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Dive into the research topics where Douglas A. Songer is active.

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Featured researches published by Douglas A. Songer.


Australian and New Zealand Journal of Psychiatry | 2014

Convergence between DSM-5 Section II and Section III diagnostic criteria for borderline personality disorder

Martin Sellbom; Randy A. Sansone; Douglas A. Songer; Jaime L. Anderson

Objective: Borderline personality disorder (BPD) is a common mental health condition in psychiatric settings. The current study examined the overlap between the operationalization of BPD listed in Section II (Diagnostic Criteria and Codes) and the alternative, dimensional personality trait-based operationalization listed in Section III (Emerging Measures and Models) of the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Moreover, the unique contributions of specific personality traits for indexing the traditional BPD operationalization were also evaluated, including conceptually relevant traits not originally proposed for Section III BPD. Method: Participants were 145 consecutive patients from a psychiatric unit in a hospital in the USA. These individuals completed a series of questionnaires that index both traditional (DSM-IV/DSM-5 Section II) and alternative (DSM-5 Section III personality traits) diagnostic criteria for BPD. Results: Structural equation modeling results revealed that latent constructs representing the Section II and Section III operationalizations of BPD, respectively, overlapped substantially (r = 0.86, p < 0.001). Hierarchical latent regression models indicated that at least five of the seven traits proposed to define Section III BPD uniquely accounted for variance (69%) in a latent Section II BPD variable. Finally, at least one other conceptually relevant trait (Perceptual Dysregulation) augmented the prediction of latent BPD scores. Conclusions: The proposed personality traits for Section III BPD are clearly aligned with traditional conceptualizations of this important personality disorder construct. At least five of the seven dimensional traits proposed to define Section III contributed uniquely to the characterization of Section II BPD, and these traits can be augmented by Perceptual Dysregulation. If replicated in other settings, these findings might warrant some modification to the operationalization of DSM-5 Section III BPD.


Journal of Psychiatric Practice | 2006

The relationship between suicide attempts and low-lethal self-harm behavior among psychiatric inpatients.

Randy A. Sansone; Douglas A. Songer; Martin Sellbom

In this study, we examined the relationship between suicide attempts and low-lethal self-harm behavior in a sample of psychiatric inpatients. Using a cross-sectional approach, we surveyed 107 participants about their histories of suicide attempts, including overdoses, as well as various low-lethal self-harm behaviors. Compared with those without such histories, individuals with histories of suicide attempts, including overdoses, were significantly more likely to report a greater number of: 1) low-lethal self-harm behaviors; 2) specific symptom clusters of self-harm behavior (i.e., self-mutilation, substance abuse, medically self-defeating behaviors); and 3) specific individual self-harm behaviors (e.g., torturing oneself with self-defeating thoughts, abusing prescription medications). These data suggest that suicide attempts and low-lethal self-harm behavior are likely to co-exist in many psychiatric inpatients.


Violence & Victims | 2002

The relationships among childhood abuse, borderline personality, and self-harm behavior in psychiatric inpatients.

Randy A. Sansone; George A. Gaither; Douglas A. Songer

The current study was undertaken to explore the relationships among childhood abuse subtypes (sexual, physical, and emotional abuse; witnessing violence), three diagnostic screenings for borderline personality disorder (BPD), and self-harm behavior. Psychiatric inpatients (N = 77) were evaluated for childhood abuse histories through a survey. Participants also underwent assessment for BPD using a self-report measure, clinical diagnosis, and a DSM-IV checklist. Finally, each was assessed for self-harm behavior using the 22-item Self-Harm Inventory (SHI). Compared with non-abused participants, those with abuse histories (with the exception of witnessing violence) had a significantly greater number of BPD confirmations (i.e., self-report, clinical diagnosis, DSM-IV checklist) as well as self-harm behaviors. When examining the total number of endorsed abuse subtypes, there was a significant correlation with the number of self-harm behaviors, but not the number of BPD diagnoses. Among psychiatric inpatients, childhood abuse demonstrates a complex relationship to BPD diagnoses and self-harm behavior.


International Journal of Psychiatry in Clinical Practice | 2005

Multiple psychiatric diagnoses and self-harm behavior

Randy A. Sansone; George A. Gaither; Douglas A. Songer; Jennifer L. Allen

Objective The purpose of this study was to examine among psychiatric inpatients (N=110) the relationship, if any, between the number of Axis I diagnoses and the number of self-harm behaviors (SHBs). We also wished to explore the role of borderline personality disorder (BPD) in mediating this possible relationship. Method We examined discharge diagnoses in relationship to scores on the Self-Harm Inventory (SHI) for all participants as well as by BPD status. Results For the entire sample, there was a significant correlation between the number of Axis I disorders and the number of SHBs [Spearmans rho(110)=0.21, p=0.03]. When examining this relationship in terms of BPD status, there were no significant between-group differences in the number of Axis I diagnoses. While patients diagnosed with BPD endorsed significantly more SHBs (M=9.53, SD=3.89) than nonBPD patients (M=5.32, SD=3.89), there was only a significant correlation between the number of Axis I disorders and SHB for the nonBPD, but not the BPD subsample. Conclusions Among psychiatric inpatients, there is a relationship between the number of Axis I diagnoses and the number of SHBs.


Psychiatry Research-neuroimaging | 1997

Power spectrum of the QRS complex in patients with panic disorder and normal controls.

Vikram K. Yeragani; Ronald D. Berger; Douglas A. Songer; Suneetha Yeragani

We performed spectral analysis on the QRS complex of the electrocardiogram obtained using standard limb leads, sampled at 500 Hz with 12 bit precision in 20 normal subjects and 15 patients with panic disorder. We divided the frequency range of the QRS into two bands based on spectral patterns before and after the postural challenge-mid frequency (MF): 7.8-20 Hz; and high frequency (HF): 21-250 Hz. Postural change from supine to standing produced a significant increase in absolute (P = 0.003) and relative HF power (P = 0.00001). Patients with panic disorder had a significantly decreased QRS HF power (P = 0.003). The increase in QRS HF power may have been due to the shortening of the QRS interval in standing posture. The decreased QRS HF power in patients with panic disorder should be further investigated due to the recent reports of an association of phobic anxiety and fatal coronary heart disease, and the possible association of decreased high frequency components of QRS in myocardial infarction.


International Journal of Psychiatry in Clinical Practice | 2007

A naturalistic study of the relationship between self-harm behaviors and Axis I diagnostic groupings among inpatients

Randy A. Sansone; Douglas A. Songer; Kimberly A. Miller

Self-harm behavior is relatively common among psychiatric patients, but few studies have examined such behavior in the context of Axis I diagnoses. In this study among 110 psychiatric inpatients, we examined clinical psychiatric diagnoses and surveyed participants for self-harm behaviors. Surprisingly, using five diagnostic groupings, there were no between-group differences in the endorsement of individual, total number of, or high-lethal self-harm behaviors. Our results suggest that the number and character of self-harm behaviors does not relate to psychiatric diagnosis among psychiatric inpatients.


Journal of Personality Disorders | 2015

COMPARING EXTERNAL CORRELATES OF DSM-5 SECTION II AND SECTION III DIMENSIONAL TRAIT OPERATIONALIZATIONS OF BORDERLINE PERSONALITY DISORDER

Jaime L. Anderson; Martin Sellbom; Randy A. Sansone; Douglas A. Songer

The current study evaluated the relative associations of the DSM-5 Section II operationalization of Borderline Personality Disorder (BPD) and dimensional traits included in a diagnosis of BPD in DSM-5 Section III with conceptually relevant external criterion variables. It is important to determine whether or not Section II BPD and constellation of Section III BPD traits have similar positions in the nomological network representing the BPD construct. Moreover, it is important to determine whether or not the trait-based Section III BPD diagnosis is an improvement upon the categorical Section II diagnosis in regard to its associations with external criteria. To evaluate this, we used two samples, a patient sample consisting of 145 psychiatric patients and a university sample consisting of 399 undergraduate students. We conducted a series of correlation and regression analyses in order to determine the relative associations of these two diagnostic methodologies with relevant external criteria. Correlation analyses did not favor either model, but indicated that both Section II and Section III BPD have associations with external criterion variables relevant to BPD. The regression analyses tended to favor the trait-based Section III model, supporting the construct validity and use of the trait profile for BPD in DSM-5 Section III. Generally, it was concluded that the Section II and Section III operationalizations have similar positions in a nomological network representing the BPD construct.


Personality Disorders: Theory, Research, and Treatment | 2017

Borderline Personality Disorder and Mental Health Care Utilization: The Role of Self-Harm.

Randy A. Sansone; Martin Sellbom; Douglas A. Songer

The current study examined the associations for borderline personality disorder (BPD) and a specific trait of the disorder, self-harm, with mental health care utilization. Our sample consisted of 145 psychiatric inpatients who completed 3 measures of BPD (Personality Diagnostic Questionnaire-4 [PDQ-4], McLean Screening Inventory for borderline personality disorder [MSI-BPD], Structured Clinical Interview for DSM–IV Axis II Disorders–Personality Questionnaire [SCID-II-PQ]) and the Self-Harm Inventory (SHI). In relationship to mental health care utilization, the correlation for the SHI was significantly larger than those for the PDQ-4, MSI-BPD, or SCID-II-PQ. Thus, self-harm was significantly better at detecting mental health care utilization than was the overall BPD construct, which indicates that some of the more severe manifestations of the disorder are the most predictive of impairment in functioning. These findings also call into question whether BPD (and by extension, personality pathology in general) is most useful in these symptom constellations as opposed to focusing on specific maladaptive traits.


Eating Behaviors | 2001

Reporting of weight history: sexually abused versus nonabused males.

Randy A. Sansone; George A. Gaither; Douglas A. Songer

In this study we explored among males a possible relationship between recollection of adult body weights and a history of sexual abuse prior to the age of 15. Using a survey format, 34 men hospitalized in an acute care psychiatric facility completed measures. Of the men who acknowledged sexual abuse (n=9), all reported their lowest, highest, and perceived ideal body weight, compared with non-sexually abused men of whom only 80%, 48%, and 52%, respectively, reported the requested weight information. It may be that sexual abuse among men during childhood results in heightened body awareness in adulthood.


International Journal of Psychiatry in Clinical Practice | 2017

Elucidating the association between the self-harm inventory and several borderline personality measures in an inpatient psychiatric sample

Martin Sellbom; Randy A. Sansone; Douglas A. Songer

Abstract Objective: The current study evaluated the utility of the self-harm inventory (SHI) as a proxy for and screening measure of borderline personality disorder (BPD) using several diagnostic and statistical manual of mental disorders (DSM)-based BPD measures as criteria. Methods: We used a sample of 145 psychiatric inpatients, who completed the SHI and a series of well-validated, DSM-based self-report measures of BPD. Results: Using a series of latent trait and latent class analyses, we found that the SHI was substantially associated with a latent construct representing BPD, as well as differentiated latent classes of ‘high’ vs. ‘low’ BPD, with good accuracy. Conclusions: The SHI can serve as proxy for and a good screening measure for BPD, but future research needs to replicate these findings using structured interview-based measurement of BPD.

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Ronald D. Berger

Johns Hopkins University School of Medicine

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