L’agression sur soi, par des automutilations ou par des comportements suicidaires, constitue l’une des facettes de l’impulsivité les plus spécifiques du comportement borderline chez les patients adultes [2] et ces patients présentent une vulnérabilité psychiatrique plus importante, notamment, en termes de dépression [1]. La tentative de suicide à l’adolescence est un véritable problème de santé publique et les unités de soins pour adolescents sont confrontées quotidiennement à ces patients qui passent à l’acte à répétition. Les liens avec le développement d’un trouble de la personnalité borderline ont été peu étudiés à cet âge. Pour ces raisons, nous nous sommes intéressés à explorer l’association entre automutilations, récidive suicidaire, caractéristiques cliniques et impulsivité chez 62 adolescents présentant un trouble de la personnalité borderline. L’évaluation clinique de notre population a été réalisée par entretien direct et par auto-questionnaires, conformément au protocole du réseau. La sévérité dépressive et la suicidalité ont été évaluées à l’aide des 3 échelles de Beck : l’Inventaire de Dépression de Beck (BDI) ; l’Echelle de Désespoir de Beck (BHS) et l’Echelle d’Idéation Suicidaire de Beck (BSI). La qualité de la dépression a été évaluée avec le Questionnaire de l’Expérience Dépressive (DEQ) de Blatt and Zuroff. L’impulsivité a été évaluée avec l’Echelle d’Impulsivité de Barratt (BIS-11). Enfin, les évènements de vie traumatiques (abus et négligences) ont été recherchés à l’aide du Questionnaire sur les Traumatismes de l’Enfance (CTQ). Nous montrons que la répétition des actes suicidaires peut être considérée comme un facteur de gravité et de mauvais pronostic chez les adolescents présentant un trouble de la personnalité borderline. Ils présentent un profil psychopathologique plus sévère en termes de trouble dépressif et d’anxiété. Ils rapportent aussi plus d’histoire d’abus sexuels dans l’enfance. L’hypothèse d’une trajectoire développementale particulière chez ces adolescents borderline semble soutenue par nos résultats. Elle est faite de premières relations d’attachement peu sécurisantes associées à une exposition traumatique qui les rend vulnérables à la souffrance dépressive, aux expériences de séparation et à une fragilité sur le plan des relations interpersonnelle.

La clinique des femmes borderlines peut apparaître simple pour les psychiatres. Celle des mères souffrant de cette pathologie est plus complexe. Le psychiatre d’adultes ne voit pas toujours la mère dans la femme qu’ils ont en entretien et encore moins le bébé qu’elle a en charge. Du côté des professionnels du prénatal, la situation se complique, la future mère borderline suscite un lien fort et proximal qui les engage dans des promesses implicites. Une fois le bébé né, la reprise des manifestations symptomatiques est souvent attribuée à un entourage malveillant, menaçant ou insuffisamment bon. Le nouveau-né n’est pas alors considéré dans l’ampleur de ses besoins ni dans sa vulnérabilité. La clinique de la souffrance de ces bébés est liée à la discontinuité interactive et à l’incapacité de créer un environnement sécure par les parents et la mère en particulier. Ces effets peuvent se percevoir par une observation de l’enfant, fine et attentive, sur la durée. Le soin à ces bébés, dans son environnement, tient compte des caractéristiques parentales. Ces prises en charge sont multiples et font intervenir les partenaires habituels du champ de tout-petit (PMI…). Elles reposent cependant sur la connaissance et les capacités cliniques du pédopsychiatre concernant le bébé et sa mère. Nous exposerons les formes possibles de soin et des modalités organisationnelles associées.

The diagnosis and management of personality disorders continues to evolve and develop alongside psychiatry internationally, however, not always in a linear fashion. Trainees working in a variety of clinical areas have regular exposure to personality disorder presentations. Psychiatry training bodies continue to adapt their training structure and curriculum, however, there seems to be a lack of sufficient emphasis with regards this area. We are now embarking on a new diagnostic system for personality disorders; this may impact on our clinical practice and perspective of these patients. The role of psychiatrists in diagnosing and managing personality disorders can be unclear at times and may benefit from on-going reflection and standardization.

In this article Shulamith Lev-Aladgem focuses on The Bride from the Sea, a community performance by three young Israeli-Palestinian mothers, presented in a sand box in a multi-functional kindergarten in Jaffa in 2008. From the beginning of the creative process, the Jewish facilitator and the performers had to struggle to overcome the various barriers erected by the intricate, oppressive daily life of the young Palestinian women. They eventually managed to perform a ‘short, thin performance’, which, despite resembling a misperformance, had an emotional and even exceptional effect on the audience. This performance is examined as a special kind of women-based community theatre, termed here ‘the bare theatre’, to indicate a form that articulates the bare daily life of women trapped between internal and external oppressive power regimes. Shulamith Lev-Aladgem is chair of the Theatre Arts Department at Tel Aviv University, a trained actress, and a community-based theatre practitioner. Her recent publications include Theatre in Co-Communities: Articulating Power (2010) and Standing Front Stage: Resistance, Celebration, and Subversion in Israeli Community-Based Theatre (2010), as well as articles in Research in Drama Education and Israeli Sociology.

Borderline personality disorder can be characterized in terms of a profile of abnormal deviations on multiple personality dimensions using the temperament and character inventory (TCI). Borderline patients show poor character development, including low TCI self-directedness (irresponsible, blaming) and low TCI cooperativeness (hostile, intolerant). Their temperament is explosive or unstable due to a combination of high TCI harm avoidance (anxious, shy), high TCI novelty seeking (impulsive, quick-tempered), and low reward dependence (cold, aloof). Consequently they are usually dysthymic with an admixture of anxiety and anger, and regulate their social problems and intense emotions in immature ways. Genetic and psychobiological studies have led to identification of biological correlates of each of the TCI dimensions of personality, including individual differences in regional brain activity, psychophysiological variables, neuroendocrine abnormalities and specific gene polymorphisms. Each dimension of personality involves complex non-linear interaction of multiple genetic and environmental factors and, in turn, each personality dimension interacts with the others in influencing the way an individual directs and adapts to his or her life experiences. Systematic clinical trials have shown that these personality variables predict the response to pharmacological and psychotherapeutic treatments. For example, high harm avoidance and low self-directedness predict slower response and more rapid relapse with both antidepressants and cognitive-behavioral therapy. Treatment with drugs and/or psychotherapy can be individually matched to the patient's profile of temperament and character traits, rather than treating a heterogeneous group of patients as if they had a discrete, homogeneous illness. Fundamental change in cognitive schemas depends on attention to all aspects of character, especially self-transcendence, which has previously been neglected in cognitive-behavioral therapy. Personality integration requires non-resistance to our natural intuitive awareness, rather than intensified intellectual and emotional defenses.

This paper seeks to balance the regional and thematic focus of cholera historiography by examining maritime quarantine in Busan, as it was devised and implemented by Japanese officials and doctors during the pre-colonial period. It also places the relationship between Korea and Japan in the context of relations with China, Russia and Britain. This paper shows that quarantine measures in Busan and other Korean ports reflected the rise of Japanese imperial power and the increasing desire on the part of the Japanese to establish an effective borderline for their regional empire.

From 1879 Japan began to impose maritime quarantine in Busan, where Japanese influence was very strong even before the colonial period, though at that time Japan was unable to perform quarantine in its own ports independently due to the objections of Western powers, particularly Britain. Victories in the Sino-Japanese and Russo-Japanese wars established Japan as a regional power on equal terms with the West, and as the dominant power in Korea and Eastern Asia. With the acquisition of the right to impose quarantine in its homeland, Japan strengthened and extended the range of quarantine from Japan to Korea, China and Russia. Now quarantine screened Japan from potentially harmful agents – pathogenic and political – and its functions diversified further as modernisation and imperial expansion gathered pace. The reliance which Japan placed upon quarantine in maintaining its empire explains why it was increasingly out of step with other powers regarding international sanitary precautions. The Japanese maritime quarantine in Busan during this period therefore shows many aspects of Japan’s ‘national empire’.

The main objective of the present investigation was to analyze the relationship between self-reported schizotypal and borderline personality traits in a sample of 759 college students (M = 19.63 years; SD = 2.03). For this purpose, the Schizotypal Personality Questionnaire-Brief (SPQB; Raine and Benishay, 1995) and Borderline Personality Questionnaire (BPQ; Poreh et al., 2006) were administered. The results showed that schizotypal and borderline features are partially related at subclinical level. The exploratory factor analysis conducted on the subscales revealed a three-factor solution comprised of the following factors: Identity/Interpersonal, Lack of Control and Schizotypal. The canonical correlation analysis showed that schizotypal features and borderline personality traits shared 34.8 % of the variance. The data highlight the overlap between schizotypal and borderline personality traits in nonclinical young adults. Future studies should continue to examine the relationship and the degree of overlap between these traits in community samples.