A comparative analysis of second-trimester ultrasound dating formulae in pregnancies conceived with artificial reproductive techniques

A dataset of 64 pregnancies conceived by artificial reproductive techniques was studied to assess the accuracy of second-trimester dating formulae when these were applied in routine ultrasound clinics in different centers. Dating formulae for biparietal diameter (BPD) and femur length (FL) were derived for a gestational age range of 14-23 weeks. The best fit curves represented linear equations: gestational age (days) = 44.2 + 2 x BPD; and gestational age (days) = 67.4 + 2.3 x FL. Twelve published formulae for biparietal diameter and femur length were reviewed and systematic and random errors were calculated for these formulae when they were applied to second-trimester scan measurements in precisely dated pregnancies. Overall, published dating formulae performed well in predicting gestational age. The 95% confidence interval was 8.3 days for biparietal diameter and 10.2 days for femur length. The study confirms the accuracy of ultrasound dating in routine ultrasound clinics and supports the use of ultrasound measurement alone in preference to menstrual history for dating pregnancy.     

Zygosity and intrauterine growth of twins

Six hundred seventy-eight sonar measurements of the fetal biparietal diameter (BPD) were used to assess the intrauterine growth of 182 twins between 18 and 40 weeks' gestation. These values, as well as the weight and body length at birth, were related to the zygosity, which was determined by sex of the infants, histologic examination of placenta, or blood grouping. The mean BPD of twin 1 was larger than that of twin 2 in both monozygotic and dizygotic pairs throughout the study period (P less than .001). The size of BPD of the dizygotic infants exceeded that of the monozygotic among both twin 1 (P less than .001) and twin 2 (P less than .001). The absolute intrapair differences of birth length and weight were larger among dizygotic than among monozygotic twins. These findings suggest that in late pregnancy a substantial one-way intertwin transfusion among monochorial twins does not occur frequently enough to mask the inherent genetically determined similarity between the twins. The appearance already in the second trimester of the difference in the longitudinally monitored BPD between monozygotic and dizygotic twins suggests that the discrepancy is determined early in gestation.     

Birth weight prediction by B-type ultrasonic measurement of fetal transverse cerebellar diameter

The fetal transverse cerebellar diameter (CD), biparietal diameter(BPD), abdominal circumference (AC) and femur length(FL) were measured by B-type ultrasonography on 222 normal pregnant women with one week before the expected date of confinement (EDC) and their correlations with birth weight of newborns were computerized. Single factorial analyses showed the best correlation was between CD and birth weight (R = 0.913 4) where as the R value for birth weight and AC, BPD, FL was 0.739 5, 0.612 5, 0.347 6 respectively. The F value of CD on stepwise regression analysis was the highest (F = 1001.95) while that of AC and BPD was 4.55, 4.36 respectively (P < 0.05). Then the regression equations of single double and triple factors were established. It was confirmed by clinical findings that the equation of log(BW) = 2,8844 + 0.01416 x CD was the most reliable one in predicting the birth weight. The error rate was less than 10% in 96% of the newborns.     

The work of the American emergency physician

OBJECTIVE: To compare gestational age (GA) calculated from oocyte retrieval and from ultrasound measurements in pregnancies after in vitro fertilization (IVF). DESIGN: In a retrospective study of 253 women with singleton and 84 women with twin pregnancies conceived from IVF, GA calculated from the day of oocyte retrieval was compared with GA calculated in the second trimester of pregnancy from ultrasound measurements of biparietal diameter (BPD) and femur length (FL). RESULTS: For singletons, the mean GA calculated from ultrasound measurements was significantly shorter than the mean GA estimated from the day of oocyte retrieval. The mean difference was 1.9 days (SD 3.3; 95% CI 1.5-2.4) if only BPD was used and 2.1 days (SD 2.1; 95% CI 1.6-2.5) if BPD and FL were combined. For twins, the mean GA calculated from ultrasound measurements was also significantly shorter than the mean GA calculated from the day of oocyte retrieval. The mean difference was 1.4 days (SD 2.7; 95% CI 1.0-1.8) if BPD was used and 1.6 days (SD 2.5; 95% CI 1.2-2.0) if BPD and FL were combined. CONCLUSIONS: In IVF pregnancies, term prediction using ultrasound in the second trimester is reliable and may reduce the number of pregnancies subsequently classified as post-term, thus avoiding unnecessary obstetric interventions.     

Impulsivity and risk-taking in borderline personality disorder with and without substance use disorders.

Impulsivity and risk taking propensity were assessed in participants with borderline personality disorder (BPD-only; n = 19), BPD and a current or past substance use disorder (BPD-SUD; n = 32), and a matched comparison group (MC; n = 28). Participants were administered behavioral measures of two facets of the multidimensional construct of impulsivity [GoStop, delay discounting task (DDT)], one measure of risk-taking propensity [Balloon Analog Risk Task (BART)], and two self-report measures of impulsivity (i.e., Barrett Impulsiveness Scale, Eysenck Impulsiveness Scale). The BPD-SUD group, but not the BPD-only group, discounted delayed rewards faster than the MC group on the DDT, suggesting that the BPD-SUD/MC group difference may be because of the SUD rather than BPD. In contrast, both the BPD-SUD and BPD-only groups exhibited poorer behavioral response inhibition compared with the MC group, but the two BPD groups did not differ from one another. This finding suggests that the differences in behavioral response inhibition may be because of BPD rather than SUD and that behavioral response disinhibition may be a core feature of BPD. None of the groups differed on the measure of risk-taking propensity (i.e., BART). On self-report questionnaires, the BPD-SUD group reported more impulsivity than the BPD-only group and both BPD groups reported more impulsivity than the MC group. Data from the DDT and self-report measures provide partial support for the hypothesis that BPD individuals with a SUD are more impulsive than BPD individuals without a SUD on some facets of impulsivity (e.g., desire to obtain a smaller immediate reward rather than wait to obtain a larger reward in the future). Results suggest that behavioral response inhibition may be a novel treatment outcome variable for BPD treatment studies. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Latent structure analysis of DSM-IV borderline personality disorder criteria

The aim of this study was to evaluate the structure of DSM-IV borderline personality disorder (BPD) criteria. The study group consisted of 564 consecutively admitted inpatients and outpatients. BPD criteria discriminatory power was tested by using corrected item-to-total and item-to-diagnosis correlations. Weighted least-squares (WLS) confirmatory factor analysis (CFA) was used to assess the fit of DSM-IV BPD unidimensional model. The categorical model of BPD was tested by exploratory latent class analysis (LCA). Item analysis suggested a hierarchy in BPD criteria discriminatory power, even if with different rank order with respect to the DSM-IV model. CFA showed a unifactorial structure with congeneric items as the best fitting model for DSM-IV BPD criteria (chi2 = 18.89, df= 27, P > .87). LCA showed evidence for three latent classes; heterogeneity was observed only among subjects falling below DSM-IV diagnostic threshold for BPD. These results support the categorical model of BPD, even if with several differences with respect to DSM-IV.     

The rejection–rage contingency in borderline personality disorder.

Though long-standing clinical observation reflected in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) suggests that the rage characteristic of borderline personality disorder (BPD) often appears in response to perceived rejection, the role of perceived rejection in triggering rage in BPD has never been empirically tested. Extending basic personality research on rejection sensitivity to a clinical sample, a priming–pronunciation experiment and a 21-day experience-sampling diary examined the contingent relationship between perceived rejection and rage in participants diagnosed with BPD compared with healthy controls. Despite the differences in these 2 assessment methods, the indices of rejection-contingent rage that they both produced were elevated in the BPD group and were strongly interrelated. They provide corroborating evidence that reactions to perceived rejection significantly explain the rage seen in BPD. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Assessment of borderline personality features in population samples: Is the Personality Assessment Inventory–Borderline Features scale measurement invariant across sex and age?

Borderline personality disorder (BPD) is more often diagnosed in women than in men, and symptoms tend to decline with age. Using a large community sample, the authors investigated whether sex and age differences in four main features of BPD, measured with the Personality Assessment Inventory–Borderline Features scale (PAI-BOR; Morey, 1991), are a result of measurement bias or if they represent true differences. The PAI-BOR was completed by four Sex × Age groups (N = 6,838). Multigroup confirmatory factor analysis showed that the PAI-BOR is measurement invariant across sex and age. Compared with men, women reported more borderline characteristics for affective instability, identity problems, and negative relationships but not for self-harm. Younger men had higher scores for identity problems and self-harm than did older men. Younger women had higher scores for identity problems and affective instability than did older women. Results suggest that the PAI-BOR can be used to study the etiology of BPD features in population-based samples and to screen for BPD features in clinical settings in both men and women of varying ages. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Five-factor trait instability in borderline relative to other personality disorders.

Borderline personality disorder (BPD) is related to five-factor model (FFM) traits and can be characterized as involving psychological and behavioral instability. A previous study comparing the FFM trait stability across individuals with borderline and other personality disorders found that the BPD group tended to have lower stability, particularly on neuroticism and conscientiousness and the overall configuration of FFM profiles over 6 years, suggesting that associated psychological and behavioral variability may be due to trait variability. The current study was designed to test the degree to which these findings replicate in another sample using different diagnostic and trait measures and extending the measurement period to 10 years. Results are consistent with previous findings in showing lower differential (rank-order) stability on conscientiousness, greater mean-level decreases on neuroticism, lower individual-level stability on conscientiousness, and lower ipsative stability of trait profile configurations among those with BPD. However, unlike the previous study, no differences were observed for differential or individual-level neuroticism or mean-level conscientiousness. Overall, findings show that the instability characteristic of BPD extends into typically stable personality traits, and that it does so with some specificity in terms of which traits are affected and how instability manifests. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An evaluation of the marmoset Callithrix jacchus (sagüi) as an experimental model for the dyslipoproteinemia of human Schistosomiasis mansoni

BACKGROUND: There have been only a few brain computed tomography imaging studies, with mostly negative findings, in subjects with borderline personality disorder (BPD). This is the first MRI study which evaluated the structural abnormalities of the brain in subjects with the sole diagnosis of BPD. METHODS: Twenty-five subjects with BPD were compared with age-, gender-matched healthy comparison subjects (n=25) on volumes of the frontal lobes, the temporal lobes, the lateral ventricles, and the cerebral hemispheres in brain magnetic resonance imaging. RESULTS: Subjects with BPD had a significantly smaller frontal lobe compared to comparison subjects (multivariate regression analysis, t=2.225, df=46, P=0.031). There were no significant differences in volumes of the temporal lobes, the lateral ventricles, and the cerebral hemispheres between subjects with and without BPD. LIMITATIONS: Strict inclusion and exclusion criteria employed in the present study may make it difficult to generalize our findings. The gray matter and white matter of the brain were not measured separately. Differences in head tilt during image acquisition were not corrected. CONCLUSIONS: The current study reports a smaller frontal lobe volume on brain MRI in subjects with BPD compared with healthy comparison subjects. This finding may serve as a potentially useful biological variable that may allow for subtyping BPD.     

An experimental investigation of emotion dysregulation in borderline personality disorder.

Despite the prominent role of emotion dysregulation in theoretical accounts of borderline personality disorder (BPD), few studies have examined emotion dysregulation in BPD. This study extends extant research by providing an experimental investigation of emotion dysregulation among outpatients with BPD. Specifically, this study modified an experimental measure of distress tolerance to examine differences between outpatients with BPD (n = 17) and those without a personality disorder (n = 18) in 2 aspects of emotion dysregulation: (a) the unwillingness to experience emotional distress in order to pursue goal-directed behavior and (b) the inability to engage in goal-directed behavior when distressed. As hypothesized, BPD participants were less willing to experience distress in order to pursue goal-directed behavior. However, BPD participants did not evidence greater difficulties engaging in goal-directed behavior when distressed. Results highlight directions for future research and suggest that particular aspects of emotion dysregulation may be more or less relevant to BPD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Directed forgetting of emotional stimuli in borderline personality disorder.

On the basis of clinical literature, the authors hypothesized that individuals with borderline personality disorder (BPD) would show biased information processing when they were exposed to negative affective stimuli of a particular type. Individuals with BPD and controls were tested using a directed forgetting paradigm. Study participants were exposed to 3 types of words (borderline, neutral, positive) and were cued to either remember or forget each word as it was presented. There were no group differences on a free recall task for words in the remember condition. However, participants with BPD recalled significantly more of the borderline words from the forget condition than did controls. In other words, borderline participants remembered borderline words that they were instructed to forget. These results may be consistent with enhanced encoding of salient words and perhaps related themes in BPD individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does comorbid substance use disorder exacerbate borderline personality features? A comparison of borderline personality disorder individuals with vs. without current substance dependence.

There is compelling evidence that comorbid borderline personality disorder (BPD) negatively impact the clinical courses and outcomes of substance use disorders (SUD). Conversely, there is little evidence that concurrent SUD exacerbates the clinical characteristics of BPD. Thus, this study sought to examine whether the presence of current substance dependence among BPD patients would be associated with stronger BPD-relevant personality traits and behavioral characteristics. Female BPD patients without (BOR; n = 37) or with current substance dependence (BSUD; n = 19), and female non-BPD/SUD controls (CON; n = 48) were compared with respect to impulsivity, affective lability, affective intensity, externalizing behaviors, and self-harming/suicidal tendencies, taking into consideration their comorbid mood disorders, anxiety disorders, and antisocial personality disorder. Results indicated that both BOR and BSUD groups scored higher than CON in most of the measures, but BOR and BSUD failed to reveal significant group differences especially when the influence of comorbid psychopathology was removed. The overall pattern of findings remained identical even when comparing BPD patients with versus without the diagnosis of lifetime substance dependence. Our results do not support the notion that BPD individuals with SUD display more severe BPD features than individuals with BPD alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rethinking the comparison of borderline personality disorder and multiple personality disorder

This article has made a number of points that assert what is today a minority position within the fields of MPD/DID and BPD. We hope our views will stimulate attempts by others to rethink their positions and test our assertions, so that issues surrounding these two disorders can be sharpened. For the sake of the clarity of future work, we summarize in outline form the essence of our viewpoint. 1. BPD and MPD/DID have similar appearing symptoms, such as identity problems, unstable affect modulation, self-destructive behaviors, chaotic impulse control, and troubled interpersonal relationships, but they have decisive differences in underlying dynamics, process, and structure. 2. DSM tends to blur these two disorders by its emphasis on phenomenology over inner structure, thus fostering misleading conclusions when DSM criteria are used to test for comorbidity or overlap between BPD and MPD/DID. 3. BPD and MPD/DID are both described dynamically as using the defense of splitting, but we contend that the splitting in each disorder is fundamentally different from the splitting in the other. BPD uses a polarization form of splitting, whereas MPD/DID uses ego splitting or identity division. 4. Both disorders partake in the process of dissociation, but the quality of dissociation in BPD is a "low-tech" spaced out type, whereas that of MPD/DID is a "high-tech" waking dream. 5. BPD structure is also "low tech," with polarization of self, object, and relationship. MPD/DID structure is "high tech," with heavily symbolic, highly nuanced variations of self, object, and relationship. 6. Although both conditions have etiologic elements of trauma, BPD has a larger degree of developmental deficiency, with a failure to complete the task of entering a repression hierarchy of defenses. MPD/DID, by use of primary process-linked symbolic dissociation, is able to continue development to the repression hierarchy, although at a profound cost of simultaneous suspension of reality testing. BPD patients suffer from the rigid use of too few defenses; MPD/DID patients suffer from the obsolete use of too many defenses. 7. BPD patients grow up in homes in which overtly expressed aggression is more tolerated, or at least more openly experienced. MPD/DID patients grow up in homes in which the fact of aggression is kept a secret. This has consequences for the formation of psychic structure in each disorder.(ABSTRACT TRUNCATED AT 400 WORDS)     

Biparietal diameter: a useful measure for determining gestational age of human abortuses

BACKGROUND: The crown-rump length is conventionally used to determine the age of human abortuses. However, it is not reliable as it is dependent on the positioning of the conceptus. We compared this with the biparietal diameter and foot length for determining the gestational age. METHODS: Different measurements, commonly used to assess gestational age, were measured in 146 human abortuses for which an accurate obstetric history could not be elicited. Measurements taken were crown-rump length, biparietal diameter and foot length. These were correlated with the observations at antenatal examinations before finalizing the approximate age. RESULTS: Multiple regression analysis of the data indicated that of the three measurements, the biparietal diameter was the most reliable for determining foetal gestational age between 8 and 26 weeks. The age determined with the biparietal diameter correlated well with that of abortuses with an accurate obstetric history. CONCLUSION: The biparietal diameter of a human foetus may be used to determine its age if the obstetric history regarding the period of gestation is vague or not available.     

Mental state decoding abilities in young adults with borderline personality disorder traits.

Previous studies have demonstrated that patients with borderline personality disorder (BPD) tend to misattribute malevolence to benign social stimuli, including facial expressions. Yet, facial emotion recognition studies examining those with BPD have yielded mixed results, with some studies showing impaired accuracy and others demonstrating enhanced accuracy in the recognition of emotions or mental states. The current study examined the ability to decode mental states from photographs of just the eye region of faces in a nonclinical sample of young adults who exhibited BPD traits (high BPD) compared with those who did not (low BPD). Group differences in mental state decoding ability depended on the valence of the stimuli. The high-BPD group performed better for negative stimuli compared with the low-BPD group, but did not perform significantly different from the low-BPD group for stimuli of neutral or positive valence. The high-BPD group also demonstrated a response bias for attributing negative mental states to facial stimuli. In addition, findings suggested that the group difference in accuracy for negative stimuli could not be explained by response bias, because the group difference in response bias for negative stimuli did not reach significance. These findings suggest that BPD traits may be associated with enhanced ability to detect negative emotions and a bias for attributing negative emotions to nonnegative social stimuli. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Treating co-occurring Axis I disorders in recurrently suicidal women with borderline personality disorder: A 2-year randomized trial of dialectical behavior therapy versus community treatment by experts.

This study evaluated whether dialectical behavior therapy (DBT) was more efficacious than treatment by nonbehavioral psychotherapy experts in reducing co-occurring Axis I disorders among suicidal individuals with borderline personality disorder (BPD). Women with BPD and recent and repeated suicidal and/or self-injurious behavior (n = 101) were randomly assigned to 1 year of DBT or community treatment by experts (CTBE), plus 1 year of follow-up assessment. For substance dependence disorders (SDD), DBT patients were more likely to achieve full remission, spent more time in partial remission, spent less time meeting full criteria, and reported more drug- and alcohol-abstinent days than did CTBE patients. These findings suggest that improvements in co-occurring SDD among suicidal BPD patients are specific to DBT and cannot be attributed to general factors associated with nonbehavioral expert psychotherapy. Further, group differences in SDD remission were not explained by either psychotropic medication usage or changes in BPD criterion behaviors. DBT and CTBE did not significantly differ in the reduction of anxiety disorders, eating disorders, or major depressive disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Photosensitizing potencies of the structural analogues of benzoporphyrin derivative in different biological test systems

Benzoporphyrin derivative (BPD) is a potent photosensitizer in biological systems. There are four structural analogues of BPD. The analogues share the same chromophor, which results in their having almost identical optical spectra, extinction coefficients, and yields of singlet oxygen. Small structural differences affect their photosensitizing potency in various biological systems, and thus make them an interesting tool to study the structure-activity relationship. The ranking of the photosensitizing potency of the analogues differed depending on the test system. The more efficient photosensitization of tumor cell lines by the highly lipophilic monoacids as compared to that by less lipophilic diacids correlated positively with the partition coefficient, and was related to the rate of diffusion into the cells. However, in the assay systems where PDT targets were located in the membrane (red blood cells hemolysis, enveloped vesicular stomatitis virus, isolated mitochondria) there was very little difference in photosensitizing potency of BPD analogues. The results indicate that the evaluation of photosensitizers is affected by the test system and thus for photosensitizers screening purposes, the choice of the test system should be made based on the intended ultimate use.     

Stability and variability of affective experience and interpersonal behavior in borderline personality disorder.

This study examined both mean levels and intraindividual variability in the mood and interpersonal behavior of individuals with borderline personality disorder (BPD) and nonclinical control participants over a 20-day event-contingent recording period. Individuals in the BPD group experienced more unpleasantly valenced affect and were less dominant, more submissive, more quarrelsome, and more extreme in overall levels of behavior than control participants. In addition to these mean-level differences, individuals with BPD also reported more intraindividual variability in overall affect valence and in pleasantly valenced affect; displayed greater variability in dominant, quarrelsome, and agreeable behaviors; and exhibited an increased tendency to "spin" among interpersonal behaviors relative to nonclinical control participants. The findings document behavioral and affective manifestations of BPD in the context of naturally occurring interpersonal situations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)