title: Self-relevant disgust and self-harm urges in patients with borderline personality disorder and depression: a pilot study with a newly designed psychological challenge.
abstract: BACKGROUND
  Borderline personality disorder (BPD) is a common psychiatric condition associated with self-harm. Self-harm is poorly understood and there is currently no treatment for acute presentations with self-harm urges.
  
  
  OBJECTIVE
  By using a new task (Self-relevant Task; SRT), to explore emotions related to one's own person (PERSON task) and body (BODY task), to study the correlations of these emotions, specifically disgust, with self-harm urge level changes, and to test the task's potential to be developed into an experimental model of self-harming for treatment trials.
  
  
  METHODS
  17 BPD patients, 27 major depressive disorder (MDD) patients, and 25 healthy volunteers performed the SRT. Emotion labels were extracted from task narratives and disgust and self-harm urge level changes measured by visual analogue scales. We used validated rating scales to measure symptom severity.
  
  
  RESULTS
  The SRT was effective at inducing negative emotions and self-harm urge changes. Self-harm urge changes correlated with borderline symptom severity. Post-task disgust levels on the visual analogue scales were higher in BPD patients than in healthy controls in the PERSON task, and higher than in both control groups in the BODY task. Changes in disgust levels during the task were significantly greater in the patient groups. Post-task disgust levels or changes in disgust were not associated with self-harm urge changes (except the latter in MDD in the PERSON task), but self-harm urge changes and disgust (but no other emotion) narrative labels were on a whole sample level.
  
  
  CONCLUSIONS
  Although associations with the analogue scale measures were not significant, self-disgust reported in the narrative of patients may be associated with a higher probability of self-harm urges. Further research with larger sample sizes is needed to confirm this relationship and to examine whether reducing self-disgust could reduce self-harm urges. The SRT was effective and safe, and could be standardized for experimental studies.
authors: Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
authors: Sawsan
authors: S
authors: Abdul-Hamid
authors: Complex Cases Service, Cambridgeshire and Peterborough Foundation NHS Trust, Cambridge, United Kingdom.
authors: Chess
authors: C
authors: Denman
authors: Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Complex Cases Service, Cambridgeshire and Peterborough Foundation NHS Trust, Cambridge, United Kingdom; Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, United Kingdom.
authors: Robert B
authors: RB
authors: Dudas
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000523:psychology*; D003710:Demography; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D010865:Pilot Projects; D015203:Reproducibility of Results; D016728:Self-Injurious Behavior / Q000523:psychology*; D013647:Task Performance and Analysis; D064232:Visual Analog Scale