Borderline Personality Disorder Diagnostic Criteria

Overview of Research in Labof Dr. Rosemery Nelson Gray
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1. Past recent research focused on risk (for psychopathology) and resilience (for coping) produced by BIS (Behavioral Inhibition System) and BAS (Behavioral Activation System) of Reinforcement Sensitivity Theory2. Current research focuses on processes related to borderline personality disorder traits
DSM-IV-TR & DSM-5
Borderline Personality Disorder Diagnostic Criteria
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301.83 Borderline Personality Disorder
A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following nine diagnostic criteria:
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Borderline PD diagnostic criteria 1-4
Frantic efforts to avoid real or imagined abandonmentA pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluationIdentity disturbance: markedly and persistently unstable self-image or sense of selfImpulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
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Borderline PD diagnostic criteria #5-9
Recurrent suicidal behavior, gestures, or threats, or self-mutilating behaviorAffective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)Chronic feelings of emptinessInappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)Transient, stress-related paranoid ideation or severe dissociative symptoms
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Typical Lab Research Paradigm
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1. Participants are undergraduates from the participant pool.2. Borderline personality traits are examined dimensionally, with participants along a continuum of higher and lower degrees of borderline personality disorder traits.3. Typically, participants come to our lab and partake of the experimental paradigm on lab computers:A. Pre measuresB. Lab manipulationC. Post measures4. Research questions focus on different processes in those high in borderline personality disorder traits
Past lab studies on relationships and BPD traits
Diagnostic criterion #1: Frantic efforts to avoid real or imagined abandonmentKatieKuhlkenthesis:The interaction of BPD symptoms and daily relationship dissatisfaction measures predicted anger (not anxiety nor depression). Anger is noted in Diagnostic Criterion #8Daily diary methodPersonality disorders: Theory, research, and treatment, 2014, 5, 20-25.
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Literature review: Women with BPD frequently partnered with men with antisocial or narcissistic personality disorderParticipants completed NEO-PI on themselves and on their partnersWomenhigher in BPD traits preferred partners similar to themselves (similarity model) (including high neuroticism) rather than partners dissimilar to themselves (complementarity model)
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KatieKuhlkendissertation
Past lab studies on relationships and BPD traits – rejection manipulation
Stephanie Skinner’s dissertationParticipants either relived a personal rejection experience or a control acceptance experience.Main effect for rejection on 1-9 rating scale (positive to negative)Women higher in BPD traits showed more anger and depression (not anxiety) (on POMS)following a rejection experience.Same effects when Rejection Sensitivity scores werepartialledout
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Lab studies on the function of romantic relationship in BPD
Diagnostic criterion: Frantic efforts to avoid real or imagined abandonmentWhy? What is the purpose or function that romantic relationships serve for those high in BPD that makes these relationships so important to them?1. Questionnaire results, such as Social Provisions Scale2. Free-form responses, coded forfunctions3. Results: Relationships serve similar functions for those across the borderline trait continuum, but participants higher in borderline traits are more anxious or worried about maintaining their relationships (consistent with a large literature that borderlines have insecure attachment patterns)4. Current study - experiencesampling methodology (ESM)–daily datacollection onrelationshipsatisfaction and daily relationship functions
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Recently completed study– effects of rejection on impulsivity on those higher in borderline traits
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AlexBirthrongthesis -Undergraduate participants (n =195) were randomly assigned to a social rejection or academic failure task in which they were asked to write about a time when they felt intensely socially rejected, or a time they experienced an academic failure, respectively.Amain effect of BPD traits was found forreported risk-taking after the social rejection or academic failure (e.g., alcoholuse, risky sexual behavior, druguse), more risky performance on a computerized analogue risk-taking task theBalloon Analogue Risk Task (BART),andemotional reactions to the relived event. An interaction between rejection condition and level of BPD traits was found to predict alcohol use, risky sexual behavior, total self-reported risk-taking behavior, and the importance of the relived event.behavior, drug use, other risk-taking behavior (e.g., reckless driving, self-injury), total risk-taking behavior (a composite sum of all self-reported risk-taking behavior scales), BART performance, and emotional reactions to the relived event.Allresultsusing a second computerized analogue risk task, the Iowa Gambling Task (IGT) werenonsignificant. Lastly, and contrary to expectation, a significant interaction between BPD traits and rejection in predicting Profile of Mood States Total Mood Disturbance was not found.
Recently completed study – effects of “rejection” on tolerance of sexual coercion on those higher in borderline traits
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Malachi Willis thesis: Thisstudy attempted to induce feelings of insecurity about one’s romantic relationship—using a false feedback manipulation—to see if this primeleadto attitudes more tolerant of sexual coercion from a romantic partner, which is a risk factor for intimate partner victimization. Participants were randomly told that they match poorly or highly with their partners. Participants higher in BPD features reported more tolerant attitudes toward sexual coercion. Moreover, there may be a significant interaction between BPD traits and condition. Those in thepoorly matchedcondition expressed more tolerant attitudes toward sexual coercion the higher their borderline features; this association was not present in thehighly matchedcondition. Follow-up analyses investigated various motivations for and approaches to sexual behavior. It appears that those higher in borderline features in thepoorly matchedcondition use sexual behavior to avoid losing their partner or having conflict with their partner.
Current studies inprogress (1)
1.Experience sampling methodology (ESM) – initial questionnaires(including a borderline measure) andexplanation to participants re. ESM methods – daily ratings of relationship satisfaction and rationale for therating based on common functions of relationships2. Jake King’sdissertation –effects of inducing a sad mood interacting with emotiondysregulation (borderline traits)in producing responseinhibition incognitive lab tasks (data collection completed)3.Blake and Shannon – participants with range of borderline traits – reaction to rejection bypotential friendsvs. potential romanticpartners – pilot study completed; follow-up to be conducted
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Current studies in progress (2)
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4.Sudheera– pre-measure of mood and emotion regulation, lab manipulation intended to dysregulate emotion (vs. a control task), post-measure of mood and emotion regulation, lab task intended to assess interpersonal functioning5. Shannon – pre-measure of mood, lab manipulation intended to awaken prosocial values, post-measure of mood, lab task intended to assess prosocial behavior6. Morgan –pre-measure of mood,cyberballtask intended to manipulate feelings of rejection or not, post-measure of mood, lab task intended to assess emotion dysregulation (Emotion Stroop)7. Ian – pre-measure of mood,cyberballtask intended to manipulate feelings of rejection or not, post-measure of mood, lab task intended to assess impulsivity (Stop Light Driving Task, Balloon Analogue Risk Task)