Risk Assessment and Its Correlation to Psychiatric Co-Morbidities in a Sample of Borderline Personality Disorder Patients

Abstract

Borderline personality disorder (BPD) is a serious mental disorder marked by a pattern of ongoing instability in moods, behavior, self-image, and functioning. These experiences often result in impulsive actions and unstable relationships. A person with BPD may experience intense episodes of anger, depression, and anxiety that may last from only a few hours to days.

Some people with BPD also have high rates of co-occurring mental disorders, such as mood disorders, anxiety disorders, and eating disorders, along with substance abuse, self-harm, suicidal thinking and behaviors, and suicide.

Although the cause of BPD is unknown, both environmental and genetic factors are thought to play a role in predisposing patients to BPD symptoms and traits. Studies show that many, but not all individuals with BPD report a history of abuse, neglect, or separation as young children.

BPD is the only personality disorder to have suicidal or self-injurious behavior among its diagnostic criteria. Adolescents with borderline personality disorder marks a period of high-risk for the onset of self-injurious behaviors (SIB), including both deliberate self-harm (DSH) and suicidal behaviors. Adolescents with BPD constitute a particularly vulnerable population for SIB, with research revealing robust associations between SIB and BPD pathology in adolescents. Further, developmental theories suggest that SIB may be an early indicator of BPD in adolescents, reflecting a key step for some youth in the developmental trajectory toward BPD.

Assessment of impulsivity and risky behaviors by self-report questionnaires in patients with borderline personality disorders are too difficult because the patients generally don’t have insight to their behaviors or they avoid reporting risky behaviors because of negative consequences.

Recent suicide attempts by individuals with BPD have shown the same degree of lethality and intent to die as recent suicide attempts by individuals without BPD. No differences in degree of intent to die compared with attempts by persons experiencing a major depressive episode or persons with both BPD and depression.