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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pain ratings during the cold pressor test were significantly lower in female inpatients with borderline personality disorder who report that they do not experience pain during self-injury (BPD-NP group, n = 11), compared with similar patients who report that they do experience pain during self-injury (BPD-P group, n = 11), and normal female subjects (n = 6). Pain ratings were not significantly different in the BPD-P and normal control groups. Self-report ratings of depression, anger, anxiety, and confusion were significantly lower, and ratings of vigor significantly higher following the cold pressor test in the BPD-NP group, but not in the BPD-P group. Only anxiety was significantly lower in the normal control group following the cold pressor test. The implications and limitations of these preliminary findings are discussed.
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PMID:Pain perception in self-injurious patients with borderline personality disorder. 144 67

Thirteen of 43 patients (30%) with inflammatory bowel disease referred for psychiatric consultation were found to be drug dependent, most commonly on oral narcotics. Drug dependence was more frequent in patients with Crohn's disease than ulcerative colitis and many had a borderline personality disorder. The study suggests that drug dependence is not recognized often enough in patients with inflammatory bowel disease and that patients with certain psychiatric disorders are at higher risk of developing it. Recognition of drug dependence is aided by interviewing family members. It is best prevented by seeking and treating the specific cause of pain and by having only one physician assigned to prescribe and manage narcotics.
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PMID:Narcotic dependence in inflammatory bowel disease. 298 Jul 62

Patients with borderline personality disorder typically are hospitalized in the midst of a crisis and in a state of acute regression. After a few days in which the patient is provided with containment and support, the therapist can assess whether the patient has the capacity for exploratory psychotherapy that may help in ego development or whether such psychotherapy may prompt further regression and dangerous acting out. For exploratory therapy certain conditions, such as an observing ego, a therapeutic alliance, and the therapist's ability to contain countertransference feelings and deal with the patient's projections, are essential. The therapist must be alert to common treatment errors that can undermine the patient's capacity to recompensate; they are likely to occur in the areas of empathy, confrontation, transference, interpretation and management, and the patient's attachment to pain.
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PMID:First do no harm: short-term inpatient psychotherapy of the borderline patient. 372 35

Twenty-seven female inpatients with borderline personality disorder were assigned to two groups on the basis of whether they did (N = 14) or did not (N = 13) report experiencing pain during self-injurious episodes. Ratings of depression, anxiety, impulsiveness, dissociation, and trauma symptoms were higher in the women who did not experience pain while injuring themselves, as were the number of suicide attempts and the prevalence of childhood sexual abuse.
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PMID:Subtypes of self-injurious patients with borderline personality disorder. 823 44

Fifteen women with borderline personality disorder who do not experience pain during self-injury were found to discriminate more poorly between imaginary painful and mildly painful situations, to reinterpret painful sensations (a pain-coping strategy related to dissociation), and to have higher scores on the Dissociative Experiences Scale than 24 similar female patients who experience pain during self-injury and 22 age-matched normal women. "Analgesia' during self-injury in borderline patients may be related to a cognitive impairment in the ability to distinguish between painful and mildly painful situations, as well as to dissociative mechanisms.
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PMID:Pain and self-injury in borderline patients: sensory decision theory, coping strategies, and locus of control. 883 74

This article explores the hypothesis that self-injurious behavior (SIB) of the type associated with borderline personality disorder (BPD) has an important mood regulatory function. Thirty-eight female inpatients with an Axis II diagnosis of BPD and a history of SIB rated a variety of mood and affective states, using visual analog scales recalled over the course of usual SIB experiences. Subjects were additionally divided into two groups according to whether they typically experience pain during SIB (BPD-P group) or did not (BPD-NP group). For both groups, the visual analog scale ratings revealed significant mood elevation and decreased dissociation following self injury, with a peak in dissociative symptoms during self injury. The ratings of dissociative symptoms were found to be higher in the BPD-NP group when compared to the BPD-P group across all stages of SIB. The ratings of sexual arousal did not change over the course of SIB for either group. These findings are discussed in light of current knowledge of the relationship between SIB and mood.
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PMID:Self-injurious behavior and mood regulation in borderline patients. 920 9

Signal detection theory measures of thermal responsivity were examined to determine whether differences in reported pain experienced during self-injurious behavior in female patients with borderline personality disorder (BPD) are explained by neurosensory factors and/or attitudinal factors (response bias). Female patients with BPD who do not experience pain during self-injury (BPD-NP group) were found to discriminate more poorly between noxious thermal stimuli of similar intensity, low P(A), than female patients with BPD who experience pain during self-injury (BPD-P group), female patients with BPD who do not have a history of self-injury (BPD-C group), and age-matched normal women. The BPD-NP group also had a higher response criterion, B (more stoical) than the BPD-C group. These findings suggest that 'analgesia' during self-injury in patients with BPD is related to both neurosensory and attitudinal/psychological abnormalities.
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PMID:Pain assessment in self-injurious patients with borderline personality disorder using signal detection theory. 921 79

The objective of this study was to identify the dysphoric states that best characterize patients meeting criteria for borderline personality disorder and distinguish them from those in patients with other forms of personality disorder. One hundred forty-six patients with criteria-defined borderline personality disorder and 34 Axis II controls filled out the Dysphoric Affect Scale, a 50-item self-report measure that was designed for this purpose and has good internal consistency and test-retest reliability. Twenty-five dysphoric states (mostly affects) were found to be significantly more common among borderline patients than controls but nonspecific to borderline personality disorder. Twenty-five other dysphoric states (mostly cognitions) were found to be both significantly more common among borderline patients than controls and highly specific to borderline personality disorder. These states tended to fall into one of four clusters: (1) extreme feelings, (2) destructiveness or self-destructiveness, (3) fragmentation or "identitylessness," and (4) victimization. In addition, three of the 25 more-specific states (feeling betrayed, like hurting myself, and completely out of control), when occurring together, were particularly strongly associated with the borderline diagnosis. Equally important, overall mean Dysphoric Affect Scale scores correctly distinguished borderline personality disorder from other personality disorders in 84% of the subjects. Taken together, the results of this study suggest that the subjective pain of borderline patients may be both more pervasive and more multifaceted than previously recognized, and that the overall "amplitude" of this pain may be a particularly good marker for the borderline diagnosis.
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PMID:The pain of being borderline: dysphoric states specific to borderline personality disorder. 1037 Apr 45

The principal aim of this study was to investigate possible neurophysiological underpinnings of self-injurious behavior in women with borderline personality disorder (BPD). Pain report and EEG power spectrum density during a laboratory pain procedure, a 4-min 10 degrees C cold pressor test (CPT), were compared among four groups; female inpatients with BPD who do (BPD-P group, n = 22) and do not (BPD-NP group, n = 19) report pain during self-injury, female inpatients with major depression (n = 15), and normal women (n = 20). The BPD-NP group reported less pain intensity during the CPT compared to the other groups. Total absolute theta power was significantly higher in the BPD-NP group compared to the Depressed (P = 0.0074) and Normal (P = 0.0001) groups, with a trend toward being significantly higher compared to the BPD-P group (P = 0.0936). Dissociative Experience Scale scores were significantly higher in the BPD-NP group compared to the Depressed and Normal groups (maximum P = 0.0004), and significantly higher in the BPD-P group compared to the Normal group (P = 0.0016). Beck Depression Inventory and Sheehan Patient Rated Anxiety Scale scores were significantly lower in the Normal group compared to all patient groups. Theta activity was significantly correlated with pain rating (Pearson partial r = -0.43, P = 0.0001) and Dissociative Experiences Scale score (Pearson partial r = 0.32, P = 0.01).
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PMID:EEG theta activity and pain insensitivity in self-injurious borderline patients. 1070 66

In time, mental health professionals will understand the etiology of BPD more fully. Although enormous strides have been made in the past decade, research into the multifactorial basis of BPD is still in its infancy. In particular, studies of children at high risk for developing BPD are needed. For now, the author suggests that one can admire patients with BPD for the integrity with which they have dealt with their pain. After all, not many people remain so loyal to and so respectful of such disheartening childhood experiences.
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PMID:Childhood experiences associated with the development of borderline personality disorder. 1072 33


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