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    Borderline personality disorder and attention deficit/hyperactivity disorder in adolescence: overlap and differences in a clinical setting
    (Bmc, 2020) Akca, Omer Faruk; Wall, Kiana; Sharp, Carla
    Background With increased consensus regarding the validity and reliability of diagnosing Borderline Personality Disorder (BPD) in adolescents, clinicians express concern over the distinction between BPD and Attention-Deficit/Hyperactivity Disorder (ADHD), and its co-morbidity in clinical settings. The goal of this study was to evaluate differences between BPD, ADHD and BPD + ADHD in terms of co-morbid psychiatric disorders and a range of self-reported behavioral problems in adolescents. Methods Our sample consisted of N = 550 inpatient adolescents with behavioral and emotional disorders that have not responded to prior intervention. We took a person-centered approach (for increase clinical relevance) and compared adolescents with ADHD, BPD and ADHD+BPD in terms of co-occurring psychiatric disorders and behavioral problems. We performed a regression analysis to test whether BPD symptoms make an incremental contribution to the prediction of psychiatric symptoms over ADHD symptoms. Results The severity of almost all co-occurring disorders, aggression, self-harm, suicidal thoughts, and substance use, were higher in the ADHD+BPD group. Borderline symptoms made an incremental contribution to the prediction of psychiatric symptoms beyond the contribution of ADHD. Conclusion Severity and co-morbidity may be helpful factors in distinguishing between ADHD and BPD in clinical practice and the co-morbidity of these two disorders may indicate a worse clinical outcome.
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    Borderline personality disorder and attention deficit/hyperactivity disorder in adolescence: overlap and differences in a clinical setting
    (Bmc, 2020) Akca, Omer Faruk; Wall, Kiana; Sharp, Carla
    Background With increased consensus regarding the validity and reliability of diagnosing Borderline Personality Disorder (BPD) in adolescents, clinicians express concern over the distinction between BPD and Attention-Deficit/Hyperactivity Disorder (ADHD), and its co-morbidity in clinical settings. The goal of this study was to evaluate differences between BPD, ADHD and BPD + ADHD in terms of co-morbid psychiatric disorders and a range of self-reported behavioral problems in adolescents. Methods Our sample consisted of N = 550 inpatient adolescents with behavioral and emotional disorders that have not responded to prior intervention. We took a person-centered approach (for increase clinical relevance) and compared adolescents with ADHD, BPD and ADHD+BPD in terms of co-occurring psychiatric disorders and behavioral problems. We performed a regression analysis to test whether BPD symptoms make an incremental contribution to the prediction of psychiatric symptoms over ADHD symptoms. Results The severity of almost all co-occurring disorders, aggression, self-harm, suicidal thoughts, and substance use, were higher in the ADHD+BPD group. Borderline symptoms made an incremental contribution to the prediction of psychiatric symptoms beyond the contribution of ADHD. Conclusion Severity and co-morbidity may be helpful factors in distinguishing between ADHD and BPD in clinical practice and the co-morbidity of these two disorders may indicate a worse clinical outcome.
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    Divergent mentalization types in adolescent borderline personality disorder and attention deficit/hyperactivity disorder
    (Taylor & Francis Ltd, 2021) Akca, Omer Faruk; Wall, Kiana; Sharp, Carla
    Background Attention deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) have several similarities and it is difficult to distinguish these disorders in adolescents. We aimed to identify the unique correlates of mentalization abilities that may distinguish these two disorders, and to investigate the mentalization abilities of adolescents with ADHD, BPD and ADHD + BPD in an inpatient sample to determine the effect of co-morbidity on mentalization abilities. Methods We have explored the relationship between Child Eye Test (CET) scores, Movie for the Assessment of Social Cognition (MASC) subscales, and ADHD and BPD symptoms in adolescent inpatients. In addition, we compared ADHD, BPD and ADHD + BPD groups in terms of their mentalization abilities. Results Correct MASC scores were negatively associated with both ADHD and BPD symptoms in girls, and negatively associated with ADHD symptoms in boys. In addition, hypermentalization scores were associated with BPD symptoms in girls, and hypomentalization and no mentalization scores were associated with ADHD symptoms in girls. CET scores were negatively associated with ADHD symptoms in girls, but no relations with BPD were found. Group comparisons revealed no significant difference among groups. Limitations We included only inpatient sample without considering their medication condition, we did not compare the mentalization scores of the patient groups with healthy controls and we used self-report measures for several assessments. Conclusion Mentalization patterns in ADHD and BPD are distinct. ADHD may be related to hypomentalization, instead, BPD may be related to hypermentalization.
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    IMPLICIT AND EXPLICIT MENTALIZING DEFICITS IN ADOLESCENT INPATIENTS: SPECIFICITY AND INCREMENTAL VALUE OF BORDERLINE PATHOLOGY
    (Guilford Publications Inc, 2020) Penner, Francesca; McLaren, Veronica; Leavitt, Jacob; Akca, Omer Faruk; Sharp, Carla
    Research has demonstrated mentalizing impairment associated with borderline personality disorder (BPD) in adolescents. However, mentalizing performance in adolescents with BPD has never been compared to that of psychiatric control and healthy control adolescents simultaneously. The present study aimed to (a) compare implicit and explicit mentalizing, and hypermentalizing errors in implicit mentalizing, across youth with BPD and psychiatric and healthy controls, and (b) evaluate the association of borderline features with mentalizing deficits over and above internalizing and externalizing. Psychiatric inpatients with BPD (n = 139), inpatient psychiatric controls (n = 310), and healthy adolescents (n = 134) completed two mentalizing tasks, an interview assessing BPD, and measures of psychopathology. Results showed that BPD specificity could be demonstrated only for implicit mentalizing and hypermentalizing. Explicit mentalizing deficits did not differ between BPD and psychiatric control groups. Borderline features had unique associations to implicit mentalizing and hypermentalizing, over and above internalizing and externalizing.
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    IMPLICIT AND EXPLICIT MENTALIZING DEFICITS IN ADOLESCENT INPATIENTS: SPECIFICITY AND INCREMENTAL VALUE OF BORDERLINE PATHOLOGY
    (Guilford Publications Inc, 2020) Penner, Francesca; McLaren, Veronica; Leavitt, Jacob; Akca, Omer Faruk; Sharp, Carla
    Research has demonstrated mentalizing impairment associated with borderline personality disorder (BPD) in adolescents. However, mentalizing performance in adolescents with BPD has never been compared to that of psychiatric control and healthy control adolescents simultaneously. The present study aimed to (a) compare implicit and explicit mentalizing, and hypermentalizing errors in implicit mentalizing, across youth with BPD and psychiatric and healthy controls, and (b) evaluate the association of borderline features with mentalizing deficits over and above internalizing and externalizing. Psychiatric inpatients with BPD (n = 139), inpatient psychiatric controls (n = 310), and healthy adolescents (n = 134) completed two mentalizing tasks, an interview assessing BPD, and measures of psychopathology. Results showed that BPD specificity could be demonstrated only for implicit mentalizing and hypermentalizing. Explicit mentalizing deficits did not differ between BPD and psychiatric control groups. Borderline features had unique associations to implicit mentalizing and hypermentalizing, over and above internalizing and externalizing.
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    Social media use and personality disorders
    (Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2020) Akca, Omer Faruk; Bilgic, Ayhan; Karagoz, Hulya; Cikili, Yahya; Kocak, Fatih; Sharp, Carla
    Objective: The aim of this study was to investigate the association between personality disorders and social media use. Methods: Five hundred and ten university students participated in the study. Personality Belief Questionnaire-Short form was used to assess DSM-based personality disorder symptoms and Social Media Disorder Scale was used to determine addictive use of social media. In addition, daily usage of social media, frequency of taking and sharing selfies were examined using a questionnaire created by the authors. Results: Participants with high levels of Social Media Disorder demonstrated higher levels of avoidant, dependent, antisocial, histrionic, paranoid and borderline personality features compared to those with low levels of social media disorder. Results of multivariate analyses showed that addictive use of social media, daily duration of social media use and frequency of selfie sharing were positively predicted by histrionic personality features and female gender. Furthermore, selfie taking was predicted only by narcissistic personality features. Conclusion: This study indicates that histrionic personality features may be risk factors for addictive use of social media.