Borderline personality features are associated with worse perceptions of (but not compliance with) chronic pain treatment.

Treating chronic illness requires ongoing patient-provider cooperation, but individual differences in patients' negative perceptions of care can undermine this cooperation. Research suggests people high on borderline personality disorder (BPD) features may react negatively to and comply less with mental health and medical treatment. This might be particularly problematic in chronic pain treatment, where BPD features are over-represented and the dysregulation typifying BPD likely undermines consistent care.

Borderline Personality Disorder Features and Risk for Prescription Opioid Misuse in a Chronic Pain Sample: Roles for Identity Disturbances and Impulsivity.

Although borderline personality disorder (BPD) is associated with both chronic pain and substance abuse, little research examines how BPD features in chronic pain patients may constitute a risk factor for misuse of prescription opioids, and no prior research has examined which particular component(s) of BPD might put chronic pain patients at risk-an oversight that undermines prevention and treatment of such problematic opioid use. In a cross-sectional study of patients in treatment for chronic pain ( = 147), BPD features were associated with several measures of prescription opioid misuse, even controlling for pain severity and interference. Specifically, the identity disturbances and self-harmful impulsivity facets of BPD were most consistently associated with opioid misuse, and exploratory analyses suggested that these factors may be interactive in their effects.

Momentary assessment of everyday physical pain in outpatients with borderline personality disorder.

Borderline personality disorder (BPD) is a severe psychiatric disorder associated with dysregulation in multiple domains of functioning. Physical health, and specifically pain, is one such domain that has gone understudied. Although evidence suggests that BPD is associated with chronic pain, few studies have examined nonchronic pain in the disorder.

Borderline personality disorder features and drinking, cannabis, and prescription opioid motives: Differential associations across substance and sex.

Introduction: Drinking motives have shown meaningful associations with borderline personality disorder (BPD) features. However, it is unknown whether other common substances of abuse (namely cannabis and prescription opioids) have the same associations with BPD features. In the present study, we tested associations between BPD features and motives across three substances: alcohol, cannabis, and prescription opioids.

Borderline Personality Disorder Features Are Associated with Concurrent Pain-Related Disability in a Chronic Pain Sample.

Objective: To determine whether core features of borderline personality disorder are associated with increased rates of being on disability benefits due to chronic pain conditions.

Subjects: A total of 147 patients currently in treatment for chronic pain at a multimodal chronic pain clinic.

Methods: We tested for a concurrent relationship between borderline personality disorder features and employment status using self-report measures.

Accounting for the association between BPD features and chronic pain complaints in a pain patient sample: The role of emotion dysregulation factors.

Although borderline personality disorder (BPD) features consistently show strong relations with chronic pain, the mechanisms underlying this association remain unclear. BPD is characterized by dysregulated emotion. Given previously observed relationships between emotion dysregulation and pain, we hypothesized that components of this dysregulation-elevated and labile negative affect and emotion sensitivity-would account for the relationship between BPD features and various pain complaints in a chronic pain patient sample.

Impulsivity and risk for prescription opioid misuse in a chronic pain patient sample.

Misuse of, and addiction to, prescription opioid pain relievers is a growing concern, in both non-clinical samples and chronic pain patients receiving opioid analgesic therapy. Research is needed to identify which patients may be more prone to misuse or dependence on opioids in a chronic pain treatment setting. Based on literature showing the role of impulsivity in substance use disorders generally, we predicted that impulsivity may also be important to understanding which individuals may be at risk for opioid misuse when opioids are prescribed for pain.

Development and validation of the opioid prescription medication motives questionnaire: a four-factor model of reasons for use.

There is considerable evidence that understanding reasons for using substances is important for understanding patterns of use and related consequences as well as for developing assessment and intervention strategies. Despite increases in prescription opioid use and related problems (e.g.

Recall of expressed affect during naturalistically observed interpersonal events in those with borderline personality disorder or depressive disorder.

We used the Electronically Activated Recorder to observe 31 individuals with either borderline personality disorder (BPD; n = 20) or a history of a depressive disorder (n = 11). The Electronically Activated Recorder yielded approximately forty-seven 50-second sound clips per day for 3 consecutive days. Recordings were coded for expressed positive affect (PA) and negative affect (NA), and coder ratings were compared to participants' reports about their PA and NA during interpersonal events.

Borderline personality disorder features and risk for prescription opioid use disorders.

Although there is evidence for high comorbidity between borderline personality disorder (BPD) and substance use disorders, particularly alcohol use, more research is needed on the associations between BPD and prescription opioid use because of the increasing national problem of prescription opioid misuse. The purpose of the present study was to examine relationships between BPD features and prescription opioid use, risk for misuse, consequences, and dependence features, and to determine which aspects of BPD account for these associations. As predicted, BPD features were associated with greater quantity and frequency of opioid use, risk for pain medication misuse, consequences, and dependence features.

Social context of anger in borderline personality disorder and depressive disorders: findings from a naturalistic observation study.

Anger and affective instability are key features of borderline personality disorder (BPD). Given the dynamic nature of affect, it is ideally studied using ambulatory assessment (AA). Recently, several major studies have examined affective instability via momentary self-report, using electronic diaries, which participants can use throughout their daily routine.

Borderline personality disorder features and mate retention tactics.

The purpose of the present study was to examine the association between features of borderline personality disorder (BPD) and mate retention tactics as a means of examining an evolutionary perspective on the association between BPD features and interpersonal problems and violence in romantic relationships. Two-hundred twenty-five college student participants completed the Personality Assessment Inventory for Borderlines (PAI-BOR; Morey, 1991) and the Mate Retention Inventory-Short Form (MRI-SF; Buss, Shackelford, & McKibbin, 2008) embedded within other measures. There was a strong association between BPD features and cost-inflicting mate retention tactics, including the specific tactics of vigilance, punishing mate's infidelity threat, intrasexual threats, and sexual inducements for both men and women.

Distinguishing general and specific personality disorder features and implications for substance dependence comorbidity.

Clinical and population-based samples show high comorbidity between Substance Use Disorders (SUDs) and Axis II Personality Disorders (PDs). However, Axis II disorders are frequently comorbid with each other, and existing research has generally failed to distinguish the extent to which SUD/PD comorbidity is general or specific with respect to both specific types of PDs and specific types of SUDs. We sought to determine whether ostensibly specific comorbid substance dependence-Axis II diagnoses (e.

Specificity of P3 event-related potential reactivity to alcohol cues in individuals low in alcohol sensitivity.

Recent research using event-related potentials (ERPs) has shown that individuals low in alcohol sensitivity show increased P3 reactivity to alcohol cues (Bartholow, Henry, & Lust, 2007). The current research sought to test the specificity of this effect by including other arousing cues in addition to alcohol, and by controlling for individual differences in trait impulsivity. Forty-seven participants varying in self-reported alcohol sensitivity completed a visual oddball task including neutral, arousing (erotic and adventure-related), and beverage-related images while ERPs were recorded.

Longitudinal associations in borderline personality disorder features: Diagnostic Interview for Borderlines-Revised (DIB-R) scores over time.

The Revised Diagnostic Interview for Borderlines (DIB-R; Zanarini, Gunderson, Frankenburg, & Chauncey, 1989) measures four major aspects of borderline personality disorder (BPD): Affect, Cognition, Impulse Action Patterns, and Interpersonal Relationships. In the present study, 353 young adults completed the DIB-R at age 18 (Wave 1) and again two years later (Wave 2) at age 20. Concerning the prediction of future BPD features, three models were compared: (a) Wave 1 Affect scores predicting all Wave 2 BPD features (NA model); (b) Wave 1 Impulse Action Patterns scores predicting all Wave 2 BPD features (IMP model); and (c) both Wave 1 Affect and Impulse Action Patterns scores predicting all Wave 2 BPD features (NA-IMP model).

Differences in illicit drug-use rates among Oklahoma and non-Oklahoma Indian youth.

Demographic factors may serve as risk or protective factors for drug use in American Indian communities. The purpose of the present study was to compare drug-use rates among Oklahoma and Non-Oklahoma Indian youth, and test corresponding rates of preventative and protective community, family, and social-demographic factors. Participants' data included 1,928 Indian 7th-12th graders from non-Oklahoma schools and 1,938 Indian students from schools in Oklahoma, aggregated across 2-3 years from an ongoing survey study of substance use and prevention among Indian youth.

Borderline personality disorder features and pain: the mediating role of negative affect in a pain patient sample.

Objectives: There is considerable evidence that personality disorders, including borderline personality disorder (BPD), tend to co-occur with chronic pain. There is also evidence that mood disorders co-occur with chronic pain conditions. Given the central role of affective instability and negative mood states in BPD, we proposed that affective features of depression, anxiety, and hostility may account for the association between BPD features and the severity of pain reported in a patient sample.

The role of affective instability and UPPS impulsivity in borderline personality disorder features.

Current theories of borderline personality disorder (BPD) suggest that extreme levels of affective instability/emotional dysregulation, impulsivity, or a combination of these traits account for the symptoms of BPD. The present study tested the extent to which personality measures of affective instability and impulsivity could account for BPD features in a nonclinical sample. One hundred forty-one undergraduates completed the Affective Lability Scale, the UPPS Impulsive Behavior Scale, and the Personality Assessment Inventory for Borderlines.

Drinking motives as mediators in the relation between personality disorder symptoms and alcohol use disorder.

Research shows high comorbidity between Cluster B Personality Disorders (PDs) and Alcohol Use Disorders (AUDs). Studies of personality traits and alcohol use have identified coping and enhancement drinking motives as mediators of the relation among impulsivity, negative affectivity or affectivity instability, and alcohol use. To the extent that certain PDs reflect extreme expression of these traits, drinking motives were hypothesized to mediate the relation between PD symptoms and presence/absence of an alcohol use disorder (AUD).

Affective instability: measuring a core feature of borderline personality disorder with ecological momentary assessment.

Ecological momentary assessment (EMA; Stone & Shiffman, 1994) was used to characterize and quantify a dynamic process--affective instability in borderline personality disorder (BPD). Sixty outpatients (34 with BPD and affective instability; 26 with current depressive disorder but not with BPD or affective instability) carried electronic diaries for approximately 1 month and were randomly prompted to rate their mood state up to 6 times a day. Results indicated that BPD patients (a) did not report significantly different mean levels of positive or negative affect; (b) displayed significantly more variability over time in their positive and negative affect scores; (c) demonstrated significantly more instability on successive scores (i.

The role of affective instability and impulsivity in predicting future BPD features.

Models of borderline personality disorder (BPD) suggest that extreme levels of affective instability/emotional dysregulation, impulsivity, or the combination of these two traits account for the symptoms characteristic of BPD. The present study utilized longitudinal data to evaluate the ability of Personality Assessment Inventory-Borderline Features (PAI-BOR; Morey, 1991) subscale scores to predict BPD features two years later as a test of these models of BPD. Participants were 156 male and 194 female young adults who completed the PAI-BOR at age 18 and again two years later.

Personality disorder symptoms, drinking motives, and alcohol use and consequences: cross-sectional and prospective mediation.

Research shows high comorbidity between Cluster B personality disorders (PDs) and alcohol use disorders (AUDs). Studies on personality traits and alcohol use have identified coping and enhancement drinking motives as mediators in the relations among impulsivity, affective instability, and alcohol use. To the extent that PDs reflect extreme expression of these traits, drinking motives should mediate the relation between PD symptoms and alcohol involvement.

Dimensional models of personality disorder: Diagnostic and Statistical Manual of Mental Disorders Fifth Edition and beyond.

Purpose Of Review: We describe several dimensional models of personality disorders and highlight future directions for the integration of dimensional approaches in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). This review is timely and relevant, given the upcoming revision of DSM (DSM-V).

Recent Findings: Research has identified four common higher order factors that could be used to characterize personality pathology.

Teasing: for superiority or solidarity?

Humor among friends is typically regarded as a means of strengthening friendships. However, there may be a side of humor that is used to compete rather than bond (R. D.

Puns and near puns in fables.

In previous research, (L. G. Lippman, K.