Knafo A, Guile JM, Breton JJ, Labelle R, Belloncle V, Bodeau N, Boudailliez B, De La Rivière SG, Kharij B, Mille C, Mirkovic B, Pripis C, Renaud J, Vervel C, Cohen D, Gerardin P. Can. J. Psychiatry 2015; 60(2 Suppl 1): S46-S54.
Affiliation
Professor and Department Head, Département de pédiatrie médicale, Fédération hospitalo-universitaire de psychiatrie de l'enfant et de l'adolescent, Centre Hospitalier universitaire de Rouen et Centre hospitalier du Rouvray, France, Rouen et Rouvray, France; Researcher, Laboratoire Psy-NCA-EA-4700, Université de Rouen, Rouen, France.
OBJECTIVES: To compare the coping strategies of adolescents with borderline personality disorder (BPD) to the coping strategies of adolescents without BPD, and to explore the association of coping with suicidal ideation and attempts among adolescents with BPD.
METHOD: Adolescent inpatients (n = 167) aged 13 to 17 years were admitted after suicide attempts and evaluated within 10 days, using the abbreviated version of the Diagnostic Interview for Borderlines-Revised, the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version supported by a team consensus best estimate method for the primary diagnosis, the Adolescent Coping Scale, and the Columbia-Suicide Severity Rating Scale.
RESULTS: Firstly, compared with adolescents without BPD, adolescents with BPD relied more on nonproductive coping strategies, mostly avoidant strategies, and less on productive coping strategies. Secondly, coping appeared as a factor associated with suicidal ideation in adolescents with BPD. While while controlling for age, sex, and depression, multivariate analyses showed a significant positive association between the coping strategy to focusing on solving the problem and suicidal ideation.
CONCLUSION: The use of avoidant strategies by adolescents with BPD could be viewed as attempts to increase emotional regulation. Problem-solving strategies in the immediate aftermath of a suicide attempt may prevent adolescents with BPD from overcoming a crisis and may increase suicidal ideation.