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Try out PMC Labs and tell us what you think. Learn More. The views and opinions expressed in this column are those of the authors and do not reflect the official policy or the position of the United States Air Force, Department of Defense, or US government. According to the Diagnostic and Statistical Manual of Mental Disordersvarious forms of impulsivity are associated with borderline personality disorder, including sexual impulsivity.
The existing empirical literature indicates that patients with borderline personality disorder appear to differ from patients without this personality disorder in a of relevant ways. Specifically, those with borderline personality disorder are more likely to exhibit greater sexual preoccupation, have earlier sexual exposure, engage in casual sexual relationships, report a greater of different sexual partners as well as promiscuity, and engage in homosexual experiences.
In addition, patients with borderline personality disorder appear to be characterized by a greater of high-risk sexual behaviors; a higher likelihood of having been coerced to have sex, experiencing date rape, or being raped by a stranger; and the contraction of more sexually transmitted diseases. Overall, the psychological themes relating to sexual Dayton MD sex dating in borderline personality disorder appear to be characterized by impulsivity and victimization.
We discuss the potential implications of these findings for clinicians in mental health and primary care settings. This ongoing column is dedicated to the challenging clinical interface between psychiatry and primary care—two fields that are inexorably linked. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Editionimpulsivity may manifest in a variety of life areas, including sexual behavior, spending behavior, substance usage, driving, and eating.
We then discuss the potential implications of these findings in terms of psychiatric and primary care settings.
There are a of reports in the literature that Dayton MD sex dating sexual behavior in individuals with BPD. These reports consist of clinical impressions, case reports, and empirical investigations. Clinical impressions. In the early literature, Hoch and Polatin 2 described a group of patients who would likely be diagnosed with BPD according to contemporary approaches.
In discussing impressions of his clinical practice, Stone, 3 another authority in the field of BPD, indicated that more than 25 percent of his outpatients with this Axis II disorder exhibited promiscuity. In contrast, Stone reported that promiscuity was uncommon among his non-BPD clientele. In discussing the issue of sexual relationships between the therapist and the patient, Gutheil 4 commented that patients with BPD are particularly prone to evoke boundary violations. As an example, he underscored sexual acting out. Case reports. In addition to authoritative clinical impressions, there are several case reports in the literature on the sexual behavior of patients with BPD.
For example, Pelsser described a female BPD patient in her 20s who suffered from promiscuity. Empirical studies. In addition to authoritative impressions and case reports, there are a of empirical studies on sexual behavior in BPD. For example, in an empirical endeavor that was deed to explore sexual attitudes, Hurlbert, Apt, and White 7 compared 32 women with BPD to 32 women without personality disorders.
In this study, the authors found that women with BPD evidenced greater sexual assertiveness, erotophilic attitudes, sexual esteem, sexual preoccupation, and sexual dissatisfaction.
In addition to poor academic performance and unemployment, the substance-using group was ificantly highlighted by promiscuity. Hull et al 9 examined 71 hospitalized female patients who were diagnosed with BPD. These investigators found that 46 percent of the participants in this study impulsively entered into sexual relationships with partners that they did not know very well i. In a dissertation thesis, Allan 10 examined 71 medical patients with regard to various sexual behaviors. In preparation for analyses, she divided participants into two groups according to their history of sexual risk—high-risk versus low-risk.
Participants in the high-risk subsample differed from those in the low-risk subsample in having a greater prevalence of BPD. Lavan and Johnson 11 explored relationships between personality pathology and high-risk sexual behaviors among teens. In this sample, the authors asked participants about the of sexual partners during the past year and their lifetime, as well as the use or not of condoms.
Chen et al 12 compared women with BPD both with and without substance abuse with regard to the prevalence of sexually transmitted diseases. In this study, participants with substance abuse reported ificantly more Dayton MD sex dating transmitted diseases, particularly gonorrhea, trichomonas, and human papillomavirus HPV.
This finding was, in part, mediated by recent unprotected sex with two or more partners and more than 20 lifetime sexual partners. Finally, in a literature review that was based upon six empirical studies, Neeleman 13 concluded that patients with BPD exhibit heightened sexual impulsivity as well as a vulnerability to homosexual experiences.
Further details of this analysis are unavailable because the original article is written in Dutch. Collectively, these preceding studies indicate that individuals with BPD may harbor greater sexual preoccupation, engage in more high-risk sexual behaviors, experience more casual sexual relationships and more sexual partners, contract more sexually transmitted diseases, and be more likely to experiment with homosexual activities.
The overall theme among patients with BPD is greater sexual impulsivity. Empirical studies by Sansone et al. We have also studied the relationship between BPD and various sexual behaviors. In a study, we examined 76 women outpatients in an internal medicine clinic regarding their sexual histories e. In this study, we found that participants with BPD were twice as likely to endorse casual sexual relationships as well as promiscuity, regardless of clinical setting.
In a third study, we examined a consecutive sample of internal medicine outpatients. In a final study on the relationship between BPD and sexual behavior, using two self-report measures for BPD, we examined a cohort of psychiatric inpatients.
There were no between-group differences with regard to age at menarche, age of first intercourse, total of times treated for a sexually transmitted disease, having experienced date rape or rape by a partner, or having had homosexual experiences. The preceding empirical findings are summarized in Table 1. Empirical studies of sexual behavior in individuals with borderline personality disorder.
Empirical studies that may refute current findings. Only two studies seemingly counter the trends reported in the preceding empirical data. In the first, Zanarini et al 18 examined patients with BPD regarding their sexual behavior. In this study, 41 percent of participants reported the avoidance of sexual activity. In addition, 34 percent of participants reported becoming symptomatic after sexual activity, suggesting a possible relationship between these two findings.
In a second study, Lloyd et al 19 examined the medical records of 85 patients who were diagnosed with compulsive sexual behavior. In this retrospective study, only one patient met the criteria for BPD. In mental health settings, clinicians need to be alert to undertaking queries in the area of sexuality, not only in the service of the psychotherapy treatment i.
Likewise, in primary care settings, clinicians need to be aware that patients with BPD may have Dayton MD sex dating of sexual impulsivity, which require careful review for sexually transmitted diseases as well as ongoing planning around contraception and prophylaxis against such diseases.
Conversely, those patients in primary care settings who present with promiscuity warrant an assessment for BPD, and if positive, probable referral to a mental health professional. The majority of the literature in this area suggests that in comparison with individuals without BPD, those with BPD evidence greater sexual impulsivity as indicated by higher levels of sexual preoccupation, earlier sexual exposure, more casual sexual relationships, a greater of different sexual partners, promiscuity, and homosexual experiences.
In addition, these patients evidence greater victimization as indicated by a higher of high-risk sexual behaviors; greater likelihood of being coerced to have sex, date rape, or rape by a stranger; and more sexually transmitted diseases. Note that both of these themes, impulsivity and victimization, characterize the psychological themes encountered in a of other common behaviors in BPD e.
From a psychiatric perspective, these findings suggest that sexual impulsivity and victimization are practical clinical concerns in patients with BPD, both in terms of relevant psychological themes as well as health risks. From a primary care perspective, findings suggest that clinicians in these settings need to maintain a high index of suspicion Dayton MD sex dating the possibility of multiple sexual partners, sexual traumatization, and sexually transmitted diseases in these patients as well as the need to address contraception and prophylaxis against sexually transmitted diseases.
Likewise, patients who present with promiscuity in primary care settings may need to be evaluated for BPD and possibly referred for treatment to a mental health professional. In summary, the Dayton MD sex dating theme of impulsivity, as described in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Editionappears to be a legitimate sub-criterion in many patients with BPD. What seems to be missing in the current descriptors is the undertone of victimization that also characterizes the sexual behavior of these patients. Randy A. Sansone, Dr. Lori A. National Center for Biotechnology InformationU.
Journal List Innov Clin Neurosci v. Innov Clin Neurosci. SansoneMD and Lori A. SansoneMD. Sansone Dr. Find articles by Lori A. Author information Copyright and information Disclaimer. Corresponding author. Copyright notice. This article has been cited by other articles in PMC. Abstract According to the Diagnostic and Statistical Manual of Mental Disordersvarious forms of impulsivity are associated with borderline personality disorder, including sexual impulsivity.
Keywords: Borderline personality, borderline personality disorder, sex, sexual behavior, sexuality. Table 1 Empirical studies of sexual behavior in individuals with borderline personality disorder. Open in a separate window.
Conclusion The majority of the literature in this area suggests that in comparison with individuals without BPD, those with BPD evidence greater sexual impulsivity as indicated by higher levels of sexual preoccupation, earlier sexual exposure, more casual sexual relationships, a greater of different sexual partners, promiscuity, and homosexual experiences.
Contributor Information Randy A. References 1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition. Hoch P, Polatin P. Pseudoneurotic forms of schizophrenia.Dayton MD sex dating
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Sexual Behavior in Borderline Personality