Alexandra Knafo1, Jean-Marc Guilé2, Jean-Jacques Breton3, Réal Labelle4, Vincent Belloncle5, Nicolas Bodeau6, Bernard Boudailliez7, Sébastien Garny De La Rivière1, Brahim Kharij1, Christian Mille8, Bojan Mirkovic9, Cornelia Pripis10, Johanne Renaud11, Christine Vervel12, David Cohen13, Priscille Gérardin14. 1. Psychiatry Resident, Service de Psychopathologie de l'Enfant et de l'Adolescent et Unité de Médecine de l'Adolescent, Centre Hospitalier Universitaire d'Amiens, Université Picardie Jules Verne, Amiens, France. 2. Professor and Department Head, Service de Psychopathologie de l'Enfant et de l'Adolescent et Unité de Médecine de l'Adolescent, Centre Hospitalier Universitaire d'Amiens, Université Picardie Jules Verne, Amiens, France; Associate Professor, Département de Psychiatrie, Université de Montréal, Montréal, Québec; Assistant Professor, Division of Child Psychiatry, Department of Psychiatry, McGill University, Montréal, Québec; Researcher, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, site de l'Hôpital Rivière-des-Prairies, Montréal, Québec. 3. Associate Professor, Département de Psychiatrie, Université de Montréal, Montréal, Québec; Researcher, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, l'Hôpital Rivière-des-Prairies, Montréal, Québec. 4. Psychologist and Researcher, Clinique des troubles de l'humeur and Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Hôpital Rivière-des-Prairies, Montréal, Québec; Full Professor, Département de psychologie, Université du Québec à Montréal, Montréal, Québec; Associate Professor, Département de psychiatrie, Université de Montréal, Montréal, Québec. 5. Psychiatrist, Département de pédiatrie médicale, Fédération hospitalo-universitaire de psychiatrie de l'enfant et de l'adolescent, Centre hospitalier universitaire de Rouen et Centre hospitalier du Rouvray, Université de Rouen, Rouen, France. 6. Statistics Engineer and Data Manager, Service de Psychiatrie de l'Enfant et de l'Adolescent, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hopitaux de Paris et Université Pierre et Marie Curie, Paris, France. 7. Professor and Department Head, Service de pédiatrie et Unité de Médecine de l'Adolescent, Centre Hospitalier Universitaire d'Amiens, Université Picardie Jules Verne, Amiens, France. 8. Professor, Service de Psychopathologie de l'Enfant et de l'Adolescent et Unité de Médecine de l'Adolescent, Centre Hospitalier Universitaire d'Amiens, Université Picardie Jules Verne, Amiens, France. 9. Psychiatrist, Fédération hospitalo-universitaire de psychiatrie de l'enfant et de l'adolescent, Centre hospitalier universitaire de Rouen, Rouen, France; PhD Student, Inserm U1079, Université de Rouen, Rouen, France. 10. Senior Psychiatrist, Service de Psychopathologie de l'Enfant et de l'Adolescent et Unité de Médecine de l'Adolescent, Centre Hospitalier Universitaire d'Amiens, Université Picardie Jules Verne, Amiens, France. 11. Child and Adolescent Psychiatrist, Standard Life Centre for Breakthroughs in Teen Depression and Suicide Prevention, Douglas Mental Health University Institute, Montréal, Québec; Medical Chief, McGill Group for Suicide Studies, McGill University, Montréal, Québec. 12. Head, Service de Pédiatrie, Centre Hospitalier de Compiègne, Compiègne, France. 13. Professor and Department Head, Service de Psychiatrie de l'Enfant et de l'Adolescent, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hopitaux de Paris et Université Pierre et Marie Curie, Paris, France; Researcher, CNRS UMR 7222 Institut des Systèmes Intelligents et Robotiques, Université Pierre et Marie Curie, Paris, France. 14. Professor and Department Head, Département de pédiatrie médicale, Fédération hospitalo-universitaire de psychiatrie de l'enfant et de l'adolescent, Centre Hospitalier universitaire de Rouen et Centre hospitalier du Rouvray, France, Rouen et Rouvray, France; Researcher, Laboratoire Psy-NCA-EA-4700, Université de Rouen, Rouen, France.
Abstract
OBJECTIVES: To compare the coping strategies of adolescents with borderline personality disorder (BPD) to the coping strategies of adolescents without BPD, and to explore the association of coping with suicidal ideation and attempts among adolescents with BPD. METHOD: Adolescent inpatients (n = 167) aged 13 to 17 years were admitted after suicide attempts and evaluated within 10 days, using the abbreviated version of the Diagnostic Interview for Borderlines-Revised, the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version supported by a team consensus best estimate method for the primary diagnosis, the Adolescent Coping Scale, and the Columbia-Suicide Severity Rating Scale. RESULTS: Firstly, compared with adolescents without BPD, adolescents with BPD relied more on nonproductive coping strategies, mostly avoidant strategies, and less on productive coping strategies. Secondly, coping appeared as a factor associated with suicidal ideation in adolescents with BPD. While while controlling for age, sex, and depression, multivariate analyses showed a significant positive association between the coping strategy to focusing on solving the problem and suicidal ideation. CONCLUSION: The use of avoidant strategies by adolescents with BPD could be viewed as attempts to increase emotional regulation. Problem-solving strategies in the immediate aftermath of a suicide attempt may prevent adolescents with BPD from overcoming a crisis and may increase suicidal ideation.
OBJECTIVES: To compare the coping strategies of adolescents with borderline personality disorder (BPD) to the coping strategies of adolescents without BPD, and to explore the association of coping with suicidal ideation and attempts among adolescents with BPD. METHOD: Adolescent inpatients (n = 167) aged 13 to 17 years were admitted after suicide attempts and evaluated within 10 days, using the abbreviated version of the Diagnostic Interview for Borderlines-Revised, the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version supported by a team consensus best estimate method for the primary diagnosis, the Adolescent Coping Scale, and the Columbia-Suicide Severity Rating Scale. RESULTS: Firstly, compared with adolescents without BPD, adolescents with BPD relied more on nonproductive coping strategies, mostly avoidant strategies, and less on productive coping strategies. Secondly, coping appeared as a factor associated with suicidal ideation in adolescents with BPD. While while controlling for age, sex, and depression, multivariate analyses showed a significant positive association between the coping strategy to focusing on solving the problem and suicidal ideation. CONCLUSION: The use of avoidant strategies by adolescents with BPD could be viewed as attempts to increase emotional regulation. Problem-solving strategies in the immediate aftermath of a suicide attempt may prevent adolescents with BPD from overcoming a crisis and may increase suicidal ideation.
Authors: Roger E Meyer; Carl Salzman; Eric A Youngstrom; Paula J Clayton; Frederick K Goodwin; J John Mann; Larry D Alphs; Karl Broich; Wayne K Goodman; John F Greden; Herbert Y Meltzer; Sharon-Lise T Normand; Kelly Posner; David Shaffer; Maria A Oquendo; Barbara Stanley; Madhukar H Trivedi; Gustavo Turecki; Charles M Beasley; Annette L Beautrais; Jeffrey A Bridge; Gregory K Brown; Dennis A Revicki; Neal D Ryan; David V Sheehan Journal: J Clin Psychiatry Date: 2010-07-13 Impact factor: 4.384
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