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INTRODUCTION: Given the contradictory data available in the literature, the aim of this systematic review was to investigate the impact of the diagnostic method for borderline personality disorder (BPD) on the acute response and the risk of early relapse in major depressed individuals treated with electroconvulsive therapy (ECT). METHOD: After a systematic literature review performed during March 2023 in the PubMed-Medline database according to the PRISMA criteria, 47 articles were identified using the keyword algorithm ("Electroconvulsive Therapy" [Mesh] or electroconvulsive therapy) and ("Borderline Personality Disorder" [Mesh] or borderline personality disorder). The inclusion criteria applied for the selection of articles in this systematic review were: (1) articles investigating the impact of BPD on the acute response and/or the risk of early relapse in major depressed individuals (> 18 years old) treated with ECT, (2) diagnosis of BPD and major depressive disorder by validated screening tests and/or systematic psychiatric interviews based on diagnostic criteria of international classification, (3) any type of study (cross-sectional, longitudinal, prospective, retrospective, interventional and experimental), (4) articles written in English or French, and (5) articles published after January 2000. After assessment of the 47 articles based on these inclusion criteria by two authors, seven studies investigating the impact of BPD diagnosed by systematic psychiatric interview or screening tests on the acute response and the risk of early relapse in major depressed individuals treated with ECT were included in this systematic review. RESULTS: Unlike the three studies diagnosing BPD by screening tests, the four studies diagnosing BPD by systematic psychiatric interview demonstrated a negative impact of this personality disorder on the acute response or the risk of early relapse in major depressed individuals treated with ECT. However, all studies included in this systematic review presented a low level of scientific evidence (cross-sectional epidemiological studies and retrospective cohort studies). CONCLUSION: Despite the need for studies of better scientific quality, the results of this systematic review seem to indicate that screening for BPD by systematic psychiatric interview during the pre-ECT assessment and the establishment of adequate therapeutic strategies in case of comorbid BPD could be promising options to allow better acute response and better prevention of early relapses in major depressed individuals treated with ECT.

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I joined François Gros' laboratory in 1975, to study mechanisms of gene expression in eukaryotes. Despite the lack of powerful tools, that would be brought later by genetic engineering, I obtained publishable results and was allowed to defend a third cycle thesis. Thereafter, I joined Margaret Buckingham's group, which was empowering within François' laboratory. I maintained regular meetings with François, a leading figure but a secretive man, who did not readily open up. It was my privilege, over the more than 45 years I have been around him, to have glimpses over what had been really significant to him. This has been a rich and very precious experience.

J'ai rejoint le laboratoire de François Gros en 1975, pour étudier les mécanismes de l'expression génétique chez les eucaryotes. Malgré la carence en outils performants, qu'allait apporter le génie génétique, j'ai obtenu des résultats publiables et pu soutenir une thèse de 3 e cycle. Après cela, j'ai rejoint le groupe de Margaret Buckingham, qui s'autonomisait dans le laboratoire de François. J'ai continué à avoir des rencontres régulières avec François, personnalité de premier plan mais homme secret, qui ne se livrait pas volontiers. J'ai eu le privilège, au cours des 45 ans et plus où je l'ai côtoyé, d'avoir quelques aperçus de ce qui l'avait marqué, l'avait formé, lui importait vraiment. Ça été une expérience riche et très précieuse.

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OBJECTIVES: To assess dysfunctional personality beliefs associated with specific personality disorders (PD), as well as psychopathological symptoms and psychological distress levels in central serous chorioretinopathy (CSC) patients. MATERIAL AND METHODS: This cross-sectional study included acute and chronic CSC patients and age- and sex-matched healthy volunteers. Dysfunctional personality beliefs and psychopathological symptoms assessed with Personality Belief Questionnaire-Short Form and Symptom Check List-90 Revised (SCL-90-R), respectively, were compared between CSC patients and healthy volunteers and between acute and chronic CSC patients. MAIN RESULTS: Of the 55 CSC patients included in the study analysis, 21 (38.2%) had acute and 34 (61.8%) chronic CSC. Avoidant PD (13.92±3.79 vs. 12.03±3.98, P=0.012) and obsessive-compulsive PD (13.94±3.95 vs. 12.27±3.75, P=0.025) scores on the PBQ-SF were significantly higher in CSC patients than in healthy volunteers. The PBQ-SF scores were similar between acute and chronic CSC patients. CSC patients scored significantly higher on the general severity index (GSI) and all symptom dimensions except phobic anxiety and psychoticism on the SCL-90-R. In addition, scores for obsessive-compulsive, depression, interpersonal sensitivity, paranoid ideation, and GSI were significantly higher in acute than in chronic CSC patients. CONCLUSIONS: This first study investigating the relationship between CSC and dysfunctional personality beliefs indicates that CSC patients have higher levels of dysfunctional beliefs related to avoidant and obsessive-compulsive PD than healthy volunteers. These findings present a new aspect of the personality profile of CSC patients and point to a target for intervention, i.e., dysfunctional beliefs, through a cognitive-psychiatric approach.

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OBJECTIVES: Many people who are diagnosed with bipolar disorder also have comorbid personality disorder. Few studies have explored how personality disorder may influence pharmacological treatment outcomes. The aim of this study was to conduct a secondary analysis of data from a clinical trial of adjunctive nutraceutical treatments for bipolar depression, to determine whether maladaptive personality traits influence treatment outcomes. METHODS: Scores on the Standardised Assessment of Personality - Abbreviated Scale screener were used to classify participants as having bipolar disorder with (n = 119) and without (n = 29) above threshold personality disorder symptoms (personality disorder). Outcome measures included: The Montgomery Åsberg Depression Rating Scale, Clinical Global Impressions and Improvement Severity Scales, Patient Global Impressions-Improvement scale, Bipolar Depression Rating Scale, Range of Impaired Functioning Tool, Social and Occupational Functioning Assessment Scale and Quality of Life and Enjoyment Scale (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form). Generalised estimated equations examined the two-way interactions of personality disorder by time or treatment and investigated personality disorder as a non-specified predictor of outcomes. RESULTS: Over time, the Patient Global Impressions-Improvement scores were significantly higher in those in the personality disorder group. No other significant differences in the two-way interactions of personality disorder by treatment group or personality disorder by time were found. Personality disorder was a significant but non-specific predictor of poorer outcomes on the Bipolar Depression Rating Scale, Range of Impaired Functioning Tool, and Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form, regardless of time or treatment group. CONCLUSIONS: This study highlights the potential impact of maladaptive personality traits on treatment outcomes and suggests that the presence of comorbid personality disorder may confer additional burden and compromise treatment outcomes. This warrants further investigation as does the corroboration of these exploratory findings. This is important because understanding the impact of comorbid personality disorder on bipolar disorder may enable the development of effective psychological and pharmacotherapeutic options for personalised treatments.

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OBJECTIVES: The assessment of personality traits is most often based on self-report. However, a growing body of research has shown that informant-report is a valuable and too often overlooked source of unique information. The aim of this study was to validate the French version of the informant-report form of the Big Five Inventory-2 (BFI-2) which assesses 15 facet traits in addition to the five major trait domains. METHODS: We asked 699 psychology and sports science and technology students to describe a person they knew well using the BFI-2 and obtained 661 valid records with demographic information. The data were analyzed using a bi-factor exploratory structural equation model with five bifactors corresponding to the Big Five domains, and three group factors (facets) each. RESULTS: This model had an excellent overall fit. Cronbach's alpha coefficients for the five domains were very satisfactory and the McDonald's omega coefficients were even better. The scales that measured the five major factors were therefore highly reliable, although Extraversion was somewhat less so. The scales measuring facets all had high reliability as measures of the whole formed by the major factor and the group factor. In addition, ten of them were reliable measures of their specific factor, and the remaining five appeared to be pure measures of the five domains. CONCLUSIONS: The informant-report form of the BFI-2 is a reliable instrument which is easy and quick to administer. These qualities should enable clinicians and researchers to exploit the much-neglected source of original information provided by informant-reports.

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BACKGROUND: Borderline personality disorder is a common and treatable personality disorder that is often underdiagnosed and untreated, mainly due to a lack of training of psychiatrists and to a lack of accessibility to specialized therapies. However, no study has been conducted in France regarding this issue. Thus, we aimed to evaluate on a national scale the level of training, knowledge, and general attitude toward BPD diagnosis of French psychiatrists. METHODS: We conducted an online survey in an unselected population of residents and senior French psychiatrists between January and March 2022, the results of which are presented descriptively. RESULTS: 228 psychiatrists fully answered the questionnaire, and 21 more psychiatrists answered it partially. We found that most of the responders were unsatisfied with the residency training or the continuing medical education offered regarding BPD, a lack of training resulting in a low level of self-confidence regarding BPD management, in a low number of evidence-based therapies trained psychiatrists in issues regarding diagnostic disclosure, and in misconceptions regarding some aspects of the disorder. CONCLUSIONS: These results underlie a clear lack of training of French psychiatrists, as well as a request from the latter for more opportunities to learn. This calls for a rethinking of the teaching system to incorporate more knowledge and tools related to BPD.

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The stressful nature of parenting infants exacerbates the characteristics of Borderline Personality Disorder (BPD). Consequently, mothers with BPD tend to be emotionally dysregulated, respond impulsively to their infants, and have poorer mother-infant relationships. Few parenting interventions target the specific skill deficits observed in mothers with BPD. This study explored the differences in parental reflective functioning (PRF) and mother-infant relationship quality at baseline and following a 24-week, group parenting intervention for mothers with BPD. PRF and mother-infant relationship quality were assessed from quantitative (N = 23) and qualitative (N = 32) perspectives. Quantitative data (Parental Reflective Functioning Questionnaire) showed a significant improvement in one of the three subscales, Interest and Curiosity, between baseline and post-intervention, and a significant moderate positive association between the subscale Certainty of Mental States and maternal-infant interaction quality post-intervention. Improvements in mother-infant relationship quality were not evident from the observational measure, Nursing Child Assessment Satellite Teaching scale. In contrast, semi-structured interview qualitative data found maternal improvements in parental reflection, coping strategies implemented post-intervention, and quality of mother-infant relationships. Overwhelmingly positive intervention feedback suggested perceived maternal benefits of group format and skills taught. Future studies with larger sample sizes would allow further clarification of such parenting interventions for mothers with BPD.

La naturaleza estresante de criar infantes agudiza las características del Trastorno Límite de la Personalidad (BPD). Por tanto, madres con BPD tienden a estar emocionalmente no reguladas, responder impulsivamente a sus infantes y tener relaciones madre-infante de menor calidad. Pocas intervenciones de crianza se centran en los específicos déficits de habilidades observados en madres con BPD. El presente estudio exploró diferencias en el funcionamiento con reflexión del progenitor y la calidad de la relación madre-infante al punto inicial y al del seguimiento a 24 semanas de la intervención de crianza en grupo para madres con BPD. Se evaluó el funcionamiento con reflexión del progenitor y la relación madre-infante desde la perspectiva cuantitativa (N=23) y cualitativa (N=32). Datos cuantitativos (Cuestionario del Funcionamiento con Reflexión del Progenitor) mostraron un significativo adelanto en una de tres subescalas, Interés y Curiosidad, entre el punto inicial y posterior a la intervención, y una significativa moderada asociación positiva entre la subescala Certeza de Estados Mentales y la calidad de la interacción materno-infantil al momento posterior a la intervención. Las mejoras en la calidad de la relación madre-infante no fueron evidentes con la medida de observación, la escala de la Enseñanza Satélite de Evaluación del Niño Lactante. En contraste, datos cualitativos de entrevista semiestructurada encontraron mejoras maternas en la reflexión del progenitor, estrategias de cómo arreglárselas puestas en práctica después de la intervención, y en la calidad de las relaciones madre-infante. La abrumadoramente positiva información sobre la intervención sugirió que había una percepción materna de beneficios del formato de grupo y las habilidades que se enseñaban. Estudios futuros con grupos mayores permitirán clarificaciones adicionales de tales intervenciones de crianza para madres con BPD.

La nature stressante du parentage des nourrissons exacerbe les caractéristiques du Trouble de la Personnalité Limite (TPL). Par conséquent les mères avec un TPL ont tendance à être émotionnellement dérégulées, réagissant de manière impulsive à leurs bébés et ont des relations mère-bébé moins bonnes. Peu d'interventions de parentage visent les déficits de compétence spécifiques qui sont observés chez les mères avec un TPL. Cette étude a exploré les différences qu'on trouve dans le fonctionnement de réflexion parental et la qualité de la relation mère-bébé au départ et après une intervention de groupe de parentage pour des mères avec un TPL, de 24 semaines. Le fonctionnement parental de réflexion et la qualité de la relation mère-bébé ont été évalués à partir de perspectives quantitatives (N=23) et qualitatives (N=32). Les données quantitatives (Questionnaire de Fonctionnement de Réflexion parental ont montré une amélioration importante dans l'une des trois sous-échelles, Intérêt et Curiosité, entre le départ de l'intervention et la post-intervention, ainsi qu'un lien positive modéré important entre la sous-échelles Certitude des Etats Mentaux et la qualité de l'interaction maternelle-bébé après l'intervention. On n'a pas trouvé d'améliorations de la qualité de la relation mère-bébé à partir de la mesure d'observation échelle d'Formation Satellite de l'Evaluation du Nourrisson. Par contre les données qualitatives de l'entretien semi-structuré a révélé des améliorations maternelles dans la réflexion parentale, dans des stratégies d'adaptation mises en place après l'intervention et dans la qualité des relations mère-bébé. Les retours de l'intervention extrêmement positifs ont suggéré que des bénéfices maternels perçus du format de groupe et des compétences enseignées. Des études avec des échantillons plus grands permettraient une clarification plus poussée sur de telles interventions avec des mères avec un TPL.

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RATIONALE: Objective structured clinical examinations (OSCEs) were introduced to evaluate students not only on their knowledge, but also on their clinical skills and attitudes. The objectives were to study the correlation between OSCE scores and scores obtained to traditional knowledge examinations and to analyse factors associated with better OSCE performance in DFASM1 and 2 students at Dijon university hospital. METHODS: This was a prospective observational study conducted among all fourth and fifth year medical students in Dijon. The scores on the OSCE elective tests (2022) and the average score on the knowledge tests (2021-2022) were collected and their correlation measured. A questionnaire asked students about their demographic characteristics, their investment in formative and practicum OSCEs, their level of empathy (Jefferson questionnaire) and their personality traits (NEO-Pi-R). RESULTS: Of 549 students, 513 completed all tests. Scores on OSCE and faculty knowledge tests were correlated (r=0.39, P<0.001). Of these, 111 (20%) students responded to the questionnaire, and 97 were analized. We did not observe any significant difference between students who performed better on OSCEs than on knowledge tests and those who did not, regarding their age, their investment in formative tests, their personality traits or their level of empathy. CONCLUSION: Our results underline the need to optimize the evaluation of empathy and clinical skills in OSCE tests, using new tools, in order to better discriminate between students on these skills.

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Borderline personality disorder (BPD) is a common disorder in general and clinical populations and is related to potentially severe medical and socio-professional consequences. Treatment of BPD is based on evidence-based psychotherapies (such as Dialectical Behavioral Therapy, Mentalization-Based Therapy, Schema-Focused Therapy or Transference Focused Psychotherapy), which have been shown effective but are poorly available in France. Pharmacological treatments, which are more easily available, are not effective in treating symptoms of the disorder but can be useful in management of comorbidities. In this context, recently called "generalist" models have been developed, which every well-trained psychiatrist can implement in their daily practice, combining practical elements from evidence-based psychotherapies and elements of pharmacological management of symptoms and comorbidities. The purpose of this article is to present one of these models, the Good Psychiatric Management (GPM) and its basic principles and its applications, and to provide one of the first French-speaking resources about this model. In addition, beyond the practical elements proposed by the GPM, we discuss the deeper question that it raises, namely the question of a pragmatic integration of different theoretical and clinical models. Indeed, the treatment of BPD patients is at the junction of different conceptualizations of mental pathology (psychopathological, neurobiological) and different modalities of practice (psychotherapy, biological psychiatry). In a French context, that sometimes separates these two models, and in our opinion GPM constitutes an example of clinical collaboration which shows the interest of the combined role of psychiatrist-psychotherapist.

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As individuals age and become aware of changes in their driving capabilities, they are more likely to self-regulate their driving by avoiding certain driving situations (i.e., night driving, rush hour traffic, etc.). In this paper, we sought to examine the correlates of situational driving avoidance with a particular emphasis on the roles of personality traits, gender, and cognition within a large sample of mid-life and older adults from the Canadian Longitudinal Study on Aging (CLSA). Our findings show that women of older ages tend to report more driving avoidance and that personality traits, specifically extraversion, emotional stability, and openness to experience, may reduce driving avoidance. A negative association was also found between cognition and driving avoidance, such that individuals with higher cognition reported less driving avoidance.

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OBJECTIVES: In this study, we aimed to evaluate the relationship between symptoms and objective findings and dry eye (DE) patients' personalities and levels of depression and anxiety. METHODS: The study group consisted of 67 DE patients who presented to the ophthalmology clinic with symptoms of dry eye disease (DED) and were first diagnosed. Patients underwent a complete ophthalmologic examination, including tear-film break-up time (TBUT), Schirmer 1 and Ocular Surface Disease Index (OSDI). All subjects also completed the Temperament and Character Inventory (TCI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). RESULTS: No relationship was found for the Schirmer 1 Test and TBUT with psychological parameters or OSDI scores. When compared with the normal values for the Turkish population, sub-dimensions of temperament in DED; novelty seeking (NS) was significantly lower (P<0.001); harm avoidance (HA) (P=0.014), and persistence (P<0.001) were significantly higher. Significant positive correlation with HA and significant negative correlation with NS were found for the OSDI results. Furthermore, our mediation model revealed that anxiety mediated the effect of NS and HA on OSDI. CONCLUSION: The significant association of temperament sub-dimensions with OSDI scores in the DED group may play a role in explaining the inconsistency between symptoms and signs. Professionals who care for DED should consider temperament sub-dimensions when they detect discordance between symptoms and signs.

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OBJECTIVES: Patients suffering from borderline personality disorder are very prevalent in various settings (emergency rooms, psychiatric and general hospitals, ambulatory consultations). However, it remains one of the most stigmatized and neglected mental health conditions, albeit being an area that is responsible for very interesting advances in psychotherapy. Today, the prognosis of patients with borderline personality disorder is rather favorable, provided that they follow a dedicated psychotherapy. Conceptions about this condition therefore deserve to be updated as it is sufficiently described in the literature that negative attitudes towards these patients diminish the quality of care they receive as well as their prognosis, and that these attitudes change with training. We decided to study the state of knowledge and attitudes towards borderline personality disorder in a group of French-speaking caregivers interested in these patients. METHODS: Between 2019 and 2020, at the start of training sessions in psychotherapeutic approaches to borderline personality disorder, we provided two questionnaires to 126 caregivers from various professional backgrounds (psychiatrists or child psychiatrists, psychologists, mental health nurses, social workers). The first consisted of 13 questions with 3 choice answers aimed at testing knowledge about borderline personality disorder and the second of 11 questions in the form of a Likert scale aimed at evaluating attitudes towards these patients (e.g. degree of comfort, involvement, hope, avoidance with these patients) adapted frome a questionnaire of Blake and colleagues. RESULTS: The sample consisted of 126 caregivers (69 psychiatrists/pedopsychiatrists; 19 mental health nurses; 23 psychologists; 14 social workers). Fifty three of them (42.06 %) worked in an outpatient setting (either in a state facility or in private practice), 50 (39.68 %) worked in an inpatient psychiatric unit, 13 (10.32%) in both care systems, and 10 (7.94 %) worked in other facilities such as sheltered homes or workshops for persons with psychiatric disabilities. The average number of years in postgraduate training was 7.73 (SD=5.67; rank=0 to 31), and 35 (27.78%) had received at least one training course on borderline disorder in the past. The mean age of the sample was 37.89 (SD=10.08; rank=20 to 64) and there were 76 women (60.32%) and 50 men (39.68%). Concerning the first questionnaire (knowledge), the rate of correct responses among caregivers was relatively low (54%) considering that the vast majority of those assessed were caregivers already trained in mental health who were working with patients suffering from borderline personality disorder. The results showed a significant knowledge gap among professionals, in particular in the nursing profession, illustrating an ever more flagrant shortfall in formations in this sub-population. Concerning the second questionnaire (attitudes), the answers showed that attitudes of caregivers towards patients with borderline personality disorder were still tinged with fear and lack of confidence in taking charge of them. Thus, one participant out of five would have liked to avoid these patients, more than 12% of caregivers did not appreciate them, and 23% thought that they were manipulative. In addition, nearly half of the caregivers surveyed had low confidence in their ability to make a positive difference in the lives of borderline patients. However, there was a recognition of their distress as well as a demand for dedicated training. CONCLUSIONS: Stigmas and ignorance persist around patients with borderline personality disorder. Current training courses do not allow caregivers who are on the front lines (in particular nurses) and who wish to be trained to acquire sufficient knowledge and tools necessary for the care of patients suffering from this disorder. This calls for an improvement in training as well as a reflection on the most appropriate approaches possible to the various target audiences.

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OBJECTIVES: The Reinforcement Sensitivity Theory (RST) is a neuropsychological theory of personality emphasizing approach and avoidance as the two core behavioral aspects. Approach is represented by the behavioral approach system (BAS). Avoidance is represented by the behavioral inhibition system (BIS) and the fight-flight-freeze system (FFFS). Although the influence of testosterone on human behavior has been demonstrated, few studies have investigated the relation between testosterone and the RST. The aim of this narrative review was to decipher the possible role of testosterone on the biological systems involved in the RST in humans. METHODS: Google scholar, PubMed, PsycARTICLES, PsycINFO, Scopus and Cochrane library databases were interrogated using keywords such as testosterone, BIS, BAS, FFFS, personality, reinforcement sensitivity theory. RESULTS: Seven original articles, published between 2009 and 2022, assessing the relation between testosterone and the systems implicated in the RST, were included. The results of these studies suggested the presence of a possible positive relation between testosterone and the BAS. However, the impact of testosterone on the BIS and/or FFFS seems to be less clear. DISCUSSION: The consistency in the results supporting the presence of a positive relation between testosterone and the BAS might lead to the consideration of testosterone as a potential correlate in the clinical assessment of several psychopathologies. The inconsistency in the conclusions regarding the impact of testosterone on the BIS and/or the FFFS might be attributed to the different questionnaires used as measurement tools. Additional research remains needed.

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Borderline personality disorder (BPD) is a severe and relatively prevalent psychiatric disorder, responsible for high rates of suicidal behaviors. Disturbed identity appears as at the very core of this disorder, being inter-related with all other BPD features. Notably, from a dimensional perspective on mental disorders, one should realize that it is from our usual self-representation that we live all our daily experiences. Then, if the understanding of self-concept (or identity) is impaired, all the interventions implemented to decrease the self's suffering will subsequently be impaired. The purpose of the present case study was to illustrate the nine identity diffusion categories described by Jørgensen & Bøye (2022) and how the level of identity function can be improved in a third-wave cognitive and behavioral therapy targeting progressive correct self-identification.

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OBJECTIVES: The aim of this work was to study whether the French versions of the brief tools available to clinicians within the framework of the Alternative Model of Personality Disorders (AMPD) can account for the risks of personality disorders in the general population. Tools are available to accurately investigate either the Level of Personality Functioning (LPF) or the Pathological Personality Dimensions (PPD) which in turn allow the validation of the relevance of the AMPD for its criteria A and B. As these tools, such as Morey's Level of Personality Functioning Scale Self Rated (LPFS-SR) for Criteria A or the Personality Inventory for DSM-5 (PID5) by Krueger et al. for Criteria B, are lengthy, the question arises as to the use of the short tools derived from them. METHOD: Data was collected from a sample of 433 people recruited on a volunteer basis with a complete protocol. The sample was predominantly female (83% female, 16% male, 2 people who did not wish to report their gender) and rather young (67% were 18-24 years old). The short version, the LPFS- BF of Hutsbaut et al., which we used in this work allows, as confirmed by several works, to consider on the basis of 12 items the global level of personality functioning. In order to assess the pathological dimensions of personality (PPD), we chose the short version of the Personality Inventory for DSM 5 (PID 5 BF) by Krueger et al. and used its validated French translation that satisfies the factor composition of the original version: Negative Affectivity, Antagonism, Detachment, Disinhibition and Psychoticism. To assess the intensity of personality disorders we used the dedicated subscale (Items 19 and 20) that the DSM 5 proposes in its Cross-Cutting Symptoms Measures of Level 1, in its French translation. A score higher than 2 was our Gold Standard when we tested the metric capacity of the two questionnaires to evaluate the A Criteria and then the B Criteria of the AMPD. RESULTS: The overall results (Table 1) show levels that place the group in a non-clinical level. In terms of the severity of personality disorders it can be seen that 27 % are at risk of personality disorder (PDs>2). Comparing these two sub-groups (Table 1), we observed significant differences for all the factors studied, pointing towards a higher score for people at risk of PDs. A logistic regression analysis of the evaluation of persons at risk lead us to find that gender and age do not have a significant influence (p=0.225 and p=0.065 respectively) in a valid model (chi square=157, df=4, p<0.001) including the overall score on the LPFS (z=5.76, p<0.001) and the PID 5 (z=2.26, p<0.001). The Area Under the Curve (AUC=0.859) of this translation (Table 3) is consistent with the original version (AUC=0.84). It has metrological qualities (Sn=73.91%, Sp=85.33%, LR+=5.1, LR-=0.3005) that allowed us to use a threshold of 24 as a discriminant of a risk of moderate or severe personality disorder. In addition, if we followed the AMPD and considered the threshold of 24 on the LFPS-BF to be a risk score for personality disorder, we could see (Fig. 2) that the scores on the PID 5 BF fairly well reflected the expected pattern with a large AUC (0.901). According to the AMPD, the cut-points for the dimensions that would evoke the presence of criteria B in the case of the presence of criterion A (LPFS-BF>24) could be either a score greater than 2 for Negative Affectivity, a score greater than 0.8 for Detachment, Antagonism and Disinhibition, or a score greater than 1.2 for Psychoticism (Table 4). DISCUSSION: The translation of the LPFS-BF that we used in this work has sufficient qualities to assess situations at risk of personality disorders when higher than 24. Its consistency was good (=0.84), and its factor composition in two factors (Self and Interpersonal Relations) was equivalent to the original version. The use of PID5-BF could therefore be used as a complement to the screening of AMPD A criteria, with a 25 for cut-point. The evaluation of the AMPD B criteria with the PID5-BF seemed relevant in view of our results; each of the subscales seemed to be able to correctly evaluate (AUC) persons with an LPFS-BF score at risk. However, the risk thresholds need to be confirmed in further work because of the essential role that the dimensions play in the diagnosis of types of personality disorders.

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A research protocol was developed to test a theoretical model regarding impulsivity in borderline personality (BP) disorder. It was hypothesized that the impact of identity disturbance of individuals with BP features on their response-inhibition functions could be explained by the disposition of their self-concept to increase the intensity of negative emotions. Participants with different levels of BP features were assigned to a self-description condition (N=29) that had the potential to manipulate the identity coherence, or a control condition (N=27) prior to a response inhibition task with high and low arousal emotional stimuli. We also explored the relationship between participants' self-description and their performance on the inhibition task. The results showed a significant interaction between condition, level of BP features, valence, and stimulus intensity on commission errors. Post-hoc analysis did not reveal significant differences. In addition, a moderate correlation was found between a lesser differentiated description of the self and a higher mean of errors of commission. This preliminary study highlights the relevance of studying the relationship between the self-concept and inhibition regarding borderline impulsivity. The findings should be replicated with a larger sample and with individuals who meet the diagnostic criteria.

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At the heart of the knotting of an addiction during the adolescent process is the possibility of conceptualizing the dynamics of an addictive behavior through the prism of attachment theory. From the inheritance of a family gift, through the coloring of attachment objects, to the adolescent oedipal reactivation, the addictive behavior finds a functional echo in compensation for an inaugural lack. This lack, this deficiency from an insecure family space, conditions the appearance of a symptomatic defense embodied by the dependent attachment to external objects. The case of Mohamed illustrates these problems in the relationship to the Other while providing a clinical window on the identity issues palliated by addictive behaviors. Witha logic of having rather than being, shaped by a relationship to language oscillating between the unspeakable and the reification of his speech, Mohamed invites us, singularly, to glimpse an avenue of clinical reflection.

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The author, although an analyst, is an initiate into the topic of environmental destruction. Following Wendell Berry, she enters the dark and begins a journey of dream-like reflection, weaving images from her own dream and drawing on the work of Vaughan, Bernstein, Soloveitchik and Sacks. She asks, 'not if but where does climate change enter the room?'. The second half of the paper focuses on the manifestations of environmental destruction in dreams and sandplay from three patients and one dream group participant. The paper argues that the analyst must see and intuit before our patients can access the objective layer of environmental destruction in dreams and symbolic material. In this way, the climate becomes the wounded patient, and the analyst as wounded healer must first access his/her own relationship to the wounds inside. Finally, using an ancient Jewish mythological story of Rabbi Shimon bar Yochai, the author argues that Jungian analysts must work to find balance between the inner world of depth psychology and the outer world with its challenges and problems that include environmental destruction.

L'auteur, bien qu'étant analyste, est une initiée du sujet de la destruction de l'environnement. Inspirée par Wendell Berry, elle entre dans le noir et commence un voyage de réflexion en tissant des images provenant de son propre rêve et utilisant les travaux de Vaughan, Bernstein, Soloveitchik et Sacks. Pour elle la question est non pas si mais où est-ce que le changement climatique entre dans la pièce ? La deuxième moitié de l'article s'intéresse aux manifestations de destruction de l'environnement dans les rêves et la thérapie par le jeu de sable de trois patients et d'une personne participant à un groupe de rêves. L'article soutient que l'analyste doit voir et suivre son intuition avant que les patients aient accès à la couche objective de la destruction de l'environnement dans les rêves et le matériel symbolique. De cette manière, le climat devient le patient blessé, et l'analyste, en tant que guérisseur blessé, doit tout d'abord accéder à sa propre relation aux blessures intérieures. Enfin, s'appuyant sur une ancienne histoire mythologique Juive, celle de Rabbi Shimon bar Yochai - qui se retira dans une caverne pendant 13 années - l'auteur soutient que les analystes Jungiens doivent œuvrer à trouver l'équilibre entre le monde intérieur de la psychologie des profondeurs et le monde extérieur avec ses défis et ses problèmes, qui incluent la destruction de l'environnement.

La autora, es analista, y también iniciada en el tópico de la destrucción medioambiental. Siguiendo a Wendell Berry, ella entra en la oscuridad y comienza una travesía reflexiva hilvanando imágenes de sus propios sueños y apoyándose en los trabajos de Vaughan, Bernstein, Soloveitchik y Sacks. Ella pregunta, '¿sino dónde el cambio climático entra en la sala? La segunda parte del trabajo se focaliza en manifestaciones de la destrucción del medioambiente en sueños y en la caja de arena de tres pacientes y de un participante de un grupo de sueños. El trabajo argumenta que el/la analista debe poder ver e intuir antes que nuestros pacientes puedan acceder la dimensión objetiva de la destrucción medioambiental en sueños y material simbólico. De este modo, el clima deviene el/la paciente herido, y el/la analista como curador herido debe primero poder acceder su propia relación con su herida interior. Finalmente, utilizando una antigua historia mitológica de la tradición Judía del Rabino Shimon bar Yochai, quien se retiró a una cueva durante trece años, ella argumenta que analistas Junguianos deben trabajar para encontrar un balance entre el mundo interno de la psicología profunda y el mundo externo con sus desafíos y problemas como el de la destrucción ambiental.

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The development of attachment in toddlers is linked to the quality of their early interactions with their mother and father. The impact of interactive dysfunctions, in relation to different parental circumstances, constitutes an important risk for the development of disorganized attachment. Although this aspect is fairly well known, few studies have been done on the children of people with borderline personality disorder.

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OBJECTIVES: Co-occurrence of Anorexia Nervosa (AN) and borderline personality disorder (BPD) is frequent (8%-40%) and associated with specificities that impact the treatment process. Lifetime history of suicide attempt (HAS), substance use disorder (SUD) and the binge-purging subtype (B-P) might be good markers of such comorbidity. We made the hypothesis that in patients with AN, the presence of HAS, SUD and B-P have sufficient predictive power to efficiently detect an associated BPD comorbidity. METHODS: After a case report analysis on a pilot sample of 119 patients with AN, we performed a cross-sectional analysis on a confirmatory sample of 84 patients with AN in a single center specialized in eating disorders systematically assessing HAS, SUD, B-P and BPD using the Mini International Neuropsychiatric Interview for DSM-5 and the Diagnostic Interview for Borderline (DIB-R). RESULTS: B-P had a 100% negative predictive value, and the combination of SUD plus HAS had a 100% positive predictive value. On a quantitative level, B-P, HAS and SUD were independent explanatory factors of the DIB-R total score. CONCLUSIONS: The main limitations were the low number of patients, the single center analyses, the potential overlapping of assessments and the fact that data were exclusively declarative. In this study, every patient with B-P, SUD and HAS had been diagnosed with BPD.