Age-related differences in individual DSM criteria for borderline personality disorder

This study examined age-related effects of individual DSM criteria for borderline personality disorder (BPD) and symptoms of depression and anxiety in three groups: patients diagnosed with BPD, another personality disorder, or no personality disorder. The goal was to determine if distinctive age effects emerged within the BPD group. This mixed clinical and community sample (N = 380) ranged from 20-50 years old. Each participant was assessed for symptoms of axis I and II psychopathology. We found significant interactions for personality disorder group x age for the suicidal behavior and impulsivity criteria that reflected distinctive changes in the BPD group. The BPD group reported significantly more anxious and depressive symptoms. However, no main effect for age or personality disorder x age interaction emerged with symptoms. These results demonstrate that older individuals with BPD report less impulsivity and fewer suicidal behaviors, although symptoms of distress persist.     

Anxiety and Depression in Children with HFASDs: Symptom Levels and Source Differences

The purpose of this study was to: (1) examine symptom levels of anxiety and depression in children with high-functioning autism spectrum disorders (HFASDs) compared with matched control children using child self-reports and parent ratings; and (2) examine source differences within the two condition groups. An overall multivariate effect indicated significantly elevated depression and anxiety symptoms for children with HFASDs based on parent reports; however no significant between-group differences based on child self-reports. Within-condition source comparisons (parent vs. child) revealed a significant multivariate effect indicating a significant difference in symptoms of depression and anxiety for the HFASD group but none for the control. Correlations between parent and child reports for the HFASD group suggested some positive association between child-reports and parent-reports for depressive symptoms only; however, the difference in average scores reflected a substantial discrepancy in the magnitude of symptoms by rater. Implications for clinical assessment and future research are provided.     

Cognitive vulnerability to depression in individuals with borderline personality disorder

The goal of the current study was to examine whether individuals with comorbid Major Depressive Disorder (MDD) and Borderline Personality Disorder (BPD) exhibit greater severity of depressive symptoms than (1) individuals with MDD without BPD and (2) individuals with neither MDD nor BPD. One hundred and forty-one individuals participated in a semi-structured clinical interview assessing MDD and BPD. They also completed measures assessing depressive symptoms, depressogenic attributional style, hopelessness, self-esteem, rumination, and dysfunctional attitudes. In line with hypotheses, individuals with BPD and MDD exhibited higher levels of depressive symptoms and cognitive vulnerability than individuals in the other two groups. In addition, after controlling for the effects of cognitive vulnerability, the effect of group membership on depressive symptoms was reduced, suggesting that the increased severity of depressive symptoms experienced by those with BPD is partially due to their possessing higher levels of cognitive vulnerability to depression.     

Anxiety and depression as correlates of self-reported behavioural inhibition in normal adolescents

In a previous study, Muris, Merckelbach, Wessel, and Van de Ven [Psychopathological correlates of self-reported behavioural inhibition in normal children. Behav. Res. Ther. 37 (1999) 575-584] found that children who defined themselves as high on behavioural inhibition displayed elevated levels of psychopathological symptoms compared to children who defined themselves as low or middle on behavioural inhibition. The present study further examined the relationship between self-reported behavioural inhibition and anxiety disorders and depression symptoms in a large sample of adolescents aged 12-18 years (N=968). Adolescents completed a measure of behavioural inhibition and questionnaires of anxiety and depression. Results indicated that adolescents who classified themselves as high on behavioural inhibition had higher scores of anxiety and depression than adolescents who classified themselves as low or middle on behavioural inhibition. Structural equations modelling was employed to test hypothetical models on the role of behavioural inhibition in childhood anxiety and depression. It was found that a pathway in which behavioural inhibition results in anxiety, which in turn leads to depression, provided the best fit for the data.     

Hypnotic discontinuation in chronic insomnia: impact of psychological distress, readiness to change, and self-efficacy.

OBJECTIVE: To compare individuals who were successful in discontinuing hypnotic medications against those who were not on measures of insomnia severity, medication withdrawal symptoms, psychological symptoms, perceived health, readiness to change and self-efficacy. DESIGN: Secondary analyses of a randomized clinical trial comparing a hypnotic taper intervention with or without self-help treatment for insomnia. MAIN OUTCOME MEASURES: Self-report measures of insomnia severity, medication withdrawal symptoms, depression and anxiety symptoms, physical and mental health, stages of change, readiness to change, decisional balance, and general and situational self-efficacy. RESULTS: There were no significant differences at baseline between medication-free individuals and those still using sleep medication at the end of a taper intervention. Group differences emerged midway through the 8-week withdrawal program and were accentuated after the intervention; participants who remained medication-free during the next six months had less severe insomnia and anxiety symptoms, a more positive perception of their health and higher self-efficacy to refrain from hypnotic use in various situations. Contrary to expectations, there were no differences between drug-free and nondrug-free participants on both readiness to change and stages of change. CONCLUSIONS: Chronic users of hypnotic medications entered a taper intervention with equal levels of psychological distress, health, self-efficacy, and readiness to change. Successful hypnotic discontinuation was associated with overall improvement of insomnia, anxiety and distress symptoms, perceived health and self-efficacy. More intensive and individualized therapeutic attention may be warranted for individuals experiencing worsening of insomnia symptoms, more withdrawal symptoms and psychological distress, and lower self-efficacy during medication discontinuation.     

Responding to symptoms of depression and anxiety: emotion regulation, neuroticism, and engagement in risky behaviors

The current study examined whether neuroticism, emotional regulation deficits, and/or their interaction predict increased engagement in risky behaviors following increases in symptoms of depression or anxiety over the course of 6 weeks. Results of hierarchical linear modeling analyses indicated that individuals who exhibited high levels of both neuroticism and emotional regulation deficits were more likely than other individuals to report increased engagement in risky behaviors following increases in symptoms of either depression or anxiety. Unexpectedly, individuals who exhibited high levels of neuroticism and adaptive emotion regulation strategies exhibited decreased engagement in risky behaviors following increases in depressive or anxious symptoms.     

Borderline personality and obsessive-compulsive symptoms

Diagnostic criteria for borderline personality disorder (BPD) are diverse, covering a broad range of symptoms. One criterion, self-mutilation, is a behavioral excess that may be considered a predictor of other psychopathological states. The present study sought to determine the extent to which two groups of BPD patients, those who mutilate and those who do not, differed on measures of general psychopathology, depression, anxiety, and obsessive-compulsive symptoms. Results indicate that the only source of significant variation was the level of obsessive-compulsive symptoms, with mutilators exhibiting greater symptomatology. The findings from this study support the idea that self-mutilation is a more severe form of psychopathology relative to the rest of the BPD population. These results are interpreted based on the affect regulation model of self-mutilation, and contrasted with contemporary models of impulse control in relation to obsessive-compulsive disorder.     

Biases in affective forecasting and recall in individuals with depression and anxiety symptoms

The authors used experience sampling to investigate biases in affective forecasting and recall in individuals with varying levels of depression and anxiety symptoms. Participants who were higher in depression symptoms demonstrated stronger (more pessimistic) negative mood prediction biases, marginally stronger negative mood recall biases, and weaker (less optimistic) positive mood prediction and recall biases. Participants who were higher in anxiety symptoms demonstrated stronger negative mood prediction biases, but positive mood prediction biases that were on par with those who were lower in anxiety. Anxiety symptoms were not associated with mood recall biases. Neither depression symptoms nor anxiety symptoms were associated with bias in event prediction. Their findings fit well with the tripartite model of depression and anxiety. Results are also consistent with the conceptualization of anxiety as a "forward-looking" disorder, and with theories that emphasize the importance of pessimism and general negative information processing in depressive functioning.     

Patient and partner correlates of couple relationship functioning in bipolar disorder

Extensive research in unipolar depressed and population-based samples has shown cross-partner associations between depressive symptoms and relationship adjustment. Yet despite evidence that bipolar disorder (BPD) is a more chronic and severe illness than unipolar depression, that individuals with BPD are at risk for interpersonal dysfunction, and that critical, unsupportive relationships are predictive of the course of depressive symptoms in BPD, there have been limited efforts to understand the correlates of relationship functioning within BPD. The current study addresses this gap in the literature by examining the associations between the depressive and manic symptoms of individuals with BPD, their partner's depressive symptoms, and relationship functioning, using a multimethod, multi-informant approach. Results revealed that the depressive symptoms of the individual with BPD were associated with poorer relationship functioning, particularly when the partner without BPD also had elevated depressive symptoms. In addition, an interaction between the individual with BPD's depressive and manic symptoms was observed, such that manic symptoms were associated with increased observed hostility and poorer partner relationship adjustment, but only when depressive symptoms were also elevated. These effects persisted even after overall mental health of both partners was controlled.     

Mindfulness and Forgiveness Buffer Distress: Associations With Interpersonal Transgression Blameworthiness

This study examined psychopathological symptom outcomes in victims of interpersonal transgressions (IPTs) based on differences in offender blameworthiness attributions. Mindfulness and forgiveness were hypothesized to serve as protective factors against depression, anxiety, and stress symptoms. The results highlight the buffering influence of dispositional mindfulness and forgiveness on symptoms of depression, anxiety, and stress. These results provide initial evidence that mindfulness‐ and forgiveness‐based procedures may have beneficial therapeutic outcomes for individuals who experience psychopathology as the result of IPTs, specifically IPTs deemed intentional by the victim.     

Evaluation of the effectiveness of Face IT, a computer-based psychosocial intervention for disfigurement-related distress

Some people who have a visible difference (disfigurement) experience psychosocial adjustment problems that can lead to social anxiety and isolation. The aim of this study was to assess the effectiveness of a new computerised CBT-based intervention (Face IT) in reducing anxiety and appearance-related distress for individuals with visible differences. Face IT was tested against a non-intervention control group and standard CBT-based face-to-face delivery. Eighty-three participants were assessed at four time points using the Hospital Anxiety and Depression Scales, Derriford Appearance Scale-24, Body Image Quality of Life Inventory and Fear of Negative Evaluation (FNE). The findings indicate a significant reduction in anxiety and appearance-related distress in both the Face IT intervention and the face-to-face condition. Similar findings were reported for depressive symptoms and FNE. Results at the three and six months follow-up demonstrate increased improvements in psychological functioning with both interventions. This new online psychosocial intervention has been found to be effective at reducing anxiety, depression and appearance concerns amongst individuals with disfigurements, whilst increasing positive adjustment. A remote-access, computer-based intervention offers the potential to provide psychosocial support more easily and in a cost-effective manner to adults with appearance-related distress.     

Understanding associations between negatively biased attention and depression and social anxiety: positively biased attention is key

ABSTRACT

Background and objectives: Although research supports the premise that depressed and socially anxious individuals direct attention preferentially toward negative emotional cues, little is known about how attention to positive emotional cues might modulate this negative attention bias risk process. The purpose of this study was to determine if associations between attention biases to sad and angry faces and depression and social anxiety symptoms, respectively, would be strongest in individuals who also show biased attention away from happy faces.

Methods: Young adults (N?=?151; 79% female; M?=?19.63 years) completed self-report measures of depression and social anxiety symptoms and a dot probe task to assess attention biases to happy, sad, and angry facial expressions.

Results: Attention bias to happy faces moderated associations between attention to negatively valenced faces and psychopathology symptoms. However, attention bias toward sad faces was positively and significantly related to depression symptoms only for individuals who also selectively attended toward happy faces. Similarly, attention bias toward angry faces was positively and significantly associated with social anxiety symptoms only for individuals who also selectively attended toward happy faces.

Conclusions: These findings suggest that individuals with high levels of depression or social anxiety symptoms attend preferentially to emotional stimuli across valences.     

Anorexia,masochism, self-mutilation,and autoerotism: the spider mother

In summary, both self-mutilators and eating-disordered individuals come from dysfunctional homes with a very controlling mother and usually absent father. They often have a history of trauma. They are depressed and obsessive, attached to their mothers, who discourage attempts at emancipation. The symptoms serve the purpose of keeping them as little girls with negative feelings toward menstruation, sexual maturity, development, and femininity in general. These symptoms comprise self-destructive behavior in the service of removing sexual thoughts, temptation, and activities. Favazza (1987) included both eating disorders and self mutilation in his "deliberate self-harm syndrome." The symptoms, whether they be anorexic, bulimic, or a form of self-mutilation are seen as "autoerotic in nature and a substitute for normal masturbation" (Hull & Lane, 1988). Eating disorders and delicate self-mutilation are said to have "a cathartic, self-purifying, function in that they modulate states of anxiety, sexual tension, anger or dissociated emptiness, and they bring about a tremendous quasi-physical sense of relief" (Cross, 1993, p. 50). These patients' use of substitutes prevents maturation and growth as women, causing regression to pregenital phases with the use of pregenital defenses, and the demise of the demands of puberty and mature sexuality.     

Effects of nicotine dose, instructional set, and outcome expectancies on the subjective effects of smoking in the presence of a stressor

The balanced placebo design (BPD) was used to evaluate the independent effects of nicotine dose and smoking-related expectancies on self-reported anxiety, urge to smoke, and withdrawal symptoms. After anxious mood was induced, participants smoked either a de-nicotinized cigarette or one with standard nicotine content. Nicotine dose was crossed with instructions that the cigarette was either de-nicotinized or standard. Nicotine cigarettes produced greater anxiety reduction than de-nicotinized cigarettes. Nicotine instructions attenuated anxiety only among those who held relevant expectancies. Nicotine dose and instructional set interacted such that either nicotine cigarettes or instructions that the cigarettes contained nicotine were sufficient to reduce urge to smoke. Implications of these findings and methodological issues regarding use of the BPD with cigarettes are discussed.     

Understanding heterogeneity in borderline personality disorder: Differences in affective reactivity explained by the traits of dependency and self-criticism

This study examined whether the personality traits of self-criticism and dependency respectively moderated the effects of perceived inferiority and emotional insecurity on negative affect during interpersonal interactions in individuals with borderline personality disorder (BPD). A sample of 38 patients with BPD and matched community comparison participants completed event-contingent record forms after each significant interaction for a 20-day period. Multilevel models showed that, controlling for baseline levels of depressive symptoms and neuroticism, as well as lagged negative affect, event-level elevations in perceived inferiority and emotional insecurity were related to more negative affect in both groups. Event-level perceived inferiority was more strongly associated with negative affect in patients with BPD who reported higher levels of self-criticism, while event-level perceived emotional insecurity was more strongly associated with negative affect in patients with BPD who reported higher levels of dependency. No significant interactions emerged for the comparison group. These findings further our understanding of differences among patients with BPD and support the application of personality-vulnerability or diathesis-stress models in predicting negative affect in BPD. Results have implications for the design of therapies for patients with BPD. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Hypervigilance in patients with borderline personality disorder: specificity, automaticity, and predictors

According to cognitive theory, an important factor in borderline personality disorder (BPD) is hypervigilance. The aim of the present study was to test whether BPD patients show schema-related biases, and to explore relations with childhood trauma, schemas, and BPD symptoms. Sixteen BPD patients were compared with 18 patients with a cluster C personality disorder, 16 patients with an axis I disorder, and 16 normal controls. An emotional Stroop task was applied with schema-related and unrelated, negative and positive, supra- and subliminal person-related stimuli. BPD patients showed hypervigilance for both negative and positive cues, but were specifically biased towards schema-related negative cues. Predictors were BPD schemas, childhood sexual traumas, and BPD anxiety symptoms. Both BPD and axis I disorder patients showed a trend for a bias for negative schema-related subliminal stimuli. More attention to hypervigilance in BPD is recommended for clinical practice.     

Role of Religious Attendance and Identity Conflict in Psychological Well-being

A sample of individuals who identified as gay or lesbian were administered measures of church attendance, their religious organization’s view of homosexuality, perceived conflict between religious faith identity and sexual orientation identity, social support, depression, and generalized anxiety. Among participants who rated their church as rejecting of homosexuality, greater frequency of attendance was related to a higher incidence of GAD symptoms, but not depression. No correlation was found for those attending accepting faith communities. Those who attend rejecting faith communities attended services less often, experienced greater identity conflict, and reported significantly less social support than those of the Accepted group. Regression analyses indicated that identity conflict and social support did not fully account for the relationship between attendance and GAD symptoms. Overall, findings from the current study support previous suggestions that participation in conservative or rejecting religious communities may adversely affect the emotional well-being of GL individuals.     

School absenteeism and mental health among sexual minority youth and heterosexual youth

Adolescent school absenteeism is associated with negative outcomes such as conduct disorders, substance abuse, and dropping out of school. Mental health factors, such as depression and anxiety, have been found to be associated with increased absenteeism from school. Sexual minority youth (youth who are attracted to the same sex or endorse a gay, lesbian, or bisexual identity) are a group at risk for increased absenteeism due to fear, avoidance, and higher rates of depression and anxiety than their heterosexual peers. The present study used longitudinal data to compare sexual minority youth and heterosexual youth on excused and unexcused absences from school and to evaluate differences in the relations between depression and anxiety symptoms and school absences among sexual minority youth and heterosexual youth. A total of 108 14- to 19-years-old adolescents (71% female and 26% sexual minority) completed self-report measures of excused and unexcused absences and depression and anxiety symptoms. Compared to heterosexual youth, sexual minority youth reported more excused and unexcused absences and more depression and anxiety symptoms. Sexual minority status significantly moderated the effects of depression and anxiety symptoms on unexcused absences such that depression and anxiety symptoms were stronger predictors of unexcused absences for sexual minority youth than for heterosexual youth. The results demonstrate that sexual minority status and mental health are important factors to consider when assessing school absenteeism and when developing interventions to prevent or reduce school absenteeism among adolescents.     

Testing the Effectiveness of Brief Behavioral Activation Treatment for Depression—Revised: Changes in Depression,Anxiety, Dysfunctional Attitudes,and Mindfulness

We tested the effectiveness of Brief Behavioral Activation Treatment for Depression-Revised (BATD-R), and its impact on secondary outcomes: anxiety, dysfunctional attitudes, and mindfulness. It was expected that individuals who completed BATD-R would exhibit decreased depression, anxiety, and dysfunctional attitudes, as well as increased mindfulness. A sample of adults with depression (n?=?42) was recruited to complete the 10-week treatment. A healthy control group (n?=?38) was included for comparison. Outcomes (depression, anxiety, dysfunctional attitudes, and mindfulness) were assessed at pre-treatment, post-treatment or 10 weeks for the healthy control group, and three-month follow-up. At pre-treatment, the clinical group reported greater depression, anxiety, and dysfunctional attitudes, and less mindfulness than the healthy control group. At post-treatment, the clinical group reported decreased depressive symptoms, trait anxiety, and dysfunctional attitudes, and increased mindfulness, compared to pre-treatment. The control group did not exhibit changes across the 10 weeks. Clinical and healthy control group post-treatment scores did not differ. At three-month follow-up, the clinical group reported a slight increase in depressive symptoms from post-treatment, but still maintained lower depressive symptoms than pre-treatment. The clinical group maintained treatment gains in dysfunctional attitudes, and mindfulness. Results support the effectiveness of BATD-R and suggest BATD-R may influence dysfunctional attitudes and mindfulness.

     

Psychopathological correlates of self-reported behavioural inhibition in normal children.

The present study examined the relationship between self-reported behavioural inhibition and psychopathological symptoms in a sample of 152 children aged 12-14 years. Children were provided with a definition of behavioural inhibition and then asked to classify themselves as low, middle or high on behavioural inhibition. Furthermore, children completed questionnaires of worry, depression and anxiety symptoms. Results showed that children who endorsed the high behavioural inhibition category had elevated levels of anxiety, worry and depression compared to children who endorsed the low or middle behavioural inhibition categories. Moreover, children high on behavioural inhibition more frequently reported anxiety disorders symptoms in the subclinical range. These findings fit well with those of previous studies on behavioural inhibition.