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Abstract
Personality disorders (PDs) are often described as stable, which ignores the important dynamic processes and shifts that are observed clinically in individuals with PD. The current study examined patterns of variability in problematic interpersonal functioning, a core feature of personality pathology. Participants (N = 150) were assessed for personality pathology at baseline and also completed the Inventory of Interpersonal Problems-Circumplex Scales at baseline and every 3 months over the course of a year. Baseline PD was used to predict individual means and variability parameters in generalized interpersonal distress, agentic problems, and communal problems across repeated assessments. Disorders associated with disinhibition predicted variability in generalized distress and agentic problems, whereas only antagonism-related disorders predicted variability in communal problems. These associations reveal dynamic processes involved in multiple dimensions of personality pathology and suggest that future research on instability is needed that expands beyond the historical focus on borderline PD.
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Affiliation(s)
| | - Lori N Scott
- Department of Psychiatry, University of Pittsburgh
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Dixon-Gordon KL, Weiss NH, Tull MT, DiLillo D, Messman-Moore T, Gratz KL. Characterizing emotional dysfunction in borderline personality, major depression, and their co-occurrence. Compr Psychiatry 2015; 62:187-203. [PMID: 26343484 PMCID: PMC4561853 DOI: 10.1016/j.comppsych.2015.07.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 07/14/2015] [Accepted: 07/22/2015] [Indexed: 12/21/2022] Open
Abstract
This research aimed to characterize patterns of emotional reactivity and dysregulation in borderline personality, depression, and their co-occurrence. In study 1, 488 young adult women from the community were categorized into four groups based on self-reported major depressive disorder (MDD) and borderline personality disorder (BPD) symptoms (Low BPD/Low MDD; Low BPD/High MDD; High BPD/Low MDD; High BPD/High MDD). Immediate and prolonged subjective emotional reactivity to a laboratory stressor were assessed, and participants completed self-report and behavioral measures of emotion dysregulation. Study 2 extended these findings, examining emotional reactivity and dysregulation in a clinical population of 176 substance dependent patients with diagnoses of BPD and MDD and including a biological index of emotional reactivity. Results revealed greater prolonged fear reactivity in the High BPD/High MDD (vs. Low BPD/Low MDD) group in study 1, and greater prolonged anxiety and negative affect reactivity in both High BPD groups (vs. Low BPD/Low MDD and Low BPD/High MDD groups) in study 2 (but no differences in cortisol reactivity). Results also demonstrated greater subjective (but not behavioral) emotion dysregulation in the High BPD/High MDD (vs. Low BPD/Low MDD) group in study 1 and both High BPD groups (vs. both Low BPD groups) in study 2. Finally, the High BPD/High MDD group reported greater difficulties controlling impulsive behaviors compared with all other groups in study 1 and the Low BPD groups in study 2. Findings suggest that BPD pathology (but not MDD pathology alone) is characterized by greater prolonged emotional (especially anxiety/fear-related) reactivity and heightened emotion dysregulation.
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Affiliation(s)
- Katherine L. Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Nicole H. Weiss
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Matthew T. Tull
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - David DiLillo
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | | | - Kim L. Gratz
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA,Correspondence concerning this article should be addressed to Kim L. Gratz, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216; Phone: (601) 815-6450;
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A comprehensive examination of delayed emotional recovery in borderline personality disorder. J Behav Ther Exp Psychiatry 2015; 47:51-9. [PMID: 25482953 PMCID: PMC4324164 DOI: 10.1016/j.jbtep.2014.11.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 10/21/2014] [Accepted: 11/09/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Despite growing attention to emotion processes in borderline personality disorder (BPD), little research has examined delayed emotional recovery (i.e., long-lasting emotions after the termination of an emotionally evocative stimulus) in this population. The extant data on delayed emotional recovery in BPD are limited by a lack of assessment across a range of indices and emotions. The present study addresses these gaps by comparing emotional recovery between individuals with BPD, social anxiety disorder (SAD), and healthy controls (HCs) using a multi-modal assessment approach. METHODS Participants underwent fear, anger, and sadness inductions followed by a 5-min "washout" phase wherein emotional recovery was assessed via self-report, respiratory sinus arrhythmia (RSA), and skin conductance responses (SCR). RESULTS After controlling for state dissociation, the BPD and SAD group exhibited decreases in RSA, while the HC group showed no changes in RSA after the anger induction only. Groups did not differ in rate of emotional recovery across self-report, RSA, or SCR after fear and sadness inductions. LIMITATIONS The present study is limited by a solely female and small sample, and the short time frame in which emotional recovery was assessed. CONCLUSIONS Findings indicate that individuals with BPD generally do not exhibit delayed emotional recovery, but may show decreases in parasympathetic activity during the recovery period after experiencing anger. However, this pattern may not be specific to this disorder.
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Wang S, Roche MJ, Pincus AL, Conroy DE, Rebar AL, Ram N. Interpersonal dependency and emotion in every day life. JOURNAL OF RESEARCH IN PERSONALITY 2014. [DOI: 10.1016/j.jrp.2014.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Riva P, Romero Lauro LJ, Vergallito A, DeWall CN, Bushman BJ. Electrified emotions: Modulatory effects of transcranial direct stimulation on negative emotional reactions to social exclusion. Soc Neurosci 2014; 10:46-54. [DOI: 10.1080/17470919.2014.946621] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Santangelo P, Bohus M, Ebner-Priemer UW. Ecological momentary assessment in borderline personality disorder: a review of recent findings and methodological challenges. J Pers Disord 2014; 28:555-76. [PMID: 22984853 DOI: 10.1521/pedi_2012_26_067] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The use of Ecological Momentary Assessment (EMA) has led to increased insight into borderline personality disorder (BPD) symptoms, especially regarding affective instability. EMA is characterized by a series of repeated assessments of current affective, behavioral, and contextual experiences or physiological processes while participants engage in normal daily activities. EMA has several advantages. It enables researchers to avoid biased recollection, to investigate within-person processes, and to enhance real-life generalizability. This review is dedicated to four main objectives: (1) to discuss the characteristics of EMA in studying BPD symptomatology; (2) to provide an extensive overview of EMA findings in BPD structured into findings regarding DSM-IV criteria and findings regarding emotional dysregulation as stated in the biosocial theory of Linehan; (3) to discuss challenges of EMA and to give recommendations for the proper use of it; and (4) to highlight prospects and promising applications that should be addressed.
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Wright AGC, Hallquist MN, Beeney JE, Pilkonis PA. Borderline personality pathology and the stability of interpersonal problems. JOURNAL OF ABNORMAL PSYCHOLOGY 2014; 122:1094-100. [PMID: 24364612 DOI: 10.1037/a0034658] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Features of borderline personality disorder (BPD) are associated with the presence and severity of interpersonal problems. At the same time, individuals with BPD are heterogeneous with regard to the types of interpersonal problems they display. BPD is also associated with temporal instability in various domains (e.g., affective lability), and this characteristic raises questions about whether BPD is associated with changes in the expression of interpersonal dysfunction over time, which may contribute to the observed heterogeneity. The focus of the present study was to evaluate the relationship between BPD features and the stability of interpersonal problems over the course of 1 year. Participants (N = 150) were assessed for borderline personality pathology at baseline and also completed the Inventory of Interpersonal Problems-Circumplex Scales at baseline and every 3 months over the course of a year. Baseline BPD was used to predict structured (i.e., latent growth trajectories) and unstructured (i.e., mean square of successive differences) change parameters in generalized interpersonal distress, agentic problems, and communal problems across assessment waves. Baseline BPD predicted individual means in generalized distress and unstructured change (i.e., instability) in agentic and communal problems across the year. Baseline BPD was not predictive, however, of structured change (i.e., linear change trajectories) for any aspect of interpersonal problems. These findings support the conclusion that interpersonal dysfunction in borderline pathology is stable in its severity but unstable in the style of its manifestation.
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Roche MJ, Pincus AL, Rebar AL, Conroy DE, Ram N. Enriching psychological assessment using a person-specific analysis of interpersonal processes in daily life. Assessment 2014; 21:515-28. [PMID: 25038215 DOI: 10.1177/1073191114540320] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We present a series of methods and approaches for clinicians interested in tracking their individual patients over time and in the natural settings of their daily lives. The application of person-specific analyses to intensive repeated measurement data can assess some aspects of persons that are distinct from the valuable results obtained from single-occasion assessments. Guided by interpersonal theory, we assess a psychotherapy patient's interpersonal processes as they unfold in his daily life. We highlight specific contexts that change these processes, use an informant report to examine discrepancies in his reported interpersonal processes, and examine how his interpersonal processes differ as a function of varying levels of self-esteem and anger. We advocate for this approach to complement existing psychological assessments and provide a scoring program to facilitate initial implementation.
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Affiliation(s)
| | - Aaron L Pincus
- The Pennsylvania State University, University Park, PA, USA
| | - Amanda L Rebar
- Central Queensland University, Rockhampton, Queensland, Australia
| | - David E Conroy
- The Pennsylvania State University, University Park, PA, USA
| | - Nilam Ram
- The Pennsylvania State University, University Park, PA, USA
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Ducasse D, Courtet P, Olié E. Physical and social pains in borderline disorder and neuroanatomical correlates: a systematic review. Curr Psychiatry Rep 2014; 16:443. [PMID: 24633938 DOI: 10.1007/s11920-014-0443-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Borderline personality disorder (BPD) is a common psychiatric disorder, the core features of which are affective dysregulation, identity disturbances, and problems in social interaction, with an intense fear of loss, abandonment, or rejection by social partners. Self-injurious behaviors (SIB), such as superficial cutting, occur in 70-80 % of BPD patients, which are associated with emotional relief. Intriguingly, the majority of BPD patients report reduced or no pain associated with SIB, whereas BPD patients are over-represented in chronic pain patients. Thus, studying pain perception in such patients may help to understand the pathophysiology of BPD, but also the interaction between affective and physical dimensions of pain. We conducted a systematic review dealing with physical and social pains in BPD patients, with a special focus on neuroimaging data. SIB appear to be an inadequate strategy to regulate negative emotions that may be related to social/psychological pain, by increasing dorsolateral prefrontal cortex activation in order to regulate amygdala activation. In addition, abnormal hyperactivation of the insula is a possible trait marker of BPD, and might contribute to modified pain sensitivity. When considering psychological pain in BPD patients, neuroanatomical studies have shown a hyper-responsive subcortical limbic network and a deficient regulatory control system operating through anterior brain regions. Promising therapeutic strategies should target neuroanatomical and neurobiological dysfunctions, which lead to altered pain perception in BPD patients.
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Affiliation(s)
- Déborah Ducasse
- Department of Psychiatric Emergencies and Post Emergencies, Lapeyronie Hospital, Academic Hospital of Montpellier, UM1 University of Montpellier, INSERM U1061, 191 Avenue du Doyen Gaston Giraud, 34295, Montpellier, France,
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Valentiner DP, Hiraoka R, Skowronski JJ. Borderline Personality Disorder Features, Self-Verification, and Committed Relationships. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2014. [DOI: 10.1521/jscp.2014.33.5.463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Dixon-Gordon KL, Gratz KL, Tull MT. Multimodal assessment of emotional reactivity in borderline personality pathology: the moderating role of posttraumatic stress disorder symptoms. Compr Psychiatry 2013; 54:639-48. [PMID: 23375184 PMCID: PMC3644527 DOI: 10.1016/j.comppsych.2012.12.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Revised: 12/18/2012] [Accepted: 12/31/2012] [Indexed: 10/27/2022] Open
Abstract
Emotional reactivity has been theorized to play a central role in borderline personality (BP) pathology. Although growing research provides evidence for subjective emotional reactivity in BP pathology, research on physiological or biological reactivity among people with BP pathology is less conclusive. With regard to biological reactivity in particular, research on cortisol reactivity (a neurobiological marker of emotional reactivity) in response to stressors among individuals with BP pathology has produced contradictory results and highlighted the potential moderating role of PTSD-related pathology. Thus, this study sought to examine the moderating role of PTSD symptoms in the relation between BP pathology and both subjective (self-report) and biological (cortisol) emotional reactivity to a laboratory stressor. Participants were 171 patients in a residential substance use disorder treatment center. Consistent with hypotheses, results revealed a significant main effect of BP pathology on subjective emotional reactivity to the laboratory stressor. Furthermore, results revealed a significant interaction between BP pathology and PTSD symptoms in the prediction of cortisol reactivity, such that BP pathology was associated with heightened cortisol reactivity only among participants with low levels of PTSD symptoms. Similar findings were obtained when examining the interaction between BP pathology and the reexperiencing and avoidance/numbing symptoms of PTSD specifically. Results highlight the moderating role of PTSD symptoms in the BP-reactivity relation.
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Dixon-Gordon KL, Yiu A, Chapman AL. Borderline personality features and emotional reactivity: the mediating role of interpersonal vulnerabilities. J Behav Ther Exp Psychiatry 2013; 44:271-8. [PMID: 23333423 DOI: 10.1016/j.jbtep.2012.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 11/02/2012] [Accepted: 12/07/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES The purpose of this study was to examine the mediating role of interpersonal vulnerabilities in the association of borderline personality (BP) features with emotional reactivity to an interpersonal stressor. METHODS For this study, female university students with high (N = 23), mid (N = 23), and low (N = 22) BP features completed the Inventory of Interpersonal Problems-Personality Disorders-25 (IIP-PD-25). Self-reported emotions, skin conductance responses (SCRs), interbeat intervals, and heart rate variability measured emotional reactivity to a social rejection stressor. RESULTS BP features were positively associated with interpersonal dysfunction and predicted greater SCR reactivity and self-reported emotional reactivity. Interpersonal dysfunction mediated the association between BP features and physiological (SCRs), but not self-reported, emotional reactivity. In particular, scores on the interpersonal ambivalence subscale of the IIP-PD-25 mediated the association of BP features with SCR reactivity. LIMITATIONS This study examined BP features in a non-clinical sample, and relied on a relatively small sample. Furthermore, the design of the present study does not capture the potential transaction between interpersonal vulnerabilities and emotional dysfunction. CONCLUSIONS The findings of this study illuminate one potential mechanism underlying the heightened reactivity of persons with BP features to rejection, suggesting that interpersonal ambivalence plays a particularly important role in physiological reactivity.
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Dixon-Gordon KL, Gratz KL, Breetz A, Tull M. A laboratory-based examination of responses to social rejection in borderline personality disorder: the mediating role of emotion dysregulation. J Pers Disord 2013; 27:157-71. [PMID: 23514181 DOI: 10.1521/pedi.2013.27.2.157] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study sought to build upon existing research on interpersonal sensitivity in borderline personality disorder (BPD) by examining whether emotion dysregulation mediates the relationship between BPD and cognitive and emotional responses to social rejection. Participants with (n = 53) and without (n = 34) BPD reported on levels of negative affect and threat to four social needs (perceived control, belonging, selfesteem, and meaningful existence) in response to a laboratory-based social ostracism task (Cyberball). Results revealed heightened interpersonal (rejection) sensitivity among BPD (vs. non-BPD) participants, as evidenced by heightened threat to all social needs and nonspecific distress (although not overall negative affect) in response to the task. Furthermore, both overall emotion dysregulation and the specific dimensions involving emotion modulation strategies, emotional clarity, and the control of behaviors when distressed mediated the relationship between BPD status and several cognitive (threats to meaningful existence, belonging, and self-esteem) and emotional (nonspecific distress) responses to the task.
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Affiliation(s)
- Katherine L Dixon-Gordon
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State St., Jackson, MS 39216, USA.
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Wright AGC, Hallquist MN, Morse JQ, Scott LN, Stepp SD, Nolf KA, Pilkonis PA. Clarifying interpersonal heterogeneity in borderline personality disorder using latent mixture modeling. J Pers Disord 2013; 27:125-43. [PMID: 23514179 PMCID: PMC3607958 DOI: 10.1521/pedi.2013.27.2.125] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Significant interpersonal impairment is a cardinal feature of borderline personality disorder (BPD). However, past research has demonstrated that the interpersonal profile associated with BPD varies across samples, which is evidence for considerable interpersonal heterogeneity. The current study used inventory of interpersonal problems-circumplex (IIP-C; Alden, Wiggins, & Pincus, 1990) scale scores to investigate interpersonal inhibitions and excesses in a large sample (N = 255) selected for significant borderline pathology. Results indicated that BPD symptom counts were unrelated to the primary dimensions of the IIPC, but were related to generalized interpersonal distress. A latent class analysis clarified this finding by revealing six homogeneous interpersonal classes with prototypical profiles associated with Intrusive, Vindictive, Avoidant, Nonassertive, and moderate and severe Exploitable interpersonal problems. These classes differed in clinically relevant features (e.g., antisocial behaviors, self-injury, past suicide attempts). Findings are discussed in terms of the incremental clinical utility of the interpersonal circumplex model and the implications for developmental and nosological models of BPD.
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Affiliation(s)
- Aidan G C Wright
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA 15213, USA.
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66
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Abstract
The categorical-dimensional debate has catalyzed a wealth of empirical advances in the study of personality pathology. However, this debate is merely one articulation of a broader conceptual question regarding whether to define and describe psychopathology as a quantitatively extreme expression of normal functioning or as qualitatively distinct in its process. In this article I argue that dynamic models of personality (e.g., object relations, cognitive-affective processing system) offer the conceptual scaffolding to reconcile these seemingly incompatible approaches to characterizing the relationship between normal and pathological personality. I propose that advances in personality assessment that sample behavior and experiences intensively provide the empirical techniques, whereas interpersonal theory offers an integrative theoretical framework, for accomplishing this goal.
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Affiliation(s)
- Aidan G C Wright
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, USA.
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67
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Coulston CM, Tanious M, Mulder RT, Porter RJ, Malhi GS. Bordering on bipolar: the overlap between borderline personality and bipolarity. Aust N Z J Psychiatry 2012; 46:506-21. [PMID: 22510555 DOI: 10.1177/0004867412445528] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE There is much debate over whether borderline personality disorder (BPD) belongs to the bipolar spectrum. The diagnosis of bipolar disorder (BD) in BPD patients, and conversely, BPD in BD patients is common, indicating prevalent co-morbidity, as well as potential misdiagnosis in either group. BD and BPD are often indistinguishable given the core characteristics of emotional dysregulation and impulsivity that feature in both. However, it may be argued that the manifestation of these characteristics in the two groups is different, and that the symptoms are driven by distinct aetiological factors. The primary objective of this paper was to examine where potential areas of discrimination lie between BD and BPD. METHODS A literature search was conducted using MEDLINE and PubMed databases to identify studies that have researched BD and BPD across the recognised domains of emotional dysregulation, impulsivity, childhood trauma, and their putative neurobiological substrates. RESULTS Research comparing BD and BPD patients on self-report measures is limited, and no studies have examined their neurobiological underpinnings in the same design. One possible differentiating variable is childhood trauma which shapes the circumstances in which emotional dysregulation and impulsivity are triggered, the types of behaviours exhibited, and the frequency and duration of mood states. There is growing evidence that childhood trauma not only predisposes individuals to both disorders, but also modulates the clinical expression and course of bipolar illness, particularly rapid cycling BD, a form of bipolarity that resembles the clinical profile of BPD, yet presents quite distinctly from other BD subtypes. CONCLUSIONS This paper provides an overview of BD and BPD with respect to emotional dysregulation, impulsivity, childhood factors, and neurobiological substrates. Based on findings predominantly within the independent areas of BD and BPD, it tentatively provides an integrated behavioural, aetiological and neurobiological approach for investigating the question of whether BPD belongs to the bipolar spectrum.
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Affiliation(s)
- Carissa M Coulston
- CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
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Reed LI, Fitzmaurice G, Zanarini MC. The course of dysphoric affective and cognitive states in borderline personality disorder: a 10-year follow-up study. Psychiatry Res 2012; 196:96-100. [PMID: 22326877 PMCID: PMC3351545 DOI: 10.1016/j.psychres.2011.08.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 07/20/2011] [Accepted: 08/30/2011] [Indexed: 11/19/2022]
Abstract
The current study aimed to assess dysphoric states among 290 patients with borderline personality disorder (BPD) and 72 non-borderline axis II comparison subjects other personality disorders, (OPD) over a 10-year course of prospective follow-up. Additionally, we assessed the severity of these states among borderline patients who had and had not recovered both symptomatically and psychosocially. The Dysphoric Affect Scale (DAS) - a 50-item self-report measure of affective and cognitive states thought to be common among borderline patients and specific to the disorder - was administered at five waves of prospective follow-up. Affective and cognitive DAS items were separately analyzed, yielding respective subscores. Borderline patients reported more severe dysphoric states compared to OPD subjects at baseline. However, the severity of affective and cognitive states declined significantly for both groups taken together over 10 years of follow-up. Within the BPD group, recovered subjects reported less severe dysphoric states compared to non-recovered subjects at baseline. Results also showed a significant decline in DAS scores over time, but at a greater rate for recovered subjects. In sum, while the severity of dysphoric states declines significantly over time, inner distress remains an area of vulnerability for borderline subjects. Additionally, the severity and pervasiveness of these states may affect recovery over time.
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Berthoud L, Kramer U, de Roten Y, Despland JN, Caspar F. Using Plan Analysis in Psychotherapeutic Case Formulation of Borderline Personality Disorder. Clin Psychol Psychother 2011; 20:1-9. [DOI: 10.1002/cpp.784] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 07/22/2011] [Accepted: 07/22/2011] [Indexed: 01/04/2023]
Affiliation(s)
- Laurent Berthoud
- University Institute of Psychotherapy; Department of Psychiatry; University of Lausanne; Switzerland
| | - Ueli Kramer
- University Institute of Psychotherapy; Department of Psychiatry; University of Lausanne; Switzerland
| | - Yves de Roten
- University Institute of Psychotherapy; Department of Psychiatry; University of Lausanne; Switzerland
| | - Jean-Nicolas Despland
- University Institute of Psychotherapy; Department of Psychiatry; University of Lausanne; Switzerland
| | - Franz Caspar
- Department for Clinical Psychology and Psychotherapy; University of Bern; Switzerland
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Pincus AL. Introduction to the special series on integrating personality, psychopathology, and psychotherapy using interpersonal assessment. J Pers Assess 2011; 92:467-70. [PMID: 20954048 DOI: 10.1080/00223891.2010.513706] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The interpersonal paradigm in personality assessment employs multiple models, measures, and methods to examine the interpenetration of personality, psychopathology, and psychotherapy. Its organizing framework is the nomological net of agency and communion, which are fundamental metaconstructs that can be conceptualized and measured at multiple levels ranging from broad interpersonal motives to stable interpersonal dispositions to specific interpersonal behaviors. This Special Series presents diverse research and clinical applications of interpersonal theory and assessment to (a) enhance diagnosis, case conceptualization, and treatment planning; (b) identify developmental catalysts of and current influences on psychopathological symptoms; and (c) articulate different ways in which personality, psychopathology, and psychotherapy are interrelated. Each article demonstrates the integrative nature of interpersonal assessment while concurrently exemplifying the unique assumptions and methods of contemporary interpersonal diagnosis.
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Affiliation(s)
- Aaron L Pincus
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802-3104, USA.
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Widiger TA. Personality, Interpersonal Circumplex, and DSM–5: A Commentary on Five Studies. J Pers Assess 2010; 92:528-32. [DOI: 10.1080/00223891.2010.513707] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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