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Borderline personality disorder symptoms and newlyweds' observed communication, partner characteristics, and longitudinal marital outcomes.

ABSTRACT: Given borderline personality disorder's (BPD) relation with interpersonal dysfunction, there is substantial interest in understanding BPD's effect on marriage. The current study used data from a community sample of 172 newlywed couples to examine spouses' BPD symptoms in relation to their observed communication, partner BPD symptoms, 4-year marital quality trajectories, and 10-year divorce rates. BPD symptoms were correlated cross-sectionally with more negative skills during observational problem-solving and social support tasks, and spouses reporting more BPD symptoms were married to partners reporting more BPD symptoms. Longitudinally, hierarchical linear modeling of newlyweds' 4-year marital trajectories indicated that BPD symptoms predicted the intercept of marital quality for spouses and their partners, reflecting lower levels of marital satisfaction and higher levels of marital problems. BPD symptoms did not predict 10-year divorce rates. These findings highlight the chronic relationship impairment associated with BPD symptoms, indicate that distress begins early in marriage, and suggest that partners with higher levels of BPD symptoms remain in more troubled marriages.

SUBMITTER: Lavner JA

PROVIDER: S-EPMC4658245 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature

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Borderline personality disorder symptoms and newlyweds' observed communication, partner characteristics, and longitudinal marital outcomes.

Lavner Justin A JA Lamkin Joanna J Miller Joshua D JD

Journal of abnormal psychology 20150907 4

Given borderline personality disorder's (BPD) relation with interpersonal dysfunction, there is substantial interest in understanding BPD's effect on marriage. The current study used data from a community sample of 172 newlywed couples to examine spouses' BPD symptoms in relation to their observed communication, partner BPD symptoms, 4-year marital quality trajectories, and 10-year divorce rates. BPD symptoms were correlated cross-sectionally with more negative skills during observational proble ...[more]

PMID: 26348097

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Project description:Personality is consistently associated with psychopathology across the lifespan. However, little is known of how observed personality dimensions in preschoolers are associated with concurrent or longitudinal symptoms across development. Spectrum, vulnerability, and pathopolasty models theorize how child personality and psychopathology are related across development. The current study tests these three models using observationally coded personality dimensions in a longitudinal sample of preschoolers. A validated 'thin slice' technique was used to code observed Five Factor Model (FFM) personality dimensions of extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience in a clinically enriched preschool sample oversampled for depression (N?=?299). Children were followed longitudinally for 9 years while assessing dimensional psychological symptoms and global functioning. Longitudinal multilevel models testing the spectrum, or shared underlying factor model, indicated depressive symptoms in adolescence were predicted by higher preschool extraversion and lower agreeableness and conscientiousness, externalizing symptoms were predicted by lower agreeableness and higher neuroticism, and worse global functioning was predicted by higher extraversion and neuroticism, and lower agreeableness and conscientiousness. Some associations held after accounting for the influence of baseline psychological symptoms, indicating support for a vulnerability relationship between personality and later psychopathology. No support was demonstrated for pathoplasty models such that personality did not influence the developmental course or change of psychopathology over time. Findings indicate personality dimensions measured as early as the preschool period prospectively impact psychopathology and functioning across child development, demonstrating support for both a spectrum and vulnerability relationship between youth personality and psychopathology.

Project description:Sleep disorders, such as insomnia and nightmares, are commonly associated with Borderline Personality Disorder (BPD) in adulthood. Whether nightmares and sleep-onset and maintenance problems predate BPD symptoms earlier in development is unknown. We addressed this gap in the literature using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants included 6050 adolescents (51.4 % female) who completed the UK Childhood Interview for DSM-IV BPD at 11 to 12 years of age. Nightmares and sleep onset and maintenance problems were prospectively assessed via mother report when children were 2.5, 3.5, 4.8 and 6.8 years of age. Psychopathological (i.e., emotional temperament; psychiatric diagnoses; and emotional and behavioural problems) and psychosocial (i.e., abuse, maladaptive parenting, and family adversity) confounders were assessed via mother report. In logistic regressions, persistent nightmares (i.e., regular nightmares at 3 or more time-points) were significantly associated with BPD symptoms following adjustment for sleep onset and maintenance problems and all confounders (Adjusted Odds Ratio = 1.62; 95 % Confidence Interval = 1.12 to 2.32). Persistent sleep onset and maintenance problems were not significantly associated with BPD symptoms. In path analysis controlling for all associations between confounders, persistent nightmares independently predicted BPD symptoms (Probit co-efficient [β] = 0.08, p = 0.013). Emotional and behavioural problems significantly mediated the association between nightmares and BPD (β =0.016, p < 0.001), while nightmares significantly mediated associations between emotional temperament (β = 0.001, p = 0.018), abuse (β = 0.015, p = 0.018), maladaptive parenting (β = 0.002, p = 0.021) and subsequent BPD. These findings tentatively support that childhood nightmares may potentially increase the risk of BPD symptoms in early adolescence via a number of aetiological pathways. If replicated, the current findings could have important implications for early intervention, and assist clinicians in the identification of children at risk of developing BPD.

Project description:Background: Remote monitoring and digital phenotyping harbor potential to aid clinical diagnosis, predict episode course and recognize early signs of mental health crises. Digital communication metrics, such as phone call and short message service (SMS) use may represent novel biomarkers of mood and diagnosis in Bipolar Disorder (BD) and Borderline Personality Disorder (BPD). Materials and Methods: BD (n = 17), BPD (n = 17) and Healthy Control (HC, n = 21) participants used a smartphone application which monitored phone calls and SMS messaging, alongside self-reported mood. Linear mixed-effects regression models were used to assess the association between digital communications and mood symptoms, mood state, trait-impulsivity, diagnosis and the interaction effect between mood and diagnosis. Results: Transdiagnostically, self-rated manic symptoms and manic state were positively associated with total and outgoing call frequency and cumulative total, incoming and outgoing call duration. Manic symptoms were also associated with total and outgoing SMS frequency. Transdiagnostic depressive symptoms were associated with increased mean incoming call duration. For the different diagnostic groups, BD was associated with increased total call frequency and BPD with increased total and outgoing SMS frequency and length compared to HC. Depression in BD, but not BPD, was associated with decreased total and outgoing call frequency, mean total and outgoing call duration and total and outgoing SMS frequency. Finally, trait-impulsivity was positively associated with total call frequency, total and outgoing SMS frequency and cumulative total and outgoing SMS length. Conclusion: These results identify a general increase in phone call and SMS communications associated with self-reported manic symptoms and a diagnosis-moderated decrease in communications associated with depression in BD, but not BPD, participants. These findings may inform the development of clinical tools to aid diagnosis and remote symptom monitoring, as well as informing understanding of differential psychopathologies in BD and BPD.

Project description:BackgroundDrugs are widely used in borderline personality disorder (BPD) treatment, chosen because of properties known from other psychiatric disorders ("off-label use"), mostly targeting affective or impulsive symptom clusters.ObjectivesTo assess the effects of drug treatment in BPD patients.Search strategyWe searched bibliographic databases according to the Cochrane Developmental, Psychosocial and Learning Problems Group strategy up to September 2009, reference lists of articles, and contacted researchers in the field.Selection criteriaRandomised studies comparing drug versus placebo, or drug versus drug(s) in BPD patients. Outcomes included total BPD severity, distinct BPD symptom facets according to DSM-IV criteria, associated psychopathology not specific to BPD, attrition and adverse effects.Data collection and analysisTwo authors selected trials, assessed quality and extracted data, independently.Main resultsTwenty-eight trials involving a total of 1742 trial participants were included. First-generation antipsychotics (flupenthixol decanoate, haloperidol, thiothixene); second-generation antipsychotics (aripirazole, olanzapine, ziprasidone), mood stabilisers (carbamazepine, valproate semisodium, lamotrigine, topiramate), antidepressants (amitriptyline, fluoxetine, fluvoxamine, phenelzine sulfate, mianserin), and dietary supplementation (omega-3 fatty acid) were tested. First-generation antipsychotics were subject to older trials, whereas recent studies focussed on second-generation antipsychotics and mood stabilisers. Data were sparse for individual comparisons, indicating marginal effects for first-generation antipsychotics and antidepressants.The findings were suggestive in supporting the use of second-generation antipsychotics, mood stabilisers, and omega-3 fatty acids, but require replication, since most effect estimates were based on single studies. The long-term use of these drugs has not been assessed.Adverse event data were scarce, except for olanzapine. There was a possible increase in self-harming behaviour, significant weight gain, sedation and changes in haemogram parameters with olanzapine. A significant decrease in body weight was observed with topiramate treatment. All drugs were well tolerated in terms of attrition.Direct drug comparisons comprised two first-generation antipsychotics (loxapine versus chlorpromazine), first-generation antipsychotic against antidepressant (haloperidol versus amitriptyline; haloperidol versus phenelzine sulfate), and second-generation antipsychotic against antidepressant (olanzapine versus fluoxetine). Data indicated better outcomes for phenelzine sulfate but no significant differences in the other comparisons, except olanzapine which showed more weight gain and sedation than fluoxetine. The only trial testing single versus combined drug treatment (olanzapine versus olanzapine plus fluoxetine; fluoxetine versus fluoxetine plus olanzapine) yielded no significant differences in outcomes.Authors' conclusionsThe available evidence indicates some beneficial effects with second-generation antipsychotics, mood stabilisers, and dietary supplementation by omega-3 fatty acids. However, these are mostly based on single study effect estimates. Antidepressants are not widely supported for BPD treatment, but may be helpful in the presence of comorbid conditions. Total BPD severity was not significantly influenced by any drug. No promising results are available for the core BPD symptoms of chronic feelings of emptiness, identity disturbance and abandonment. Conclusions have to be drawn carefully in the light of several limitations of the RCT evidence that constrain applicability to everyday clinical settings (among others, patients' characteristics and duration of interventions and observation periods).

Dataset Information

Borderline personality disorder symptoms and newlyweds' observed communication, partner characteristics, and longitudinal marital outcomes.

Publications

Borderline personality disorder symptoms and newlyweds' observed communication, partner characteristics, and longitudinal marital outcomes.

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