THE ROLE OF BORDERLINE PERSONALITY DISORDER IN THE SEVERITY OF SUBSTANCE USE DISORDER: A STUDY IN DEHRADUN
DOI:
https://doi.org/10.29121/shodhkosh.v5.i7.2024.4971Keywords:
Borderline Personality Disorder, Substance Use Disorder, Comorbidity, Risk Factors, Dehradun, Mental Health, Addiction TreatmentAbstract [English]
Borderline Personality Disorder (BPD) is a severe mental health condition characterized by emotional dysregulation, impulsivity, and unstable interpersonal relationships. Individuals with BPD are at a significantly higher risk of developing Substance Use Disorder (SUD), leading to worsened clinical outcomes, increased relapse rates, and challenges in treatment. This study examines the role of BPD in the severity of SUD in Dehradun, India, a region witnessing rising cases of substance abuse. Using a sample of 150 individuals diagnosed with SUD from rehabilitation centers and psychiatric clinics, the study employs standardized clinical assessments, including the DSM-5 diagnostic criteria and substance dependence severity scales. Findings reveal that 47% of individuals with SUD also exhibit symptoms of BPD, with a notably higher relapse rate (65%) compared to non-BPD individuals (38%). The study identifies key risk factors such as childhood trauma, emotional instability, and impulsivity, which contribute to increased substance dependence. The findings highlight the necessity for integrated treatment approaches that address both BPD and SUD concurrently. Mental health policies in India need to incorporate dual-diagnosis screening and specialized intervention strategies within rehabilitation programs. This research underscores the urgent need for structured rehabilitation models that focus on both personality disorders and addiction recovery. Future research should explore longitudinal data to establish causality and compare regional variations in BPD-SUD comorbidity across India.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. DOI: https://doi.org/10.1176/appi.books.9780890425596
Ball, S. A., & Links, P. S. (2009). Borderline personality disorder and substance abuse: Clinical and therapeutic issues. Harvard Review of Psychiatry, 17(6), 337-349. https://doi.org/10.3109/10673220903463231
Bornovalova, M. A., Lejuez, C. W., Daughters, S. B., Rosenthal, M. Z., & Lynch, T. R. (2005). Impulsivity as a common process across borderline personality and substance use disorders. Clinical Psychology Review, 25(6), 790-812. https://doi.org/10.1016/j.cpr.2005.05.005 DOI: https://doi.org/10.1016/j.cpr.2005.05.005
Chanen, A. M., & Kaess, M. (2012). Developmental pathways to borderline personality disorder. Current Psychiatry Reports, 14(1), 45-53. https://doi.org/10.1007/s11920-011-0242-y DOI: https://doi.org/10.1007/s11920-011-0242-y
Conklin, C. Z., & Westen, D. (2005). Borderline personality disorder in clinical practice. American Journal of Psychiatry, 162(5), 867-875. https://doi.org/10.1176/appi.ajp.162.5.867 DOI: https://doi.org/10.1176/appi.ajp.162.5.867
Grant, B. F., Chou, S. P., Goldstein, R. B., Huang, B., Stinson, F. S., Saha, T. D., ... & Ruan, W. J. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69(4), 533-545. https://doi.org/10.4088/JCP.v69n0404 DOI: https://doi.org/10.4088/JCP.v69n0404
Herman, J. L. (1992). Trauma and recovery: The aftermath of violence—from domestic abuse to political terror. New York, NY: Basic Books.
Links, P. S., & Eynan, R. (2013). The relationship between personality disorders and Axis I psychopathology: Deconstructing comorbidity. Annual Review of Clinical Psychology, 9, 529-554. https://doi.org/10.1146/annurev-clinpsy-050212-185624 DOI: https://doi.org/10.1146/annurev-clinpsy-050212-185624
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press.
National Institute on Drug Abuse. (2020). Common comorbidities with substance use disorders. Retrieved from https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders
National Institute of Mental Health. (2017). Borderline personality disorder. Retrieved from https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml
Oldham, J. M., & Skodol, A. E. (2000). Charting the future of Axis II. Journal of Personality Disorders, 14(1), 17-29. https://doi.org/10.1521/pedi.2000.14.1.17 DOI: https://doi.org/10.1521/pedi.2000.14.1.17
Paris, J. (2005). Borderline personality disorder: Etiology and treatment. Washington, DC: American Psychiatric Publishing.
Sansone, R. A., & Sansone, L. A. (2011). Borderline personality disorder and substance abuse. Innovations in Clinical Neuroscience, 8(11), 10-13.
Skodol, A. E., Gunderson, J. G., Pfohl, B., Widiger, T. A., Livesley, W. J., & Siever, L. J. (2002). The borderline diagnosis II: Biology, genetics, and clinical course. Biological Psychiatry, 51(12), 951-963. https://doi.org/10.1016/S0006-3223(02)01324-0 DOI: https://doi.org/10.1016/S0006-3223(02)01325-2
Trull, T. J., Freeman, L. K., Vebares, T. J., Choate, A. M., & Helle, A. C. (2018). Borderline personality disorder and substance use disorders: An updated review. Borderline Personality Disorder and Emotion Dysregulation, 5(15). https://doi.org/10.1186/s40479-018-0093-9 DOI: https://doi.org/10.1186/s40479-018-0093-9
van den Bosch, L. M., & Verheul, R. (2007). Patients with addiction and personality disorder: Treatment outcomes and clinical implications. Current Opinion in Psychiatry, 20(1), 67-71. https://doi.org/10.1097/YCO.0b013e328010c7b2 DOI: https://doi.org/10.1097/YCO.0b013e328011740c
Verheul, R. (2001). Co-morbidity of personality disorders in individuals with substance use disorders. European Psychiatry, 16(5), 274-282. https://doi.org/10.1016/S0924-9338(01)00578-8 DOI: https://doi.org/10.1016/S0924-9338(01)00578-8
Volkow, N. D., & Li, T. K. (2005). The neuroscience of addiction. Nature Neuroscience, 8(11), 1429-1430. https://doi.org/10.1038/nn1105-1429 DOI: https://doi.org/10.1038/nn1105-1429
World Health Organization. (2004). Global status report on alcohol and health. Retrieved from https://www.who.int/substance_abuse/publications/global_status_report_2004_overview.pdf
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. (2010). Time to attainment of recovery from borderline personality disorder and stability of recovery: A 10-year prospective follow-up study. American Journal of Psychiatry, 167(6), 663-667. https://doi.org/10.1176/appi.ajp.2009.09081130 DOI: https://doi.org/10.1176/appi.ajp.2009.09081130
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. (2012). Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and Axis II comparison subjects: A 16-year prospective follow-up study. American Journal of Psychiatry, 169(5), 476-483. https://doi.org/10.1176/appi.ajp.2011.11101550 DOI: https://doi.org/10.1176/appi.ajp.2011.11101550
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Manjari Gupta, Dr. Garima Singh, Dr. Mohan Dhyani
This work is licensed under a Creative Commons Attribution 4.0 International License.
With the licence CC-BY, authors retain the copyright, allowing anyone to download, reuse, re-print, modify, distribute, and/or copy their contribution. The work must be properly attributed to its author.
It is not necessary to ask for further permission from the author or journal board.
This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.
