning and clinical features of borderline personality disorder

Objective: To investigate the relationship between neurocognitive profiles and clinical manifestations of borderline personality disorder (BPD). Methods: Forty-five patients diagnosed with BPD and 35 healthy volunteers were included in the study. The BPD group was evaluated with the Borderline Personality Inventory for dissociative, impulsivity and suicidal dimensions. The Verbal Memory Processes Test and the Cambridge Neurophysiological Assessment Battery were administered to both the BPD and healthy control groups. Results: BPD patients differed from controls in sustained attention, facial emotion recognition, and deteriorated verbal memory function. A model consisting of the Dissociative Experiences Scale - Taxon (DES-T), motor impulsivity and Scale for Suicidal Behavior scores explained 52% of the variance in Borderline Personality Inventory scores. It was detected that motor impulsivity, decision-making and recognizing sadness may significantly predict DES-T scores, and response inhibition and facial emotion recognition scores may significantly predict impulsivity. Conclusion: Our findings demonstrate that the disassociation, impulsivity, and suicidality dimensions are sufficient to represent the clinical manifestations of BPD, that they are related to neurocognitive differences, and that they interact with clinical features.

The association between neurocognitive functioning and clinical features of borderline personality disorder.

OBJECTIVE: To investigate the relationship between neurocognitive profiles and clinical manifestations of borderline personality disorder (BPD). METHODS: Forty-five patients diagnosed with BPD and 35 healthy volunteers were included in the study. The BPD group was evaluated with the Borderline Personality Inventory for dissociative, impulsivity and suicidal dimensions. The Verbal Memory Processes Test and the Cambridge Neurophysiological Assessment Battery were administered to both the BPD and healthy control groups. RESULTS: BPD patients differed from controls in sustained attention, facial emotion recognition, and deteriorated verbal memory function. A model consisting of the Dissociative Experiences Scale - Taxon (DES-T), motor impulsivity and Scale for Suicidal Behavior scores explained 52% of the variance in Borderline Personality Inventory scores. It was detected that motor impulsivity, decision-making and recognizing sadness may significantly predict DES-T scores, and response inhibition and facial emotion recognition scores may significantly predict impulsivity. CONCLUSION: Our findings demonstrate that the disassociation, impulsivity, and suicidality dimensions are sufficient to represent the clinical manifestations of BPD, that they are related to neurocognitive differences, and that they interact with clinical features.

Comorbid personality disorders and their impact on severe dissociative experiences in Mexican patients with borderline personality disorder.

Objective: To identify personality disorders comorbid with borderline personality disorder (BPD) that may confer greater risk for the presence of severe dissociative experiences. Method: Three hundred and one outpatients with a primary diagnosis of BPD were evaluated using the Structured Clinical Interview for DSM-IV Axis II personality disorders, the Borderline Evaluation of Severity Over Time (BEST) and the Dissociative Experiences Scale (DES). Results: The most frequent personality disorders comorbid to BPD were paranoid (83.2%, n = 263) and depressive (81.3%, n = 257). The mean BEST and DES total score were 43.3 (SD = 11.4, range 15-69) and 28.6 (SD = 19.8, range 0-98), respectively. We categorized the sample into patients with and without severe dissociative experiences (41% were positive). A logistic regression model revealed that Schizotypal, Obsessive-compulsive and Antisocial personality disorders conferred greater risk for the presence of severe dissociative experiences. Discussion: Our results suggest that a large proportion of patients with BPD present a high rate of severe dissociative experiences and that some clinical factors such as personality comorbidity confer greater risk for severe dissociation, which is related to greater dysfunction and suffering, as well as a worse progression of the BPD.

Irritabilidad como síntoma transdiagnóstico / Irritability as a transdiagnostic Symptom

Resumen. La irritabilidad es un síntoma transdiagnóstico que atraviesa la barrera de las patologías internalizantes y externalizantes. Se define como un umbral bajo para experimentar la ira en respuesta a la frustración y es uno de los síntomas más comunes en niños y adolescentes. Las conductas relacionadas con la ira apropiadas para el desarrollo tienden a reflejar frustración en contextos esperados, mientras que la irritabilidad crónica es inapropiada para la situación. La presentación de la irritabilidad, crónica o episódica, es crucial para comprender su significado psicopatológico, en particular porque las estructuras de la irritabilidad episódica y crónica son separables y permanecen estables a lo largo del tiempo. Existen varios estudios acerca de la irritabilidad en patologías como trastorno afectivo bipolar y trastorno de desregulación disruptiva del estado del ánimo, en ambos casos es importante plantearse como punto de partida la identificación de la episodicidad. La irritabilidad también se encuentra presente en el trastorno de personalidad límite observándose dentro de una inestabilidad afectiva debida a una reactividad notable del estado de ánimo. Estas emociones tienen un correlato anatómico relacionado con deficiencias de los circuitos frontolímbicos. Para el manejo de la irritabilidad en las distintas patologías, la evidencia del tratamiento incluye terapia cognitivo conductual, intervención de los padres, mindfulness, pero existe una necesidad apremiante de investigación sobre el tratamiento farmacológico complementario.

Irritability is a transdiagnostic symptom that crosses the barrier between internalizing and externalizing pathologies. It is defined as a low threshold to experience anger in response to frustration and it is one of the most common symptoms in children and adolescents. Behaviors related to appropriate developmental anger tend to reflect frustration in expected contexts, while chronic irritability is inappropriate to the situation. The presentation of irritability, chronic or episodic, is crucial to understanding its psychopathological meaning, particularly because the structures of episodic and chronic irritability are separable and remain stable over time. There are several studies about irritability in pathologies such as bipolar affective disorder and disruptive mood dysregulation disorder, in both cases it is important to consider the identification of episodicity as a starting point. Irritability is also present in borderline personality disorder, where it is expressed as an affective instability due to a remarkable reactivity of the state of mind. These emotions have been anatomically related to deficiencies of the frontolimbic circuits. For the management of irritability in different patholo-gies, the evidence includes cognitive behavioral therapy, parental intervention, mindfulness, but there still is a pressing need for research on complementary pharmacological treatment.

Dependency, mood instability, and inconsequence traits for discriminating borderline personality disorder.

INTRODUCTION: Borderline personality disorder (BPD) is one of the most widely studied personality disorders (PDs). It recurrently shows traits of emotional lability, anxiety, separation insecurity, depressiveness, impulsiveness, risk exposure, and hostility, mainly affecting the domains of negative affectivity and antagonism. OBJECTIVES: To investigate the most discriminant dimensions of the Dimensional Clinical Personality Inventory (Inventário Dimensional Clínico da Personalidade 2 [IDCP-2]) to distinguish people diagnosed with BPD from people without this diagnosis. METHODS: A total of 305 participants were included in this study: psychiatric outpatients diagnosed with BPD (n = 30), psychiatric outpatients diagnosed with other PDs (n = 75), and a community sample (n = 200). BPD traits were assessed using the dependency, mood instability, and inconsequence dimensions of the IDCP-2. RESULTS: Analysis of variance (ANOVA) comparisons indicated highest mean measures in the BPD group, and mood instability factors were the most discriminant ones when considering all groups. Applying the multiple regression analysis, we found an adjusted r 2 = 0.50, and hopelessness was the most predictive measure (ß = 0.32; t = 6.19; p < 0.001). CONCLUSIONS: We found discriminatory capacity for factors of all dimensions, although at different levels, and more consistent results to discriminate the BPD group from the community sample.

Dependency, mood instability, and inconsequence traits for discriminating borderline personality disorder / Traços de dependência, instabilidade de humor e inconsequência para discriminação do transtorno da personalidade borderline

Abstract Introduction Borderline personality disorder (BPD) is one of the most widely studied personality disorders (PDs). It recurrently shows traits of emotional lability, anxiety, separation insecurity, depressiveness, impulsiveness, risk exposure, and hostility, mainly affecting the domains of negative affectivity and antagonism. Objectives To investigate the most discriminant dimensions of the Dimensional Clinical Personality Inventory (Inventário Dimensional Clínico da Personalidade 2 [IDCP-2]) to distinguish people diagnosed with BPD from people without this diagnosis. Methods A total of 305 participants were included in this study: psychiatric outpatients diagnosed with BPD (n = 30), psychiatric outpatients diagnosed with other PDs (n = 75), and a community sample (n = 200). BPD traits were assessed using the dependency, mood instability, and inconsequence dimensions of the IDCP-2. Results Analysis of variance (ANOVA) comparisons indicated highest mean measures in the BPD group, and mood instability factors were the most discriminant ones when considering all groups. Applying the multiple regression analysis, we found an adjusted r 2 = 0.50, and hopelessness was the most predictive measure (β = 0.32; t = 6.19; p < 0.001). Conclusions We found discriminatory capacity for factors of all dimensions, although at different levels, and more consistent results to discriminate the BPD group from the community sample.

Resumo Introdução O transtorno da personalidade borderline (TPB) tem sido um dos transtornos de personalidade (TPs) mais estudados. O TPB recorrentemente apresenta traços de instabilidade emocional, ansiedade, insegurança de separação, depressividade, impulsividade, exposição ao risco e hostilidade, afetando principalmente os domínios relacionados à afetividade negativa e ao antagonismo. Objetivos Investigar as dimensões mais discriminativas do Inventário Dimensional Clínico da Personalidade 2 (IDCP-2) para distinguir pessoas diagnosticadas com TPB de pessoas sem esse diagnóstico. Métodos Foram incluídos no estudo 305 participantes: pacientes psiquiátricos com TPB (n = 30), pacientes psiquiátricos com outros TPs (n = 75) e amostra da população geral (n = 200). Os traços de TPB foram avaliados utilizando as dimensões dependência, instabilidade de humor e inconsequência do IDCP-2. Resultados As comparações com análise de variância (ANOVA) indicaram que o grupo TPB apresentou as maiores médias, e os fatores da dimensão instabilidade de humor foram os mais discriminativos ao se comparar os três grupos. Usando a análise de regressão múltipla, foi encontrado um r 2 ajustado = 0,50, e o fator desesperança foi o mais preditivo (β = 0,32; t = 6,19; p < 0,001). Conclusões Foi encontrada capacidade discriminativa para fatores de todas as dimensões, embora em diferentes níveis, e resultados mais consistentes quanto à discriminação foram observados para a distinção entre o grupo com TPB e a população geral.

Differential Diagnosis between Anomalous Experiences and Dissociation Disorder Using the Dissociative Disorders Interview Schedule (DDIS).

BACKGROUND: It is important to understand the most diverse cultural aspects related to religiosity. Scientifically, it is important to understand religious manifestations and their relation to health, and to differentiate them from psychopathological manifestations. OBJECTIVE: To evaluate the mental health of a group of mediums and compare it with that of a control group from the same religious context who do not manifest mediumship, using the Dissociative Disorders Interview Schedule (DDIS). METHODS: This was a cross-sectional study, evaluating 47 mediums (Group 1) and comparing them with 22 non-medium volunteers from the same religious context (Group 2) using the DDIS questionnaire. All results were matched with historical data from patients with dissociative identity disorder (DID) who answered the DDIS. RESULTS: Scores obtained from the DDIS were similar in both groups. The number of positive symptoms was comparable in a wide range of analyzed areas, involving but not being restricted to somatization disorder, major depressive episode, borderline personality disorder, extrasensory/paranormal experiences, physical/sexual abuse and five dissociative disorders. There were considerable differences when we compared these results with historical data from patients with DID. CONCLUSION: In agreement with the extant literature, these results showed that mediumship can be considered a non-pathological form of dissociative phenomena.

Borderline personality disorder: an adaptation of the Taiwan short version of the screening inventory into Brazilian Portuguese.

Objective The current study presents the translation and adaptation of the 20-item Taiwan version of the Borderline Personality Inventory (BPI) into Brazilian Portuguese (BPI-P). Methods After translation and back-translation, the Brazilian Portuguese version was administered to three samples: patients with borderline personality disorder, psychiatric patients with comorbid substance use disorder and volunteers with no reported mental disorders. Results Significant differences between groups for borderline scores (analysis of variance [ANOVA], F = 52.923, p = 0.01) were found but there were no significant correlations between scores for borderline personality disorder and alcohol or nicotine dependence. The BPI-P had satisfactory validity for borderline personality disorder, even when anxiety and depression were present, with an area under the receiver operating characteristic curve of 0.931 at a cutoff point of 14. Conclusion This study provides support for the potential utility of the BPI-P as a screening instrument for clinical practice in Portuguese speaking countries, including outpatients with alcohol and nicotine use disorders in early or sustained remission.

Borderline personality disorder: an adaptation of the Taiwan short version of the screening inventory into Brazilian Portuguese / Transtorno de personalidade borderline: uma adaptação para o português brasileiro do inventário de rastreamento de Taiwan em sua forma reduzida

Abstract Objective The current study presents the translation and adaptation of the 20-item Taiwan version of the Borderline Personality Inventory (BPI) into Brazilian Portuguese (BPI-P). Methods After translation and back-translation, the Brazilian Portuguese version was administered to three samples: patients with borderline personality disorder, psychiatric patients with comorbid substance use disorder and volunteers with no reported mental disorders. Results Significant differences between groups for borderline scores (analysis of variance [ANOVA], F = 52.923, p = 0.01) were found but there were no significant correlations between scores for borderline personality disorder and alcohol or nicotine dependence. The BPI-P had satisfactory validity for borderline personality disorder, even when anxiety and depression were present, with an area under the receiver operating characteristic curve of 0.931 at a cutoff point of 14. Conclusion This study provides support for the potential utility of the BPI-P as a screening instrument for clinical practice in Portuguese speaking countries, including outpatients with alcohol and nicotine use disorders in early or sustained remission.

Resumo Objetivo Este estudo apresenta a tradução e adaptação do Inventário de Taiwan para Transtorno de Personalidade Borderline (IPB) de 20 itens, para o português brasileiro (IPB-P). Métodos Após tradução e retrotradução, a versão em português brasileiro foi aplicada em três amostras: pacientes com transtorno de personalidade borderline, pacientes psiquiátricos com comorbidade de transtorno de uso de substâncias e voluntários sem transtornos mentais relatados. Resultados Diferenças significantes entre os grupos em relação aos graus para borderline (análise de variância [ANOVA], F = 52,923, p = 0,01) foram encontradas mas não houve correlações significantes entre as pontuações para transtorno de personalidade borderline e dependência de álcool ou nicotina. O IPB-P teve uma validade satisfatória para transtorno de personalidade borderline mesmo quando ansiedade e depressão estavam presentes, com uma área sob a ROC (receiver operating characteristic curve) de 0,931 no ponto de corte de 14. Conclusão Este estudo dá suporte para a utilidade potencial do IPB-P como um instrumento de rastreamento para a prática clínica em países de língua portuguesa, incluindo pacientes ambulatoriais com transtorno de uso de álcool e nicotina em remissão precoce ou sustentada.

Entre lo pseudoneurótico y lo limítrofe / Among the pseudo-neurotic and the borderline

El término Pseudoneurótico recogería el problema de la interface fenomenológica entre psicosis y neurosis. Acuñan este término para tratar de especificar un cuadro psicopatológico caracterizado por exhibir manifestaciones clínicas pan-neuróticas, pan-sexuales y pan-ansiosas, enmascarando síntomas de una real esquizofrenia. Los fenómenos psicóticos serían sutiles y breves y en ocasiones se sufriría de episodios psicóticos intensos diurnos o nocturnos tales como pesadillas que se continúan con alucinaciones. La esquizofrenia Pseudoneurótica, junto con los conceptos de demencia precoz atenuada, esquizofrenia latente, esquizofrenia ambulatoria, estructura de personalidad pre esquizofrénica y esquizofrenia límite, se reclutaron en la noción de personalidad límite.

The term Pseudoneurotic would pick up the problem of the phenomenological interface between psychosis and neurosis. This term was coined trying to specify a psychopathological disorder characterized by exhibiting pan-neurotic, pan-sexual and pan-anxious clinical manifestations, masking symptoms of a real schizophrenia. Pseudoneurotic schizophrenia, together with the concepts of attenuated early dementia, latent schizophrenia, ambulatory schizophrenia, preschizophrenic personality structure and borderline schizophrenia, were recruited into the notion of borderline personality.

Transtornos da personalidade / Personality disorders

RESUMO Os Transtornos da personalidade são padrões psicológicos de difícil diagnóstico que exigem uma avaliação criteriosa por parte do profissional da saúde mental. A relação médico-paciente também se configura como fator de extrema importância para o manejo destes quadros. Dentro deste contexto, é imprescindível orientar os alunos das áreas de graduação em saúde sobre a existência de tal categoria de transtornos. O presente artigo consiste em uma revisão descritiva, que busca elucidar a definição de transtornos da personalidade; além de discorrer sobre aspectos históricos, nosológicos e epidemiológicos. Nesta publicação ainda serão revisadas as particularidades referentes ao diagnóstico, as comorbidades, ao curso e tratamento destes transtornos. O enfoque maior será no manejo de indivíduos com transtorno da personalidade borderline, dada a maior procura destes por unidades de atendimento psiquiátrico.(AU)

Personality disorders are psychological patterns of difficult diagnosis that require careful evaluations from mental health professionals. The physician-patient relationship is a crucial condition for the management of these disorders. On this view it must be important guide undergraduate students from health care areas through the existence of such a category of disorders. This article consists of a descriptive review aiming at clarifying the definition of personality disorders; furthermore discuss historical, physiological and epidemiological aspects. On this publication will be reviewed some particularities from diagnostic comorbidity, course and treatment of these disorders. The management of individuals with borderline personality disorder will be emphasized in this publication due to increased seek from this public for mental health care units. (AU)

Self-Embedding Behavior in Adults: A Report of Two Cases and a Systematic Review.

Self-embedding behavior (SEB) is the repeated insertion of sharp objects, such as needles or pins, into the soft tissues of abdomen, limbs, and other body parts. In this study, two cases of SEB were reported and the scientific worldwide literature reviewed. Thirty-two cases of SEB were identified through systematic searches in the main bibliographic databases. Mean age was 35 years (SD = 8.97). Just over two-thirds of the patients were female. Although the number of embedded objects could be as high as 200, major clinical and surgical complications were uncommon and mortality was null. Patients with SEB presented three major diagnoses: psychotic (25%), personality (21.9%), and factitious (28.1%) disorders. The practice of SEB largely went undetected as the patients themselves did not bring it to the attention of family members or physicians and usually denied they have engaged in SEB. A high level of suspicion is required to avoid a missed diagnosis.

Factor structure and psychometric properties of the Dispositional Resilience Scale among Brazilian adult patients.

OBJECTIVE: Verifying the psychometrics of a Brazilian version of the Dispositional Resilience Scale (DRS-15). METHODS: Cross-cultural adaptation was done interviewing 65 adult patients. Validation was evaluated by application of the Lipp Brazilian Stress Symptoms Inventory (ISSL), Self-Report Questionnaire (SRQ), and other measures to 575 participants from the psychiatric ambulatories (for borderline personality, anxiety or post-traumatic stress disorders) and non-psychiatric ambulatories (chronic pain, pre-anesthetic consultation and companions for the latter). Temporal stability was verified with 123 participants. RESULTS: Exploratory factor analysis yielded a three-factor solution. Psychometrics were acceptable (alpha coefficient, 0.71; intraclass correlation coefficient, 0.81). Correlations with the ISSL, SRQ and other measures were noted except for factor 3. In the psychiatric sample, hardiness scores of borderline patients were lower than those of patients with anxiety disorders. CONCLUSION: This version of the DRS-15 exhibited good reliability in a sample of Brazilian patients; validity was confirmed in two of the scale factors.

[Personality Traits Screening in a Colombian Adult Population Sample - Colombian National Survey of Mental Health-2015]. / Tamizaje de rasgos de personalidad en población adulta colombiana. Encuesta Nacional de Salud Mental 2015.

INTRODUCTION: Personality refers to the individual style in characteristic patterns of thinking, feeling and behaving. Traits may configure a personality disorder when there is a long-lasting rigid pattern of inner experience that deviates from the expectations of the individual's culture, are inflexible and form maladaptative schemes in different interpersonal scenarios. Given the pervasiveness of this structure, they cause impairment of functioning in the affected person. OBJECTIVE: To establish the prevalence of personality traits in all selected adults, using the module-structured interview WHO WHM-CIDI-CAPI for clusters A, B and C of personality traits. METHODS: Colombian National Survey on Mental Health with persons older than 18 years of age. RESULTS: Personality traits that are the most frequently described: Cluster A 46% (95%CI, 45.2-48.1) of people believe they are convinced that there are conspiracies behind many things in the world. Regarding the features of cluster B, 35.6% (95%CI, 34.2-37.0) of the population reports that generally they do not feel bad when offending or upsetting someone and 35.4% (95%CI, 33.9-36.8) refer to show feelings to anyone. The highest proportion of traits were found to the probable borderline personality disorder, as 4.6% (95%CI, 4.1-5.2) of the Colombian population aged 18 and older has 6 or more features of this type, and is the widely reported as an individual entity with similar rates in men and women. CONCLUSIONS: The high prevalence of disruptive personality traits requires more research. The high prevalence reported for borderline personality traits suggests the need to implement measures to improve and integrate a collaborative model of care for people afflicted with a possible borderline personality disorder.

Factor structure and psychometric properties of the Dispositional Resilience Scale among Brazilian adult patients / Estrutura fatorial e propriedades psicométricas da Escala de Resiliência Disposicional para pacientes brasileiros adultos

ABSTRACT Objective Verifying the psychometrics of a Brazilian version of the Dispositional Resilience Scale (DRS-15). Methods Cross-cultural adaptation was done interviewing 65 adult patients. Validation was evaluated by application of the Lipp Brazilian Stress Symptoms Inventory (ISSL), Self-Report Questionnaire (SRQ), and other measures to 575 participants from the psychiatric ambulatories (for borderline personality, anxiety or post-traumatic stress disorders) and non-psychiatric ambulatories (chronic pain, pre-anesthetic consultation and companions for the latter). Temporal stability was verified with 123 participants. Results Exploratory factor analysis yielded a three-factor solution. Psychometrics were acceptable (alpha coefficient, 0.71; intraclass correlation coefficient, 0.81). Correlations with the ISSL, SRQ and other measures were noted except for factor 3. In the psychiatric sample, hardiness scores of borderline patients were lower than those of patients with anxiety disorders. Conclusion This version of the DRS-15 exhibited good reliability in a sample of Brazilian patients; validity was confirmed in two of the scale factors.

RESUMO Objetivo Verificar as propriedades psicométricas da versão brasileira da Escala de Resiliência Disposicional (DRS-15). Métodos A adaptação transcultural foi feita com 65 pacientes. A validação foi estudada pela aplicação do Inventário de Sintomas de Stress para Adultos de Lipp (ISSL), Self-Report Questionnaire (SRQ) e outros instrumentos a 575 participantes de ambulatórios psiquiátricos (transtorno borderline de personalidade, ansiedade ou transtorno de estresse pós-traumático) e não-psiquiátricos (dor crônica, avaliação pré-anestésica ou acompanhantes). A estabilidade foi verificada com 123 participantes. Resultados A análise exploratória revelou três fatores, com propriedades aceitáveis (alfa de 0,71; coeficiente de correlação intraclasse de 0,81). Notaram-se correlações com o ISSL, SRQ e demais instrumentos, exceto para o fator 3. Na amostra psiquiátrica, a resiliência disposicional dos pacientes borderlines foi menor que a dos pacientes com transtornos de ansiedade. Conclusão Esta versão da DRS-15 apresentou boa confiabilidade numa amostra de adultos; a validade foi confirmada para dois fatores da escala.

The International Mood Network (IMN) Nosology Project: differentiating borderline personality from bipolar illness.

OBJECTIVE: The differential diagnosis of bipolar illness vs. borderline personality is controversial. Both conditions manifest impulsive behavior, unstable interpersonal relationships, and mood symptoms. This study examines whether and which mood clinical features can differentiate between both conditions. METHOD: A total of 260 patients (mean ± standard deviation age 41 ± 13 years, 68% female) attending to a mood clinic were examined for diagnosis of bipolar illness and borderline personality disorder using SCID-I, SCID-II, and clinical mood criteria extracted from Mood Disorder Questionnaire (MDQ). They were analyzed using diagnoses as dependent variables. Predictors of bipolar and borderline diagnoses were identified by multivariable logistic regressions, and predictive validity of models was assessed using ROC curve analysis. RESULTS: Bipolar illness was strongly predicted by elevated mood (OR = 4.02, 95% CI: 1.80-9.15), increased goal-directed activities (OR = 3.90, 95% CI: 1.73-8.96), and episodicity of mood symptoms (OR = 3.48, 95% CI 1.49-8.39). This triad model predicted bipolar illness with 88.7% sensitivity, 81.4% specificity, and obtained an auROC of 0.91 (95% CI: 0.76-0.96) and a positive predictive value of 85.1%. For borderline personality disorder, only female gender was a statistically significant predictor (OR = 3.41, 95% CI: 1.29-13.7), and the predictive model obtained an auROC of 0.67 (95% CI: 0.53-0.74). CONCLUSION: In a mood disorder clinic setting, manic criteria and episodic mood course distinguished bipolar illness from borderline personality disorder.

Self over time: another difference between borderline personality disorder and bipolar disorder.

RATIONALE, AIMS AND OBJECTIVES: The nature of the relationship between bipolar disorder and borderline personality disorder has been an intense field of debate in the last two decades. Current diagnostic classifications approach this complex phenomenon using syndromatic definitions based on presence or absence of a restricted set of signs or symptoms that have demonstrated low specificity. One of the several utilities of the phenomenological method in psychiatry is to complement the clinical panorama, helping in the process of identifying potential differences between two separated clinical syndromes. The main objective of this publication is to explore one particular clinical difference between these two conditions - that is, the experience of self-continuity and time perception. METHODS: the argument explored in this paper is based on previous second-person or phenomenological accounts of sufferers of both conditions. RESULTS AND CONCLUSIONS: Whereas borderline personality disorder patients tend to experience only the present moment, referring frequent difficulties of drawing experiences of the past in order to determine their own future, bipolar disorder patients are constantly worried about the contradictions in their past experiences and the latent risk of losing control of themselves in future episodes of their disease. This contrast should be, however, corroborated in future research comparing directly the two groups in terms of the continuity of the self and their temporal structures.

[PROPOSAL OF INITIAL PSYCHOTERAPEUTIC AND PSYCHOPHARMACOLOGICAL APPROACH IN PATIENTS WITH DIAGNOSE OF 5 DIFFERENT SUBTYPES OF BORDERLINE PERSONALITY DISORDER]. / Propuesta de enfoque psicofarmacológico y psicoterapéutico inicial en pacientes con diagnóstico de cinco subtipos diferentes de Trastorno Límite de la Personalidad.

The evidence shows that borderline personality disorder (BPD) is the most frequently diagnosed personality disorder. However, the diagnostic criteria are very heterogeneous, suggesting that very different patients may be included within a single construct. Despite its severity, there are no standardized treatments for this group of patients. We find the same problem in the Acute Mental Health Services. The numerous proposals that have been put forward are unclear and have not reached a final consensus. According to Oldham's classification, BPD can be divided into the following subtypes: Affective, Impulsive, Aggressive, Empty and Dependent. In this paper, we propose a psychotherapeutic initial approach from the Dialectical Behavioral Therapy (DBT) perspective and an initial psychopharmacological approach for each subtype of BPD.