![Page 1: Research into BPD SPDN Jeremy Hall. Borderline Personality Disorder First defined by Gunderson Core features –Affective instability –Interpersonal difficulties](https://reader036.vdocument.in/reader036/viewer/2022062421/56649e425503460f94b34681/html5/thumbnails/1.jpg)
Research into BPD
SPDN
Jeremy Hall
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Borderline Personality Disorder
• First defined by Gunderson
• Core features– Affective instability– Interpersonal difficulties– Impulsivity
• Heritability about 40%
• Strongly associated with early life stress
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The Scale of the Problem
• BPD affects 1-2% of the population
• BPD accounts for 10% OPD contacts
• BPD main diagnosis in 6% admissions
• Frequent cause of attendance at A&E
• Associated with a 10% risk of suicide
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Current Treatments
• 1. Pharmacological Treatments– Antidepressants only if concurrent depression– Antipsychotics for perceptual disturbances– Some evidence for mood stabilisers– All trials very small– NICE unable to recommend any treatment
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Current Treatments
• 2. Psychological Treatments– Best evidence is for DBT– Some evidence also for CBT– HOWEVER
• Trials generally small• Limited availability • Not suitable for all
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How can Research help?
• Psychological Research– Larger studies– “Real-life” settings
• Biological Research– Develop measures of deficits in BPD– Relate these to changes in the brain– Develop new treatments
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Our Research
• Developing measures of BPD symptoms– Affective responses– Interpersonal interactions– Impulsivity
• Determining their specificity to BPD
• Developing translational assessments
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Emotion and Impulse Study
• 1. Background information
• 2. Symptom severity
• 3. Computer tests of:– A. Emotion processing– B. Social responses– C. Impulsivity
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Who did we study?
• 20 people with symptoms
• 20 people without symptoms
• Age range 20-55
• 75% female
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What did we find out?
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Background and Symptoms
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Some things weren’t different…
0
10
20
30
40
CON SYMPT
Group
Ag
e
0
20
40
60
80
100
120
CON SYMPT
Group
IQ
AGE IQ
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… and some things were:
CHILD STRESS DEPRESSION
0
10
20
30
40
50
CON SYMPT
Group
Ch
ild S
tres
s
0
5
10
15
20
CON SYMPT
Group
Ham
ilto
n
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Computer tests 1
Emotion Processing
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Expression in faces
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Facial Emotion Recognition
Anger
Happiness
Fear
Sadness
Surprise
Disgust
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Results: Emotions
0
2
4
6
8
10
12
ANG HAP SAD SUR FEAR DIS
Task
Sco
re CON
SYMPT
**
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Emotion Recognition and Trauma
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Computer tests 2
Social Responses
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Social decisions
Trustworthy?
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Social Judgement
APPROACHABLE NOT APPROACHABLE
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Results: Social
16
18
20
22
24
26
28
30
32
AGE ATT DIS INT TRU APP
Task
Sco
re CON
SYMPT
***
**
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Social Judgement Bias
BPD
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Social Judgement and Trauma
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Computer tests 3
Impulsivity
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Motor Impulsivity
0
50
100
150
200
250
300
350
400
CON SYMPT
Group
SS
RT
(m
s)
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Delayed Reward
£10 Straight away
£20 In two weeks
Which would you prefer?:
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Delayed Reward
0
10
20
30
40
50
60
70
80
90
100
2 7 30 180
Delay (days)
% w
aiti
ng
fo
r la
ter
CON
SYMPT
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Conclusions
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Conclusions
• We could measure difficulties in core areas:– Emotion processing– Social responses– Impulsivity
• What does this mean in the brain?
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Basis in the brain?
PFC
AMY
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The future!
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Acknowledgements
• CSO / SFC
• Merrick Pope
• Katie Nicol
• All the participants
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Contacts
• Jeremy Hall– Email: [email protected]– Tel: 0131 537 6313
• Merrick Pope– Email: [email protected]– Tel: 0131 537 6390