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The purpose of this paper is to examine the associations among psychopathic and borderline traits, intimate partner violence (IPV) and sensitivity to facial affect. The authors hypothesized that IPV men high in psychopathic traits would exhibit reduced sensitivity to expressions of distress specifically (fear + sadness), while IPV men high in borderline traits would show heightened sensitivity to facial affect more generally.

A community sample of 79 IPV men in heterosexual relationships were exposed to slides of facial affect displays while psychophysiological reactions were recorded. Sensitivity to facial affect was operationalized as accuracy in recognizing and skin conductance responses (SCR) while viewing discrete facial expressions.

Borderline personality disorder (BPD) features were positively related to accuracy in labeling fear and surprise while primary psychopathy (Factor 1) was negatively related to accuracy in labeling disgust. Borderline traits were positively associated with SCR while primary psychopathy was negatively associated with SCR while viewing slides of facial affect. Secondary psychopathy (Factor 2) follows the same physiological patterns of BPD traits but the correlates are weaker. Results suggest that IPV men high in traits of primary psychopathy show hypoarousal whereas those high borderline features show hyperarousal to facial emotions.

Limitations include a small sample of heterosexual violent community couples. Women’s IPV was not analyzed. Findings suggest that BPD and primary psychopathy traits are diametrically opposite in SCR, making them powerful comparison groups for psychophysiological studies. Findings challenge Blair’s (1995) model of a specific deficit in processing distress cues for individuals high in psychopathic traits. Rather results suggest that IPV men high in traits of primary psychopathy show more pervasive hypoarousal to facial emotion. The hyperarousal of men high in BPD traits across facial expressions supports Linehan’s (1993) emotional vulnerability model of borderline personality disorder.

Differences in psychophysiological responding to emotions may be clinically relevant in the motivations for violence perpetration. The hypoarousal associated with primary psychopathy may facilitate the perpetration of proactive violence. The hyperarousal associated with BPD and secondary psychopathy may be fundamental in the perpetration of reactive violence. Treatment matching by IPV perpetrators’ personality traits may improve the efficacy of battering intervention programs. Perpetrators high in borderline personality features may benefit from emotional regulation therapies, such as Dialectical Behavior Therapy. IPV men high in traits of primary psychopathy may benefit from affective empathy and validation training.

Currently, battering intervention programs show little efficacy in reducing intimate partner recidivism. Experimental psychopathology studies such as this one may inform advocates seeking to develop new, tailored treatment packages for partner violence offenders with different personality disorder traits.

Many treatment providers assume that men who batter women have deficits in empathy and emotional intelligence. However, this study suggests that rather than global deficits, deficits depend on personality traits. The current study is the first to assess psychophysiological reactivity in response to facial affect displays among IPV perpetrators. Examining SCR responding to photos of facial affect may be used in future studies of affect sensitivity.

The term borderline applied to personality dynamics was first introduced by Adolph Stern in 1938. This new term included a particular group of patients who, in an organizational blurring, remained in the limbo between neurosis and psychosis. To find a more assertive and holistic characterization of borderline personality disorder (BPD), the purpose of this paper is to explore borderline phenomenology, setting boundaries and discussing points of approach and divergence of this personality disorder comparing them specifically to bipolar affective disorder (BAD) and also explore the differences in their treatment and prognosis.

This paper is a review and synthesis of the extant literature, mapping out the similar and unique aspects of each pathology.

Although there are approximation parameters between BPD and BAD, the phenomenology and the course of both diseases appear to be different. Indeed, this paper seems to have some uncertainty about the sphere of each entity and the domain of comorbidity. Despite the overlapping rates found, it is the understanding that the consequences and strategies for managing comorbidity are underexplored.

As the association of both disorders can be difficult not only in terms of management and understanding of their consequences and implications but also in long-term negative perpetuation, this review has direct implications for clinicians so that they can understand the similarities and particularities of each entity, leading to a more correct psychopathological approach in these individuals.

Borderline personality disorder (BPD) is a debilitating illness characterised by a pervasive pattern of emotional instability, interpersonal difficulties and impulsive behaviour in association with repeated self-injury and chronic suicidal ideation. People diagnosed with BPD also have high rates of co-occurring psychopathology, including disorders associated with disturbed impulse control, such as substance use disorder (SUD) and disordered eating behaviours. The co-occurrence of BPD and impulse control disorders contributes to the severity and complexity of clinical presentations and negatively impacts the course of treatment and recovery. This study qualitatively documents aspects of the lived experience and recovery journeys of people diagnosed with BPD and co-occurring SUD and/or disordered eating. This study aims to identify similarities with respect to themes reported at different stages of the recovery process, as well as highlight important factors that may hinder and/or foster recovery.

In-person, in-depth, semi-structured interviews were conducted with 12 specialist service consumers within a clinical setting. Ten women and two men (22–58 years; mean: 35.5 years) were recruited. Interview transcripts were analysed using thematic analysis principles.

As expected, participants with co-occurring disorders experienced severe forms of psychopathology. The lived experience descriptions aligned with the proposition that people with BPD engage in impulsive behaviours as a response to extreme emotional states. Key emergent themes and sub-themes relating to recovery comprised three domains: factors hindering adaptive change; factors assisting adaptive change and factors that constitute change. An inability to regulate negative affect appears to be an important underlying mechanism that links the three disorders.

This study highlights the potential shortcomings in the traditional approach of treating co-occurring disorders of BPD, SUD and eating disorders as separate diagnoses. The current findings strongly support the adoption of an integrative approach to treating complex mental health issues while concurrently emphasising social connection, support and general health and lifestyle changes.

The findings of this study contribute to the burgeoning BPD recovery literature. A feature of the current study was its use of in-depth face-to-face interviews, which provided rich, many layered, detailed and nuanced data, which is a major goal of qualitative research (Fusch and Ness, 2015). Furthermore, the interviews were conducted within a safe clinical setting with engagement facilitated by a clinically trained professional. There was also a genuine willingness among participants to share their stories in the belief that doing so would inform effective future clinical practice. Their willingness and engagement as participants may reflect their progress along the path to recovery in comparison to others with similar diagnoses. Finally, most of the interviewees were engaging in dialectical behavioural therapy (DBT)-style therapies; two were receiving mentalisation-based therapy treatment, and most had previously engaged in cognitive behavioural therapy or acceptance and commitment therapy-based approaches. The predominance of DBT-style therapy may have influenced the ways that themes were articulated. Future studies could supplement this area of research by interviewing participants receiving therapeutic interventions other than DBT for the treatment of BPD and heightened impulsivity.

Borderline personality disorder (BPD) is a complex condition characterized by a number of psychosocial difficulties that typically involve considerable suffering for individuals with the condition. Recovery from BPD may involve specific processes such as work on how the self is perceived by the individual with BPD and his or her relationships which differ from those common to recovery from other mental health conditions. The details of the processes that may best promote changes within the self and relationships are yet to be established. The paper aims to discuss these issues.

In total, 17 consumers from a specialist BPD service were interviewed to identify factors they have experienced that contribute to recovery from BPD. Thematic analysis within a grounded theory framework was used to understand key themes within the interview data. The emphasis was on specific conditions of change rather than the more global goals for recovery suggested by recent models.

Key themes identified included five conditions of change: support from others; accepting the need for change; working on trauma without blaming oneself; curiosity about oneself; and reflecting on one’s behavior. To apply these conditions of change more broadly, clinicians working in the BPD field need to support processes that promote BPD-specific recovery identified by consumers rather than focusing exclusively on the more general recovery principles previously identified within the literature.

The specific factors identified by consumers as supporting recovery in BPD are significant because they involve specific skills or attitudes rather than aspirations or goals. These specific skills may be constructively supported in clinical practice.

This paper aims to examine the ways in which the criminal justice system has evolved to accommodate mental illness. Mental health courts are one such alternative; these courts actively seek rehabilitative and therapeutic outcomes for participants. However, current literature suggests that these courts are ineffective for offenders who have been diagnosed with borderline personality disorder (BPD).

The aim of the current inquiry was to determine the degree to which participation in the Assessment and Referral Court (ARC) List in the Magistrates’ Court of Victoria reduced re-offending rates for offenders diagnosed with BPD by providing a comparative analysis of pre and post ARC List offending.

The results of a two-year recidivism study suggest that successful completion of the ARC List reduces recidivism for 50% of offenders diagnosed with BPD.

To the authoring team’s knowledge, this is the second paper to explore the efficacy of the Assessment of Referral Court List (Magistrates’ Court of Victoria) in reducing recidivist behaviours for programme participants; however, it is the first paper to look specifically at the recidivist behaviours of participants of the Assessment of Referral Court List (Magistrates’ Court of Victoria) who have been diagnosed with BPD.

The purpose of this paper is to explore the lived experience of having a diagnosis of Borderline Personality Disorder (BPD) in a forensic setting.

Semi-structured interviews were conducted with eight women with a diagnosis of BPD in private secure units. The interview data were analysed using interpretative phenomenological analysis (IPA).

Four main themes emerged: identity, power, protection and containment, and confusion. The themes of identity, power and protection and containment represented polarised positions which in turn contributed to the theme of confusion.

There are limitations to this study mainly the heterogeneous nature of the sample. However, good quality control and the similarities with previous findings indicate that this study makes a valuable contribution to the understanding of BPD in a forensic setting. In addition it has implications for further research; exploring sense of self and the differences between a sample from a community and a sample from a forensic setting with a diagnosis of BPD.

For practitioners to acknowledge power dynamics and to be able to formulate and address these with patients with a diagnosis of BPD.

This is the first IPA study to ask women with a diagnosis of BPD in a forensic setting what their experience is. It is a qualitative study due to the need to genuinely explore the topic and to provide a basis for others to conduct further research.

This study aims to identify and critically appraise literature exploring the effectiveness of psychological interventions in improving borderline personality disorder (BPD) symptomatology for individuals who misuse substances.

Systematic searches across six databases (PsycINFO, Embase, Scopus, Medline, CINAHL and ProQuest), hand searching and citation chaining were conducted between June and August 2021. Key search terms included BPD, substance use, therapy and effect. Study and sample characteristics, interventions, outcome measures and key findings were extracted. Quality assessment and a narrative synthesis approach were used to explore strengths, limitations and relationships between and within studies.

Seven eligible reports were included and showed mostly adequate quality. Mixed samples, designs, outcomes, definitions and implementation varied. Treatment completion did not differ significantly between those who did and did not misuse substances. Interventions demonstrated effectiveness in relation to psychiatric symptoms, hospital admissions, self-efficacy and impulsive and self-mutilating (cutting, burning, etc.) behaviours. No effects were found for suicidal or parasuicidal (threats, preparation and attempts) behaviours.

This review only considers individuals with diagnoses of BPD who are not accessing substance misuse treatment. Radically open dialectical behaviour therapy (DBT), therapeutic communities and other interventions are available as interventions for substance misuse (Beaulieu et al., 2021). Based on the findings of this review, it should not be assumed that such interventions affect substance misuse rather than BPD symptomatology. Therefore, future research might explore the effectiveness of these interventions on BPD symptomatology despite this not being the primary target for intervention.

Despite McCrone et al. (2008) noting the cost of this population’s difficulties to both themselves and services, the limited number of studies in this area is astonishing. Despite a lack of quality in the data available, there i some evidence to support the use of DBT and general psychiatric management (GPM) interventions for those with BPD and concurrent substance misuse. It is therefore of principal importance that health and social care services action Public Health England’s (2017) recommendations. Individuals with coexisting BPD and substance misuse would then receive support from any professional they see, who could then refer for psychological therapies.

Although the reports appear to show that DBT, integrated therapies and GPM may be effective for this population, conclusions cannot be drawn with high levels of confidence due to heterogeneity among studies. The findings indicate that future, high-quality research is needed to test the effects of interventions on BPD symptomatology for those who misuse substances. Randomised controlled trials with sufficient statistical power, homogeneous outcomes and standardised methodological approaches are needed.

Recovery is an important concept within mental healthcare policy. There is a growing expectation that clinicians adopt approaches that align with the recovery principles, despite significant disagreements about what recovery-oriented interventions might look like in practice. It is also unclear how recovery may be relevant to personality disorder. This paper aims to discuss these issues.

In total, 16 clinicians were interviewed at two mental health services in Melbourne, Australia. These clinicians had specialist training and experience in the treatment of borderline personality disorder (BPD) and provided insight regarding the meaning and relevance of the recovery paradigm in the context of BPD. Thematic analysis within a grounded theory approach was used to understand key themes identified from the interview data.

Thematic analysis suggested that clinicians understand recovery in three distinct ways: as moving towards a satisfying and meaningful life, as different ways of relating to oneself and as remission of symptoms and improved psychosocial functioning. Clinicians also identified ways in which recovery-related interventions in current use were problematic for individuals diagnosed with BPD. Different approaches that may better support recovery were discussed. This study suggests that practices supporting recovery in BPD may need to be tailored to individuals with BPD, with a focus on cultivating agency while acknowledging the creative nature of recovery.

Clinicians are in a strong position to observe recovery. Their insights suggest key refinements that will enhance the ways in which recovery in BPD is conceptualized and can be promoted.

The purpose of this study is to investigate how mock jurors’ experiences of deliberations are impacted by the defendant having a personality disorder.

This study used a qualitative approach to explore mock jurors’ experiences during the deliberations of a fictional defendant, Sarah Priest. Ten participants formed two mock juries, and each mock jury were given two case studies to deliberate. Case study one described Priest as having “Severe Personality Disorder, Borderline Pattern” whereas case study two described Priest as having “Complex Mental Health Problems”. There were no changes to the content of the case studies aside from the change in language used to describe the defendant.

An inductive thematic analysis identified two main themes relating to juror experience: “Interaction with Other Mock Jurors” and “Language as a Barrier to a Verdict”. Participants constructed that prosocial interactions with other mock jurors in the deliberations helped them make a verdict decision, but some of these interactions led to disagreements between participants due to a wide variation of opinion. Second, the different description of the defendant in each case study were constructed to have made the deliberations and decision-making difficult, but for different reasons. In case study one, a lack of knowledge surrounding BPD was the reason for this difficulty, and in case study two, participants thought that the applicability of diminished responsibility criteria were unclear, making it hard to reach a verdict.

The findings have key implications for the judicial system; common experiences can be identified and recorded to implement procedures to protect jurors from adverse experiences.

There is a lack of studies that have investigated juror experience in the UK, and the few studies available have used a quantitative methodology. The approach taken in the current study is, therefore, unique in a UK context. The findings have key implications for the judicial system; common experiences can be identified and recorded to implement procedures to protect jurors from adverse experiences.

Borderline personality disorder (BPD) is a controversial psychiatric diagnosis. Despite an increasing amount of research looking at the BPD diagnosis when applied to young people, there is limited understanding of the key viewpoints of mental health professionals working with young people in the UK. This research aims to use Q-methodology to contribute to understanding the multiple views of the diagnosis.

Q-statements about views of the BPD diagnosis were selected from relevant journals, internet sites and social media platforms and were validated by a Q-methodology research group, the research supervisors and an online group of individuals with BPD. Q-sorts were then used to explore the viewpoints of 27 mental health professionals in the UK working with children and adolescents. Analysis of the data was completed using Q-methodology analysis software.

Three main factors emerged from the data, explaining 66% of the variance. Of the 27 participants, 24 loaded onto these three factors, defined as: harmful not helpful; language and optimism; and caution and specialist services. Three Q-sorts did not load significantly onto any one factor.

There appears to be at least three ways of understanding the BPD diagnosis for young people. It may be useful for clinicians to consider and share their own viewpoint, be open to difference and formulate difficulties from an individual perspective.