title: Relationship between maladaptive cognitions about sleep and recovery in patients with borderline personality disorder.
abstract: Borderline personality disorder (BPD) has been associated with maladaptive cognitive processes including dysfunctional attitudes and a negative attribution style. Comorbid insomnia affects the course of multiple psychiatric disorders, and has been associated with the absence of recovery from BPD. Because dysfunctional beliefs and attitudes are common among patients with insomnia, the purpose of this study was to evaluate the association between maladaptive sleep-related cognitions and recovery status (symptomatic remission plus good concurrent psychosocial functioning) in patients with BPD. Two hundred and twenty three BPD patients participating in the McLean Study of Adult Development (MSAD) were administered the Dysfunctional Beliefs and Attitudes about Sleep questionnaire (DBAS-16) as part of the 16-year follow-up wave. Maladaptive sleep cognitions were compared between recovered (n=105) and non-recovered (n=118) BPD participants, in analyses that adjusted for age, sex, depression, anxiety, and primary sleep disorders. Results demonstrated that non-recovered BPD patients had significantly more severe maladaptive sleep-related cognitions as measured by the overall DBAS-16 score. These results demonstrate an association between dysfunctional beliefs and attitudes about sleep and recovery status among BPD patients. Further research is warranted to evaluate treatments targeted towards maladaptive sleep-related cognitions, and their subsequent effects on the course of BPD.
authors: Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Electronic address: dplante@wisc.edu.
authors: David T
authors: DT
authors: Plante
authors: Frances R
authors: FR
authors: Frankenburg
authors: Garrett M
authors: GM
authors: Fitzmaurice
authors: Mary C
authors: MC
authors: Zanarini
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders; D012893:Sleep Wake Disorders / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Borderline personality disorder; DBAS; Insomnia
references: J Psychosom Res. 2013 Apr;74(4):278-82
references: 23497827
references: Compr Psychiatry. 1987 Nov-Dec;28(6):530-5
references: 3691077
references: Prim Care Companion J Clin Psychiatry. 2010;12(5):
references: 21274357
references: Compr Psychiatry. 1987 Nov-Dec;28(6):467-80
references: 3691072
references: J Clin Sleep Med. 2010 Apr 15;6(2):196-204
references: 20411700
references: J Clin Psychiatry. 2008 Apr;69(4):533-45
references: 18426259
references: Behav Res Ther. 2002 Jul;40(7):741-52
references: 12074370
references: JAMA. 1989 Sep 15;262(11):1479-84
references: 2769898
references: Arch Gen Psychiatry. 1986 Jan;43(1):20-30
references: 3942471
references: Compr Psychiatry. 1985 Sep-Oct;26(5):448-55
references: 4028695
references: J Affect Disord. 2007 Nov;103(1-3):77-82
references: 17321595
references: Am J Psychiatry. 2004 Oct;161(10):1877-84
references: 15465986
references: J Clin Psychiatry. 2007 Feb;68(2):254-60
references: 17335324
references: Gen Hosp Psychiatry. 1997 Jul;19(4):245-50
references: 9327253
references: J Pers Disord. 2009 Dec;23(6):563-71
references: 20001175
references: Compr Psychiatry. 2001 Sep-Oct;42(5):369-74
references: 11559863
references: J Clin Sleep Med. 2008 Oct 15;4(5):462-70
references: 18853705
references: Am J Psychiatry. 2010 Jun;167(6):663-7
references: 20395399
references: Am J Psychother. 2008;62(4):377-94
references: 19189813
references: Psychiatry Res. 1989 May;28(2):193-213
references: 2748771
references: Sleep. 2009 Apr;32(4):499-510
references: 19413144
references: Biol Psychiatry. 1996 Mar 15;39(6):411-8
references: 8679786
references: Sleep. 2001 Aug 1;24(5):591-9
references: 11480656
references: Psychiatr Clin North Am. 2006 Dec;29(4):1047-58; abstract x
references: 17118281
references: Psychiatry Res. 2012 Dec 30;200(2-3):430-6
references: 22657954
references: Compr Psychiatry. 2003 Nov-Dec;44(6):454-8
references: 14610722
references: J Psychosom Res. 2008 Apr;64(4):443-9
references: 18374745
references: Sleep. 2007 Nov;30(11):1547-54
references: 18041487
references: J Clin Psychiatry. 2008 Feb;69(2):259-65
references: 18363454
references: Sleep. 2008 Apr;31(4):473-80
references: 18457234
references: Sleep. 1994 Oct;17(7):630-7
references: 7846462
references: Sleep Med. 2010 Oct;11(9):807-15
references: 20817595
references: Arch Gen Psychiatry. 1992 Aug;49(8):624-9
references: 1637252
references: Clin Psychol Rev. 2012 Jul;32(5):359-69
references: 22561966
references: Am J Psychiatry. 1994 Sep;151(9):1351-60
references: 8067492
references: Am J Psychiatry. 2013 Jun;170(6):671-9
references: 23558452
references: Sleep. 2007 Jul;30(7):873-80
references: 17682658
references: Behav Res Ther. 2002 Aug;40(8):869-93
references: 12186352
references: Lancet. 2012 Mar 24;379(9821):1129-41
references: 22265700
references: Am J Psychiatry. 1990 Jan;147(1):57-63
references: 2293789
references: Sleep. 2008 Apr;31(4):489-95
references: 18457236
references: J Pers Disord. 2002 Jun;16(3):270-6
references: 12136682
references: Am J Epidemiol. 2010 Mar 15;171(6):709-20
references: 20167581
references: J Psychosom Res. 2007 Feb;62(2):179-88
references: 17270576
references: J Psychosom Res. 2010 Jan;68(1):57-65
references: 20004301
references: Sleep. 2007 Mar;30(3):274-80
references: 17425223
references: Behav Res Ther. 2002 Oct;40(10):1231-40
references: 12375731
references: Am J Psychiatry. 2012 May;169(5):476-83
references: 22737693
references: Arch Gen Psychiatry. 2005 Sep;62(9):953-9
references: 16143727
references: Psychol Med. 1995 Nov;25(6):1171-80
references: 8637947
references: J Consult Clin Psychol. 2008 Feb;76(1):84-91
references: 18229986
references: J Psychiatr Res. 2005 Sep;39(5):489-98
references: 15992558
references: Am J Epidemiol. 1997 Jul 15;146(2):105-14
references: 9230772
references: J Clin Sleep Med. 2011 Aug 15;7(4):351-6
references: 21897771
references: Annu Rev Clin Psychol. 2005;1:167-95
references: 17716086
references: Am J Psychiatry. 2003 Feb;160(2):274-83
references: 12562573
references: J Psychiatr Res. 2009 Feb;43(5):526-31
references: 18778837