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Gao S, Assink M, Bi C, Chan KL. Child Maltreatment as a Risk Factor for Rejection Sensitivity: A Three-Level Meta-Analytic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:680-690. [PMID: 37036152 DOI: 10.1177/15248380231162979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Theoretical and empirical evidence has suggested that child maltreatment victimization is associated with rejection sensitivity. However, empirical evidence on this association is inconsistent. Therefore, this meta-analysis aimed to examine the overall association between child maltreatment and rejection sensitivity, and to investigate variables that may affect the strength of this association. Studies eligible for inclusion were searched in the databases: Web of Science, Science Direct, PubMed, MEDLINE, and China National Knowledge Infrastructure after which relevant studies were coded. Studies were synthesized in advanced three-level meta-analytic models in R. A total of 16 studies (N = 5,335 participants) yielding 41 effect sizes were included. Results showed that child maltreatment is significantly and positively related to rejection sensitivity (mean r = 0.230; p < .001), and to a small extent. Furthermore, this association is stronger for emotional abuse (r = 0.275) than for physical abuse (r = 0.157). It is not affected by the mean age and gender distribution of primary study samples nor by sample type (community sample versus clinical sample). It is concluded that child maltreatment is a risk factor for developing rejection sensitivity later in life. Therefore, interventions for rejection sensitivity should consider potential trauma resulting from prior child maltreatment experiences.
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Affiliation(s)
| | - Mark Assink
- University of Amsterdam, Amsterdam, The Netherlands
| | | | - Ko Ling Chan
- The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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2
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Yuan Y, Lee H, Eack SM, Newhill CE. A Systematic Review of the Association Between Early Childhood Trauma and Borderline Personality Disorder. J Pers Disord 2023; 37:16-35. [PMID: 36723424 DOI: 10.1521/pedi.2023.37.1.16] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Borderline personality disorder (BPD) is a debilitating clinical disorder associated with adverse impacts on multiple levels. While a high prevalence of childhood trauma has been noted, the ways such trauma impacts the development of BPD symptomatology remain unclear. In this systematic review, the authors examine the literature from 2000 to 2020, focusing on the association between trauma and BPD, and offer a comprehensive synthesis of possible etiological implications related to either one specific or multiple trauma types. In addition, results are analyzed based on commonly tested trauma parameters, including repeated exposure, polytrauma, onset, perpetrators, and gender. The authors also note some limitations in areas of sampling, measurement, causal inference methods, and data analyses. Results of this review point to several parameters of trauma that can be used to inform training for practitioners as well as enhance current interventions.
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Affiliation(s)
- Yan Yuan
- School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Hyunji Lee
- School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Shaun M Eack
- University of Pittsburgh, Pittsburgh, Pennsylvania
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3
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Noda S, Masaki M, Kishimoto T, Kaiya H. Effect of rejection sensitivity on the development of anxious-depressive attack in Japanese outpatients: The mediating roles of rumination, social anxiety, and depressive symptoms. Front Psychol 2022; 13:1016879. [PMID: 36532964 PMCID: PMC9749812 DOI: 10.3389/fpsyg.2022.1016879] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/01/2022] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE Anxious-depressive attack (ADA) is a cluster of symptoms, including sudden and intense anxiety or depression, intrusive rumination about negative memories or future worries, prominent agitation, impatient behavior, and/or loneliness; in some cases, symptoms include a wide range of violent coping behaviors to manage emotional distress. Four characteristics-rejection sensitivity, rumination, social anxiety symptoms, and depressive symptoms-are thought to be associated with the development of ADA. However, the complex relationships among these factors have not been clarified. In this study, we aimed to examine the mechanism by which these four characteristics influence the development of ADA. METHODS We conducted a structured interview about ADA with 332 outpatients, who completed several self-report measures, to assess rejection sensitivity, rumination, social anxiety symptoms, and depressive symptoms. RESULTS A structural equation model showed goodness-of-fit with the data. These findings suggest that rejection sensitivity may demonstrate a direct effect on the occurrence of ADA. Furthermore, rejection sensitivity might affect depressive symptoms through rumination and social anxiety symptoms and consequently contribute to the development of ADA. CONCLUSION These results provide preliminary evidence that rejection sensitivity contributes to the development of ADA.
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Affiliation(s)
- Shota Noda
- Panic Disorder Research Center, Warakukai Medical Corporation, Tokyo, Japan
- Tokyo Mindfulness Center, Tokyo, Japan
| | - Mina Masaki
- Nagoya Mental Clinic, Warakukai Medical Corporation, Aichi, Japan
| | | | - Hisanobu Kaiya
- Panic Disorder Research Center, Warakukai Medical Corporation, Tokyo, Japan
- Tokyo Mindfulness Center, Tokyo, Japan
- Nagoya Mental Clinic, Warakukai Medical Corporation, Aichi, Japan
- Department of Psychiatry, Kyoto Prefectural University of Medicine, Kyoto, Japan
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4
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Stone BM. The Pathogenesis of Borderline Personality Disorder: Evolution of Evidence and Treatment Implications for Two Prominent Models. Psychol Rep 2022:332941221127618. [PMID: 36112891 DOI: 10.1177/00332941221127618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Since Stern first started his work in 1938, the field has recognized several empirically supported models of the etiology of borderline personality disorder (BPD). Two such models are the Tripartite Model of the Development of BPD and the Biosocial Development Model of BPD. The Tripartite Model of the Development of BPD suggests that it is a combination of a hyperbolic temperament, traumatic childhood experiences, and an event or series of events that trigger the onset of BPD. Whereas the Biosocial Development Model of BPD elaborates on the work of Linehan's Biosocial Theory. This model suggests a combination of an emotionally vulnerable temperament and an invalidating environment cause BPD. Over 70 years of research support these models. This article covers a detailed description of each of these models, the decades of research supporting these models, similarities, differences, treatment implications, the latest research, and future directions.
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Fitzpatrick S, Liebman RE, Monson CM. The borderline interpersonal-affective systems (BIAS) model: Extending understanding of the interpersonal context of borderline personality disorder. Clin Psychol Rev 2021; 84:101983. [PMID: 33517245 DOI: 10.1016/j.cpr.2021.101983] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 12/16/2020] [Accepted: 01/19/2021] [Indexed: 01/10/2023]
Abstract
Prominent explanatory models for borderline personality disorder (BPD) are intrapersonal in nature and hold that it is an emotional disorder. However, the empirical support for emotional models of BPD is mixed. Refinements to BPD explanatory models are needed to increase the precision with which BPD can be understood and treated. Drawing on existing theoretical and empirical research in BPD, this manuscript presents the Borderline Interpersonal-Affective Systems (BIAS) model. The BIAS model purports that harmful early life relationships and subsequent conflictual relationships lead individuals with BPD to develop a sensitivity to interpersonal threat in the form of attentional and appraisal biases. Individuals with BPD are posited to 1) experience heightened emotional reactivity specifically to perceived interpersonal threat and 2) engage in destructive behaviors both to regulate increasing emotion and to meet interpersonal needs. We review the empirical support for each component of the BIAS model, along with the role of the cognitions, emotions, and behaviors of significant others in influencing BIAS model processes in individuals with BPD over time. The BIAS model highlights a novel way of understanding and integrating interpersonal and emotional components of the disorder. Key directives for future research and clinical implications are discussed.
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Affiliation(s)
- Skye Fitzpatrick
- Department of Psychology, York University, Behavioural Science Building, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
| | - Rachel E Liebman
- Department of Psychology, York University, Behavioural Science Building, 4700 Keele Street, Toronto, ON M3J 1P3, Canada; Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
| | - Candice M Monson
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
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6
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Porter C, Palmier-Claus J, Branitsky A, Mansell W, Warwick H, Varese F. Childhood adversity and borderline personality disorder: a meta-analysis. Acta Psychiatr Scand 2020; 141:6-20. [PMID: 31630389 DOI: 10.1111/acps.13118] [Citation(s) in RCA: 167] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/15/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this meta-analysis was to better understand the magnitude and consistency of the association between childhood adversity and borderline personality disorder (BPD) across case-control, epidemiological and prospective cohort studies. METHOD Following the review protocol (reference: CRD42017075179), search terms pertaining to adversity and BPD were entered into three search engines. Random-effects meta-analysis synthesised the size and consistency of the effects. RESULTS A total of 97 studies compared BPD to non-clinical (k = 40) and clinical (k = 70) controls. Meta-analysis of case-control studies indicated that individuals with BPD are 13.91 (95% CI 11.11-17.43) times more likely to report childhood adversity than non-clinical controls. This effect was smaller when considering retrospective cohort (OR: 2.59; 95% CI 0.93-7.30) and epidemiological (OR: 2.56, 95% CI 1.24-5.30) studies. Findings were significant across adversity subtypes with emotional abuse (OR: 38.11, 95% CI: 25.99-55.88) and neglect (OR: 17.73, 95% CI = 13.01-24.17) demonstrating the largest effects. Individuals with BPD were 3.15 (95% CI 2.62-3.79) times more likely to report childhood adversity than other psychiatric groups. CONCLUSIONS This meta-analysis corroborates theoretical proposals that exposure to adverse life experiences is associated with BPD. It highlights the importance of considering childhood adversity when treating people diagnosed with BPD.
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Affiliation(s)
- C Porter
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - J Palmier-Claus
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK.,Lancashire Care NHS Foundation Trust, Lancashire, UK
| | - A Branitsky
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - W Mansell
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - H Warwick
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - F Varese
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Abstract
PURPOSE OF REVIEW We review recent empirical investigations about two core processes subtending impairments in interpersonal functioning and, more precisely, cooperative behaviors in personality disorders: Trust toward others and rejection sensitivity. The main contributions are about borderline and narcissistic personality disorders but we report a little evidence about other personality disorders too (i.e., avoidant, antisocial, and paranoid personality disorders). RECENT FINDINGS Regarding borderline personality disorder, a misinterpretation of situations as threatening seems to be relevant for both trust and rejection sensitivity. With specific regard to narcissistic personality disorder, results suggest rejection sensitivity and distrust to be plausible risk factors for aggressive outbursts. Empirical findings display specific patterns of disturbances in rejection sensitivity and trust dynamics across different personality disorders. Nonetheless, further studies on personality disorders other than borderline or narcissistic personality disorder are needed. A deeper understanding may provide insight for better clinical management of such impairments among patients with personality disorders.
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8
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Foxhall M, Hamilton-Giachritsis C, Button K. The link between rejection sensitivity and borderline personality disorder: A systematic review and meta-analysis. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2019; 58:289-326. [PMID: 30900278 DOI: 10.1111/bjc.12216] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 12/06/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE People with Borderline Personality Disorder (BPD) may experience heightened rejection sensitivity (RS), a disposition developing from repeated childhood rejecting experiences. It is not known whether the full RS model accounts for the cognitive-affective experiences common in BPD. This systematic review extends upon previous reviews, firstly by assessing the link between childhood rejecting experiences and adult RS, and secondly by considering the link between BPD and RS in both non-clinical and clinical samples. METHOD Two research questions were devised, and searches based on predetermined criteria were conducted using PsycNET, PubMed, SCOPUS, and Web of Science. Data were extracted by one researcher and 20% was inter-rated, with high levels of agreement. Forty-three papers were systematically reviewed, and 31 included in meta-analysis and meta-regression. RESULTS Studies assessing the link between childhood rejection and RS are limited; however, emotional abuse and neglect appears linked with RS. Pooled effect sizes suggest RS is linked with BPD (r = .326), with strong effect sizes when comparing clinical and control samples (r = .655). Qualitative synthesis suggests this may be mediated by executive control, although further research is required. The small number of studies considering the full RS model with regard to BPD suggests the interaction between emotional abuse and neglect affects rejection sensitivity; however, outcomes are inconsistent. CONCLUSIONS Childhood rejection, particularly emotional abuse and neglect, appears to be linked to rejection sensitivity, and rejection sensitivity is linked to BPD. However, this may not be linear. Implications for clinical practice and research are discussed. PRACTITIONER POINTS Rejection sensitivity is consistently linked with BPD, in clinical and non-clinical samples. Supporting mentalization or improved theory of mind may offer a therapeutic target for this disposition. Considering the causes and effects of rejection sensitivity may offer a non-blaming explanation of interpersonal difficulties in BPD and could be utilized as part of formulation and the therapeutic relationship. However, the possible interaction between emotional abuse and neglect and rejection sensitivity suggests rejection sensitivity is not always apparent for people with BPD. Idiosyncratic formulation should consider this. The literature included in the review is limited to Western populations with a high proportion of females, which may limit generalizability. Measures of rejection sensitivity included in the review were restricted to self-report, which may be subject to bias. Furthermore, measures of childhood rejection were retrospective in nature due to the exclusion of child samples. Further research should consider longitudinal and observational study designs.
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Affiliation(s)
- Mia Foxhall
- Department of Psychology, University of Bath, UK
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9
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Abstract
The Borderline personality disorder (BPD) diagnosis has its origins in the concept of borderline personality organization (BPO). BPO is rooted in psychoanalytic object relations theory (ORT) which conceptualizes BPD and BPO to exhibit a propensity to view significant others as either idealized or persecutory (splitting) and a trait-like paranoid view of interpersonal relations. From the ORT model, those with BPD think that they will ultimately be betrayed, abandoned, or neglected by significant others, despite periodic idealizations. This article synthesizes the extant literature splitting and trust impairments in BPD, identifies avenues for further investigation, and discusses the relative promise of different methods to evaluate these clinical processes.
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10
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A systematic review of negative parenting practices predicting borderline personality disorder: Are we measuring biosocial theory's ‘invalidating environment’? Clin Psychol Rev 2018; 65:1-16. [DOI: 10.1016/j.cpr.2018.06.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 01/16/2018] [Accepted: 06/06/2018] [Indexed: 11/19/2022]
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11
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Lyons M, Aksayli ND, Brewer G. Mental distress and language use: Linguistic analysis of discussion forum posts. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2018.05.035] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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12
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Gao S, Assink M, Cipriani A, Lin K. Associations between rejection sensitivity and mental health outcomes: A meta-analytic review. Clin Psychol Rev 2017; 57:59-74. [DOI: 10.1016/j.cpr.2017.08.007] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 08/12/2017] [Accepted: 08/14/2017] [Indexed: 11/25/2022]
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13
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Cirasola A, Hillman S, Fonagy P, Chiesa M. Mapping the road from childhood adversity to personality disorder: The role of unresolved states of mind. Personal Ment Health 2017; 11:77-90. [PMID: 28101905 DOI: 10.1002/pmh.1365] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 12/01/2016] [Accepted: 12/12/2016] [Indexed: 11/10/2022]
Abstract
Childhood adversity has been found to be an important aetiological factor in the development of personality disorder (PD) in several studies. However, the role of disorganized attachment with unresolved mental states for traumatic experiences requires further investigation. This study explores the relationship between childhood adversities, unresolved states of mind, PD diagnosis and psychiatric distress. Two hundred forty-five adult participants, 124 from a clinical PD group and 121 non-psychiatric controls were assessed using the Structured Clinical Interview for DSM-IV, the Cassel Baseline Questionnaire, the Symptom Checklist-90-R and the Adult Attachment Interview, in order to ascertain presence of PD, childhood adversity, level of psychiatric distress and unresolved states of mind. Within the overall unresolved (U-overall) attachment category, a distinction was made between unresolved for abuse (U-abuse) and unresolved for loss (U-loss). The results indicated that childhood adversity was significantly associated with unresolved states of mind, as well as with overall PD diagnosis, paranoid PD, borderline PD, avoidant PD and psychiatric distress. Mediation analyses confirmed that U-overall and U-loss were significant mediators between childhood adversity and PD diagnoses, but surprisingly, U-abuse was not a significant mediator. The strength, limitations and clinical implications of the findings are discussed. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Antonella Cirasola
- Child Attachment and Psychological Therapies Research Unit, The Anna Freud Centre and University College London, London, UK
| | | | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Marco Chiesa
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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14
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Bujalski AS, Chesin MS, Jeglic EL. Cognitive Empathy Partially Mediates the Relationship between Childhood Physical Abuse and Borderline Personality Disorder Features in College Students. CURRENT PSYCHOLOGY 2017. [DOI: 10.1007/s12144-017-9597-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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De Panfilis C, Meehan KB, Cain NM, Clarkin JF. Effortful Control, Rejection Sensitivity, and Borderline Personality Disorder Features in Adulthood. J Pers Disord 2016; 30:595-612. [PMID: 26623540 DOI: 10.1521/pedi_2015_29_226] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This investigation examined the moderating role of effortful control (EC) in the association between rejection sensitivity (RS) and its subsequent interpersonal distress (IP-distress) on borderline personality disorder (BPD) features. In total, 625 multicultural undergraduates (Study 1) and 562 community international adults (Study 2) completed scales evaluating EC, RS, IP-distress, and BPD features; Study 2 participants also self-reported both anxious and angry expectations of rejection. In both samples, EC moderated the mediating effect of IP-distress in the link between RS and BPD-related psychopathology. The extent to which RS was associated with BPD symptoms through increased IP-distress was greater for individuals with low EC and less so for those with high EC. Thus, low self-regulatory abilities may foster the association between RS and BPD by magnifying interpersonal distress. The implications and limitations of findings are discussed.
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Affiliation(s)
- Chiara De Panfilis
- Department of Neuroscience, Unit of Psychiatry, University of Parma, Italy.,Personality Disorders Lab, Parma, Italy
| | - Kevin B Meehan
- Department of Psychology, PhD Program in Clinical Psychology, Long Island University Brooklyn Campus, Brooklyn, New York, USA.,Department of Psychiatry, Weill Medical College of Cornell University, White Plains, New York, USA
| | - Nicole M Cain
- Department of Psychology, PhD Program in Clinical Psychology, Long Island University Brooklyn Campus, Brooklyn, New York, USA
| | - John F Clarkin
- Department of Psychiatry, Weill Medical College of Cornell University, White Plains, New York, USA
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Fertuck EA, Tsoi F, Grinband J, Ruglass L, Melara R, Hien DA. Facial trustworthiness perception bias elevated in individuals with PTSD compared to trauma exposed controls. Psychiatry Res 2016; 237:43-8. [PMID: 26921050 DOI: 10.1016/j.psychres.2016.01.056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 10/28/2015] [Accepted: 01/26/2016] [Indexed: 11/17/2022]
Abstract
Posttraumatic stress disorder (PTSD) research has focused largely on fear processing. However, interpersonal trauma exposure can also impact interpersonal functioning and the perception of the trustworthiness of others. The present study examined facial perceptions of fearfulness and trustworthiness in individuals with PTSD (n=29), trauma-exposed without PTSD (n=19), and healthy controls (n=18). The PTSD group was hypothesized to exhibit a bias to perceive more fear and untrustworthiness in faces relative to controls. Participants rated the level of fearfulness or trustworthiness of faces that were parametrically morphed along a fear or trustworthiness dimension. The PTSD group was biased to perceive faces as more trustworthy compared to the trauma-exposed healthy controls, yet there were no differences between groups in fear processing. A trustworthiness bias in PTSD may represent a vulnerability factor. Conversely, lower trustworthiness perception may represent a protective disposition in trauma-exposed individuals who do not develop PTSD. Differences in the perception of trustworthiness may be an aspect of social perception that is independent of the fear processing abnormalities observed in PTSD.
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Affiliation(s)
- Eric A Fertuck
- City University of New York - City College, Department of Psychology, 160 Convent Avenue, NAC Bldg 7/120, New York, NY 10031, USA; New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| | - Fai Tsoi
- City University of New York - City College, Department of Psychology, 160 Convent Avenue, NAC Bldg 7/120, New York, NY 10031, USA
| | - Jack Grinband
- Columbia University Medical Center, Department of Neurology, 630 West 168th Street, New York, NY 10032, USA
| | - Lesia Ruglass
- City University of New York - City College, Department of Psychology, 160 Convent Avenue, NAC Bldg 7/120, New York, NY 10031, USA
| | - Robert Melara
- City University of New York - City College, Department of Psychology, 160 Convent Avenue, NAC Bldg 7/120, New York, NY 10031, USA
| | - Denise A Hien
- City University of New York - City College, Department of Psychology, 160 Convent Avenue, NAC Bldg 7/120, New York, NY 10031, USA; New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA.
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17
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Fertuck EA, Karan E, Stanley B. The specificity of mental pain in borderline personality disorder compared to depressive disorders and healthy controls. Borderline Personal Disord Emot Dysregul 2016; 3:2. [PMID: 26918191 PMCID: PMC4766740 DOI: 10.1186/s40479-016-0036-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/10/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Individuals with Borderline Personality Disorder (BPD) may experience a qualitatively distinct depression which includes "mental pain." Mental pain includes chronic, aversive emotions, negative self-concept, and a sense of pervasive helplessness. The present study investigated whether mental pain is elevated in BPD compared to Depressive Disorders (DD) without BPD. METHODS The Orbach and Mikulincer Mental Pain Scale (OMMP) was administered to BPD (N = 57), DD (N = 22), and healthy controls (N = 31). The OMMP assesses total mental pain, comprised of nine subtypes: irreversibility, loss of control, narcissistic wounds, emotional flooding, freezing, self-estrangement, confusion, social distancing, and emptiness. Co-occurring psychiatric diagnoses, depression severity, and other potentially confounding clinical and demographic variables were also assessed. RESULTS The total Mental Pain score did not differentiate BPD from DD. Moreover, most of the subscales of the OMMP were not significantly different in BPD compared to DD. However, the elevation of mental pain subscale "narcissistic wounds," characterized by feeling rejected and having low self-worth, was a specific predictor of BPD status and the severity of BPD symptoms. CONCLUSION On OMMP total score, mental pain was similarly elevated in BPD and DD. However, the narcissistic wounds sub-type of mental pain was a sensitive and specific diagnostic indicator of BPD and, therefore, may be an important aspect of BPD in need of increased focus in assessment and theoretical models.
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Affiliation(s)
- Eric A. Fertuck
- />Department of Psychology, Clinical Psychology Doctoral Program, The City College of the City University of New York, New York, USA
- />New York State Psychiatric Institute, New York, NY USA
| | - Esen Karan
- />Department of Psychology, Clinical Psychology Doctoral Program, The City College of the City University of New York, New York, USA
| | - Barbara Stanley
- />Department of Psychiatry, Columbia University, New York, USA
- />New York State Psychiatric Institute, New York, NY USA
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18
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Goodman J, Fertuck E, Chesin M, Lichenstein S, Stanley B. The moderating role of rejection sensitivity in the relationship between emotional maltreatment and borderline symptoms. PERSONALITY AND INDIVIDUAL DIFFERENCES 2014; 71:146-150. [DOI: 10.1016/j.paid.2014.07.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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