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Interpersonal Precipitants and Suicide Attempts in Borderline Personality Disorder

Authors

  • Beth S. Brodsky PhD,

    Corresponding author
    1. Department of Neuroscience, New York State Psychiatric Institute and Department of Psychiatry, Columbia University College of Physicians and Surgeons; Barbara Stanley is also affiliated with the City University of New York, John Jay College.
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  • Shelly A. Groves BA,

    1. Department of Neuroscience, New York State Psychiatric Institute and Department of Psychiatry, Columbia University College of Physicians and Surgeons; Barbara Stanley is also affiliated with the City University of New York, John Jay College.
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  • Maria A. Oquendo MD,

    1. Department of Neuroscience, New York State Psychiatric Institute and Department of Psychiatry, Columbia University College of Physicians and Surgeons; Barbara Stanley is also affiliated with the City University of New York, John Jay College.
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  • J. John Mann MD,

    1. Department of Neuroscience, New York State Psychiatric Institute and Department of Psychiatry, Columbia University College of Physicians and Surgeons; Barbara Stanley is also affiliated with the City University of New York, John Jay College.
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  • Barbara Stanley PhD

    1. Department of Neuroscience, New York State Psychiatric Institute and Department of Psychiatry, Columbia University College of Physicians and Surgeons; Barbara Stanley is also affiliated with the City University of New York, John Jay College.
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  • This research was funded by the following PHS grants: MH62185, MH61079, and MH62665. The authors would like to acknowledge the assistance of Ainsley Burke, PhD, Steven P. Ellis, PhD, and Joselin Mackly, BS.

Department of Neuroscience, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 42, New York, NY 10032; E-mail: bsb21@columbia.edu

Abstract

Borderline personality disorder (BPD) is often characterized by multiple low lethality suicide attempts triggered by seemingly minor incidents, and less commonly by high lethality attempts that are attributed to impulsiveness or comorbid major depression. The relationships among life events, impulsiveness, and type of suicidal behavior has hardly been studied in BPD and mood disorders. This study compared depressed attempters with and without BPD to identify specific suicide precipitants and risk factors in BPD and their relationship to severity of suicidal behavior. Attempters with comorbid BPD and major depressive disorder (MDD) had a higher number of lifetime suicide attempts; made their first attempt at a younger age; reported more interpersonal triggers; and had higher levels of lifetime aggression, hostility, and impulsivity, compared with attempters with major depression only. Environmental triggers of attempts in BPD are more likely to be interpersonal stressors. Lethality of attempts in BPD plus MDD is equal to that in MDD only, indicating that the seriousness of precipitants is unrelated to the lethality of the suicidal behavior. The differences between groups suggest that risk assessment and treatment should target both depression and personality disorder in those with combined illness.

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