Identity disturbance in adolescence: Associations with borderline personality disorder

2011 ◽  
Vol 23 (1) ◽  
pp. 305-313 ◽  
Author(s):  
Drew Westen ◽  
Ephi Betan ◽  
Jared A. DeFife
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Clinical Sample ◽  
Borderline Personality ◽  
Personality Pathology ◽  
Developmental Task ◽  
Identity Disturbance ◽  
Adult Personality ◽  
Sturm Und Drang ◽  
Wide Range

AbstractAlthough establishing a coherent identity is often viewed as a normative developmental task of adolescence, an important question is whether forms of identity disturbance seen in adult personality disorders can also be distinguished in adolescents. If so, such disturbances would constitute an essential target for research and clinical interventions. The goal of this study is to investigate the nature of identity disturbance in an adolescent clinical sample and to explore its links with personality pathology, particularly borderline personality disorder. A national random sample of 139 psychiatrists and clinical psychologists completed a battery of instruments on a randomly selected adolescent patient in their care, including measures of Axis II symptoms and the Identity Disturbance Questionnaire—Adolescent Version, an instrument designed for clinically experienced observers that assesses a wide range of manifestations of potential identity disturbance among adolescents. Factor analysis of the Identity Disturbance Questionnaire—Adolescent Version yielded four clinically and conceptually coherent factors that resembled dimensions previously identified in adults: lack of normative commitment, role absorption, painful incoherence, and lack of consistency. As in adults, identity disturbance in adolescents is a clinically meaningful, multidimensional construct exhibiting significant relationships with different forms of severe personality pathology, most notably borderline personality disorder. As such, identity disturbance can be a manifestation of psychopathology above and beyond the typical Sturm und Drang (storm and stress) of adolescence.

Borderline personality disorder: does its clinical features show specificity to differing developmental risk factors?

2018 ◽  
Vol 26 (4) ◽  
pp. 410-413 ◽  
Author(s):  
Gordon Parker ◽  
Stacey McCraw ◽  
Adam Bayes
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Clinical Sample ◽  
Diagnostic Interview ◽  
Borderline Personality ◽  
Self Report ◽  
Therapeutic Interventions ◽  
Identity Disturbance ◽  
Developmental Factors ◽  
Dsm Iv

Objectives: To determine if differing developmental factors show specificity to differing manifestations of borderline personality disorder (BPD). Methods: A clinical sample of 73 females diagnosed with BPD undertook a psychiatrist interview and completed self-report questionnaires, including the semi-structured Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV) assessing for BPD status. A set of negative and potentially traumatic developmental factors were included in the assessment. Results: Childhood sexual abuse, affirmed by 49% of the sample, showed specificity in being linked with DIPD-defined affective instability. DIPD-defined identity disturbance also showed specificity in being associated only with reporting significant non-sexual developmental trauma. DIPD-defined anger and paranoia/dissociation showed minimal specificity and were associated with most antecedent developmental factors in adulthood. Conclusions: Differing manifestations of BPD are likely to be shaped by specific and non-specific developmental events. Clarification of such links has the potential to shape more specific therapeutic interventions.

Positive Emotion in Borderline Personality Disorder

2019 ◽  
pp. 332-352
Author(s):  
Jill M. Hooley ◽  
Sara R. Masland
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Positive Emotions ◽  
Negative Emotions ◽  
Negative Mood ◽  
Severe Form ◽  
Borderline Personality ◽  
Negative Emotionality ◽  
Personality Pathology ◽  
Emotional Experiences

Borderline personality disorder (BPD) is a severe form of personality pathology characterized by high levels of negative emotionality. Because negative emotions are so central to the clinical presentation of BPD, the issue of how people with this disorder process and experience positive emotional experiences is relatively unexplored. This chapter provides an overview of what is currently known about positive emotions and BPD. Although the literature is characterized by many inconsistencies, our review suggests that people with BPD do indeed experience positive emotions. However, their recall of positive emotional experiences appears to be reduced, perhaps because such experiences are more transient, less stable, and more likely to be quickly replaced by negative emotions. Problems with the identification and accurate differentiation of positive emotions may also play a role. Such difficulties may conspire to create a psychological world for people with BPD that is characterized by a focus on negative mood and negative emotional experiences. In addition to focusing on negative affect, we suggest that it might also be clinically beneficial to make problems with positive affect a specific clinical target.

Meaningful Ways of Understanding and Measuring Change for People with Borderline Personality Disorder: A Thematic Analysis

2018 ◽  
Vol 46 (5) ◽  
pp. 528-540 ◽  
Author(s):  
Louise McCusker ◽  
Marie-Louise Turner ◽  
Georgina Pike ◽  
Helen Startup
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Borderline Personality ◽  
Complex Nature ◽  
Service Users ◽  
Starting Point ◽  
Wide Range ◽  
Measuring Change

Background:The effective treatment of Borderline Personality Disorder (BPD) presents healthcare providers with a significant challenge. The evidence base remains limited partially due to a lack of professional consensus and service user involvement regarding ways of measuring change. As a result, the limited evidence that is available draws on such a wide range of outcome measures, that comparison across treatment types is hindered, maintaining a lack of clarity regarding the clinical needs of this group.Aims:This investigation aimed to follow the National Institute of Clinical Excellence (NICE, 2009) research recommendations by asking service users about meaningful change within their recovery. This forms a starting point for the future development of a tailored outcome measure.Method:Fifteen service users with a diagnosis of BPD participated in three focus groups across two specialist Personality Disorder services. The focus groups were analysed using Thematic Analysis.Results:Two superordinate themes were synthesized from the data: (1) recovery to what?: ‘How do you rewrite who you are?’; and (2) conditions for change. Each superordinate theme further consisted of three subordinate themes which elucidated the over-arching themes.Conclusion:This investigation highlights the complex nature of measuring change in people who have received a BPD diagnosis. Further research is needed to develop meaningful ways of measuring change according to the needs and priorities of people with BPD.

scholarly journals Autobiographical memories, identity disturbance and brain functioning in patients with borderline personality disorder: An fMRI study

Heliyon ◽  
2019 ◽  
Vol 5 (3) ◽  
pp. e01323 ◽  
Author(s):  
Paola Bozzatello ◽  
Rosalba Morese ◽  
Maria Consuelo Valentini ◽  
Paola Rocca ◽  
Francesca Bosco ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Autobiographical Memories ◽  
Brain Functioning ◽  
Identity Disturbance ◽  
Fmri Study

Cognitive analytic therapy: A bibliometric review

2016 ◽  
Vol 33 (S1) ◽  
pp. s233-s233
Author(s):  
E. Gimeno ◽  
C. Chiclana
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Theoretical Concepts ◽  
Wide Range ◽  
Bibliometric Review ◽  
Analytic Therapy ◽  
Competing Interest ◽  
Cognitive Analytic Therapy

IntroductionCognitive Analytic Therapy (CAT) has emerged as an integrative new approach with promising results in the treatment of personality-disordered patients, particularly in borderline personality disorder. Although this approach has already demonstrated its effectiveness in adults, increasingly studies try to validate it in young population, which has meant a turning point in research.Aim and objectivesThe goal of this study is to know the whole production about CAT in a double way:–articles that describes the main theoretical concepts underlying CAT theory;–articles with evidence supporting its effectiveness in different mental disorders.MethodsA bibliometric review of 397 scientific articles extracted from research databases including Dialnet, EBSCO, PUBMED, Unika and Scholar Google was conducted.ResultsThe results indicate an exponential growth in published studies on CAT, from first publications in the late 1960s, particularly strong in the last two decades and reaching its peak in 2008. Total research includes 247 literature reviews, 109 clinical studies, 47 case studies, 17 letters and comments from authors, 4 studies on diagnostic tests and 1 meta-analysis. Most research has focused on borderline personality disorder or other personality disorders (35% and 12% respectively) and eating disorders (11%). Studies have been conducted with adults (49%) the same as children and adolescents (46%) whereas only the 4% has been developed for elderly population.ConclusionsCognitive analytic therapy represents a well-documented psychotherapy with a proven efficacy in a wide range of clinical contexts.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Borderline personality disorder: stress reactivity or stress generation? A prospective dimensional study

2020 ◽  
pp. 1-8
Author(s):  
Timothy A. Allen ◽  
Alexandre Y. Dombrovski ◽  
Paul H. Soloff ◽  
Michael N. Hallquist
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Negative Affect ◽  
Life Events ◽  
Stressful Life Events ◽  
Stress Reactivity ◽  
Clinical Sample ◽  
Borderline Personality ◽  
Stress Generation ◽  
Stressful Life

Abstract Background Individuals diagnosed with borderline personality disorder (BPD) often describe their lives as stressful and unpredictable. However, it is unclear whether the adversity faced by those with BPD is a product of stress reactivity or stress generation. Here, we examined the dynamic, prospective associations between BPD and stressful life events over 3 years. Given the heterogeneity present in BPD, we sought to understand which empirically derived dimensions of this heterogeneous disorder explain stress reactivity v. stress generation. Methods Participants included 355 individuals diagnosed with BPD and followed longitudinally at three annual assessments. Auto-regressive cross-lagged panel models were used to examine prospective associations between stressful life events and three latent dimensions implicated in BPD: negative affect, disinhibition, and antagonism. Results Antagonism and disinhibition, but not negative affect, prospectively predicted dependent stressful life events (events the individual may have some role in). Evidence for decompensation under stress was more tenuous, with independent stressful life events (those presumably outside the individual's control) predicting increases in negative affect. Conclusions Our longitudinal study of a well-characterized clinical sample found more evidence for stress generation than for stress-induced decompensation in BPD. Stress generation in BPD is driven by externalizing dimensions: antagonism and disinhibition. These results highlight the utility of empirically derived dimensions for parsing heterogeneity present in BPD, leading to improvements in diagnostic evaluation, clinical prediction, and individualized approaches to treatment planning.

Gender Differences in a Clinical Sample of Patients with Borderline Personality Disorder

2012 ◽  
Vol 26 (3) ◽  
pp. 368-380 ◽  
Author(s):  
Anke Banzhaf ◽  
Kathrin Ritter ◽  
Angela Merkl ◽  
Olaf Schulte-Herbrüggen ◽  
Claas-Hinrich Lammers ◽  
...  
Keyword(s):  
Gender Differences ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Clinical Sample ◽  
Borderline Personality

The Experience of Maltreatment in Young Children Whose Mothers Have Borderline Personality Disorder: Reflections in Their Narrative Representations

2020 ◽  
Vol 34 (6) ◽  
pp. 750-763 ◽  
Author(s):  
Jenny Macfie ◽  
Gretchen Kurdziel
Keyword(s):  
Sexual Abuse ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Identity Disturbance ◽  
Narrative Representations ◽  
Child Relationship ◽  
Self Harm ◽  
Normative Comparisons ◽  
Negative Relationships

Child maltreatment is an etiological factor in borderline personality disorder (BPD), which may be transmitted to the children of mothers with BPD. We assessed maltreatment in 36 children aged 4–7 whose mothers have BPD and in 34 normative comparisons. Children whose mothers have BPD were more likely to have experienced sexual abuse, physical abuse, and neglect than were normative comparisons. Mothers’ self-reported borderline features were significantly correlated with children's maltreatment. Neglect was associated with mothers’ affective instability, identity disturbance, negative relationships, and self-harm; sexual abuse was associated with mothers’ identity disturbance, and negative relationships; and physical abuse was associated with mothers’ self-harm. Maltreatment mediated the relationship between all four of mothers’ borderline features and children's narrative representations of the caregiver–child relationship, which included fear of abandonment, role reversal, and mother–child relationship expectations. The authors discuss results in the context of risk for developing BPD in early adulthood and early preventive interventions targeting children's representations.

scholarly journals Boredom in Borderline Personality Disorder: A Lost Criterion Reconsidered

2020 ◽  
Vol 53 (5-6) ◽  
pp. 239-253
Author(s):  
Sara R. Masland ◽  
Tanya V. Shah ◽  
Lois W. Choi-Kain
Keyword(s):  
Clinical Practice ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Diagnostic Criteria ◽  
Empirical Research ◽  
Borderline Personality ◽  
Cascade Model ◽  
Identity Disturbance ◽  
Behavioral Dysregulation

Difficulty with boredom was eliminated from the formal diagnostic criteria for borderline personality disorder (BPD) in 1994 based on significantly limited, unpublished data. However, it is apparent in clinical practice that boredom remains relevant to BPD. This review synthesizes empirical research, with consideration of theoretical accounts, to critically examine the relevance of boredom to BPD. We first briefly review issues in defining and measuring boredom and offer an expanded conceptualization for BPD, which includes the notion of boredom reactivity, before turning to boredom’s differentiation from and overlap with feelings of emptiness, with which it was paired prior to its removal from the DSM. We then discuss perspectives on boredom’s significance in BPD, briefly touching on its relevance in other personality disorders. We propose a Boredom Cascade Model that articulates how boredom and boredom reactivity interact with identity disturbance and chronic emptiness to create escalating patterns of behavioral dysregulation and make recommendations for research and treatment.

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