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Mungo A, Delhaye M, Blondiau C, Hein M. Identity Formation in Individuals between 16 and 25 Years Old with Borderline Personality Disorder. J Clin Med 2024; 13:3221. [PMID: 38892931 PMCID: PMC11173068 DOI: 10.3390/jcm13113221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Background/Objectives: Identity disruption is a key feature of borderline personality disorder (BPD), characterized by disturbances in self-image. This study aimed to use the Dimensions of Identity Development Scale (DIDS) in a population aged 16-25, to assess differences in identity status and correlations with BPD features as well as whether a correlation exists between the BPD features, the scores obtained on the DIDS and the scores of the different dimensions of this disorder. Methods: We analyzed data from 132 individuals: 44 with BPD using the Diagnostic Interview for Borderline-Revised (DIB-R). Statistical analyses included quantile regression to determine the differences in the DIDS after adjusting for confounding factors identified during group comparisons and Spearman correlation between the DIDS, the BPD features and the DIB-R. Results: Results indicated significantly lower DIDS scores in the BPD group, particularly in commitment making, exploration breadth (EB), identity with commitment (IM) and ruminative exploration (RE). After adjusting, only EB differs significantly between the two groups. All dimensions of the DIDS except for the exploration in depth (ED) are correlated with BPD features. Significant correlations could be demonstrated between cognitive dimension and ED, between the total DIDS and the number of suicide attempt (SA) and between the IM and the number of SA. Conclusions: Our clinical sample showed distinct identity formation compared to controls, with a lower EB associated with BPD. RE correlated with BPD, suggesting that the individuals engage in repetitive exploratory processes. SA was negatively associated with overall identity development and commitment, indicating impulsive behaviors in BPD intersect with identity struggles.
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Affiliation(s)
- Anaïs Mungo
- CH Le Domaine-ULB, Department of Psychiatry, Université Libre de Bruxelles, 1420 Braine l’Alleud, Belgium
| | - Marie Delhaye
- CHU HELORA, Department of Psychiatry, Hôpital de La Louvière-Site Jolimont, 7100 La Louvière, Belgium;
| | - Camille Blondiau
- HUB—Site Anderlecht, Department of Baby, Child, Adolescent and Young Adult Psychiatry, Université Libre de Bruxelles, 1070 Bruxelles, Belgium;
| | - Matthieu Hein
- HUB—Site Anderlecht, Department of Psychiatry and Sleep Laboratory, Université Libre de Bruxelles, 1050 Brussels, Belgium;
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Balzen KM, Blacutt M, Lind M, Penner F, Sharp C. Awareness of Narrative Identity Questionnaire (ANIQ) in Early Adolescents: Psychometric Evaluation and Association with Features of Personality Disorder. J Pers Assess 2024; 106:337-346. [PMID: 37732705 DOI: 10.1080/00223891.2023.2258979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 09/03/2023] [Indexed: 09/22/2023]
Abstract
Identity formation is central to adolescent development. Challenges in establishing a stable sense of self is associated with maladaptive identity function, which has been recognized as a core feature of personality pathology. The narrative identity framework offers a unique lens to garner salient information about one's sense of self. The Awareness of Narrative Identity Questionnaire (ANIQ) is a self-report measure of narrative identity validated in adults but is yet to be validated in adolescents. The current study aimed to conduct the first psychometric evaluation of the ANIQ in a sample of 205 youth aged 10-14 years (M = 12.1 ± 1.06 years; 50.7% female; 73.7% Hispanic) recruited from a public charter school. Results confirmed the four-factor structure of the ANIQ and showed high internal consistency. Convergent validity was supported through negative associations between the ANIQ and borderline personality features and identity diffusion. Incremental validity of the ANIQ over identity diffusion in predicting borderline personality features was also examined, but not supported. Overall, results support the ANIQ as a promising instrument for the assessment of narrative identity in youth. However, some improvements to the ANIQ might be necessary in order to use it as a clinical tool in identifying youth with personality pathology.
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Affiliation(s)
| | | | - Majse Lind
- Department of Psychology, Aalborg University
| | | | - Carla Sharp
- Department of Psychology, University of Houston
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Heekerens JB, Schulze L, Enge J, Renneberg B, Roepke S. Increases in negative affective arousal precede lower self-esteem in patients with borderline personality disorder but not in patients with depressive disorders: an experience sampling approach. Borderline Personal Disord Emot Dysregul 2023; 10:29. [PMID: 37784203 PMCID: PMC10546701 DOI: 10.1186/s40479-023-00229-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/19/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Instability in self-esteem and instability in affect are core features of borderline personality disorder (BPD). For decades, researchers and theorists have been interested in the temporal dynamics between these constructs. Some hypothesize that changes in affective states should precede changes in self-esteem (Linehan, Cognitive-behavioral treatment of borderline personality disorder. Diagnosis and treatment of mental disorders, 1993), while others suggest that changes in self-esteem should precede changes in affective states (Kernberg, Borderline conditions and pathological narcissism, 1975). METHODS In this study, we investigated the temporal relations between negative affective arousal states and current self-esteem in daily life. Patients with BPD (n = 42) or depressive disorders (DD; n = 40), and non-clinical controls (NCC; n = 40) were assessed every 15 min for 13 h. RESULTS As expected, dynamic structural equation modeling showed higher levels of average daily negative affective arousal and lower levels of average daily self-esteem in the BPD group compared with the NCC group, and scores in the DD group were in-between the BPD and the NCC groups. In line with predictions based on Linehan's (Cognitive-behavioral treatment of borderline personality disorder. Diagnosis and treatment of mental disorders, 1993) model of affective dysregulation in BPD, negative affective arousal (t) and subsequent self-esteem (t+ 1) were significantly linked only in the BPD group, implying that higher negative affective arousal is followed by lower current self-esteem in the next measurement (ca. 15 min later). Importantly, self-esteem (t) and subsequent negative affective arousal (t + 1) were not significantly related (Kernberg, Borderline conditions and pathological narcissism, 1975). CONCLUSIONS Our findings suggest close dynamic temporal relations between affective instability and self-esteem instability in BPD, which highlights the importance of providing patients with means to effectively modulate high negative affective arousal states.
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Affiliation(s)
- Johannes Bodo Heekerens
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Lars Schulze
- Department of Education and Psychology, Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, Berlin, 14195, Germany
| | - Juliane Enge
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Babette Renneberg
- Department of Education and Psychology, Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, Berlin, 14195, Germany
| | - Stefan Roepke
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Bogaerts A, Luyckx K, Bastiaens T, Sleuwaegen E, Berens A, Claes L. The Self-Concept and Identity Measure in Patients with Personality Disorders: A Psychometric Evaluation and Associations With Identity Processes, Core Domains of Self-Functioning, and Personality Disorder Symptoms. Assessment 2023; 30:2184-2197. [PMID: 36594676 DOI: 10.1177/10731911221140313] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
As developmental and clinical research on identity has largely developed in disconnect, scholars recommend adopting a developmental psychopathology perspective on identity, which considers adaptive and pathological identity functioning. Such a perspective has also been introduced in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Alternative Model for Personality Disorders (AMPD), which suggests that all personality disorders (PDs) are marked by moderate to extreme deficits in self-functioning (i.e., identity and self-direction). The present study aims to validate the Dutch Self-Concept and Identity Measure (SCIM), a 27-item self-report questionnaire that assesses consolidated identity, disturbed identity, and lack of identity, in 153 psychiatric inpatients with PDs (75.2% female; Mage = 31.73). We investigated the factor structure and reliability of the SCIM, and examined associations of SCIM scales with typical identity processes, AMPD domains of self-functioning, and symptoms of all PDs. Results indicated that a 23-item Dutch SCIM produced valid and reliable scores among patients with PDs. Furthermore, SCIM scales were significantly and differentially related to identity commitment processes, ruminative identity exploration, domains of self-functioning, and symptoms of all PDs. Moreover, findings indicated that PDs varied regarding the severity of identity impairment.
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Affiliation(s)
- Annabel Bogaerts
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- UNIBS, University of the Free State, Bloemfontein, South Africa
| | - Tim Bastiaens
- University Psychiatric Centre, KU Leuven, Kortenberg, Belgium
| | - Ellen Sleuwaegen
- University Psychiatric Centre, UZA, Duffel, Belgium
- Faculty of Medicine and Health Sciences, University Antwerp, Belgium
| | - Ann Berens
- University Psychiatric Centre, UZA, Duffel, Belgium
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences, University Antwerp, Belgium
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Szily D, Kelemen R, Nagy ZS, Szabó D, Unoka ZS. Disturbed body schema, perceptual body image, and attitudinal body image in patients with borderline personality disorder. Front Psychiatry 2023; 14:1168611. [PMID: 37822796 PMCID: PMC10562535 DOI: 10.3389/fpsyt.2023.1168611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/28/2023] [Indexed: 10/13/2023] Open
Abstract
Background Borderline personality disorder (BPD) is a severe mental disorder that affects attitudes toward the body. However, whether this condition also affects body schema and perceptual body image remains unclear. Previous questionnaire-based studies found dissatisfaction with one's body in patients with BPD. In addition to attitudinal body image, our study investigates whether body schema and perceptual body image are disturbed in patients with BPD. Method Our study included 31 patients diagnosed with BPD (25 women) and 30 healthy individuals (19 women) (Mage = 29 for both groups). The SCID-5-PD interview was used to determine personality disorder. Attitudinal body image was measured using the Body Attitude Test (BAT) factors. Body schema and perceptual body image were measured by two conditions of a body representation task, the body portraying method (BPM). Results BPD patients achieved higher scores in all three BAT factors and were more susceptible to misinformation in both conditions of BPM. Based on the results, BPD patients appear to have more negative attitudes toward their bodies and worse perceptual body image and body schema. Conclusion The novel finding of our study is that, besides the previously found attitudinal dissatisfaction with the body, individuals with BPD also show disturbances at the levels of body schema and perceptual body image. Our findings concerning disturbances in body schema and perceptual body need further research into their etiological factors and provide new therapeutic targets for the treatment of BPD.
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Affiliation(s)
- Dorottya Szily
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
| | | | - Zita S. Nagy
- OMINT-National Institute of Medical Rehabilitation, Budapest, Hungary
| | - Dominik Szabó
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
| | - Zsolt Szabolcs Unoka
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
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James R, Daukantaité D, Nilsson M. A validation of the Swedish self-concept and Identity Measure (SCIM) and its association with mental health problems. Heliyon 2023; 9:e18151. [PMID: 37519721 PMCID: PMC10372226 DOI: 10.1016/j.heliyon.2023.e18151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 06/20/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023] Open
Abstract
Pathological disturbance to one's identity is closely linked with mental illness and in particular personality disorders. Current measures of identity pathology within clinical research are nevertheless inconsistently used and present with substantial limitations such as disproportionate focus on adolescence. The Self-Concept and Identity Measure (SCIM) identifies pathological and non-pathological identity disturbance by implementing a measurement for clinical components of identity, as well as introducing the Lack of Identity concept. This study thus explores the psychometric properties (factor structure, internal consistency, and criterion validity) of the Swedish SCIM in a large sample of Swedish university students (N = 1500). Model fit indices for the three-dimension model of identity pathology consisting of consolidated-, disturbed-, and lack of identity subscales were deemed acceptable and the Swedish SCIM scores correlated with measures of psychopathology in the expected direction, together concluding that the Swedish SCIM was satisfactorily valid and reliable. The results further reveal a significant positive correlation between identity pathology and non-suicidal self-injury, two concepts that co-occur in psychopathologies, such as borderline personality disorder, but have not yet been studied in a Western population with this tool. The potential clinical use of this translated dimensional tool needs to be tested in a Swedish clinical population, however, we conclude that it already offers insight into the complexities of identity functioning and correlations with clinical symptoms.
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Affiliation(s)
- Rosie James
- Faculty of Medicine at Lund University, Sweden
- Department of Clinical Sciences Lund, Psychiatry, Lund University, Sweden
| | | | - Magnus Nilsson
- Department of Clinical Sciences Lund, Psychiatry, Lund University, Sweden
- Clinical Psychiatric Research Centre, Region Skåne, Lund, Sweden
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Peters JR, Crowe ML, Morgan T, Zimmerman M, Sharp C, Grilo CM, Sanislow CA, Shea MT, Zanarini MC, McGlashan TH, Morey LC, Skodol AE, Yen S. Borderline personality disorder symptom networks across adolescent and adult clinical samples: examining symptom centrality and replicability. Psychol Med 2023; 53:2946-2953. [PMID: 35094733 PMCID: PMC9339041 DOI: 10.1017/s0033291721004931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/22/2021] [Accepted: 11/09/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Numerous theories posit different core features to borderline personality disorder (BPD). Recent advances in network analysis provide a method of examining the relative centrality of BPD symptoms, as well as examine the replicability of findings across samples. Additionally, despite the increase in research supporting the validity of BPD in adolescents, clinicians are reluctant to diagnose BPD in adolescents. Establishing the replicability of the syndrome across adolescents and adults informs clinical practice and research. This study examined the stability of BPD symptom networks and centrality of symptoms across samples varying in age and clinical characteristics. METHODS Cross-sectional analyses of BPD symptoms from semi-structured diagnostic interviews from the Collaborative Longitudinal Study of Personality Disorders (CLPS), the Methods to Improve Diagnostic Assessment and Service (MIDAS) study, and an adolescent clinical sample. Network attributes, including edge (partial association) strength and node (symptom) expected influence, were compared. RESULTS The three networks were largely similar and strongly correlated. Affective instability and identity disturbance emerged as relatively central symptoms across the three samples, and relationship difficulties across adult networks. Differences in network attributes were more evident between networks varying both in age and in BPD symptom severity level. CONCLUSIONS Findings highlight the relative importance of affective, identity, and relationship symptoms, consistent with several leading theories of BPD. The network structure of BPD symptoms appears generally replicable across multiple large samples including adolescents and adults, providing further support for the validity of the diagnosis across these developmental phases.
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Affiliation(s)
| | - Michael L. Crowe
- Alpert Medical School of Brown University, Providence, USA
- VA Boston Healthcare System, Boston, USA
| | - Theresa Morgan
- Butler Hospital, Alpert Medical School of Brown University, Providence, USA
| | - Mark Zimmerman
- Rhode Island Hospital, Alpert Medical School of Brown University, Providence, USA
| | | | | | | | - M. Tracie Shea
- Alpert Medical School of Brown University, Providence, USA
| | | | | | | | | | - Shirley Yen
- Alpert Medical School of Brown University, Providence, USA
- Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Harvard Medical School, Boston, USA
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8
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Brewin CR. Identity - A critical but neglected construct in cognitive-behaviour therapy. J Behav Ther Exp Psychiatry 2023; 78:101808. [PMID: 36435550 DOI: 10.1016/j.jbtep.2022.101808] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/26/2022] [Accepted: 11/12/2022] [Indexed: 11/24/2022]
Abstract
In cognitive-behaviour therapy attention paid to the self and identity has primarily involved self-representations (the Me-Self) rather than how the self is experienced (the I-Self). Within the I-Self experiences vary on a continuum from pre-reflective consciousness (raw experienced perceptions and states of being) to self-awareness (permitting reflection on and evaluation of subjective experience). There is considerable evidence that the I-Self is affected in many if not all disorders, and I review illustrative studies of OCD, eating disorders, body dysmorphic disorder, PTSD, and personality disorder. These indicate that patients often experience themselves as being defective in various ways, or as having an unstable or contradictory I-Self. Recognition of this neglected aspect of patients' experience has major implications for assessment and treatment. For example, acknowledgment that their sense of self may fluctuate dramatically from moment to moment, may be fragmented, or may consist of a sense of emptiness, may help to build a more empathic therapeutic relationship. If frightening or distressing pre-reflective experiences are the cause of avoidance or other maladaptive coping strategies, conscious attention paid to them in therapy may help to better integrate the I-Self and Me-Self, restoring a sense of predictability and control.
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Vizgaitis AL, Lenzenweger MF. Identity and Personality Pathology: A Convergence Across the DSM-5 Personality Disorder Model and the Alternative Model for Personality Disorders. J Pers Disord 2022; 36:537-558. [PMID: 36181489 DOI: 10.1521/pedi.2022.36.5.537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Long-standing theory regarding personality pathology as well as the recently proposed DSM-5 Alternative Model for Personality Disorders (AMPD) posit that self/identity problems are a hallmark feature cutting across forms of personality pathology. With emergence of the AMPD, researchers have started to focus empirical investigations on identity pathology as a transdiagnostic factor across personality pathology. The current study investigated identity pathology across indicators of personality pathology from both the current categorical perspective (DSM-5 PD) and the dimensional perspective in the AMPD. Identity diffusion and low self-concept clarity were correlated with all PD feature scales and all maladaptive personality dimension scales. Regression analyses revealed most indicators of personality pathology were significant correlates of identity diffusion and low self-concept clarity. Borderline and Avoidant PD feature scales and Negative Affectivity and Detachment maladaptive personality dimension scales emerged as the strongest correlates of identity pathology. The role that identity pathology plays in personality pathology is highlighted.
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Affiliation(s)
- Alexandra L Vizgaitis
- Department of Psychology, State University of New York at Cortland, Cortland, New York
| | - Mark F Lenzenweger
- Department of Psychology, State University of New York at Binghamton, and Department of Psychiatry, Weill Cornell Medical College, New York, New York
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10
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Sharp C, McLaren V, Musetti A, Vanwoerden S, Hernandez Ortiz J, Schmeck K, Birkhoelzer M, Goth K. The Assessment of Identity Development in Adolescence (AIDA) Questionnaire: First Psychometric Evaluation in Two North American Samples of Young People. J Pers Assess 2022:1-12. [PMID: 36121311 DOI: 10.1080/00223891.2022.2119860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The Assessment of Identity Development in Adolescence (AIDA) is a recently developed measure of identity diffusion in young people. Originally validated in Switzerland, the English version has not yet been validated. Our aim was to evaluate the AIDA's internal factor structure, internal consistency, incremental validity, and relations to other variables in adolescents and young adults and derive clinical cutoffs for use in clinical settings. Study 1, involving 2,119 undergraduate students between the ages of 18-25 years, confirmed the expected bi-factor structure for the AIDA. Study 2 involved the recruitment of 122 adolescent inpatients (ages 12-17), of whom 36 met full DSM-based criteria for Borderline Personality Disorder, in addition to 164 adolescents of the same age, recruited from public schools (total 286 adolescents). Results of both studies demonstrated strong internal consistency and correlations of the expected magnitude and direction with other self-report measures of personality pathology. In addition, Study 2 demonstrated that the AIDA could successfully discriminate between adolescent inpatients with and without BPD, as well as healthy controls, and established preliminary clinical cutoffs that should be replicated in future studies. In all, these studies provide support for further validation and use of the AIDA in young people.
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Maffly-Kipp J, McCredie MN, Morey LC. The self-reference effect as a behavioral indicator of identity disturbances associated with borderline personality features in a non-clinical sample. Borderline Personal Disord Emot Dysregul 2022; 9:20. [PMID: 35854373 PMCID: PMC9297558 DOI: 10.1186/s40479-022-00189-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 06/22/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Identity disturbances are a common feature of personality pathology and BPD. The Self-Reference Effect paradigm is a method used to measure the impact of self-relevant processing on encoding/memory, whereby self-relevant information is typically advantaged in cognitive processes. We postulated that difficulties with identity might impede the process by which one encodes self-relevant information. Based on this reasoning, we predicted that high levels of identity disturbance could be associated with atypical impact of the SRE. METHODS Undergraduate participants were randomized into one of three groups where they were exposed to 60 trait adjectives for seven seconds each. Depending on condition, participants either indicated whether a word was/wasn't capitalized (Capitalization condition), whether it was a good synonym for "openness" (Synonyms condition), or whether it described them as a person (Self-reference condition). After a brief delay, all participants were asked to recall as many of the 60 words as possible. Finally, we measured identity disturbance using the Borderline Features-Identity Problems (BOR-I) scale from the Personality Assessment Inventory. RESULTS We found significant but modest correlations between Recall and scores on the BOR-I subscale in the Self-Reference condition, but not the two control conditions. Contrary to expectations, the interaction between BOR-I and Condition was not a significant predictor of Recall, suggesting that identity disturbance did not significantly moderate the SRE. CONCLUSIONS While our primary hypothesis was not supported, there is a need for multimethod approaches to studying personality pathology. Future research should continue to examine the extent to which behavioral paradigms like the SRE might be useful indicators of identity disturbance/personality pathology, with an emphasis on the use of clinical populations.
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Affiliation(s)
- Joseph Maffly-Kipp
- Department of Psychological and Brain Sciences, Texas A&M University, 4235 TAMU, College Station, TX, 77843, USA.
| | - Morgan N McCredie
- Department of Psychological and Brain Sciences, Texas A&M University, 4235 TAMU, College Station, TX, 77843, USA
| | - Leslie C Morey
- Department of Psychological and Brain Sciences, Texas A&M University, 4235 TAMU, College Station, TX, 77843, USA
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Schmidt P. Affective Instability and Emotion Dysregulation as a Social Impairment. Front Psychol 2022; 13:666016. [PMID: 35496195 PMCID: PMC9051371 DOI: 10.3389/fpsyg.2022.666016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/25/2022] [Indexed: 11/27/2022] Open
Abstract
Borderline personality disorder is a complex psychopathological phenomenon. It is usually thought to consist in a vast instability of different aspects that are central to our experience of the world, and to manifest as “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity” [American Psychiatric Association (APA), 2013, p. 663]. Typically, of the instability triad—instability in (1) self, (2) affect and emotion, and (3) interpersonal relationships—only the first two are described, examined, and conceptualized from an experiential point of view. In this context, disorders of self have often motivated analyses of self-experience and the sense of self, affective disorders have been frequently considered in the light of emotional experience and its phenomenological structure. Patterns in the phenomenology of social experience have found comparatively little traction when it comes to the conceptualization of the interpersonal disturbances in borderline. In this paper, I argue that interpersonal instability in borderline consists in much more than fragile and shifting relationships but, most importantly, also involves certain styles in experiencing others. These styles, I suggest, may play an explanatory role for the borderline-typical patterns of interpersonal turmoil and so deserve more attention. To better describe and understand these styles, I explore the phenomenological structure of borderline affective instability and discuss the implications it might have for how a person experiences and relates to other people. Considering core aspects of borderline affective instability, such as alexithymia, emotional contagion, emotion dysregulation, and chronic emptiness, I propose borderline can be interpreted as a disturbance of interaffective exchange, which gives rise to certain ways of experiencing others that imply a social impairment.
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Affiliation(s)
- Philipp Schmidt
- Department of Philosophy, Technical University Darmstadt, Darmstadt, Germany
- Department of Philosophy, Julius Maximilian University of Würzburg, Würzburg, Germany
- Phenomenological Psychopathology and Psychotherapy, Psychiatric Clinic, Heidelberg University, Heidelberg, Germany
- *Correspondence: Philipp Schmidt,
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Plakolm Erlač S, Bucik V, Gregorič Kumperščak H. Explicit and Implicit Measures of Identity Diffusion in Adolescent Girls With Borderline Personality Disorder. Front Psychiatry 2021; 12:805390. [PMID: 35046857 PMCID: PMC8762200 DOI: 10.3389/fpsyt.2021.805390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/07/2021] [Indexed: 11/21/2022] Open
Abstract
The present study is the first to examine both the implicit and explicit self-concept of identity diffusion in a sample of adolescent patients with borderline personality disorder (BPD). A clinical sample of adolescent girls with diagnosed BPD (N = 30; M age = 15.9 years) and a sample of girls with a healthy personality development (N = 33; M age = 16.6 years) completed an implicit association test (IAT) that was adjusted to identity diffusion, the core of BPD. Common domains of child and adolescent psychopathology and core components of BPD were assessed using self-reports on the Strengths and Difficulties Questionnaire (SDQ), the Borderline Personality Features Scale for Children-11 (BPFSC-11) and the Assessment of Identity Development in Adolescence (AIDA). BPD patients scored significantly higher on explicit measures of borderline pathology than girls with a healthy personality development. A crucial finding for this study was that girls with BPD had a significantly lower implicit preference for stability than their counterparts in the control group. Moreover, explicit measures of borderline personality pathology were significantly correlated with an implicit measure of identity diffusion, the core of BPD. However, when looking at the predictive ability of implicit and explicit measures, only explicit identity diffusion was significantly associated with borderline features. Our data suggests that adolescent girls with BPD differ from healthy individuals not only in their conscious representation but also in their implicit representation of the self with regard to BPD related characteristics, which further advances the need for the identification of at-risk adolescents.
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Affiliation(s)
- Sara Plakolm Erlač
- Child and Adolescent Psychiatry Unit, Pediatrics Clinic, University Medical Centre Maribor, Maribor, Slovenia.,Department of Psychology, University of Ljubljana, Ljubljana, Slovenia
| | - Valentin Bucik
- Department of Psychology, University of Ljubljana, Ljubljana, Slovenia
| | - Hojka Gregorič Kumperščak
- Child and Adolescent Psychiatry Unit, Pediatrics Clinic, University Medical Centre Maribor, Maribor, Slovenia
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Rivnyák A, Pohárnok M, Péley B, Láng A. Identity Diffusion as the Organizing Principle of Borderline Personality Traits in Adolescents-A Non-clinical Study. Front Psychiatry 2021; 12:683288. [PMID: 34295274 PMCID: PMC8289896 DOI: 10.3389/fpsyt.2021.683288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
Growing evidence shows that diagnosing and treating borderline personality disorder (BPD) is of high relevance for affected youths. Although identity crisis is part of the normative developmental process, identity diffusion is a potential candidate for being an appropriate concept in further developing screening tools and interventions for BPD treatment in adolescence. We hypothesized that severity of borderline traits (as indicated by the strength of their associations with identity diffusion) would be negatively associated with non-clinical adolescents' endorsement of borderline features' presence. We also hypothesized that identity diffusion had a central role in the network of borderline personality traits and could be conceived of as a latent organizing principle of borderline personality disorder. In our study, 169 non-clinical adolescents (81 girls and 88 boys; M age = 15.38; SDage = 1.52) filled out self-report measures of borderline personality features and identity diffusion. According to our results, having strong feelings and interpersonal sensitivity were the two most endorsed borderline personality features. Borderline personality features were positively correlated with identity diffusion. The more severe a borderline personality feature was, the less relevant it was for non-clinical adolescents. According to a network analysis, identity diffusion was the most central and least redundant element of the network of borderline personality traits. Results are discussed from a clinical point of view, further encouraging professionals to use identity diffusion screening tools to detect BPD in adolescence.
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Affiliation(s)
- Adrienn Rivnyák
- Faculty of Humanities and Social Sciences, Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Melinda Pohárnok
- Faculty of Humanities and Social Sciences, Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Bernadette Péley
- Faculty of Humanities and Social Sciences, Institute of Psychology, University of Pécs, Pécs, Hungary
| | - András Láng
- Faculty of Humanities and Social Sciences, Institute of Psychology, University of Pécs, Pécs, Hungary
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