Borderline personality disorder criteria associated with prospectively observed suicidal behavior.
OBJECTIVE
The authors prospectively examined associations between each DSM-IV borderline personality disorder criterion and suicidal behaviors.


METHODS
Borderline personality disorder diagnosis and criteria, major depressive disorder, substance use disorders, and history of childhood sexual abuse were assessed with semistructured interviews. Participants (N=621) were followed for 2 years with repeated structured evaluations that included assessments of suicidality.


RESULTS
With the self-injury criterion excluded, the borderline personality disorder criteria of affective instability, identity disturbance, and impulsivity significantly predicted suicidal behaviors. Only affective instability and childhood sexual abuse were significantly associated with suicide attempts (i.e., behavior with some intent to die).


CONCLUSIONS
Affective instability is the borderline personality disorder criterion (excluding self-injury) most strongly associated with suicidal behaviors. Since major depressive disorder did not significantly predict suicidal behaviors, the reactivity associated with affective instability (more so than negative mood states) appears to be a critical element in predicting suicidal behaviors.
Yen
Shirley
S
Department of Psychiatry and Human Behavior, Brown University, 700 Butler Drive, Duncan Building, Providence, RI 02906, USA.
Shea
M Tracie
MT
Sanislow
Charles A
CA
Grilo
Carlos M
CM
Skodol
Andrew E
AE
Gunderson
John G
JG
McGlashan
Thomas H
TH
Zanarini
Mary C
MC
Morey
Leslie C
LC
D000293:Adolescent; D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis*; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data