Study on the Lethality of Suicide and Borderline Personality Disorder
Recurrent suicidal behaviors in patients with Borderline Personality Disorder (BPD) are often considered communicative gestures; however, 10% complete suicide. This study seeks to identify risk factors for suicide within a BPD sample by comparing patients with High- and Low Lethality attempts. BPD attempters (n = 113) were assessed on demographic, diagnostic, and personality variables: clinical symptoms, suicidal behaviors; childhood, family, and treatment histories; social adjustment; and recent life events. Forty-four High-Lethality attempters, defined by a score of 4 or more on Beck’s Medical Lethality Scale, were compared to 69 Low-Lethality attempters.
Discriminating variables were entered in a multivariate logistic regression model to define predictors of High-Lethality status. High-Lethality attempters were older, with children, less education, and lower socioeconomic class (SES) than Low-Lethality attempters. They were more likely to have Major Depressive Disorder (MDD), co-morbid Antisocial Personality Disorder (ASPD), and family histories of substance abuse. They reported greater intent to die, more lifetime attempts, hospitalizations, and time in the hospital. High-Lethality status was best predicted by low SES, co-morbid ASPD, extensive treatment histories, and greater intent to die. These characteristics resemble profiles of patients who complete suicide, are not specific for BPD, and do not include impulsivity, aggression, or severity of BPD criteria.
One Comment
lulu_bpd
first, i want to say thank you, mr. bon dobbs. your compassion for and understanding of people who are (mis)wired as i am, and your ability to communicate about our condition and educate people, is a beautiful thing which i appreciate more than i have words to say.
so, fwiw, i’m a middle aged bpd lady (diagnosed) and i’ve given some consideration to this suicide vs. parasuicidal issue, which i believe this actually is, over the course of my life. i do not know if this applies to any other bpd people besides myself. as my shrink used to say before i fired him (bpd joke!) every borderline person is boerderlined out in their own unique, very special way. so this may be specific to me and not common to bpd people in general, idk.
anyway, what i wanted to say was this: i’ve made all sorts of retarded, childish, embarrassing parasuicidal gestures in my half century life. i did them when i felt abandoned, threatened, delegitimized… you name it. but the only times i have ever been genuinely suicidal and made serious attempts to end my own life it was as a direct result of the crushing shame after some particularly embarrassing ‘impulse control’ failure, particularly in public.
to me shame is the real soul killer. not depression or sadness or hopelessness or emptiness or… anything else. shame is what fuels the drive to want to not exist. at least in my experience.
thanks again for your work. i lurves me your site and the good work you are doing for people like me. <3