Borderline Personality Disorder is a psychiatric disorder defined, in part, by recurrent impulsive and suicidal behaviors. With a suicide rate of up to 9.5 percent, BPD is among the most lethal of psychiatric disorders, comparable to affective and schizophrenic disorders. This study is the continuation of a first prospective, multidimensional study of the clinical, psychosocial and biological risk factors for suicidal behavior in patients with BPD. Following a stress-diathesis model of suicide, we assess predicted risk factors at baseline and follow patients annually for up to ten years, assessing for suicidal behavior, psychiatric co-morbidities, substance use disorders, episodes of impulsive-aggression, psychosocial stressors, treatment effects, social and clinical outcomes. The role of central serotonergic regulation in impulsive and suicidal behavior is studied using the 5HT2A specific radioligand [F-18] altanserin and PET neuroimaging. The effects of a childhood history of abuse are assessed on suicide risk, impulsive-aggressive behavior and on measures of central serotonergic function. Stressors increasing the risk of suicidal behavior include co-morbidity with Major Depression or Substance Use Disorders, Recent Life Events, and poor social support. Personality characteristics such as impulsivity and aggression represent chronic vulnerabilities to suicidal behavior. Longitudinal follow-up of suicidal patients allows testing of predictor hypotheses concerning risk factors for suicidal behavior in BPD through the application of survival analyses. Risk factors predicting recurrence and medical lethality of attempts will allow early identification of BPD patients at highest risk for suicide and inform treatment efforts.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH048463-13
Application #
6897894
Study Section
Special Emphasis Panel (ZRG1-BBBP-5 (01))
Program Officer
Breiling, James P
Project Start
1992-09-30
Project End
2007-05-31
Budget Start
2005-06-01
Budget End
2007-05-31
Support Year
13
Fiscal Year
2005
Total Cost
$473,215
Indirect Cost
Name
University of Pittsburgh
Department
Psychiatry
Type
Schools of Medicine
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Zhang, Ke; Szanto, Katalin; Clark, Luke et al. (2018) Behavioral empathy failures and suicidal behavior. Behav Res Ther :
Dombrovski, Alexandre Y; Aslinger, Elizabeth; Wright, Aidan G C et al. (2018) Losing the battle: Perceived status loss and contemplated or attempted suicide in older adults. Int J Geriatr Psychiatry 33:907-914
Hallquist, Michael N; Hall, Nathan T; Schreiber, Alison M et al. (2018) Interpersonal dysfunction in borderline personality: a decision neuroscience perspective. Curr Opin Psychol 21:94-104
Dombrovski, Alexandre Y; Hallquist, Michael N; Brown, Vanessa M et al. (2018) Value-Based Choice, Contingency Learning, and Suicidal Behavior in Mid- and Late-Life Depression. Biol Psychiatry :
Soloff, Paul H; Abraham, Kristy; Burgess, Ashley et al. (2017) Impulsivity and aggression mediate regional brain responses in Borderline Personality Disorder: An fMRI study. Psychiatry Res Neuroimaging 260:76-85
Soloff, Paul H; Abraham, Kristy; Ramaseshan, Karthik et al. (2017) Hyper-modulation of brain networks by the amygdala among women with Borderline Personality Disorder: Network signatures of affective interference during cognitive processing. J Psychiatr Res 88:56-63
Soloff, Paul H; White, Richard; Omari, Amro et al. (2015) Affective context interferes with brain responses during cognitive processing in borderline personality disorder: fMRI evidence. Psychiatry Res 233:23-35
Soloff, Paul H; Chiappetta, Laurel; Mason, Neale Scott et al. (2014) Effects of serotonin-2A receptor binding and gender on personality traits and suicidal behavior in borderline personality disorder. Psychiatry Res 222:140-8
Soloff, Paul; White, Richard; Diwadkar, Vaibhav A (2014) Impulsivity, aggression and brain structure in high and low lethality suicide attempters with borderline personality disorder. Psychiatry Res 222:131-9
Soloff, Paul H; Pruitt, Patrick; Sharma, Mohit et al. (2012) Structural brain abnormalities and suicidal behavior in borderline personality disorder. J Psychiatr Res 46:516-25

Showing the most recent 10 out of 25 publications