Intentional self-harm behavior is an important clinical phenomenon that appears highly related to borderline personality disorder (BPD). Self-harm behavior in the context of borderline personality probably exists along a continuum from graphic, self-harm behavior to milder forms of self-sabotaging behavior that might be viewed as self-defeating Relatively little attention has been paid to developing a self-report measure of intentional self-harm, particularly as a screening device for detecting BPD. In Study 1, an initial list of self-harm behaviors encountered in clinical practice was narrowed to those behaviors related to BPD in a sample comprised of adults from both a mental health and non-mental health setting. All participants (N = 221) underwent a semistructured diagnostic interview for BPD. Using a cut-off score of 5 on the resulting 22-item Self-Harm Inventory (SHI), 83.7% of research participants were correctly classified as having BPD or not. In Study 2, women (N = 285) sampled from an outpatient medical setting completed the SHI and a widely used self-report measure of BPD. The SHI cut-off score resulted in correct classification of 87.9% of the individuals. In Study 3, using a sample of adults involuntarily hospitalized for psychiatric reasons (N = 32), the SHI performed at least as well as another self-report measure of BPD in diagnosing participants (the final diagnosis was based on a semistructured interview). The results are discussed with regard to potential advantages and utility of the SHI and need for further validation.

Preview Borderline personality disorder can be intriguing. The protagonists in Fatal Attraction, The Rose, and Play Misty for Me all provided dramatic examples. In a milder form, the disorder is seen fairly often in all medical settings. The authors review diagnostic characteristics of the disorder, how these show up in behavior during office visits, and tips for treating these challenging patients in the primary care setting.

The genuine prevalence of personality disorders among those with eating disorders is unknown. However, in this paper, we summarize the existing data, with careful acknowledgment of our approach to interpretation as well as the limitations of previous studies. Our findings indicate that obsessive-compulsive personality is the most common personality disorder in restricting-type anorexia nervosa, while borderline personality is the most common personality disorder in binge-eating/purging type anorexia nervosa. Borderline personality is the most common personality disorder in bulimia nervosa, as well. In those with binge eating disorder, obsessive-compulsive personality is the most common personality disorder although, compared with the preceding eating disorder diagnoses, there are broader clusters of personality disorders represented in this group. We discuss the implications of these findings.

Addressing sexuality issues is an inherent part of being a professional psychologist. A survey of training directors revealed that, although about one half of the doctoral programs covered at least some sexuality topics within courses, 19% to 21% of programs did not offer any training with regard to sexual dysfunction, therapy with gay clients, and HTV-AIDS. Sexuality training was even less likely in predoctoral internships. Sexuality training was unrelated to size of the program but was a function of the number of faculty with relevant expertise. Psychologists with adequate knowledge and comfort regarding sexuality will be better able to serve clients and avoid ethical pitfalls. Suggestions for infusing sexuality training into the already-crowded curricula are offered.