Timeline of borderline personality disorder

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This is a timeline of borderline personality disorder.

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Year Month and date Event type Details
1998 Zanarini et al. publish a study aiming to identify dysphoric states specific to BPD compared to other personality disorders. They administer the Dysphoric Affect Scale to 146 BPD patients and 34 Axis II controls. Results show 25 dysphoric states more common in BPD patients, with 25 being highly specific to BPD. These states cluster into extreme feelings, destructiveness, fragmentation, and victimization. Some specific states like feeling betrayed and out of control strongly associate with BPD. Overall, Dysphoric Affect Scale scores accurately distinguishes BPD from other personality disorders in 84% of cases, suggesting the pervasive and multifaceted nature of subjective pain in BPD.[1]
2007 May This study investigates risk factors for suicide completion in individuals with BPD using a case-control design with 120 subjects. Results show that BPD suicides had fewer psychiatric hospitalizations and suicide attempts but higher rates of substance dependence, Axis I comorbidity, novelty seeking, impulsivity, hostility, and comorbid personality disorders, with lower harm avoidance. Crucially, cluster B comorbidity is more common among BPD suicides. Impulsivity and aggression initially predict suicide but are not significant after accounting for cluster B comorbidity. These findings suggest that BPD suicides differ from typical clinical BPD cases, with cluster B comorbidity playing a critical role in the lethality of suicidal behavior.[2]
2013 July 1 A study explores the relationship between BPD features, body mass index (BMI), and chronic health problems in older adults. In a sample of 1,051 individuals aged 55-64, BPD features are significantly associated with heart disease, arthritis, and obesity. BMI is found to be significantly related to heart disease and arthritis, fully mediating the relationship between BPD features and arthritis. These findings suggest that obesity may be a critical pathway linking BPD to chronic health issues.[3]
2014 May A study investigates the phenomenon of self-injurious behaviors (SIB) and the intriguing lack of pain perception in many BPD patients during SIB. The study explores the relationship between affective dysregulation and physical pain, highlighting the inadequacy of SIB as a coping mechanism for emotional distress. Neuroimaging data suggest abnormalities in brain activation patterns, particularly in the dorsolateral prefrontal cortex and insula, which may contribute to altered pain sensitivity in BPD. Therapeutic interventions targeting these neurobiological dysfunctions show promise for improving pain perception and management in BPD patients.[4]
2015 December 22 Research A study investigates the impact of BPD on obstetrical and neonatal outcomes. Conducted from 2003 to 2012, it analyzes 989 births to women with BPD. Findings reveal that women with BPD, often younger and of lower socioeconomic status, faced increased risks during pregnancy, including gestational diabetes, premature rupture of membranes, chorioamnionitis, venous thromboembolism, caesarian delivery, and preterm birth. Notably, BPD is not linked with postpartum hemorrhage or instrumental delivery and is negatively associated with induction of labor. The study emphasizes the importance of closely monitoring pregnant women with BPD to mitigate adverse outcomes through multidisciplinary care.[5]
2017 January Terzi et al investigate the relationship between impulsivity, emotion dysregulation, and aggressive behavior/self-harm in outpatients with BPD. They find that trait impulsivity predicts both aggressive behavior and self-mutilation. Moreover, emotion dysregulation significantly contributes to the vulnerability to aggression and self-injury, beyond the effects of impulsivity alone. These findings suggest that emotion dysregulation plays a crucial role in exacerbating dysfunctional behaviors in individuals with BPD who are also impulsive. The study highlights the importance of addressing both impulsivity and emotion dysregulation in the treatment and management of aggressive behavior and self-harm in BPD patients.[6]
2019 October 24 A study examines the association between BPD traits and cardiometabolic risk in midlife adults, considering the potential confounding effect of comorbid depression. Using a sample of 1,295 individuals, BPD traits and depressive symptoms are assessed alongside cardiometabolic risk indicators, including insulin resistance, adiposity, dyslipidemia, and blood pressure. Structural equation modeling reveals that BPD traits, but not depressive symptoms, independently associate with increased cardiometabolic risk. These findings highlight a specific link between BPD pathology and cardiovascular risk, suggesting the need for further research into the behavioral and biological mechanisms underlying this relationship.[7]
2021 February 22 A review explores the relationship between sleep disorders and BPD, assessing contemporary literature and databases to provide insights into the prevalence of sleep disorders in BPD patients and clinical suggestions for managing them. Sleep disturbance is common among BPD patients, with prevalence rates ranging from 5% to 45%. Objective changes in sleep architecture in BPD are inconsistent across studies, with some showing alterations in REM sleep and slow-wave sleep while others find no objective changes. Higher prevalence of nightmares is also noted. It is noted that proper diagnosis and treatment of sleep disorders in BPD patients may improve therapy outcomes, and psychotherapeutic approaches can address both sleep disorders and BPD symptoms. Further research is needed for reliable conclusions and effective treatment strategies.[8]
2021 December 17 An article reviews neurobiological changes in BPD after Dialectical Behavior Therapy (DBT), a leading therapy for BPD, which shows significant neurobiological changes post-treatment. Nine studies reveal decreased activity in the amygdala and ACC, and altered activity in the inferior frontal gyrus and prefrontal cortex, linked to improved emotional and inhibitory control. The findings highlight the potential of neuroimaging to understand DBT’s effectiveness, suggesting further research to clarify DBT’s biological impact and optimize treatment.[9]
2022 January 3 A study investigates the relationship between homocysteine (Hcy) levels and cardiovascular risk in young female patients with BPD. Compared to healthy controls, BPD patients show significantly higher, though non-pathological, Hcy levels. Hcy correlated with the severity of childhood trauma, chronic stress, and sleep disturbances. The findings suggest that elevated Hcy levels in BPD patients may indicate a higher risk of cardiovascular disease (CVD), potentially making Hcy a useful marker for assessing midlife CVD risk in this population. This underscores the broader health risks associated with BPD beyond psychological symptoms.[10]
2022 February 26 Research A systematic review and meta-analysis investigates the prevalence of BPD and borderline personality features (BPF) during the perinatal period. Conducted by Divya Prasad and colleagues, the study examines 16 publications, including 14 research articles and 2 conference abstracts, gathered from PubMed, PsycINFO, and Embase. Among non-clinical samples, BPF prevalence during pregnancy ranges from 6.9% to 26.7%, while BPD rates across the perinatal period ranges from 0.7% to 1.7%. Clinical samples exhibit higher rates, with BPF and BPD ranging from 9.7% to 34% and 2.0% to 35.2%, respectively. The meta-analysis reveal a pooled BPD prevalence of 14.0% (95% CI [7.0, 22.0]) among clinical perinatal samples, indicating a significant prevalence of borderline personality pathology. The review underscores the importance of validated screening methods for identifying and treating BPD in the perinatal population.[11]
2022 September Fitzpatrick et al. conduct a study aiming to determine if BPD is truly an emotion dysregulation disorder and, if so, in what ways. Their unified paradigm assesses five main components of emotion dysregulation in individuals with BPD compared to those with generalized anxiety disorder (GAD) and healthy controls (HCs). Results show higher self-reported and sympathetic baseline emotion in BPD and GAD groups compared to HCs. Additionally, individuals with BPD exhibit emotion regulation deficits specifically in distraction compared to the GAD group. The findings suggest that while some aspects of emotion dysregulation are present in BPD, others may be common across high emotion dysregulation groups.[12]
2022 September Koenigsberg et al. publish a study aiming to understand affective instability in BPD by examining six affective domains and subjective affective intensity. They study 152 patients with personality disorders, measuring lability and intensity of affect. Results show greater lability in anger, anxiety, and oscillation between depression and anxiety in BPD. However, oscillation between depression and elation do not significantly differ. Surprisingly, subjective affective intensity increase is not more prominent in BPD compared to other personality disorders. This study provides a nuanced perspective on affective instability patterns specific to BPD, shedding light on its distinct affective experiences.[13]
2024 January Waite et al. publish a study investigating the relationship between BPD, multidimensional impulsivity, and emotion dysregulation, considering both positive and negative aspects. They assess adults with BPD, subthreshold BPD, and without BPD using diagnostic interviews, self-report measures, and behavioral tasks. Results show that negative emotion dysregulation mediates the link between BPD and negative urgency, lack of premeditation, and lack of perseverance. Positive emotion dysregulation mediates the association between BPD and sensation seeking. The study underscores the distinct roles of negative and positive emotion dysregulation in impulsive behaviors, contributing to the understanding and treatment of BPD.[14]
2024 March 30 A study investigates the use of Optical Coherence Tomography (OCT) and OCT Angiography (OCTA) in patients with BPD compared to healthy controls. It measures retinal microvascular and morphological changes, finding significant differences in macular vessel density (MVD), retinal nerve fiber layer (RNFL), and central retinal thickness (CRT) between BPD patients and controls. Notably, BPD patients show reduced MVD, RNFL, and CRT, with correlations between these measures and BPD symptoms. These findings suggest OCT and OCTA can detect retinal changes in BPD non-invasively.[15]

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References

  1. ↑ Fitzpatrick, Skye; Varma, Sonya; Kuo, Janice R. (September 2022). "Is borderline personality disorder really an emotion dysregulation disorder and, if so, how? A comprehensive experimental paradigm". Psychological Medicine. 52 (12): 2319–2331. ISSN 1469-8978. doi:10.1017/S0033291720004225. 
  2. ↑ Gratz KL, Tull MT (2007). "An open trial of a comprehensive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder". Behavior Therapy. 38 (1): 69–80. PMID 17503981. doi:10.1016/j.beth.2006.05.001. 
  3. ↑ Powers, Abigail D.; Oltmanns, Thomas F. (April 2013). "Borderline Personality Pathology and Chronic Health Problems in Later Adulthood: The Mediating Role of Obesity". Personality disorders. 4 (2): 152–159. ISSN 1949-2715. doi:10.1037/a0028709. 
  4. ↑ Ducasse, Déborah; Courtet, Philippe; Olié, Emilie (May 2014). "Physical and social pains in borderline disorder and neuroanatomical correlates: a systematic review". Current Psychiatry Reports. 16 (5): 443. ISSN 1535-1645. doi:10.1007/s11920-014-0443-2. 
  5. ↑ Pare-Miron, Valerie; Czuzoj-Shulman, Nicholas; Oddy, Lisa; Spence, Andrea R.; Abenhaim, Haim Arie (2016). "Effect of Borderline Personality Disorder on Obstetrical and Neonatal Outcomes". Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health. 26 (2): 190–195. ISSN 1878-4321. doi:10.1016/j.whi.2015.11.001. 
  6. ↑ Terzi, Laura; Martino, Francesca; Berardi, Domenico; Bortolotti, Biancamaria; Sasdelli, Anna; Menchetti, Marco (March 2017). "Aggressive behavior and self-harm in Borderline Personality Disorder: The role of impulsivity and emotion dysregulation in a sample of outpatients". Psychiatry Research. 249: 321–326. ISSN 1872-7123. doi:10.1016/j.psychres.2017.01.011. 
  7. ↑ Barber, Taylor A.; Ringwald, Whitney R.; Wright, Aidan G.C.; Manuck, Stephen B. (March 2020). "Borderline personality disorder traits associate with midlife cardiometabolic risk". Personality disorders. 11 (2): 151–156. ISSN 1949-2715. doi:10.1037/per0000373. 
  8. ↑ Vanek, Jakub; Prasko, Jan; Ociskova, Marie; Hodny, Frantisek; Holubova, Michaela; Minarikova, Kamila; Slepecky, Milos; Nesnidal, Vlastimil (2021). "Insomnia in Patients with Borderline Personality Disorder". Nature and Science of Sleep. 13: 239–250. ISSN 1179-1608. doi:10.2147/NSS.S295030. 
  9. ↑ Salman, Sohaib; Sabir, Anjum; Sarfaraz, Zeeshan; Ashraf, Shazia; Haider, Naqi; Moeed, Adnan; Javed, Ali (2021). "The potential role of melatonin in various types of cancers". International Journal of Endocrinology. 2021: 1–10. PMC PMC8718753Freely accessible Check |pmc= value (help). PMID 34888594 Check |pmid= value (help). doi:10.1155/2021/7309822. 
  10. ↑ Kern, Katharina; Sinningen, Kathrin; Engemann, Luisa; Maiß, Clara; Hanusch, Beatrice; Mügge, Andreas; Lücke, Thomas; Brüne, Martin (3 January 2022). "Homocysteine as a potential indicator of endothelial dysfunction and cardiovascular risk in female patients with borderline personality disorder". Borderline Personality Disorder and Emotion Dysregulation. 9: 11. ISSN 2051-6673. doi:10.1186/s40479-021-00171-9. 
  11. ↑ Prasad, Divya; Kuhathasan, Nirushi; de Azevedo Cardoso, Taiane; Suh, Jee Su; Frey, Benicio N. (April 2022). "The prevalence of borderline personality features and borderline personality disorder during the perinatal period: a systematic review and meta-analysis". Archives of Women's Mental Health. 25 (2): 277–289. ISSN 1435-1102. doi:10.1007/s00737-022-01218-8. 
  12. ↑ Fitzpatrick, Skye; Varma, Sonya; Kuo, Janice R. (September 2022). "Is borderline personality disorder really an emotion dysregulation disorder and, if so, how? A comprehensive experimental paradigm". Psychological Medicine. 52 (12): 2319–2331. ISSN 1469-8978. doi:10.1017/S0033291720004225. 
  13. ↑ Koenigsberg, Harold W.; Harvey, Philip D.; Mitropoulou, Vivian; Schmeidler, James; New, Antonia S.; Goodman, Marianne; Silverman, Jeremy M.; Serby, Michael; Schopick, Frances; Siever, Larry J. (May 2002). "Characterizing affective instability in borderline personality disorder". The American Journal of Psychiatry. 159 (5): 784–788. ISSN 0002-953X. doi:10.1176/appi.ajp.159.5.784. 
  14. ↑ Waite, Elinor E.; DeFontes, Clara; Weiss, Nicole H.; Karnedy, Colten; Woods, Sherry E.; Haliczer, Lauren A.; Dixon-Gordon, Katherine L. (1 January 2024). "Borderline personality disorder and multidimensional impulsivity: The roles of positive and negative emotion dysregulation". Journal of Affective Disorders. 344: 635–643. ISSN 1573-2517. doi:10.1016/j.jad.2023.10.030. 
  15. ↑ Xu, Bei; Li, Fangling; Zhang, Zhejia; Xiao, Qian (March 2024). "The use of optical coherence tomography (OCT) and OCT angiography in borderline personality disorder compared to health control subjects". CNS neuroscience & therapeutics. 30 (3): e14699. ISSN 1755-5949. doi:10.1111/cns.14699. 
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