Wednesday, November 18, 2020

Specific Symptoms of Borderline Personality Disorder Linked to Suicide Risk

Certain symptoms of borderline personality disorder—especially chronic feelings of emptiness, fear of abandonment, and disturbances in one’s sense of identity—appear to be significantly associated with suicide attempts, according to a report published today in JAMA Psychiatry.

“[T]he results of this study show the importance of assessing and targeting identity disturbance, abandonment, and emptiness in patients with BPD [borderline personality disorder] when considering suicide prevention, symptoms that may often be overshadowed by affective or behavioral features of BPD [borderline personality disorder],” wrote Shirley Yen, Ph.D., of Beth Israel Deaconess Medical Center in Boston and colleagues.

Yen and colleagues analyzed data from the Collaborative Longitudinal Study of Personality Disorders, a multisite, prospective study of adults with at least one of four personality disorders (schizotypal, borderline, avoidant, and obsessive compulsive) and a comparison group of adults with major depressive disorder. They looked at the occurrence of suicide attempts in both groups over a 10-year period and examined the associations between specific symptoms and suicide attempts.

Of all disorders, borderline personality disorder emerged as the most robust factor associated with suicide attempts, even after controlling for demographic and clinical factors (such as childhood sexual abuse, alcohol use disorder, substance use disorder, and posttraumatic stress disorder).

Among the specific borderline personality disorder criteria, identity disturbance, chronic feelings of emptiness, and “frantic efforts to avoid abandonment” were significantly associated with suicide attempts.

“These criteria may interfere with self-direction, development of meaningful and lasting interpersonal relationships, and engagement in goals and value-directed living, becoming increasingly problematic throughout the life span because these facets of life might otherwise buffer suicidal tendencies,” Yen and colleagues wrote.

For related information, see the Psychiatric News article “Data Mining May Help Identify Suicide Risk.”

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