Mind Your Psychology

Mind Your Psychology ISSUE NO. 3 | JANUARY ISSUE

Insight into BPD's comorbidites Do you know about the comorbidity of BPD and substance/alcohol use?

How sleep can affect your memory The dangers of sleep deprivation

The hidden links between dyslexia and substance abuse Dyslexia's under-recognized dangers

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Passion and Insight Exclusive Interview with the author herself, Tanya Nanda!

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MIND YOUR PSYCHOLOGY

January 2019

Table of Contents What are the links between BPD and Substance/Alcohol Use?

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This article explores the comorbidity of BPD and Substance and Alcohol use, and the causes for this comorbidity, and how the two can lead to each other.

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How does sleep deprivation give rise to false memories?

In this article, we discover the dangers of sleep deprivation, and how they can lead to false memories

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Are people diagnosed with dyslexia more prone to substance abuse?

In our final article, we take a deep insight into the risks and challenges people with dyslexia have with substance abuse

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Citations: APA

ABNORMAL PSYCHOLOGY

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CASE STUDY

WHAT ARE THE LINKS BETWEEN BORDERLINE PERSONALITY DISORDER AND SUBSTANCE/ALCOHOL USE?

Borderline Personality Disorder, more commonly known as BPD, has been proved to have a strong linkage to alcohol and substance use. People suffering from BPD can have an unstable relationship with alcohol and substance abuse; they use it to desensitize the pain of their panic of dissociation, and abandonment. When substance abuse is present within a

What is Borderline Personality Disorder?: A mental illness classified by an ongoing pattern of varying moods, self-image and behavior. Symptoms can include intense episodes of anger, depression, and anxiety (can last from a few hours to days).

People with BPD can view things in extremes such as all good, or all bad, and their opinions and points of views can change rapidly. They also have feelings of dissociation, and unreality.

person diagnosed with BPD, he or she is more often involved in self-mutilating behaviours such as cutting, and also suicide

The Taiwan National Health Insurance conducted a study

attempts. A study in 2014 by Deutsches Ärzteblatt International

to further explore the comorbidities of substance abuse and

showed that 78% of adults diagnosed with BPD develop a co-

BPD. A retrospective case-control study was conducted with

occurring substance-related disorder or addiction at some time period in their lives. This denotes that symptoms of BPD and the substance or alcohol abuse can happen simultaneously.

There are several causes for these co-occurring substance disorders along with BPD. Environmental causes are a major factor that could play a role in these comorbid disorders; sexual abuse, physical abuse, mistreatment, neglect, or emotional abuse during childhood have links to BPD and substance abuse.

Also, BPD and alcoholism can share similar genetic routes,

the information of 1460 patients from the Taiwan National Health Insurance Research Database. 292 (20%) of these patients were diagnosed with BPD and 1168 (80%) were control patients. Psychiatric comorbidities and physical comorbidities information were collected. These comorbidities were diagnosed within 3 years either before enrollment or after enrollment. To calculate the ratios of comorbidities between non-BPD and BPD patients, a logistic regression model was utilized. To study associations between BPD and psychiatric comorbidities, the ARM technique was

meaning that some of the genes that make people have a

utilized. In the results, 13 categories with physical

higher risk of being diagnosed with BPD can also create a higher

comorbidities were classified. The results conveyed that 12 of

risk for alcoholism. Also, people with BPD could use alcohol to

these comorbidities were more common in the BPD patients.

reduce the intense emotional experiences felt in their lives.

Psychiatric comorbidities including substance use disorder

Since people with BPD have powerful emotions, regular usage

were much more common in BPD patients as well. 16.8% (50)

of alcohol could lead to alcohol abuse or dependence.

of the BPD patients (3.4% of total patients) had a substance use disorder co-occurring within them. Only 0.26% (4) of nonBPD patients (0.27% of total patients) had a substance use disorder. 12.7% (38) of BPD patients had an alcohol use

w... kno u te itters o y unica ansm r t Did o r comm neu

o that use t the know ain cells le in o u r g of o a y r lay tionin d Did at b p c h t n o u s s f l n tance er) can a terrupted ne, a ly pami (subs th In o o ike d ? l h , D c e ea onin f BP mor t l o o r a t with e u n s e are id lopm itters indiv itters n m a s deve rotransm e n k a ges. n ma e neurotr eu nd ur the n a s ne ca i l e s a h n t n o dre D, as l of emoti nora p BP o o r l t e n v o to de the c ed in v l o v in

disorder (2.6% of total patients), and only 0.26% (4) of nonBPD patients (0.27% of total patients) had an alcohol use disorder. The following graph conveys that people with BPD are more vulnerable than people without BPD to substance abuse comorbidities and alcoholism.

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ABNORMAL PSYCHOLOGY

Some treatment options for BPD and substance abuse comorbidities....

CASE STUDY

A study conducted by Bridget F. Grant and others explored the prevalence of comorbidity, such as substance and alcohol use with people who have BPD.

Dialectical Behavioral Therapy, or DBT: from the basis of the principle that "change can be balanced with selfacceptance. DBT helps people to construct stable and meaningful lives from severe psychiatric disorders.

DBT has been used several times very effectively to help patients who are emotionally unsteady and selfdestructive to learn how to control their emotions and find motivation to change themselves.

Their method was the following: face-to-face

Counseling sessions: These sessions can prevent relapses and also include peer group support sessions, where people who have been diagnosed with BPD along with an addiction can share their ways of coping and their challenges and difficulties in their journey, living with this disorder.

different results based on two areas: The prevalence of

interviews with 34,653 adults in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. The results conveyed several different results, and each result was based on gender. The male and female numbers varied, and the study concluded that alcohol dependence was one of the most prevalent disorders along with BPD. There were BPD among respondents with other psychiatric disorder, and the prevalence of other psychiatric disorder along with BPD. In the majority of the results, women were more affected by all the factors than men, however, some psychiatric disorders appearing with BPD were more common in men.

Psychiatric Medication + Anti-addiction Drugs: These can reinstate balanced levels of neurotransmitters, and can help reduce cravings of alcohol and drugs.

Results from the prevalence of BPD among respondents with other psychiatric disorder: These percentages are both genders combined: 14.1% with any substance use disorder, 11.1% with any substance

... know u o y Did t drug a h t w u kno ion co t c Did yo i d d a an lcohol BPD c and a h t i w ing n of occurr patter a y b sed n be cau ness i i d a e t nd uns jobs, a , s p i h ns relatio es? financ

abuse, 25.5% with any substance dependence, 14.7% with any alcohol use disorder, 6.9% with alcohol abuse, 24.2% with alcohol dependence, 32.2% with any drug use disorder, 26.5% with any drug abuse, and 45.8% with any drug dependence.

Results from the prevalence of other psychiatric disorders among respondents with BPD: These percentages are both genders combined: 50.7% with any substance use disorder, 12.9% with any substance abuse, 21% with any substance dependence, 24.2% with any alcohol use disorder, 6.2% with alcohol

BPD and Substance/Alcohol Use: What's the Link?

As the studies have shown, BPD has several links to Alcohol and substance use, and even their abuse. The first study conveyed that psychiatric comorbidities were substantially more present in people diagnosed with BPD. Therefore, people who are already diagnosed with BPD are at a much higher chance of developing an alcohol or substance use disorder along with it. The second study conveyed two different viewpoints of the links between BPD and alcohol and substance use. The first part of the study proved that people with a substance or alcohol use disorder have a higher risk of developing BPD along with their disorders. The second part conveyed that people with BPD have a higher probability of generating a substance use disorder.

abuse, 18% with alcohol dependence, 13% with any drug use disorder, 7.7% with any drug abuse, and 6.3% with any drug dependence.

The study can justify that there are several links to BPD and alcohol and substance use and it is extremely common within the general population. .

In conclusion, BPD increases the chance of having a substance or an alcohol use along with it, and the opposite goes for having an alcohol or substance us disorder, and the formation of BPD.

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INTERVIEW WITH THE AUTHOR! E!!!

V I S XCLU AILS!!

E L L A DET T U O FIND

How old are you and which school do you attend?

I am 15 years old, and currently attend Dubai American Academy

Why and how did you choose and find interest in your article topics?

I have always loved to read about psychology in my free time, especially about abnormal psychology and criminal psychology. I feel that we all need to raise awareness about the dangers of psychological disorders, and learning disorders, and how dangerous they can be in What is your favorite branch of leading to substance use. A lot Psychology?

What else do you enjoy of young adults, and adults as to do? Any hobbies? well find themselves in My favorite branch of Psychology is the forensics and I love to travel and visit new loneliness and isolation, and are susceptible to these criminology part. I enjoy reading places. I play tennis and about these a lot, as well as track as well. I enjoy playing behaviors. psychological disorders, the piano and expressing because I have had many myself through it. Of course, friends around the world who I love reading! Especially have been diagnosed with about Psychology! disorders.

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MEMORY

CASE STUDY

HOW DOES SLEEP DEPRIVATION GIVE RISE TO FALSE MEMORIES? Sleep deprivation has affected nearly one-third of the entire American population, and one in three American adults are sleep deprived. Many studies have been conducted to explore the effects that lack of sleep has on creating false memories, either long-term memories, or short-term memories. False memories are contorted and inaccurate recollections of events.

Memories can be recreated as people age, conveying the higher chances of false memories forming within older people. For example, a person could incorrectly remember that he or she locked the front door. A longterm false memory could be an accident that a person witnessed, but remembered completely distorted details. Sleep deprivation has proven to play a major role in creating false memories in many studies conducted throughout decades.

What are false memories? False memories are contorted and inaccurate recollections of events. They are extremely unique as they present a discrete recollection of something that never happened.

False memories usually come in the recollection of crime scenes, or important events that traumatized people or had a major impact in their life. It can also be small memories, such as forgetting to lock the door, although your memory tells you that you definitely did lock the door.

t Fun Fac igh erican h m A f o ep , 87% ically sle In 2006 n o r h c s were student d deprive

In 2016, the Centre for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke‐NUS Medical School, Singapore conducted a study exploring the formation of false memories caused by a lack of sleep, or sleep deprivation. To begin, there were 58 participants. They were undergraduates, and were randomly separated into three groups: control group, PSD (partial sleep deprivation) group, and TSD (total sleep deprivation) group. The control and PSD groups had to stay in bed for 8 hours and 5 hours every night. This was for 7 nights foregoing to experiment. These groups had to wake up at 9:00 am on the day of the experiment. The TSD group slept with their own schedule, and woke up at 9:00 am the morning prior to the experiment. The misinformation study started at 10:00 am after the last sleep manipulation night.

The misinformation experiment was composed of three parts. Event-coding, misinformation, and memory-source tests. In the event-coding part, the participants were shown sets of 50 photographs each portraying two car crimes (break-in and a robbery). Each photograph was shown for 3500 ms. 40 minutes after the event-coding part, the misinformation part began. 2 sets of 50 narratives were shown, each correlating with a previously depicted photograph. 5500 ms was given for each narrative. For every crime presented, 12 narratives were conducting the picture’s content. The participants were shown 24 segments of misinformation complying with details of the event, with sentences agreeing with the photographs. The assessment for the memory of the two crimes was done 20 minutes after the misinformation phase. The test included “36 threealternative forced-choice questions” and participants were told to answer the questions derived from the comprehension of only the photographs. 12 of 18 questions were “critical” for each crime. The rest of the 6 questions were “non-critical” including messages that went along with the pictures and narratives. Along with the three alternative for “critical” questions; one questions was “novel foil”, one was the correct answer, and one was corresponding to the misinformation shown in the narrative. For the “non-critical” questions, an extra “novel foil” was given instead of misinformation. Three types of performance measures were taken: correct memory rate (percentage of correct noncritical questions), misinformation consistent response rate (percentage of critical questions that misinformation was put in) , and false memory rate (percentage of critical questions that misinformation was put in and when the participants misassigned the source of information as a picture). The results showed that the in the false memory rate, the TSD group has the highest percentage.

The results of this experiment conveyed that totally sleepdeprived young adults had a higher probability of encompassing deceptive post-event information in their answers while in the process of retrieving memories of the original event that happened. This could play a major role in real-life situations, such as college exams or tests, as false memories have a higher chance of forming in these young adults.

MEMORY

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CASE STUDY

Some more proof.....

Crossword Puzzle

In 2008, The University of Tuebingen conducted a study to explore how sleep loss produced false memories. Initially, the participants learned lists of linked words. The “theme” of the list was not shown during the learning process. At retrieval testing which happened wither 9, 33, or 44 hours after learning, the lists were shown along with the “theme” word. Also, there were unrelated words, distractors, and the participants had to say (for each word) if the word was shown to them during learning or not. The participants either slept or stayed awake in the period after learning, which meant that they were or were not immensely sleep

Across: 1. condition of not having enough sleep Down: 1. contorted and incorrect recollection of an event 2. percentage of high school students sleep deprived in America in 2006 3. a memory that can last for many years, or decades 4. a memory that lasts for a few minutes or seconds 5. worldwide number of hours average of sleep in 1942 6. worldwide number of hours average of sleep in 2016

deprived during retrieval.

In the experiment, they compared the false memory rates of three different groups, along with a delay of 9 hours in the middle of learning and retrieval testing. Two of the groups had their learning in the evening and had testing the following morning after they slept (“night sleep”). There were a total of 15 in the “night sleep” group. The other group stayed awake during that night; “night wake” consisted of 14 people. The third group did their learning in

HOW CAN WE SLEEP BETTER AT NIGHT?

the morning and were tested in the evening after staying awake during the day normally.

Research conducted around the world has shown that sleep deprivation causes negative impacts on

The “night wake group” (immensely sleep deprived) created substantially more false memories during retrieval testing. They

hormones, exercise, performance, and brain function.

falsely identified on a rate of 88%, unlike the “night sleep group”

In addition to that, it can cause weight gain and have

whose rate was 75% and the “day wake” group whose rate was

higher chance of getting a disease in adults and in

77%. The correct memory rate the same for all three groups. These

children. Some tips for better sleep are reduce blue

results show that the participants who were sleep deprived created

light exposure during the evening, don't consume caffeine late in the day, reduce irregular and longtime

much more false memories compared to the groups who were not sleep deprived.

day naps, have a consistent sleep and wake time

This study has proved that a lack of sleep can lead to the

schedule, avoid eating late in the evening, and relax

formation of false memories. These memories that were produced

and clear your ming and body in the evening. These

were long-term memories, as they had to remember lists from the

small changes could have a major impact on your

previous day or a minimum of 9 hours in between the learning and

sleep schedule, and decrease the risk of the formation of false memories.

Did you know...

Did you know that interrogation techniques like pretending to have evidence that is not there, can influence false confessions? This could affect people's lives in a major way, as they could be put behind bars!

retrieval processes.

Back to the question........

In conclusion, sleep deprivation has been proved to be able to produce false memories. According to statistics from 2016, no country in the world averages 8 hours of sleep in the night. In 1941, the global average of sleep was 8 hours. In the worldwide sleep average was 6.8 hours, showing a 2016,

massive decrease in sleep around the world. False memories can be extremely dangerous, especially when crime scenes take place. Sleep deprivation could lead to the creation of false memories, and people’s lives could be changed due to lack of sleep. The first study conveyed that totally sleep deprived people have a high possibility of developing false memories compared to people who are not sleep deprived. The second study proved that a lack of sleep can give rise to false memories, specifically as long-term memories. When someone reconstructs a long-term memory and that person has had a lack of sleep the night before, the long-term memory has a high chance of being false and incorrectly recalled.

LEARNING AND BEHAVIOR

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CASE STUDY

ARE PEOPLE DIAGNOSED WITH DYSLEXIA MORE PRONE TO SUBSTANCE ABUSE? Symptoms of dyslexia are normally first seen in young children, usually around the ages of 5 and 6. This is the age when children enter kindergarten, and when they start to focus on how to read and write. Dyslexia causes people to struggle with reading and writing, and is something that they are born with.

Substance abuse or addiction is commonly known as when someone consumes substances which are not legal. However, substance abuse can also be classified as when someone uses alcohol, prescribed medicine(s), or other types of substances in a harmful way, too much, or in the wrong way. These two disorders are commonly co-occurred in people, as dyslexia has similar emotional and behavioral problems, that are elements of risk for substance abuse. These include low self-esteem, depression, and social issues. Health centers recommend that children get diagnosed as early as possible, if any symptoms are seen, to avoid future associations with substance abuse.

However, today, even adults can get the help that they need to make their reading and writing better, and to learn how to put themselves away from substance use, or alcohol use. Children, or teenagers have the ability to develop several issues, from not doing well in school, to developing a low-self esteem and social difficulties, and if not recognized, can begin investigating with substances of alcohol, and can develop a substance use disorder early in their lives.

The co-occurrence of dyslexia and a substance abuse is known as a comorbidity, which is the existence of two or more disorders in the same person.

What is Dyslexia? And what are symptoms of Dyslexia?

Dyslexia is a learning disorder that creates problems with reading and writing, such as spelling, or solving math problems. For children, symptoms can include slower speech development (compared with other children), mixing up letters in words, making wrong sentences, difficulty or little interest in learning the alphabet, confusion in the order of letters in words, reading slowly or with mistakes, bad handwriting, and slow speed of writing.

In 2016, Stephen J. Macdonald, Lesley Deacon, and Jacqueline Merchant conducted a study to investigate the relationship between dyslexia, homelessness, and drug use, or dependancy. Homelessness has severe associations with loneliness and isolation, which can lead to substance abuse or dependence. The study used data from “Multiple Exclusion Homelessness Across the United Kingdom Survey”. To be able to collect the data and results, the study explored the quantitative “increased likelihood of respondents with dyslexia” who had gone through being homeless and also using substances. Along with receiving the data from the survey, there was a questionnaire survey and extended interviews which took place in 2010 with people who had experienced several types of segregation such as, but not limited to, learning disorders, and homelessness. From those groups, a total of six services were chosen at random from a vast range of locations in the United Kingdom in order to have a population sample. The complications of homelessness were analyzed with the interchanging associations between “homelessness, drug use, mental health, and institutional care”. For the analysis, the information was taken to investigate the homeless people who had dyslexia.

Two groups who responded were the independent variable.

The first group of people, 68 in total, were homeless and had dyslexia. The second group of people were homeless, but did not have dyslexia, and were 375 in total.

The results for the analysis between dyslexia and drug use had a variety of results. The group that reported the most encounters with drug use was the non dyslexic group, which was 76% compared to the dyslexic group which was 62%.

However, when the study was comparing the types of drugs that they used, the dyslexic group had used more drugs which were more harmful and addictive than the non dyslexic group. 56% of the dyslexic people used hard drugs compared to 41.6% of non dyslexic people. 50% of dyslexic people had a more monthly usage of drugs compared to 33.6% of non dyslexic people’s monthly drug use. In addition, 50% of dyslexic people used methadone, and 30.2% of non dyslexic people used it. Dyslexic people’s average age when they started to drinking alcohol daily was 21 years, while the non dyslexic group was 25 years. In essence, this study conveys that dyslexic people are more prone to use drugs that can harm them, or become highly addictive, to remove their feelings of loneliness and isolation, as they were homeless. Also, the age that dyslexic people started to engage in alcohol consumption was substantially less than non dyslexic people, at 21 compared to 25. This proves that dyslexia can cause exclusion and isolation, which has increased risks of leading to experimentation with drugs and alcohol to remove those feelings.

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LEARNING AND BEHAVIOR

CASE STUDY

The City, University of London conducted a study exploring the relationship between dyslexia and substance abuse in a university undergraduate population. All the data used was from the University of

Test Your Knowledge!

1. What are 2 symptoms of Dyslexia?

2. Around what ages do symptoms start appearing for Dyslexia?

3. What is a comorbidity?

4. What relationship did the study conducted by University of London investigate?

5. How and why does homelessness relate to developing engagements with substance use?

6. What are 3 behavioral and emotional problems linked with dyslexia?

What kinds of treatment are available?

Medication therapy: Doing a drug or alcohol rehabilitation program that specifically specializes in the treatment of comorbidities can help in co-occurring disorders. Antidepressants, antipsychotic medication, and anti-anxiety drugs are all psychotherapeutic medications, which can be prescribed in these types of programs. Anti-addiction medications can help to reduce cravings or withdrawal symptoms.

Individual Therapy: These programs for co-occurring disorders can focus on factors such as but not limited to motivation, positive thinking, and identifying selfdestructive thoughts.

Peer Support Groups: Social interaction can help with learning disorder combining with substance use disorders. This is a step away from isolation, and can lead to a healthy lifestyle.

London. There were a total of 97 participants who took part in the study: 35 dyslexic, 62 non-dyslexic (controls), and 28 males and 69 females. Of those, there were 11 dyslexic males, 24 dyslexic females, 17 control males, 45 control females. All the participants were undergraduate university students, the average age of males being 21.5 years and the average age of females being 22.3 years.

The participants who were dyslexic were diagnosed beforehand by “an educational psychologist” according to the University of London.

The method used the Substance use Questionnaire, which was a moderately changed version of the University of East London Questionnaire. It asked the participants to give an account of the amount of they approximated the use of 15 different types of substances that they used in their life and these included: alcohol, nicotine, cannabis, ecstasy/MDMA, amphetamine, cocaine, LSD, barbiturates/benzodiazepines, opiates, magic mushrooms, anabolic steroids, solvents, poppers, ketamine, and Prozac. They responded with either yes or no, and their response designated whether they had used the substance as well as the amount of times they did. The questionnaire was used to investigate the presumed differences between dyslexics and non dyslexics.

The results showed that the dyslexic group had a

Going back to the question.....

Dyslexic people have proven to be more prone and more vulnerable to substance abuse. Dyslexia can create feelings of worthlessness, isolation, and neglecting, especially during young years, when children and teenagers grow up in school, and do not engage socially with their peers. This can lead to curiosity, and experimentation with substances or alcohol, to try and take away those feelings of loneliness. Substance abuse did prove to start at a younger age with dyslexics compared to non dyslexics, and this proves that it is crucial to go and check children with psychologists as early as possible if showing signs of dyslexia, in order to avoid these possible engagements in the future.

much higher rate of engaging in substance use than the non dyslexic group, which proves the hypothesis that dyslexic people are more prone to engaging in substance use than non dyslexic people are.

Did you know...?

Did you know that the dyslexic brain is usually larger, and more creative than the normal brain?

People with dyslexia are really good at creative tasks, seeing the bigger picture, and have good spatial knowledge

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Bibliography 1. Addiction and Dyslexia. (2019. Retrieved from https://www.altamirarecovery.com/co-occurring-disorders/dyslexia-addictiontreatment/ 2. Cherry, K. (2018, December 5). What Is a False Memory? Retrieved from https://www.verywellmind.com/what-is-a-false-memory-2795193 3. Co-occurring Disorders Treatment. (2019). Retrieved from https://www.dualdiagnosis.org/co-occurring-disorders-treatment/ 4. Diekelmann, S. (2008, October 23). Sleep Loss Produces False Memories.

Retrieved from https://journals.plos.org/plosone/article? id=10.1371/journal.pone.0003512 5. Grant, B.F. (2009, May 4). Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Borderline Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2676679/ 6. Jhanjee, S. (2015, July to September). Dyslexia and Substance Abuse: The Under-Recognized Link. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4649807/ 7. Lo, J.C. (2016, December). Sleep deprivation increases formation of false memory. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5324644/ 8. Macdonald, S.J. (2016). “Too Far Gone�: Dyslexia, Homelessness, and Pathways to Drug Use and Dependency. Retrieved from https://files.eric.ed.gov/fulltext/EJ1122799.pdf

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9. Markman, A. (2014, October 7). Sleep and False Memories. Retrieved from https://www.psychologytoday.com/us/blog/ulterior-motives/201410/sleep-andfalse-memories 10. Overview, Dyslexia. (2018, July 7). Retrieved from https://www.nhs.uk/conditions/dyslexia/# 11. Retrospective Case Control Study. (2018, October 28). Retreived from https://www.eupati.eu/glossary/retrospective-case-control-study/ 12. Salters-Pedneault, Kristalyn. (2018, August 22). Alcoholism and Borderline Personality Disorder. Retrieved from https://www.verywellmind.com/alcoholismand-borderline-personality-disorder-425428 13. Shen, Cheng-She. Hu, Li-Yu. Hu, Ya-Han. (2017, January 11). Comorbidity study of borderline personality disorder: applying association rule mining to the Taiwan national health insurance research database. Retreived from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225571/ 14. This Data Shows A Shocking Worldwide Lack of Sleep. (2018). Retrieved from https://www.dreams.co.uk/sleep-matters-club/data-shows-a-shockingworldwide-lack-of-sleep/ 15. What is Borderline Personality DIsorder? (2018, November 19) Retreived from https://www.addictioncenter.com/addiction/borderline-personality-disorder/ 16. What is Substance Abuse? (2017). Retrieved from https://www.webmd.com/mental-health/addiction/substance-abuse#1 17. Wilcockson, T.D.W. (2016, January 15). Dyslexia and Substance Use in a University Undergraduate Population. Retrieved from http://openaccess.city.ac.uk/13722/3/Dyslexia_Substance_Use_SUMU_MS_vS econdResubmission.pdf