Delay of discounting (DD) refers to the tendency to prefer immediate but smaller rewards to delayed larger ones. High co-morbidity and the remarkable role of impulsivity in both borderline personality disorder (BPD) and substance abuse (SUD) justify a deficit in DD. The aim of the current study was therefore to explore the effect of BPD and SUD regarding delay discounting and to explore group differences concerning the different types of substances participants use.

We compared 4 groups, a total of N = 345 participants: 3 clinical and a healthy comparison group: BPD with (N = 74) and without (N = 36) SUD, substance users without BPD (N = 124) and a healthy comparison group (N = 111). Impulsivity (Barratt Impulsiveness Scale), symptom severity (Brief Symptom Inventory), the presence of BPD (Structured Clinical Interview for DSM-IV Disorders) and delay discounting task were assessed.

Data suggests that the BPD + SUD group has the strongest preference for immediate rewards as opposed to a larger reward in the future compared to the CG and the SUD-only.

BPD + alcohol using group have significant deficit in DD compared to CG while the other substances with or without the presence of BPD do not seem to make a difference.

Results suggest that only the presence of both BPD and SUD play a role in the deficit of delaying gratification, either one does not. These results also propose that BPD and deficit in DD may well be a vulnerability marker for alcohol dependence.

The National Institute for Health and Clinical Excellence (NICE) guidelines state that patients with Borderline Personality Disorder (BPD) should not be prescribed medication for the individual symptoms related to the illness and that psychological interventions should be considered as part of their management. We aimed to assess the use of medication and access to psychological therapies in an inpatient population, after the implementation of NICE guidance introduced in January 2009.

This was a retrospective study. Case notes of patients with a diagnosis of BPD (ICD-10 F60.3 and F60.31), discharged from four acute inpatient wards in Sheffield for a period of twelve months, were studied using a structured questionnaire based on BPD NICE guidance (2009).

There were 68 discharges, involving 47 patients, with BPD accounting for 10.1% of the 670 total discharges. Of the 68 discharges, 78% were prescribed drug treatment specifically for BPD (including antipsychotics, antidepressants, mood stabilisers and anxiolytics), whilst 45% were prescribed medication without documented evidence a co-morbid diagnosis existed, and 41.2% received 3 or more medications. Of the 47 patients, only 17% received a structured psychological intervention which included cognitive analytical therapy (n = 4), cognitive behavioural therapy (n = 3) and dialectical behavioural therapy (n = 1).

Despite NICE recommendations, patients with BPD continue to receive a variety of psychotropic medications and to have limited interventions from psychological services with a high proportion receiving unstructured therapy. Reasons (including service costs and evidence of effectiveness of all treatments) need to be explored.

To ascertain personality factors that generate vulnerability for suicidal behavior, and can be identified through the Temperament and Character Inventory developed by Robert Cloninger. The Temperament and Character Inventory (TCI) is a battery of tests comprised of a self-assessment questionnaire with 240 items presented as true-or-false statements, which assess 7 high-rank descriptors of personality or behavior. TCI describes a total of 25 traits (12 facets of temperament and 13 of cheracter.A total of 131 patients diagnosed with personality disorders were included in the study. Specific attention was paid to subjects with active suicidality (i.e. recent suicide attempt prior to hospitalization and severe suicide ideation), in which personality disorders were ascertained - this was one of the study groups.

Personality dimensions that both correlate with high levels of hopelessness, and generate increased suicide risk are harm avoidance (increased scores), and low reward dependence, self-directedness and cooperation, respectively.

The borderline personality disorder is a part of the «Impulse spectrum disorders». At the borderlines patients, the impulsiveness expresses itself clinically on two plans: acting out violent and the conducts of dependence.

We propose in this work:

1. – To study the impulsiveness and its consequences at the patients presenting a borderline personality.

2. – And to raise factors correlated in a stronger impulsiveness among these subjects.

It is about a transverse study which took place over a period of 1year. It concerned 50 patients to which the diagnosis of borderline personality was retained according to the criteria of the DSM-IV-TR and having been hospitalized at least once.

We used a semi structured questionnaire managed by an investigator and specific scales of measure.

Our patients with a borderline personality disorder showed important rates of impulsiveness in its three subcategories motricity, non-plannig and cognitive.

This impulsiveness was at the origin of multiple violent acting out. The violence often shows itself from verbal way, then, it can degenerate and take other forms.

Factors correlated at the important rates of impulsiveness at our borderlines patients are: the young age (p = 0,047), the male gender (p = 0,033), personal antecedent of sexual or physical early abuse (p = 0,05 and p = 0,09) and the addictives conducts (p = 0,034).

The reduction of the impulsiveness constitutes an important stage in the coverage of these subjects and in the prevention of this aggressive behavior.

Several studies have stated the possitive effects of physical exercise over mental health, mainly in clinical samples. However, the results of these experimental estudies might not be generalized to general population. Some authors propose that physical activity could be not really promoting a psychological benefit but, instead, be a consequence of some personal or circumstantial features that would be acting as confusion factors. Personality, as it involves a steady pattern of behaviors, is theorized to arise as one of these factors.

Our objective was to assess the relationship between personality features and voluntary physical activity in a medical resident sample from Hospital 12 de Octubre (Madrid).

High levels of voluntary physical activity will be associated to high scores on extraversion and conscientiousness dimensions after assessing personality.

The project has been conducted as a transversal descriptive study. Sample: 80 first-year medical residents, ages 23 to 40, and no story of mental disorder, nor chronic disabilities. Main variables: voluntary physical activity measured through International Physical Activity Questionary (IPAQ) and personality features assessed through Revised NEO Personality Inventory (NEO PI-R) as proposed from the 5 factors model (neuroticism, extraversion, openess, agreeableness and conscientiouness).

Frequency measures have been used to describe qualitative variables. Arithmetic mean and standard deviation were used to describe quantitative variables. Pearson's correlation was used in order to study the relationship between scores on physical activity and personality factors.

We present preliminary results from first stage of the study, as well implications are discused.

The Domains of Perfectionism Scale (DP; Rhéaume et al., 1995) assesses the extent in which the respondent is perfectionist across 22 life domains, using a five-point Likert scale.

1. 1. To analyze the psychometric properties and factorial structure of the Portuguese version of the DP scale;

2. 2. To investigate which domains are more prevalent and whether the DP mean scores are affected by gender.

The Portuguese version of DP scale was administered to a sample of 217 university students (Mean age = 18.50 ± 2.345). To study the temporal stability, 31 respondents answered the scale again after six weeks. Response options were collapsed into 0 and 1, in order to compute the variable “Number of domains” (NrD).

The DP Cronbach's alpha coefficient was .85. The test-retest correlation coefficient for the total score was. 98 (p < .001). The factorial analysis resulted in a four factors structure explaining 50.14% of variance: F1 Relationships and Appearance, F2 Studies and Work, F3 Health and Leisure and F4 Order and Domestic Affairs. The most frequent individual domains were Bodily hygiene, Romantic relationships, Work, Social relationships and Studies (>80%). DP total mean score did not significantly differ between genders (Males 66.62 ± 10.446 vs. Females 67.83 ± 7.734, p = .525), nor the NrD (15.76 ± 2.220 vs. 15.52 ± 4.236, p = .752). The individual domains Studies, Orthography, Presentation of documents and Domestic chores and F2 were significantly higher in females; Sports and F3 were significantly higher in males.

The Portuguese version of the DP scale presented good reliability and construct validity.

Neuroticism (N) is a powerful correlate and predictor of many forms of psychopathology. This has prompted many to consider neuroticism an informative causal risk factor for psychopathology. However, this assumption may be flawed and reflect a misunderstanding of the nature of N-measures.

To establish the etiological meaning of the neuroticism-psychopathology association.

Review of relevant literature.

1. (1) The item content of N-measures is similar to (subthreshold) symptoms of psychopathology, especially internalizing disorders.

2. (2) Although N-scores strongly predict mental disorders adequate control for baseline symptoms and earlier episodes is typically lacking.

3. (3) Across adulthood, N-scores and psychiatric symptoms show a similar longitudinal pattern of decreasing differential stability with time, although the stability of N-scores is slightly higher.

4. (4) Differential consistency of both N-scores and psychopathology tend to drop over time, but do approach zero.

5. (5) The genetic influences on N and psychopathology substantially overlap and they share important environmental determinants.

6. (6) N-scores are heterogeneous in terms of lower-order traits, their manifestation in everyday life emotional processes, and innate versus acquired origins.

7. (7) N-scores reflect person-specific negative affect set points.

The prospective neuroticism-psychopathology association is largely non-causal and etiologically non-informative. The great utility of N-measures is that they index risk. In stead of considering high N-scores a causal risk factor that explains psychopathology, high N-scores are better conceptualized as a dependent variable in need of explanation. To become etiologically informative, elucidation of the basis and determinants of N is necessary.

We tried to find the intercorrelations between the: intensity of symptoms of eating disorders in two groups of girls those who used internet pornography and the second one that not used. We further analyzed the group of girls that used internet pornography concerning symptoms of eating disorders and family factors.

186 girls in age 16 to 19.

We used the Inventory that divided the girls into two groups - 29 girls that used internet pornography and 156 who not used Eating Disorders Inventory (by Garner, Olmsted & Polivy) and our own Inventory of Attitudes to Eating Disorders.

1. 1. The girls from the group that used internet pornography more often than the control group girls use laxatives, abuse alcohol and binge.

2. 2. The girls from the group that used internet pornography experience significantly more common emotional, physical and sexual abuse, lack of acceptance, rejection, and more often defend mothers against the aggression of their fathers.

3. 3. More girls from the group that used internet pornography made coalitions with their mothers against their fathers

The knowledge about the specificity of perfectionism domains is scarce.

To explore the extent to which perfectionism is a general personality trait influencing multiple functioning areas rather than a context-specific trait and to investigate the relation between domains of perfectionism and perfectionism dimensions and affect.

217 University students answered to the Portuguese versions of the Domains of Perfectionism Scale (DP; Rhéaume et al., 1995), Multidimensional Perfectionism Scale (Hewitt and Flett, 1991; MPS-H&F), Multidimensional Perfectionism Scale (Frost et al., 1990; MPS-F) and Profile of Mood States (McNair et al., 1971).

On average participants were perfectionists in approximately 15 domains. All the 22 individual domains and the 4 DP factorial scores presented moderate (≥.30) to high (≥.50) coefficients with the Number of Domains (NrD). Self Oriented Perfectionism (SOP/MPS-H&F), was the perfectionism dimension correlating with most DP variables; Social Prescribed Perfectionism (MPS-H&F) did not significantly correlate with any DP variable. Organization and Personal High Standards (both MPS-F) significantly and positively correlated with several specific domains and with the NrD. Positive Affect (PA), but not Negative Affect, presented positive correlations with almost all DP variables, including NrD. The mean NrD, SOP and PA were significantly higher in subjects who considered themselves highly perfectionist in the most prevalent domains of perfectionism. PA, Organization and SOP were independent significant predictors of the NrD.

Perfectionism influence multiple areas; perfectionism expressing in a greater number of life domains seems to be internally motivated and to be associated with positive psychological variables.

The aim of this open study was to assess the effectiveness of a 6-week combined therapy with the application of bright light (10,000 lux, 6:30 to 7:30 a.m. for 6 weeks) added to SSRIs in drug-resistant depressed patients with comorbid BPD who did not respond with improvement to 6-week administration of antidepressants. The study comprised 13 female patients who met the ICD-10 diagnostic criteria for research and the DSM-IV-TR diagnostic criteria for major depression. The participants were regularly evaluated using the CGI, HAMD and MADRS scales and the BDI and BDI self-report inventories.

According to all the assessment instruments, the application of bright white light leads to a significant improvement. However, the results must be interpreted with caution due to the open nature of the study.

By IGA MZ CR NT 11047-4/2010

The aim of the study was to asses the efficacy of the 6 week therapeutic program designed for social phobia (SSRIs and CBT) in patients suffering with social phobia and comorbid personality disorder (27 patients) and social phobia without comorbid personality disorder (26 patients). Patients were assessed in week 0, 2, 4, and 6 on the CGI, LSAS, BAI and BDI.

Patients of both two groups improved in assessment instruments. The treatment efficacy in the patients with social phobia without personality disorder had been showed significantly better compared with the group with social phobia comorbid with personality disorder in CGI and LSAS. Also the scores in subjective depression inventory BDI showed significantly higher degrease during the treatment in the group without personality disorder. But the treatment effect between groups did not differ in subjective general anxiety scales BAI.

The low frequency rTMS administered over the right dorso-lateral prefrontal cortex after 10sessions did not differ from sham rTMS that was add on serotonin reuptake inhibitors in patients suffering from panic disorder. Further studies are indicated to assess the efficacy of rTMS in panic disorder and to clarify the optimal stimulation characteristics.

By IGA MZ CR NT 11047-4/2010.

Borderline Personality Disorder (BPD) is a common psychiatric disorder and the most frequent personality disorders.

To review the scientific literature and search for features of psychobiological disposition to BPD in childhood and the influence of parental educative strategies on the development of this personality disorder; to review the scientific advances on heritability and neurobiology of BPD.

Using Pubmed, we have searched for research and review articles published in the last ten years. The keywords were: borderline personality disorder and genetics, neurobiology and development.

We have obtained 23 related articles.

There is supporting evidence that the preborderline child has a genetically based hypersensitivity to interpersonal interactions that interacts with adverse early caretaking experiences and later stressors to become elaborated into disorganized and controlling interpersonal strategies. These interpersonal strategies then provide the soil from which the borderline patient's prototypically contradictory interpersonal features arise.

Juvenile delinquency represents a broad term to identify behaviors that vary from engaging in status offenses (eg running away from home, school absenteeism, alcohol consumption) up to engage in criminal acts and violence (use/distribution of illegal substances, burglary, robbery). (Montgomery & colab., 2001)

Identifying personality disorders in delinquent adolescents.

This paper aimed to determine if juvenile deliquency is related to personality disorders and a set of risk factors.

We used a lot of 30 patients, aged 14–18 years, subjected to forensic examination at the Child Psychiatry Clinic of Cluj-Napoca during 2011. To assess personality disorders we used SCID II - structured interview to identify personality disorders on axis II-DSM and a set of questions related to the origin area, socioeconomic status, education level, family environment, consumption of toxic, belonging to certain social groups, family history,were adressed to the adolescents and their parents. To assess intellectual coefficient were used Raven Progressive Matrices.

The most common personality disorders found in delinquent teenagers were borderline personality disorder, obsessive-compulsive personality disorder, narcissistic personality disorder and traits of antisocial personality disorder. We couldn't identify a statistically significant relationship between the family environment, the socioeconomic status, the presence of a concurrent psychiatric disorder, the consumption of toxic, the education level and juvenile deliquency.

Because juvenile delinquency represents a real social problem is important to identify underlying traits or personality disorders in order to establish individualized and specific treatment plans.

The convenience of a dimensional Axis II in the DSM-5 has been discussed, since there is criticism about the current categorical model, such as the high comorbidity or the scarce interrater agreement. Some think that those flaws could be attributed to the lack of an underlying theoretical model. To this respect, there are evidences that show that the personality disorders could be considered as extreme cases of normal personality traits. We try to find out if the factor analysis of a personality disorder scale (MCMI-III) reflects normal personality factors.

Participants and procedure: we analyzed the MCMI-III (Millon, 1998) profiles of 50 Personality Disorders patients and 50 controls. Principal Components Factor Analyses with varimax rotation were computed globally and separately for each sample.

A three factor structure (paranoid introversion, self control and insecurity) was found when analyzing both samples together. The separated samples analysis showed the same structure in controls, while in patients we found a three factor structure: neurotic introversion, hostility and self control. Both structures were basically equivalent, and differences among them could be qualified by a test bias (namely, higher averages for patients in the anxious and psychotic-like disorders).

Factor structures did not reflect the DSM-IV cluster division, and neither did it reflect Millon's classification. Conversely, the factors we found were consistent with personality traits previously described by normal personality models (e.g.: Cattell, 1957; Costa y McCrae, 1990; Eysenck, 1981).

To identify clinical and sociodemographic characteristics of people with BPD in secondary care mental health service.

29 individuals (27 women and 2 men, average age 32.8 years) with a diagnosis of BPD treated within secondary care services from 1st January to 31st December 2010.

96.5% of the clients were on a combination of psychotropics; 93% on antidepressants; 82% on anxiolytics; 72.4% on antipsychotics; 55% on hypnotics; 38% on mood stabilisers; and 24% taking other medication. All had a co-morbid axis-I disorder; moreover 55% of subjects had two, and 14% three co-morbidities. Substance misuse (44.8%), “neurotic” disorders (41.4%), depression (27.6%); and eating disorders (13.8%) were the most common co-morbidities. 55% disclosed a history of a sexual abuse. 60% had been assessed, and 40% detained under the MHA 1983. 96.5% were admitted to hospital, with the average length of admission of 41 days. 68% admitted ≥2 times; and on average, each client had a history of 3 admissions within a year. 90% had basic education and were unemployed. All patients had a history of a suicide attempt; 90% requiring an assessment at the A&E; 80% attending the A&E ≥2 times; and on average clients attended the A&E 5 times a year. One patient died as a result of hanging.

People with BPD represent one of the most challenging groups of patients, with multiple needs. Polypharmacy and co-morbidity is very widespread. They are one of the most frequent consumers of emergency services, requiring immediate medical and psychiatric input.

Borderline personality disorder (BPD) is characterized by impulsivity with emotional and behavioral dysregulation. Inappropriate anger becomes a central problem of these patients who underwent aggressive behavior against themselves or against other. Impulsive aggression has been consistently related with serotonergic dysfunction. Drug therapy with SSRIs has proven effective in treatment of impulsive aggression in varying amounts, but still there have not been described clinical predictors of good response to this treatment. Is known that neuroticism is a stable trait in BPD, also related to serotonergic dysfunction.

To investigate the relationship between neuroticism and clinical response to fluoxetine in impulsive aggression in BPD. We hypothesized that the level of neuroticism at baseline may predict aggression response to pharmacologic treatment.

59 patients were recruited, all meet DSM IV criteria for BPD according to IPDE. They did not fulfill criteria for axis I diagnoses or other personality disorders. Patients were treated with fluoxetine (Prozac®) for 12 weeks, in doses 20 to 60 mg. Aggression was measured with OAS-M.

Temperament was evaluated with NEO-PI-R.

Multiple regression analysis of OAS-M reduction at endpoint as dependent variable, and temperament as independent variables shown a significant predictive model with neuroticism as an inverse predictor factor (ß = −0.36, p = 0.005). We discusses that high levels of neuroticism at baseline can predict lower aggression response to fluoxetine, perhaps due to the relationship of both disorders with serotonergic dysfunction.

We can conclude that neuroticism is a relevant predictor of impulsive aggression response to treatment with SSRIs in BPD.