Psychosocial impairment and treatment utilization by patients with borderline personality disorder, other personality disorders, mood and anxiety disorders, and a healthy comparison group
Open accessAbstract
This study compared psychosocial functioning and treatment utilization in 130 participants who were diagnosed with a borderline personality disorder (BPD), a non-BPD personality disorder (OPD), a mood and/or anxiety disorder (MAD), or had no current psychiatric diagnosis and served as a healthy comparison group. Diagnostic and Statistical Manual of Mental Disorders (4th Edition) diagnoses, psychosocial functioning, and treatment utilization were determined by using well-established semistructured research interviews conducted by trained doctoral-level clinicians. Analysis of variance revealed the most severe deficits in functioning characterized the BPD group across areas of global functioning with more moderate impairments in functioning occurring in OPD and MAD groups. The BPD group was characterized by significantly greater psychiatric and nonpsychiatric treatment utilization than the other groups. These findings indicate that BPD as well as other personality disorders are a source of considerable psychologic distress and functional impairment equivalent to, and at times exceeding, the distress found in mood and anxiety disorders. The public health impact of BPD diagnosis is highlighted by the high rates of psychiatric and nonpsychiatric treatment utilization. © 2007 Elsevier Inc. All rights reserved.
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Claims the paper makes
5 of 27 cited sources checked · 4 supported · 0 flagged · accuracy not yet measured
- Premisecitation
There are increased rates of comorbidity of mood and anxiety disorders in patients with borderline personality disorder.
“The inclusion of a variety of anxiety and mood disorders would accurately reflect the increased rates of comorbidity of these disorders in patients with BPD [12,13]”
Quote in the paperSubstantial claim1 of 2 sources checked- cites [12] McGlashan, 2000, The Collaborative Longitudinal Personality Disorders Study: baseline axis I/II and II/II diagnostic co-occurrence, Acta Psychiatr Scand source
The Lifetime Axis I disorders section (page not supplied) reports significantly elevated PTSD co-occurrence in the BPD group, supporting the anxiety-disorder part for PTSD. The Axis I/II co-occurrence section says major depression was common across personality-disorder groups and not specific to BPD. The paper therefore does not establish broadly increased comorbidity of both mood and anxiety disorders in patients with BPD. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [13] Grilo, 2000, Stability and course of personality disorders: the need to consider comorbidities and continuities between axis I psychiatric disorders and axis II personality disorders, Psychiatr Q source
- Findingown data
The BPD group was significantly different from the healthy, the MAD, or the OPD group in time spent in self-help groups over the past 6 months.
“The BPD group was also significantly different from the healthy, the MAD, or the OPD group in time spent in self-help groups over the past 6 months.”
Quote in the paperNot a substantial claim - Findingreasoning
The BPD group reported increased time spent inpatient for psychiatric hospitalization.
“The BPD group reported increased time spent inpatient for psychiatric hospitalization.”
Quote in the paperSubstantial claim - Findingown data
There was a significant effect of study group on psychosocial functioning.
“However, a significant effect was found for study group (F = 1.42,P = .01).”
Quote in the paperSubstantial claim - Findingreasoning
The OPD group does not differ from healthy individuals in impairment at the workplace.
“However, the OPD group does not differ from healthy individuals in impairment at the workplace.”
Quote in the paperSubstantial claim
- Findingown data
Study groups also differed in relationships with siblings during the month before assessment.
“Significant differences in relationships with siblings were also found for the month before assessment.”
Quote in the paperNot a substantial claim - Findingown data
Patients with BPD diagnoses use more psychiatric and nonpsychiatric treatment than any of the other study groups.
“Results indicate that patients with BPD diagnoses use more psychiatric and nonpsychiatric treatment than any of the other study groups.”
Quote in the paperSubstantial claim - Findingown data
Ratings for relationships with siblings and children for the month before assessment showed more dysfunction in the BPD group compared to the healthy group.
“Ratings for relationships with siblings and children for the month before assessment revealed more dysfunction in the BPD group compared to the healthy group.”
Quote in the paperNot a substantial claim - Findingown data
There were no significant differences between groups in impairment of student work.
“There were no significant differences between groups in impairment of student work although this finding may be accounted for by a low frequency of students across groups.”
Quote in the paperNot a substantial claim - Findingown data
Recreation ratings for the best 6 months showed that the BPD, OPD, and MAD groups were significantly more impaired in recreational activities than the healthy group.
“However, recreation ratings for the best 6 months revealed that the BPD, the OPD, and the MAD groups were significantly more impaired in recreational activities than the healthy group.”
Quote in the paperNot a substantial claim - Findingown data
The OPD group differed little in treatment utilization from the comparison group.
“Of note is that the OPD group differed little in treatment utilization from the comparison group.”
Quote in the paperSubstantial claim - Findingown data
Recreation ratings for the month before assessment showed that the BPD group was significantly more impaired in recreational activities than all the other study groups.
“Recreation ratings revealed that the BPD group was significantly more impaired in recreational activities than all the other study groups for the month before assessment.”
Quote in the paperNot a substantial claim - Findingcitation
The BPD group is uniquely characterized by impairment in relations with children.
“The BPD group is uniquely characterized by impairment in relations with children.”
Quote in the paperNot a substantial claim - Interpretationreasoning
The similarities of OPD to BPD at the best 6-month interval for friendship impairment and global satisfaction indicate a sense of stability in the impairment for all PD groups.
“the similarities of OPD to BPD at the best 6-month interval for friendship impairment and global satisfaction indicate a sense of stability in the impairment for all PD groups.”
Quote in the paperNot a substantial claim - Premisecitation
Individuals with borderline personality disorder have substantially greater functional impairment than patients with major depressive disorder without coexisting personality disorder.
“and substantially greater impairment than patients with major depressive disorder without coexisting PD [4].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [4] Skodol, 2002, Functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder, Am J Psychiatry source
- Interpretationown data
The frequency of treatment use for the OPD group is not commensurately increased relative to their psychosocial impairment.
“the frequency of treatment use is not commensurately increased.”
Quote in the paperSubstantial claim - Interpretationown data
These differences followed relatively similar patterns between groups in the extent of impairment each group exhibited.
“Second, these differences followed relatively similar [patterns between groups in the extent of impairment each group exhibited.”
Quote in the paperSubstantial claim - Interpretationown data
Individuals in the OPD and MAD groups were also characterized by lower psychosocial functioning in global and specific areas than healthy individuals.
“Individuals in the OPD and MAD groups were also characterized by lower psychosocial functioning in global and specific areas than healthy individuals.”
Quote in the paperSubstantial claim - Study design and conductown data
There were no significant effects of sex or ethnicity on psychosocial functioning in the analysis controlling for sex and ethnicity.
“No significant effects for sex (F = 1.22,P = .22)or ethnicity (F = 1.06,P = .40)were found.”
Quote in the paperNot a substantial claim - Premisecitation
Patients with borderline personality disorder receive more psychotropic medications when compared to all other non-personality-disorder diagnostic groups.
“Patients with BPD also receive more psychotropic medications when compared to all other non-PD diagnostic groups [10,11].”
Quote in the paperNot a substantial claim0 of 2 sources checked - Interpretationreasoning
The healthy comparison group elucidates clinically significant differences in patients with OPD that were undifferentiated in previous research from axis I comparison groups.
“In addition, the healthy comparison group elucidates clinically significant differences in patients with OPD that were undifferentiated in previous research from axis I comparison groups.”
Quote in the paperSubstantial claim - Interpretationcitation
Based on GAF scores, the subjects recruited in this study were slightly less severely impaired than subjects in other examinations of PD and psychosocial functioning.
“Based on GAF scores, it is likely that the subjects recruited in this study were slightly less severely impaired than subjects in other examinations of PD and psychosocial functioning [3,4].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [3] Zanarini, 2005, Psychosocial functioning of borderline patients and axis II comparison subjects followed prospectively for six years, J Personal Disord source
- cites [4] Skodol, 2002, Functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder, Am J Psychiatry source
- Interpretationown data
These findings match similar patterns of severe impairment in BPD identified by Skodol et al and Zanarini et al.
“These findings match similar patterns of severe impairment in BPD identified by Skodol et al [4] and Zanarini et al [3].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Skodol et al [4]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Zanarini et al [3]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
Individuals with borderline personality disorder have greater functional impairment than individuals with other personality disorder diagnoses.
“A controlled comparison of functional impairment in patients with PDs revealed that individuals with BPD have greater impairment than individuals with other PD diagnoses [3]”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [3] Zanarini, 2005, Psychosocial functioning of borderline patients and axis II comparison subjects followed prospectively for six years, J Personal Disord source
- Interpretationreasoning
The economic impact of a BPD diagnosis is likely considerable.
“Given the significant increase in treatment utilization by patients in the BPD group over utilization by patients in the MAD group, the economic impact of a BPD diagnosis is likely considerable.”
Quote in the paperSubstantial claim - Interpretationreasoning
The BPD group's increased time spent inpatient for psychiatric hospitalization is consistent with the suicidal ideation, suicidal gestures, and impulsivity that characterize the disorder.
“This is consistent with the suicidal ideation, suicidal gestures, and impulsivity that characterize the disorder.”
Quote in the paperNot a substantial claim
- Classified as probably not a substantial claim. 16
- May combine two claims. 27
Classified as probably not a substantial claim.
PremisecitationPrevious studies found that patients with OPD were more likely to use specific types of treatment than patients with major depression.
“previous studies, which found that patients with OPD were more likely to use specific types of treatment than patients with major depression [18].”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [18] Bender, 2006, Prospective assessment of treatment use by patients with personality disorders, Psychiatr Serv source
Probably not a substantial claim: may not pass S3 (load-bearing).
InterpretationcitationThese findings match the results of previous investigations of treatment utilization by patients with BPD.
“These findings match the results of previous investigations of treatment utilization by patients with BPD [9,18].”
Quote in the paperNot a substantial claim1 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationRates of diagnostic cooccurrence among the PD groups were reflective of clinical samples.
“although rates of diagnostic cooccurrence among the PD groups was reflective of clinical samples [12,22,23].”
Quote in the paperNot a substantial claim2 of 3 sources checked- cites [12] McGlashan, 2000, The Collaborative Longitudinal Personality Disorders Study: baseline axis I/II and II/II diagnostic co-occurrence, Acta Psychiatr Scand source
- cites [22] Tyrer, 1997, Extent of comorbidity between mental state and personality disorders, J Personal Disord source
- cites [23] Grilo, 2002, Co-occurrence of DSM-IV personality disorders with borderline personality disorder, J Nerv Ment Dis source
May combine two claims.
Findingown dataRatings of friendships for the best 6 months in the past 2 years showed that the BPD and OPD groups had significantly more dysfunction in friendships than the healthy group and the BPD group had significantly more dysfunction in friendships than the MAD group.
“Ratings of friendships for the best 6 months in the past 2 years revealed that the BPD and OPD groups had significantly more dysfunction in friendships than the healthy group and the BPD group had significantly more dysfunction in friendships than the MAD group.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataFor global satisfaction during the best 6 months within the past 2 years, the BPD and OPD groups were significantly more dissatisfied than the MAD group, which was significantly more dissatisfied than the healthy group.
“Ratings of global satisfaction for the best 6 months within the past 2 years revealed that the BPD and OPD groups were significantly more dissatisfied than the MAD group, which was significantly more dissatisfied than the healthy group.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataFor GAF scores, the BPD group had greater functional impairment than the MAD group, which had greater functional impairment than the healthy group, during both the month before assessment and the best 6 months over the past 2 years.
“Ratings of GAF scores revealed that the BPD group had greater functional impairment than the MAD group, which had greater functional impairment than the healthy group.”
- Also stated in: § 3.2. Psychosocial functioning · plain
“This pattern was true for functional impairment during the month before assessment and the best 6 months over the past 2 years.”
Quote in the paperSubstantial claim- Also stated in: § 3.2. Psychosocial functioning · plain
May combine two claims.
Findingown dataRatings of friendships for the month before assessment showed that the BPD group had significantly more dysfunction in friendships than the OPD group or the MAD group, and both the BPD and OPD groups were significantly more dysfunctional in relations with friends than the healthy group.
“Ratings of friendships for the month before assessment revealed that the BPD group had significantly more dysfunction in friendships than the OPD group or the MAD group, and both the BPD and OPD groups were significantly more dysfunctional in relations with friends than the healthy group.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe BPD group spent more time inpatient for psychiatric hospitalizations in the past 6 months than the OPD, the MAD, or the healthy group, and spent more time inpatient for psychiatric hospitalizations in their lifetime compared to the OPD or the healthy group.
“The BPD group spent more time inpatient for psychiatric hospitalizations in the past 6 months than the OPD, the MAD, or the healthy group, and spent more time inpatient for psychiatric hospitalizations in their lifetime compared to the OPD or the healthy group.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataFor global satisfaction during the month before assessment, the BPD group was significantly more dissatisfied than the MAD or OPD groups, which were significantly more dissatisfied than the healthy group.
“Ratings of global satisfaction for the month before assessment revealed that the BPD group was significantly more dissatisfied than the MAD or OPD groups, which were significantly more dissatisfied than the healthy group.”
Quote in the paperSubstantial claimMay combine two claims.
Findingnone givenThe OPD group was characterized by significant impairment over healthy groups in specific areas of household duties, recreation, friendships and global areas of satisfaction, social adjustment, and GAF.
“The OPD group was characterized by significant impairment over healthy groups in specific areas of household duties, recreation, friendships and global areas of satisfaction, social adjustment, and GAF.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataFor GAF scores, the OPD group had greater functional impairment than the healthy group with a mean GAF score between, but not significantly different from, the BPD group or the MAD group, during both the month before assessment and the best 6 months over the past 2 years.
“The OPD group had greater functional impairment than the healthy group with a mean GAF score between, but not significantly different from, the BPD group or the MAD group.”
- Also stated in: § 3.2. Psychosocial functioning · plain
“This pattern was true for functional impairment during the month before assessment and the best 6 months over the past 2 years.”
Quote in the paperSubstantial claim- Also stated in: § 3.2. Psychosocial functioning · plain
May combine two claims.
Findingown dataDifferences between study groups were found during both periods for individual psychotherapy, group psychotherapy, day treatment, psychiatric hospitalization, half-way house, outpatient medical visits, and number of psychiatric medications.
“Differences between study groups were found during both periods for the following areas of psychiatric and nonpsychiatric treatment utilization: individual psychotherapy, group psychotherapy, day treatment, psychiatric hospitalization, half-way house, outpatient medical visits, and number of psychiatric medications.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataFor global social adjustment, the BPD group was significantly more socially impaired than the MAD and OPD groups, which were significantly more socially impaired than the healthy group, during both the month before assessment and the best 6 months over the past 2 years.
“Ratings of global social adjustment revealed that the BPD group was significantly more socially impaired than the MAD and OPD groups, which were significantly more socially impaired than the healthy group.This pattern was true for global social adjustment during the month before assessment and the best 6 months over the past 2 years.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataPsychiatric treatment with significant differences included psychotherapy, day treatment, and psychiatric medications.
“Psychiatric treatment with significant differences included psychotherapy, day treatment, and psychiatric medications.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataEmployment ratings showed that the BPD and MAD groups were significantly more impaired than the healthy group in work performance during the month before assessment and for the best 6 months, while the OPD group was not significantly different from the healthy group in work functioning.
“Employment ratings revealed that the BPD and the MAD groups were significantly more impaired than the healthy group in work performance during the month before assessment and for the best 6 months.Interestingly, the OPD group was not significantly different from the healthy group in terms of work functioning.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataStudy groups differed during both the month before assessment and the best 6 months in employment, household duties, relationships with children, relationships with friends, recreation, global satisfaction, global social adjustment, and global assessment of functioning.
“Differences between study groups were found during both periods for the following areas: employment, household duties, relationships with children, relationships with friends, recreation, global satisfaction, global social adjustment, and global assessment of functioning.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataMembers of the BPD group use more individual and group psychotherapy, day treatment, half-way house programs, outpatient (nonpsychiatric) medical visits, and psychiatric medications than the OPD, the MAD, or the healthy group for both the past 6 months and their lifetime.
“Duncan posthoc tests indicate that members of the BPD group use more individual and group psychotherapy, day treatment, half-way house programs, outpatient (nonpsychiatric) medical visits, and psychiatric medications than the OPD, the MAD, or the healthy group for both the past 6 months and their lifetime.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAlthough there was no difference in number of hospital admissions for nonpsychiatric reasons, the BPD group spent more total days in the hospital for physical health reasons in their lifetime than the OPD, the MAD, or the healthy group.
“Although there was no difference in number of hospital admissions for nonpsychiatric reasons, the BPD group spent more total days in the hospital for physical health reasons in their lifetime than the OPD, the MAD, or the healthy group.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataUnivariate analyses of variance revealed significant effects between study groups for 7 of 8 assessed areas in psychiatric treatment and 1 of 3 areas in nonpsychiatric treatment within the 6-month period before assessment, and 6 of 8 assessed areas in psychiatric treatment and 2 of 3 areas in nonpsychiatric treatment within the lifetime history of the participants.
“Univariate analyses of variance revealed significant effects between study groups for 7 of 8 assessed areas in psychiatric treatment and 1 of 3 areas in nonpsychiatric treatment within the 6-month period before assessment, and 6 of 8 assessed areas in psychiatric treatment and 2 of 3 areas in nonpsychiatric treatment within the lifetime history of the participants.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataHousehold ratings showed that the BPD group was significantly more impaired in performing household duties than the MAD or OPD group, and the OPD group was significantly more impaired in performing household duties than the healthy group.
“Household ratings revealed that the BPD group was significantly more impaired in performing household duties than the MAD or the OPD group, and the OPD group was significantly more impaired in performing household duties than the healthy group.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataUnivariate analyses of variance revealed significant effects for 9 of 13 assessed areas of functioning during the month before assessment and 8 of 13 assessed areas during the best 6 months in the past 2 years.
“Univariate analyses of variance revealed significant effects for 9 of 13 assessed areas of functioning during the month before assessment and 8 of 13 assessed areas of functioning during the best 6 months in the past 2 years.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataDifferences between study groups were also found for self-help groups within the past 6 months and for days spent in the hospital for nonpsychiatric admissions.
“Differences between study groups were also found for self-help groups within the past 6 months and for days spent in the hospital for nonpsychiatric admissions.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingnone givenThese differences exist in both recent (month prior) and chronic (best 6 months) levels of psychosocial functioning.
“These differences exist in both recent (month prior) and chronic (best 6 months) levels of psychosocial functioning.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataThese deficits in psychosocial functioning were, in general, present in both the month before the assessment and the best 6 months within the past 2 years, suggesting a longer-term dysfunction not accounted for by any acute symptomatic pattern.
“Third, these deficits in psychosocial functioning were, in general, present in both the month before the assessment and the best 6 months within the past 2 years, suggesting a longer-term dysfunction not accounted for by any acute symptomatic pattern.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationSchizoid, antisocial, histrionic, avoidant, and borderline personality disorders predict lower functioning even when controlling for axis I disorders.
“Other research suggests that schizoid, antisocial, histrionic, and avoidant along with borderline PDs predict lower functioning even when controlling for axis I disorders [5].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [5] Hong, 2005, The longitudinal relationship between personality disorder dimensions and global functioning in a community-residing population, Psychol Med source
Classified as probably not a substantial claim. May combine two claims.
Study design and conductnone givenStudy group assignment was determined by information obtained in the assessment interviews and was congruent with DSM-IV guidelines.
“Study group assignment was determined by information obtained in the assessment interviews and was congruent with DSM-IV guidelines.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductown dataThere were no significant differences between the BPD, OPD, MAD, and healthy groups in marital status, educational attainment, or employment status.
“As summarized in Table 1, logistic regression analyses revealed no significant differences between groups in these demographic features.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataIndividuals in the BPD group were characterized by substantially lower psychosocial functioning levels for global and specific areas than healthy individuals, and frequently significantly more impairment than either the OPD or the MAD group.
“Individuals in the BPD group were characterized by substantially lower psychosocial functioning levels for global and specific areas than healthy individuals, and frequently significantly more impairment than either the OPD or the MAD group.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationBorderline personality disorder individuals differ in usage of outpatient, inpatient, and psychopharmacologic treatments when compared to major depression groups without personality disorder.
“and when compared to major depression groups without PD [9].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [9] Bender, 2001, Treatment utilization by patients with personality disorders, Am J Psychiatry source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPsychosocial impairment, particularly with social relationships, seems relatively stable over time.
“Psychosocial impairment, particularly with social relationships, also seems relatively stable over time [6]”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] Skodol, 2005, Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder over two years, Psychol Med source
Classified as probably not a substantial claim.
PremisecitationBorderline personality disorder individuals differ in usage of outpatient, inpatient, and psychopharmacologic treatments when compared to other personality disorder groups.
“Previous studies on individuals with PD diagnoses demonstrated that BPD individuals differ in usage of outpatient, inpatient, and psychopharmacologic treatments when compared to other PD groups [7,8]”
Quote in the paperSubstantial claim0 of 2 sources checkedClassified as probably not a substantial claim.
PremisecitationPatients with any personality disorder are more functionally impaired than those without a personality disorder.
“Research suggests that patients with any PD are more functionally impaired than those without a PD [2].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [2] Nakao, 1992, Functional impairment in personality disorders, J Personal Disord source
Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).
InterpretationreasoningThe results presented here may differ for participants recruited from psychiatric samples that are treatment seeking or from samples in the community that are more resistant or reluctant to become involved in a research study.
“The results presented here may differ for participants recruited from psychiatric samples that are treatment seeking or from samples in the community that are more resistant or reluctant to become involved in a research study.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe relatively small sample size may limit the ability to detect small effects or differences.
“One potential limitation is the relatively small sample size, which may limit our ability to detect small effects or differences.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationOther prospective PD research suggests that a level of stability is present in functional impairment, particularly for problems in social relating.
“Other prospective PD research suggests that a level of stability is present in functional impairment, particularly for problems in social relating [6].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] Skodol, 2005, Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder over two years, Psychol Med source
May combine two claims.
Interpretationnone givenCommunity samples meeting diagnostic criteria for these disorders demonstrate similar patterns of psychosocial functioning between groups as well as significantly different clinical impairment from healthy groups.
“It is nonetheless interesting that community samples meeting diagnostic criteria for these disorders demonstrate similar patterns of psychosocial functioning between groups as well as significantly different clinical impairment from healthy groups.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationParental BPD diagnosis impacts a child's mental health.
“it is supported by recent findings that parental BPD diagnosis impacts a child's mental health [17].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [17] Abela, 2005, The impact of parental borderline personality disorder on vulnerability to depression in children of affectively ill parents, J Personal Disord source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationDepression has a significant economic impact on medical care costs and worker productivity.
“Previous research indicated that depression has a significant economic impact on medical care costs [19] and worker productivity [20]”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe psychosocial functioning levels were solely based on participant report.
“A further limitation is that the psychosocial functioning levels were solely based on participant report.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningPDs are a source of considerable psychologic distress and functional impairment equivalent to, and at times exceeding, the distress found in mood and anxiety disorders.
“these findings suggest that PDs are a source of considerable psychologic distress and functional impairment equivalent to, and at times exceeding, the distress found in mood and anxiety disorders.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThere are typically high rates of diagnostic co-occurrence of depressive disorders with BPD.
“given the typically high rates of diagnostic co-occurrence of depressive disorders with BPD [21]”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [21] Gunderson, 2004, Major depressive disorder and borderline personality disorder revisited: longitudinal interactions, J Clin Psychiatry source
The paper relies on this without support.
Prior research has not examined the clinical significance of psychosocial dysfunction between BPD, other personality disorder, and major depression groups when compared to a healthy group, nor documented the clinical impairment of these groups in relation to each other and a healthy comparison group.
“Although research has differentiated impairment in BPD patients relative to other PDs and to major depression, research has not examined the clinical significance of dysfunction between these groups when compared to a healthy group.”
“Although several studies have documented functional impairment in patients with PDs compared to patients with axis I disorders, none have documented the clinical impairment of these groups in relation to each other and a healthy comparison group.”
The paper relies on this without support.
It remains unknown whether there are areas of psychosocial impairment specific to personality disorder or whether impaired functioning is similar to that observed for other psychiatric disorders, relative to psychiatrically healthy controls.
“In particular, it remains unknown whether there are areas of psychosocial impairment specific to PD or whether impaired functioning is similar to that observed for other psychiatric disorders, relative to psychiatrically healthy controls.”
The paper relies on this without support.
Few studies have examined whether specific areas of impairment differ between personality disorder groups, particularly between groups with borderline personality disorder and other personality disorder diagnoses or healthy controls.
“A few studies have examined psychosocial functioning in PDs relative to other psychiatric disorders, and even fewer have examined whether specific areas of impairment differ between personality disorder groups, particularly between groups with borderline personality disorder (BPD) and other PD diagnoses or healthy controls.”
The paper relies on this without support.
Ample power was present to allow detection of clinically meaningful differences between groups in global and specific areas of functioning as well as treatment utilization.
“However, ample power was present to allow detection of clinically meaningful differences between groups in global and specific areas of functioning as well as treatment utilization.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The wide-spread use of pharmacotherapy in patients with BPD is adequately reflected by the included primary studies.
“Overall, the wide-spread use of pharmacotherapy in patients with BPD (Ansell 2007; Hörz 2010) is adequately reflected by the included primary studies.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Ansell 2007
Borderline traits showed the strongest association with disability pensioning among individual personality disorder traits (OR 1.76).
“Borderline traits showed the strongest association (OR 1.76), consistent with previous studies indicating that impairment in borderline PD is particularly severe [13, 16, 19].”
From Personality disorders are important risk factors for disability pensioning (2014) · cites this paper as [13]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Sex counts leave five participants unaccounted for
MinorThe reported counts of men and women add to 125, not the stated total of 130 participants. The text does not account for the remaining five.
Reported 130 · recomputed 125
“Of the 130 participants, 41 (31.5%) men and 84 (64.6%) were women.”
Psychotherapy variability is impossible within six months
MinorTable 4 describes treatment use within six months, yet reports individual-psychotherapy means and standard deviations of 3.83 and 4.11 months for BPD, and 0.75 and 4.24 months for healthy participants. For values bounded between zero and six months, those standard deviations cannot occur with the stated means.
“Table 4 Treatment utilization by subjects within the past 6 months”
“Individual psychotherapy (mo) 3.83 4.11 1.88 2.51 0.96 2.13 0.75 4.24”
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Keller, M. B. (1987) · Archives of General Psychiatry · doi:10.1001/archpsyc.1987.01800180050009 · Cited by 1,643 · see citing works
(1997) · American Psychiatric Press eBooks · Cited by 1,436 · see citing works
Treatment utilization by patients with personality disorders
Bender, D. S., Dolan, R. T., Skodol, A. E., Sanislow, C. A., Dyck, I. R., McGlashan, T. H., Shea, M. T., Zanarini, M. C., Oldham, J. M., & Gunderson, J. G. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.2.295 · Cited by 779 · see citing works
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Self-citationHealth and disability costs of depressive illness in a major U.S. corporation
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Self-citationInformant-reports of personality disorder: relation to self-reports and future research directions
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Treatment histories of borderline inpatients
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Major Depressive Disorder and Borderline Personality Disorder Revisited: Longitudinal Interactions
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Brief Reports: Prospective Assessment of Treatment Use by Patients With Personality Disorders
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Self-citationEconomic implications of treatment-resistant depression among employees
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Special Feature: Extent of Comorbidity Between Mental State and Personality Disorders
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Newer anticonvulsants in the treatment of bipolar disorder.
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Functional impairment in personality disorders
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Co-occurrence of DSM-IV personality disorders with borderline personality disorder
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Self-citationBorderline personality and psychotropic medication prescription in an outpatient psychiatry clinic
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Psychological therapies for people with borderline personality disorder.
Stoffers-Winterling, J. M., Völlm, B. A., Rücker, G., Timmer, A., Huband, N., & Lieb, K. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005652.pub2 · Cited by 895 · see citing works
Tomko, R. L., Trull, T. J., Wood, P. K., & Sher, K. J. (2014) · Journal of Personality Disorders · doi:10.1521/pedi_2012_26_093 · Cited by 483 · see citing works
“Specifically, individuals with BPD show impaired functioning in social relationships, occupation, and leisure activities (Ansell et al., 2007; J Pers Disord.”
BackgroundPsychological therapies for people with borderline personality disorder
Storebø, O. J., Stoffers-Winterling, J. M., Völlm, B. A., Kongerslev, M. T., Mattivi, J. T., Jørgensen, M. S., Faltinsen, E., Todorovac, A., Sales, C. P., Callesen, H. E., et al. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012955.pub2 · Cited by 450 · see citing works
Schulze, L., Schmahl, C., & Niedtfeld, I. (2016) · Biological Psychiatry · doi:10.1016/j.biopsych.2015.03.027 · Cited by 48 · see citing works
“Smaller GMV in this brain region was restricted to unmedicated samples of BPD patients (0: [48, 28, 2], SDM-Z 5 23.”
Eaton, N. R., Krueger, R. F., Keyes, K. M., Skodol, A. E., Markon, K. E., Grant, B. F., & Hasin, D. S. (2011) · Psychological Medicine · doi:10.1017/s0033291710001662 · Cited by 275 · see citing works
“Borderline personality disorder (BPD) is a serious form of psychopathology associated with distress, suicide, impaired functioning, and considerable healthcare costs (Skodol et al. 2002 ; Yen et al. 2004 ; Ansell et al. 2007).”
BackgroundPersonality Disorders and the 3-Year Course of Alcohol, Drug, and Nicotine Use Disorders
Hasin, D. S. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.136 · Cited by 200 · see citing works
Interpersonal dysfunction in personality disorders: A meta-analytic review.
Wilson, S., Stroud, C. B., & Durbin, C. E. (2017) · Psychological Bulletin · doi:10.1037/bul0000101 · Cited by 173 · see citing works
Barnicot, K., Katsakou, C., Bhatti, N., Savill, M., Fearns, N., & Priebe, S. (2012) · Clinical Psychology Review · doi:10.1016/j.cpr.2012.04.004 · Cited by 159 · see citing works
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Pharmacotherapy for Borderline Personality Disorder—Current Evidence and Recent Trends
Stoffers-Winterling, J. M., & Lieb, K. (2014) · Current Psychiatry Reports · doi:10.1007/s11920-014-0534-0 · Cited by 114 · see citing works
Keuroghlian, A. S., Frankenburg, F. R., & Zanarini, M. C. (2013) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2013.06.012 · Cited by 110 · see citing works
“, 2011), as well as increased utilization of medical office visits (Ansell et al., 2007; Sansone et al., 1996; Sansone et al., 1998), telephone calls to medical offices (Sansone et al.”
BackgroundPharmacological interventions for people with borderline personality disorder
Stoffers-Winterling, J. M., Storebø, O. J., Ribeiro, J. P., Kongerslev, M., Vӧllm, B., Mattivi, J. T., Faltinsen, E. G., Todorovac, A., Jørgensen, M. S., Edemann-Callesen, H., et al. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012956.pub2 · Cited by 118 · see citing works
Rodriguez-Seijas, C. A., Eaton, N. R., & Krueger, R. F. (2015) · Journal of Personality Assessment · doi:10.1080/00223891.2015.1055752 · Cited by 104 · see citing works
Structural stigma and its impact on healthcare for borderline personality disorder: a scoping review
Klein, P., Fairweather‐Schmidt, A. K., & Lawn, S. (2022) · International Journal of Mental Health Systems · doi:10.1186/s13033-022-00558-3 · Cited by 106 · see citing works
“Exploring the body of literature addressing stigma in relation to BPD will allow us to identify the existing structural problems in healthcare systems and inform recommendations for addressing these significant public health concerns [29].”
BackgroundMcMain, S. F., Chapman, A. L., Kuo, J. R., Guimond, T., Streiner, D. L., Dixon-Gordon, K. L., Isaranuwatchai, W., & Hoch, J. S. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1802-z · Cited by 82 · see citing works
McMain, S., Chapman, A. L., Kuo, J. R., Dixon–Gordon, K. L., Guimond, T. H., Labrish, C., Isaranuwatchai, W., & Streiner, D. L. (2022) · Psychotherapy and Psychosomatics · doi:10.1159/000525102 · Cited by 90 · see citing works
Montejo, Á. L., Arango, C., Bernardo, M., Carrasco, J. L., Crespo-Facorro, B., Cruz, J. J., Del Pino-Montes, J., García-Escudero, M. A., García-Rizo, C., González-Pinto, A., et al. (2017) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2017.02.003 · Cited by 75 · see citing works
Lewis, K. L., Fanaian, M., Kotzé, B., & Grenyer, B. F. S. (2018) · BJPsych Open · doi:10.1192/bjo.2018.72 · Cited by 75 · see citing works
Personality disorders are important risk factors for disability pensioning
Østby, K. A., Czajkowski, N., Knudsen, G. P., Ystrom, E., Gjerde, L. C., Kendler, K. S., Ørstavik, R. E., & Reichborn-Kjennerud, T. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-014-0878-0 · Cited by 72 · see citing works
“76), consistent with previous studies indicating that impairment in borderline PD is particularly severe [13, 16, 19].”
Dialectical behaviour therapy v. mentalisation-based therapy for borderline personality disorder
Barnicot, K., & Crawford, M. (2018) · Psychological Medicine · doi:10.1017/s0033291718002878 · Cited by 70 · see citing works
“Borderline personality disorder (BPD) is a severe mental health problem that is associated with emotional dysregulation, extreme subjective distress, high levels of psychosocial and work impairment, and frequent use of Accident and Emergency (A&E) and inpatient services linked to self-harm and suicide attempts (Ansell…”
BackgroundRomantic attachment style and borderline personality pathology: A meta-analysis.
Smith, M., & South, S. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.101781 · Cited by 63 · see citing works
Utilization of primary care physicians in borderline personality
Sansone, R. A., Farukhi, S., & Wiederman, M. W. (2011) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2011.04.006 · Cited by 59 · see citing works
Doering, S. (2019) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000724 · Cited by 55 · see citing works
“service use is increased compared with other psychiatric diagnostic groups (8,39) and with the general population (38,40).”
Treatment Utilization by Gender in Patients With Borderline Personality Disorder
Goodman, M. S., Patil, U., Steffel, L., Avedon, J., Sasso, S., Triebwasser, J., & Stanley, B. (2010) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000375711.47337.27 · Cited by 52 · see citing works
“Parents were asked to rate their satisfaction with their BPD offspring’s clinicians and satisfaction with their child’s psychiatric health using a 5-point Likert scale anchored with descriptions ranging from very unsatisfied (1) to very satisfied (5), with the midpoint being neutral (3).”
MethodBozzatello, P., Rocca, P., Rosa, M. L. D., & Bellino, S. (2019) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2019.1686482 · Cited by 51 · see citing works
“Patients with BPD exhibit impairment in a wide range of functions [2], to a greater extent than patients with other psychiatric disorders [3].”
BackgroundMolendijk, M. L., Bamelis, L., van Emmerik, A. A. P., Arntz, A., Haringsma, R., & Spinhoven, P. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.09.007 · Cited by 45 · see citing works
Psychological therapies for people with borderline personality disorder
Storebø, O. J., Stoffers-Winterling, J. M., Vӧllm, B., Kongerslev, M., Mattivi, J. T., Kielsholm, M. L., Nielsen, S. S., Jørgensen, M. S., Faltinsen, E. G., Lieb, K., et al. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012955 · Cited by 48 · see citing works
Melartin, T., Häkkinen, M., Koivisto, M., Suominen, K., & Isometsä, E. (2009) · Nordic Journal of Psychiatry · doi:10.3109/08039480903062968 · Cited by 57 · see citing works
The societal cost of treatment-seeking patients with borderline personality disorder in Germany
Wagner, T., Assmann, N., Köhne, S., Schaich, A., Alvarez‐Fischer, D., Borgwardt, S., Arntz, A. R., Schweiger, U., & Faßbinder, E. (2021) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-021-01332-1 · Cited by 43 · see citing works
Harned, M. S., Wilks, C. R., Schmidt, S. C., & Coyle, T. N. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.02.002 · Cited by 39 · see citing works
Using Clinician-Rated Five-Factor Model Data to Score the DSM–IV Personality Disorders
Miller, J. D., Maples, J. L., Few, L. R., Morse, J. Q., Yaggi, K. E., & Pilkonis, P. A. (2010) · Journal of Personality Assessment · doi:10.1080/00223891.2010.481984 · Cited by 39 · see citing works
“This is consistent with previous work that has documented the significant impairment and dysfunction associated with this PD (eg, Ansell, Sanislow, McGlashan, & Grilo, 2007 ; Ryder, Costa, & Bagby, 2007 ; Skodol et al, 2002 ).”
ResultAmianto, F., Ferrero, A., Pierò, A., Cairo, E., Rocca, G., Simonelli, B., Fassina, S., Daga, G. A., & Fassino, S. (2011) · BMC Psychiatry · doi:10.1186/1471-244x-11-181 · Cited by 38 · see citing works
“In order to identify some peculiar therapeutic elements [13], we hypothesized that these two interventions could be addressed to different core psychopathological features of BPD [14,15]: supportive as usual interventions are focused on individuals’ impairment while SB-APP is carefully focused on personality functioni…”
BackgroundManeta, E. K., Cohen, S., Schulz, M. S., & Waldinger, R. J. (2013) · Journal of Personality Disorders · doi:10.1521/pedi.2013.27.2.233 · Cited by 44 · see citing works
Treatment of Borderline Personality Disorder.
Levy, K. N., McMain, S. F., Bateman, A., & Clouthier, T. L. (2018) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2018.07.011 · Cited by 26 · see citing works
Edens, J. F., Marcus, D. K., & Morey, L. C. (2009) · Journal of Abnormal Psychology · doi:10.1037/a0016313 · Cited by 35 · see citing works
“The DIPD-IV is widely used in research and considerable evidence has accumulated in support of its construct validity (e.g., Ansell et al., 2007; Morey et al., 2007).”
MethodCameron, A., Reed, K. M. P., & Gaudiano, B. A. (2013) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-013-9253-9 · Cited by 36 · see citing works
Is Borderline Personality Disorder a Serious Mental Illness?
Le, H., Hashmi, A. M., Czelusta, K.-L. T., Matin, A., Moukaddam, N. J., & Shah, A. A. (2020) · Psychiatric Annals · doi:10.3928/00485713-20191203-02 · Cited by 34 · see citing works
Borderline Personality Disorder
Zimmerman, M. A. (2015) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000226 · Cited by 34 · see citing works
Few, L. R., Miller, J. D., Grant, J. D., Maples, J. L., Trull, T. J., Nelson, E. C., Oltmanns, T. F., Martin, N. G., Lynskey, M. T., & Arpana Agrawal, A. (2015) · Psychological Assessment · doi:10.1037/pas0000142 · Cited by 34 · see citing works
Euler, S., Stalujanis, E., Lindenmeyer, H. J., Nicastro, R., Kramer, U., Perroud, N. A., & Weibel, S. (2019) · Journal of Personality Disorders · doi:10.1521/pedi_2019_33_461 · Cited by 34 · see citing works
Fassbinder, E., Assmann, N., Schaich, A., Heinecke, K., Wagner, T., Sipos, V., Jauch-Chara, K., Hüppe, M., Arntz, A., & Schweiger, U. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1905-6 · Cited by 33 · see citing works
A meta-analysis of psychodynamic treatments for borderline and cluster C personality disorders.
Keefe, J. R., McMain, S. F., McCarthy, K. S., Zilcha-Mano, S., Dinger, U., Sahin, Z., Graham, K., & Barber, J. P. (2020) · Personality Disorders: Theory, Research, and Treatment · doi:10.1037/per0000382 · Cited by 32 · see citing works
Zeitler, M.-L., Bohus, M., Kleindienst, N., Knies, R., Ostermann, M., Schmahl, C. G., & Lyssenko, L. (2018) · Journal of Personality Disorders · doi:10.1521/pedi_2018_32_394 · Cited by 33 · see citing works
Tomko, R. L., Trull, T. J., Wood, P. K., & Sher, K. J. (2013) · Journal of Personality Disorders · doi:10.1521/pedi_2013_27_093 · Cited by 33 · see citing works
Rodriguez-Seijas, C. A., Morgan, T. A., & Zimmerman, M. (2021) · Assessment · doi:10.1177/1073191121991922 · Cited by 31 · see citing works
“The diagnosis of borderline personality disorder (BPD) is associated with a host of deleterious outcomes (Ansell et al., 2007; Grant et al., 2008; Gunderson et al., 2011; Skodol et al., 2002; Zimmerman & Mattia, 1999).”
BackgroundKvarstein, E. H., Arnevik, E. A., Halsteinli, V., Rø, F. G., Karterud, S., & Wilberg, T. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-315 · Cited by 31 · see citing works
“Personality disorders (PD) have been associated with considerable social and occupational impairment, high medical comorbidity, extensive health service use, and low quality of life [1-9].”
BackgroundUnderstanding the Experience of Parents with a Diagnosis of Borderline Personality Disorder
Bartsch, D. R., Roberts, R., Davies, M., & Proeve, M. J. (2016) · Australian Psychologist · doi:10.1111/ap.12174 · Cited by 31 · see citing works
The Limits between Bipolar Disorder and Borderline Personality Disorder: A Review of the Evidence
Sanches, M. (2019) · Diseases · doi:10.3390/diseases7030049 · Cited by 33 · see citing works
Kvarstein, E. H., & Karterud, S. (2013) · Personality and Mental Health · doi:10.1002/pmh.1226 · Cited by 29 · see citing works
Neacsiu, A. D., Rompogren, J., Eberle, J. W., & McMahon, K. (2017) · Behavior Therapy · doi:10.1016/j.beth.2017.10.004 · Cited by 28 · see citing works
Physical health-related quality of life among older adults with personality disorders
Holzer, K. J., & Huang, J. (2018) · Aging & Mental Health · doi:10.1080/13607863.2018.1468412 · Cited by 27 · see citing works
“The inclusion of the other PDs, borderline, schizotypal, and narcissistic PD, could affect these results, especially as borderline and narcissistic PDs have been found to be associated with increased risks of functional impairment (Ansell et al., 2007; Skodol et al., 2002).”
Living through distress: A skills training group for reducing deliberate self-harm
Booth, R., Keogh, K., Doyle, J., & Owens, T. (2014) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465812001002 · Cited by 26 · see citing works
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Personality traits and mental health treatment utilization
Hopwood, C. J., Quigley, B. D., Grilo, C. M., Sanislow, C. A., McGlashan, T. H., Yen, S., Shea, M. T., Zanarini, M. C., Gunderson, J. G., Skodol, A. E., et al. (2008) · Personality and Mental Health · doi:10.1002/pmh.51 · Cited by 25 · see citing works
Self-citationBailey, A. J., & Finn, P. (2019) · Journal of Personality Disorders · doi:10.1521/pedi_2019_33_415 · Cited by 25 · see citing works
Schulze, L., Grove, M., Tamm, S., Renneberg, B., & Roepke, S. (2019) · Scientific Reports · doi:10.1038/s41598-018-37315-x · Cited by 24 · see citing works
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“Patients affected by this disorder often require high treatment costs through broad use of psychiatric services (National Institute for Mental Health in England, 2003; Ansell et al., 2007), stemming in part from their instability in affect and interpersonal relationships.”
BackgroundIs research on borderline personality disorder underfunded by the National Institute of Health?
Zimmerman, M. A., & Gazarian, D. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.09.021 · Cited by 24 · see citing works
“In largely separate literatures both disorders have been associated with impaired occupational functioning (Skodol et al., 2002; Morgan et al., 2005; Kessler et al., 2006; Ansell et al., 2007; Zanarini et al., 2009; Zimmerman et al., 2010), impaired social functioning (Jovev and Jackson, 2006; Grant et al.”
BackgroundKeefe, J. R., Milrod, B. L., Gallop, R., Barber, J. P., & Chambless, D. L. (2017) · Depression and Anxiety · doi:10.1002/da.22708 · Cited by 23 · see citing works
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Bartsch, D. R., Roberts, R., Davies, M., & Proeve, M. J. (2014) · Personality and Mental Health · doi:10.1002/pmh.1274 · Cited by 23 · see citing works
Suicide Attempts in Major Depressed Patients with Personality Disorder
Amore, M., Innamorati, M., Vittorio, C. D., Weinberg, I., Turecki, G., Sher, L., Paris, J., Girardi, P., & Pompili, M. (2013) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12059 · Cited by 22 · see citing works
Haynos, A. F., Widge, A. S., Anderson, L. M., & Redish, A. D. (2022) · Current Psychiatry Reports · doi:10.1007/s11920-022-01320-9 · Cited by 24 · see citing works
Holth, F., Walby, F., Røstbakken, T., Lunde, I., Ringen, P. A., Ramleth, R., Romm, K. L., Tveit, T., Torgersen, T., Urnes, Ø., et al. (2018) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2018.1511751 · Cited by 20 · see citing works
Storebø, O. J., Ribeiro, J. P., Kongerslev, M., Stoffers-Winterling, J. M., Jørgensen, M. S., Lieb, K., BATEMAN, A. W., Kirubakaran, R., Dérian, N., Karyotaki, E., et al. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-047416 · Cited by 21 · see citing works
Improving the Recognition of Borderline Personality Disorder in a Bipolar World
Zimmerman, M. A. (2015) · Journal of Personality Disorders · doi:10.1521/pedi_2015_29_195 · Cited by 21 · see citing works
Larivière, N., Denis, C., Payeur, A., Ferron, A., Levesque, S., & Rivard, G. (2016) · Psychiatric Quarterly · doi:10.1007/s11126-016-9417-3 · Cited by 23 · see citing works
An investigation of the mentalization-based model of borderline pathology in adolescents
Quek, J., Bennett, C., Melvin, G. A., Saeedi, N., Gordon, M. S., & Newman, L. K. (2018) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2018.04.005 · Cited by 19 · see citing works
Borderline Personality Disorder: Updates in a Postpandemic World
Choi-Kain, L. W., Şahin, Z., & Traynor, J. M. (2022) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20220057 · Cited by 18 · see citing works
Is borderline personality disorder only a mental health problem?
Cailhol, L., Francois, M., Thalamas, C., Garrido, C., Birmes, P. J., Pourcel, L., Lapeyre‐Mestre, M., & Paris, J. (2016) · Personality and Mental Health · doi:10.1002/pmh.1350 · Cited by 18 · see citing works
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Pharmacological interventions for people with borderline personality disorder
Stoffers-Winterling, J. M., Storebø, O. J., Vӧllm, B., Mattivi, J. T., Nielsen, S. S., Kielsholm, M. L., Faltinsen, E. G., Simonsen, E. H., & Lieb, K. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012956 · Cited by 18 · see citing works
Borderline Kişilik Bozukluğunun Ergenlik Döneminde Belirlenmesine Dair Bir Değerlendirme
FARAJİ, H. (2021) · Opus uluslararası toplum araştırmaları dergisi · doi:10.26466/opus.898571 · Cited by 15 · see citing works
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Bujalski, A. S., Chesin, M. S., & Jeglic, E. L. (2017) · Current Psychology · doi:10.1007/s12144-017-9597-5 · Cited by 13 · see citing works
“BPD is also associated with interpersonal difficulty and loss, including separation and divorce and problems with bosses, co-workers, children and friends (Ansell et al. 2007; Tomko et al. 2014).”
BackgroundLu, W.-H., Wang, P., Ko, C., Hsiao, R. C.-J., Liu, T., & Yen, C. (2017) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2017.04.020 · Cited by 12 · see citing works
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The prediction of healthcare utilization by three self-report measures for borderline personality
Sansone, R. A., McLean, J. S., & Wiederman, M. W. (2008) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651500802238901 · Cited by 13 · see citing works
“Ansell and colleagues [4] also affirmed greater medical healthcare utilization by patients with BPD.”
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Personality dysfunction and employment dysfunction: double, double, toil and trouble.
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Exploring Social Participation of People with Cluster B Personality Disorders
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“From previous studies (Ansell et al., 2007; Skodol et al., 2002; Zanarini et al., 2005) and this investigation, there seems to be a strong trend that employment, relationships, and recreation are areas of life that are problematic for people with cluster B personality disorders.”
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“005 comorbidity and are also more complex in psychiatric intervention [1-4].”
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“Insecure attachment relationships (Berlin, Cassidy, & Appleyard, 2008) and psychopathology (Ansell, Sanislow, McGlashdan, & Grilo, 2007; Rodriguez, Bruce, Pagano, & Keller, 2005) including anxiety disorders (Ansell et al., 2007; Beard, Weisberg, & Keller, 2010; D’Avanzato et al., 2013; Essau, Lewinsohn, Olaya, & Seele…”
Neurological soft signs in adolescents with borderline personality traits
Zhang, J., Cai, L., Zhu, X., Yi, J., Yao, S., Hu, M., Bai, M., Li, L., & Wang, Y. (2014) · International Journal of Psychiatry in Clinical Practice · doi:10.3109/13651501.2014.981544 · Cited by 10 · see citing works
“Individuals with BPD have a tendency of suicide, self-injury, and distress, and are associated with substantial morbidity of other mental disorders and impaired cognitive function (Ansell et al. 2007; Skodol et al. 2002; Yen et al. 2004).”
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“Most individuals diagnosed with BPD report severe functional impairments across interpersonal, occupational, academic, and financial domains (Ansell et al. 2007; Jørgensen et al. 2009; Skodol et al. 2002; Winograd et al. 2008), and these impairments are higher in BPD than in other personality…”
Steylaerts, B., Dierckx, E., & Schotte, C. (2023) · Cognitive Therapy and Research · doi:10.1007/s10608-023-10349-w · Cited by 9 · see citing works
“Personality disorders (PDs) are severe mental conditions that can lead to a significant decrease in quality of life (Ansell et al., 2007) and psychosocial functioning (Nakao et al.”
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“BPD symptoms severely reduce patients’ quality of life and impair their psychosocial functioning [49, 53].”
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Transcranial Magnetic Stimulation in Neuropsychiatry
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“PD has been linked to high emergency department (ED) usage, partly resulting from high rates of suicidal behaviour and drug use.(10,11) In one study, it was found that 20.”
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“Individuals with BPD utilize significantly more treatment resources than individuals with mood, anxiety, or other personality disorders (Ansell et al., 2007).”
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Borderline Personality Disorder
Chapman, A. L., Hope, N. H., & Turner, B. J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108333931.041 · Cited by 6 · see citing works
Structural stigma and its impact on healthcare for borderline personality disorder: a scoping reviewPreprint
Klein, P., Fairweather‐Schmidt, A. K., & Lawn, S. (2022) · Research Square · doi:10.21203/rs.3.rs-1672634/v1 · Cited by 6 · see citing works
Symptom domains and psychosocial functioning in borderline personality disorder
Culina, I., Ranjbar, S., Maillard, P., Martin-Söelch, C., Berney, S., Kolly, S., André, J., Conus, P., & Kramer, U. (2024) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-024-00255-2 · Cited by 6 · see citing works
“Even though functional impairment can result from any mental disorders, research suggests that individuals with BPD are more likely to present difficulties in psychosocial functioning in comparison to almost all other personality disorders [8, 15], as well as mood and anxiety disorders [30].”
- Authors
- Ansell, E. B., Sanislow, C. A., McGlashan, T. H., & Grilo, C. M.
- Affiliations
- Yale University (US)
- Corresponding author
- Ansell, Emily B.
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 2007-07
- Volume
- 48
- Issue
- 4
- Pages
- 329-336
- ISSN
- 0010-440X (ISSN-L)
- OpenAlex
- W2114160321
- Cited by
- 143
- References
- 25
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 5 · 2023: 4 · 2022: 11 · 2021: 9 · 2020: 7 · 2019: 13 · 2018: 16 · 2017: 9 · 2016: 7 · 2015: 7 · 2014: 9 · 2013: 8 · 2012: 7
- FWCI
- 4.72
- Type
- journal article
- Language
- en
- Open access
- green
- works.bepress.com
- Locations
- Comprehensive Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Wesleyan University Digital Collections (Wesleyan University) (submittedVersion)
- Wesleyan University Digital Collections (Wesleyan University) (submittedVersion, public-domain)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- WESLEYAN
- Funders
- National Institutes of Health
- National Institute of Mental Health (MH50850, MH01654, K23MH073708, MH 073708, K05MH001654)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- borderline personality disorder, personality disorders, mood disorders, anxiety disorders, psychosocial functioning, functional disability, treatment utilization, psychiatric treatment, public health impact
- MeSH terms
- Adaptation, Psychological, Adult, Anxiety Disorders, Borderline Personality Disorder, Cross-Sectional Studies, Female, Health Status, Humans, Interpersonal Relations, Male, Mental Health Services, Middle Aged, Patient Acceptance of Health Care, Personality Disorders, Psychiatric Status Rating Scales, Psychotherapy, Social Adjustment, Stress, Psychological, Mood Disorders
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