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Bogaerts A, Claes L, Raymaekers K, Buelens T, Bastiaens T, Luyckx K. Trajectories of adaptive and disturbed identity dimensions in adolescence: developmental associations with self-esteem, resilience, symptoms of depression, and borderline personality disorder features. Front Psychiatry 2023; 14:1125812. [PMID: 37168080 PMCID: PMC10165116 DOI: 10.3389/fpsyt.2023.1125812] [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: 12/16/2022] [Accepted: 04/06/2023] [Indexed: 05/13/2023] Open
Abstract
To advance our understanding of adolescents' identity formation and how it may play into their psychological functioning, this study investigated developmental trajectory classes of adaptive and disturbed dimensions of identity formation, and whether adolescents belonging to different trajectory classes develop differently on self-esteem, resilience, symptoms of depression, and borderline personality disorder (BPD) features. Three-wave longitudinal data from 2,123 Flemish adolescents was used (54.2% girls; Mage = 14.64, range = 12-18 at T1). Results pointed to four trajectory classes of identity formation: adaptive identity, identity progression, identity regression, and diffused identity. The adaptive identity class presented with stable high levels of self-esteem and resilience, and stable low levels of symptoms of depression and BPD, whereas opposite results were obtained for the diffused identity class. The identity progression class reported an increase in self-esteem and resilience as well as a decrease in symptoms of depression and BPD, whereas opposite results were obtained for the identity regression class. These results emphasize that adaptive and disturbed dimensions of identity formation are closely related to markers of well-being and psychopathology among adolescents, and could help identify adolescents with an increased risk for negative psychological functioning or increased opportunity for positive psychological functioning.
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Affiliation(s)
- Annabel Bogaerts
- Department of Clinical Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
- *Correspondence: Annabel Bogaerts,
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences, University Antwerp, Antwerp, Belgium
| | - Koen Raymaekers
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Fonds Wetenschappelijk Onderzoek, Brussels, Belgium
| | - Tinne Buelens
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Tim Bastiaens
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Centre, KU Leuven, Kortenberg, Belgium
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- UNIBS, University of the Free State, Bloemfontein, South Africa
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Aleva A, Laceulle OM, Denissen JJA, Hessels CJ, van Aken MAG. Adolescence as a peak period of borderline personality features? A meta-analytic approach. EUROPEAN JOURNAL OF PERSONALITY 2022. [DOI: 10.1177/08902070221134652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This meta-analysis of cross-sectional data aimed to shed light on the often assumed peak in mean-level of borderline personality features during middle to late adolescence (i.e. age 17–22). Borderline personality features were operationalized through the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Search terms were entered into PsycINFO and Scopus. A total of 168 samples were included in the analyses, comprising 25,053 participants. Mean age ranged from 14.35 to 51.47 years ( M = 29.01, SD = 8.52) and mean number of borderline personality features from 0 to 8.10 ( M = 4.59, SD = 2.34). The hypothesized peak between age 17 and 22 was not substantiated by the confirmatory ANOVA analysis. However, subsequent exploratory GAM analysis provided evidence for a peak at 29.4 years. Caution is needed in interpreting these findings given that different trends appeared when GAM models were constructed separately for community, patient and borderline personality disorder (BPD) samples. Age differences in community samples indicated a significant linear decline in mean-level of borderline personality features over time. A linear rising trend was found in BPD samples. As a between-person mean-level approach was used in the current study, future longitudinal studies are needed to substantiate if between-person age difference generalize to within-person changes.
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Affiliation(s)
- Anouk Aleva
- HYPE Centre of Expertise on Early Intervention for Borderline Personality Disorder, GGz Centraal, The Netherlands
- Department of Developmental Psychology, Utrecht University, The Netherlands
| | - Odilia M Laceulle
- HYPE Centre of Expertise on Early Intervention for Borderline Personality Disorder, GGz Centraal, The Netherlands
- Department of Developmental Psychology, Utrecht University, The Netherlands
| | - Jaap JA Denissen
- Department of Developmental Psychology, Utrecht University, The Netherlands
| | - Christel J Hessels
- HYPE Centre of Expertise on Early Intervention for Borderline Personality Disorder, GGz Centraal, The Netherlands
| | - Marcel AG van Aken
- Department of Developmental Psychology, Utrecht University, The Netherlands
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Carreiras D, Cunha M, Castilho P. Which self-compassion components mediate the relationship between adverse experiences in childhood and borderline features in adolescents? EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2021. [DOI: 10.1080/17405629.2021.1981283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Diogo Carreiras
- University of Coimbra, Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Marina Cunha
- University of Coimbra, Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
- Miguel Torga Institute of Higher Education, Coimbra, Portugal
| | - Paula Castilho
- University of Coimbra, Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
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Johnson BN, Vanwoerden S. Future directions in personality pathology development research from a trainee perspective: Suggestions for theory, methodology, and practice. Curr Opin Psychol 2021; 37:66-71. [PMID: 32891979 PMCID: PMC7895861 DOI: 10.1016/j.copsyc.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/02/2020] [Accepted: 08/09/2020] [Indexed: 11/28/2022]
Abstract
Research on personality disorder (PD) development has received increased attention in the last two decades, spurring reconceptualization in theoretical models of etiology, use of advanced methods, and development of effective treatments. The current manuscript briefly reviews the state of the field and proposes avenues of new research on the development of personality pathology in theoretical, methodological, and clinical veins. We identify the need to adopt a unifying and comprehensive theory to describe PD development across the lifespan, novel statistical methods to complement traditional methods relied on thus far, and the adoption of developmentally sensitive interventions that are disseminated to professionals and trainees alike. These directions for future research aim to augment prevention efforts to reduce the burden of PDs earlier in life.
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Affiliation(s)
- Benjamin N Johnson
- The Pennsylvania State University, Mount Sinai Beth Israel, United States
| | - Salome Vanwoerden
- University of Pittsburgh Medical Center, Western Psychiatric Hospital, United States
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The Course of Borderline Psychopathology in Adolescents with Complex Mental Health Problems: An 18 Month Longitudinal Follow-up Study. Res Child Adolesc Psychopathol 2021; 49:545-557. [PMID: 33439418 DOI: 10.1007/s10802-020-00756-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2020] [Indexed: 10/22/2022]
Abstract
A persistent and significant barrier to the diagnosis and treatment of borderline personality disorder (BPD) in adolescents is clinician reluctance to label an adolescent with a stigmatized, intractable, treatment-resistant diagnosis. The goal of the current study was to evaluate this claim by examining the 18-month longitudinal course of borderline pathology in adolescents after discharge from inpatient treatment. 556 adolescent consecutive admissions (64.6% female; ages 12-17, M = 15.29, SD = 1.46) were assessed during admission to an inpatient treatment facility. They were followed up at discharge, 6 months, 12 months and 18 months after discharge with validated self-and parent report measures of adolescent BPD features. Latent growth modeling was used to evaluate outcomes. BPD features showed a significant decline over the follow-up period with very large effect sizes (> .80) for both parent and adolescent self-report. Rates of change were steeper for adolescent report although adolescent report fell below clinical cut-off 6 months later than parent-report. However, when internalizing and externalizing psychopathology were included in latent growth models, youth-reported BPD features did not show the same level of decline, while parent-reported BPD features maintained the same level of decline. The rate of decline between parents and adolescents was correlated, and baseline levels of BPD features were predictive of rate of change. This is the first study to show that adolescent borderline pathology follows a similar course after discharge from inpatient treatment previously demonstrated for adults. Like adult BPD, adolescent BPD appears to be not as intractable and treatment resistant as previously thought, mitigating against therapeutic nihilism.
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Hutsebaut J, Debbané M, Sharp C. Designing a range of mentalizing interventions for young people using a clinical staging approach to borderline pathology. Borderline Personal Disord Emot Dysregul 2020; 7:6. [PMID: 32190330 PMCID: PMC7068993 DOI: 10.1186/s40479-020-0121-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 02/11/2020] [Indexed: 12/21/2022] Open
Abstract
Borderline personality disorder (BPD) can have a long-lasting impact on social and professional functioning, even when core symptoms of BPD are in remission. Adolescence may be a critical developmental period to change the potential long-term functional outcome of BPD. This paper presents a range of mentalizing interventions to alter the course and outcome of BPD, based upon a model of clinical staging. Mentalizing interventions have in common a focus on strengthening self-regulatory and interpersonal capacities, aiming to improve adaptive social learning. This paper argues that these interventions should be dosed and organized according to the stage of progression of BPD, which is illustrated by discussing different specific formats for mentalization-based interventions, including an early-intervention program for BPD and a standard program for full BPD.
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Affiliation(s)
- Joost Hutsebaut
- Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands
- Centre of Expertise on Personality Disorders, Utrecht, the Netherlands
| | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, Texas USA
- University of the Free State, Bloemfontein, South Africa
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Stewart JG, Singleton P, Benau EM, Foti D, Allchurch H, Kaplan CS, Aguirre B, Auerbach RP. Neurophysiological activity following rewards and losses among female adolescents and young adults with borderline personality disorder. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 128:610-621. [PMID: 31318241 DOI: 10.1037/abn0000439] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Borderline personality disorder (BPD) is a complex and debilitating psychiatric illness. Prior research in adults has shown that neurophysiological deficits in feedback processing and learning from rewards may be central to the development of BPD; however, little research has examined these markers in adolescents and young adults with BPD. The present study used event-related potentials and time-frequency decomposition analysis to probe neural responses to wins and losses in a guessing task among 68 females (13 to 23 years old) either with BPD (n = 35) or no history of mental disorders (healthy control [HC]; n = 33). Participants completed a guessing task wherein they won and lost money at equal frequencies while electroencephalogram (EEG) data were acquired. Adolescents and young adults with BPD showed a smaller differentiation between wins and losses in the reward positivity (RewP) relative to HCs. Using time-frequency decomposition, we isolated distinct frequency bands sensitive to wins (delta = < 3Hz) and losses (theta = 4 Hz to 7 Hz). Compared with BPD participants, HCs showed significantly larger delta power to wins, specifically. The groups did not differ in delta power to losses, nor theta power to wins or losses. Collectively, findings implicate altered reward processing in the pathophysiology of BPD and may inform early identification and targeted intervention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Dan Foti
- Department of Psychological Sciences
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