Isabel V Glass, Frances R Frankenburg, Garrett M Fitzmaurice, Mary C Zanarini
This study describes the 6-year course of grit scores among patients with borderline personality disorder (BPD) who have and have not experienced a symptomatic and psychosocial recovery. This study also explores predictors of grittiness in BPD patients. These patients (N = 224) were assessed as part of the McLean Study of Adult Development (MSAD). Levels of grit were assessed using the Grit Scale, a self-report measure assessing overall grittiness and three sub-scales of grit: consistency of interest, perseverance, and ambition. Recovered patients reported significantly higher levels of grit on three outcomes (overall grit, perseverance, and ambition) compared to non-recovered patients across time. One temperamental factor (conscientiousness) and one childhood factor (competency) were significant multivariate predictors of overall grit scores in patients with BPD. Taken together, these results suggest that recovered BPD patients have higher levels of grit that are stable across time. These results also suggest that grit is related to both temperamental and environmental factors.
{"title":"Levels of grit in patients with borderline personality disorder: Description and prediction.","authors":"Isabel V Glass, Frances R Frankenburg, Garrett M Fitzmaurice, Mary C Zanarini","doi":"10.1002/pmh.1636","DOIUrl":"https://doi.org/10.1002/pmh.1636","url":null,"abstract":"<p><p>This study describes the 6-year course of grit scores among patients with borderline personality disorder (BPD) who have and have not experienced a symptomatic and psychosocial recovery. This study also explores predictors of grittiness in BPD patients. These patients (N = 224) were assessed as part of the McLean Study of Adult Development (MSAD). Levels of grit were assessed using the Grit Scale, a self-report measure assessing overall grittiness and three sub-scales of grit: consistency of interest, perseverance, and ambition. Recovered patients reported significantly higher levels of grit on three outcomes (overall grit, perseverance, and ambition) compared to non-recovered patients across time. One temperamental factor (conscientiousness) and one childhood factor (competency) were significant multivariate predictors of overall grit scores in patients with BPD. Taken together, these results suggest that recovered BPD patients have higher levels of grit that are stable across time. These results also suggest that grit is related to both temperamental and environmental factors.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Borderline personality disorder (BPD) is characterized by affective, interpersonal, and identity instability, as well as marked impulsivity. There is evidence that BPD may be best operationalized dimensionally using models such as the Alternative Model for Personality Disorders (AMPD) described in Section III of the Diagnostic and Statistical Manual for Mental Disorders (DSM). Moreover, biosocial theory is a well‐known etiological theory of BPD emphasizing emotion dysregulation, inherited impulsivity, and development within invalidating contexts as key etiological mechanisms. Given that current research and clinical efforts for BPD are informed by both nosology and etiology, this narrative review examined how well biosocial theory (a) aligns with AMPD conceptualizations, (b) accounts for psychiatric comorbidity, and (c) accounts for heterogeneity in BPD presentation. Findings suggested that tenets of biosocial theory align well with Criteria A and B of the AMPD; however, biosocial theory focuses narrowly on roles of emotion dysregulation, impulsivity, and invalidating contexts, and empirical support is lacking in some ways for several etiological explanations proposed by biosocial theory. Additionally, although biosocial theory captures empirically supported features of BPD and emphasizes high‐risk subgroups, the theory may not account for lower‐risk subgroups. Finally, the theory accounts for diagnostic co‐occurrence via the central role of emotion dysregulation, but biosocial theory may not be specific to BPD and may broadly apply to a range of psychopathology. Based on the literature reviewed, implications for future research and clinical efforts are highlighted.
边缘型人格障碍(BPD)的特点是情感、人际关系和身份不稳定,以及明显的冲动性。有证据表明,使用《精神疾病诊断与统计手册》(DSM)第三部分中描述的人格障碍替代模型(AMPD)等模型,可以从多个维度对 BPD 进行最佳操作。此外,生物社会理论是一种众所周知的 BPD 病因学理论,强调情绪失调、遗传性冲动和在无效环境中发展是关键的病因机制。鉴于目前针对 BPD 的研究和临床工作都是以病名学和病因学为基础的,本叙述性综述研究了生物社会理论(a)与 AMPD 概念的一致性,(b)对精神疾病合并症的解释,以及(c)对 BPD 表现的异质性的解释。研究结果表明,生物社会理论的原则与 AMPD 的标准 A 和 B 非常一致;但是,生物社会理论狭隘地关注情绪失调、冲动和无效环境的作用,而且生物社会理论提出的一些病因学解释在某些方面缺乏经验支持。此外,虽然生物社会理论捕捉到了经验支持的 BPD 特征,并强调了高风险亚群,但该理论可能无法解释低风险亚群。最后,该理论通过情绪失调的核心作用解释了诊断的共存性,但生物社会理论可能并非专门针对 BPD,而是广泛适用于一系列精神病理学。在回顾文献的基础上,强调了未来研究和临床工作的意义。
{"title":"Compatibility of Linehan's biosocial theory and the DSM‐5 Alternative Model of Personality Disorders for borderline personality disorder","authors":"Nicholas R. Livingston, Kasey Stanton","doi":"10.1002/pmh.1635","DOIUrl":"https://doi.org/10.1002/pmh.1635","url":null,"abstract":"Borderline personality disorder (BPD) is characterized by affective, interpersonal, and identity instability, as well as marked impulsivity. There is evidence that BPD may be best operationalized dimensionally using models such as the Alternative Model for Personality Disorders (AMPD) described in Section III of the <jats:italic>Diagnostic and Statistical Manual for Mental Disorders</jats:italic> (<jats:italic>DSM</jats:italic>). Moreover, biosocial theory is a well‐known etiological theory of BPD emphasizing emotion dysregulation, inherited impulsivity, and development within invalidating contexts as key etiological mechanisms. Given that current research and clinical efforts for BPD are informed by both nosology and etiology, this narrative review examined how well biosocial theory (a) aligns with AMPD conceptualizations, (b) accounts for psychiatric comorbidity, and (c) accounts for heterogeneity in BPD presentation. Findings suggested that tenets of biosocial theory align well with Criteria A and B of the AMPD; however, biosocial theory focuses narrowly on roles of emotion dysregulation, impulsivity, and invalidating contexts, and empirical support is lacking in some ways for several etiological explanations proposed by biosocial theory. Additionally, although biosocial theory captures empirically supported features of BPD and emphasizes high‐risk subgroups, the theory may not account for lower‐risk subgroups. Finally, the theory accounts for diagnostic co‐occurrence via the central role of emotion dysregulation, but biosocial theory may not be specific to BPD and may broadly apply to a range of psychopathology. Based on the literature reviewed, implications for future research and clinical efforts are highlighted.","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142204427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katherine M Lawson, Azad Hemmati, Farzin Rezaei, Khaled Rahmani, Saeid Komasi, Christopher J Hopwood
The present study examined the extent to which the currently established factor structure of the Personality Inventory for DSM-5 (PID-5; Krueger et al., 2013) generalizes to a large Persian community sample, as well as relations between the resulting PID-5 factors and two temperament measures. Cross-sectional data came from 946 adults (65% female) from western Iran. With the use of exploratory structural equation modeling (ESEM) with target rotation, we found factor loadings that showed fairly similar patterns to those found in two previous meta-analytic PID-5 studies with predominantly North American and European samples (Watters & Bagby, 2018; Somma et al., 2019). Despite slight differences in each of the target rotations, there were moderate congruence coefficients (~0.85) between loadings for the five PID-5 domains, with the weakest evidence supporting the Disinhibition factor. The resulting PID-5 factors showed meaningful associations with temperament domains assessed via the Temperament and Character Inventory (TCI; Cloninger, 1994) and Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A; Akiskal et al., 2005). Overall, our findings suggest that the documented structure of personality pathology assessed by the PID-5 generalizes somewhat to this sample of Persian participants, and pathological personality traits show important overlap with temperament, although these constructs are meaningfully distinct.
{"title":"The structure of pathological personality traits and temperament in a Persian community sample.","authors":"Katherine M Lawson, Azad Hemmati, Farzin Rezaei, Khaled Rahmani, Saeid Komasi, Christopher J Hopwood","doi":"10.1002/pmh.1634","DOIUrl":"https://doi.org/10.1002/pmh.1634","url":null,"abstract":"<p><p>The present study examined the extent to which the currently established factor structure of the Personality Inventory for DSM-5 (PID-5; Krueger et al., 2013) generalizes to a large Persian community sample, as well as relations between the resulting PID-5 factors and two temperament measures. Cross-sectional data came from 946 adults (65% female) from western Iran. With the use of exploratory structural equation modeling (ESEM) with target rotation, we found factor loadings that showed fairly similar patterns to those found in two previous meta-analytic PID-5 studies with predominantly North American and European samples (Watters & Bagby, 2018; Somma et al., 2019). Despite slight differences in each of the target rotations, there were moderate congruence coefficients (~0.85) between loadings for the five PID-5 domains, with the weakest evidence supporting the Disinhibition factor. The resulting PID-5 factors showed meaningful associations with temperament domains assessed via the Temperament and Character Inventory (TCI; Cloninger, 1994) and Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A; Akiskal et al., 2005). Overall, our findings suggest that the documented structure of personality pathology assessed by the PID-5 generalizes somewhat to this sample of Persian participants, and pathological personality traits show important overlap with temperament, although these constructs are meaningfully distinct.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter Jacobsson, Christopher J Hopwood, Robert F Krueger, Bo Söderpalm, Thomas Nilsson
Personality traits and personality disorders are related to ADHD and indicate dysfunction in clinical populations. The goals of this study were to examine how the DSM-5 Alternative Model of Personality Disorder (AMPD) a) indicates the presence of ADHD and b) communicates information about dysfunction over and above ADHD diagnosis. A sample of 330 adult psychiatric patients with and without ADHD (60% female; mean age 33 years) were assessed for ADHD symptoms, personality impairment, maladaptive personality traits, and functional life impairment domains. The maladaptive personality domain Disinhibition and particularly the lower order facet of Distractibility distinguished between individuals with psychiatric difficulties with and without ADHD. Distractibility is strongly related to the ADHD symptom dimension Inattentiveness, and Antagonism to Hyperactivity/impulsivity. General personality impairment augmented ADHD diagnosis in predicting life impairments. The AMPD has utility in ADHD assessments for diagnosis and prognosis.
{"title":"Conceptualizing adult ADHD with the DSM alternative model of personality disorder.","authors":"Peter Jacobsson, Christopher J Hopwood, Robert F Krueger, Bo Söderpalm, Thomas Nilsson","doi":"10.1002/pmh.1632","DOIUrl":"https://doi.org/10.1002/pmh.1632","url":null,"abstract":"<p><p>Personality traits and personality disorders are related to ADHD and indicate dysfunction in clinical populations. The goals of this study were to examine how the DSM-5 Alternative Model of Personality Disorder (AMPD) a) indicates the presence of ADHD and b) communicates information about dysfunction over and above ADHD diagnosis. A sample of 330 adult psychiatric patients with and without ADHD (60% female; mean age 33 years) were assessed for ADHD symptoms, personality impairment, maladaptive personality traits, and functional life impairment domains. The maladaptive personality domain Disinhibition and particularly the lower order facet of Distractibility distinguished between individuals with psychiatric difficulties with and without ADHD. Distractibility is strongly related to the ADHD symptom dimension Inattentiveness, and Antagonism to Hyperactivity/impulsivity. General personality impairment augmented ADHD diagnosis in predicting life impairments. The AMPD has utility in ADHD assessments for diagnosis and prognosis.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-03-13DOI: 10.1002/pmh.1611
Jodie N Davies, Seth C Harty, Joseph M Boden
Although the influences of extraversion and neuroticism on the relationship between childhood adversity and substance misuse have been considered in adults, they are not yet clear and have not been examined among adolescent samples. This study sought to investigate the relationship between childhood adversity and adolescent substance misuse, alongside the influences of extraversion and neuroticism, using data from a longitudinal birth cohort study. Statistical analyses were performed on a longitudinal dataset provided by the Christchurch Health and Development Study (CHDS). After controlling for confounds, childhood adversity was a significant predictor of substance use disorder symptoms in adolescence. Moderation analyses showed that experiences of childhood adversity were most strongly associated with adolescent substance use disorder symptoms at higher levels of extraversion and at higher levels of neuroticism. Among adolescents who have experienced childhood adversity, extraversion and neuroticism may be risk factors for substance use disorder. By encouraging professionals to target adolescent substance misuse intervention and prevention approaches towards those who have experienced childhood adversity and are high in extraversion and/or neuroticism, these findings may help to diminish the prevalence of adolescent substance misuse and improve the health of adolescents.
{"title":"The roles of extraversion and neuroticism in the relationship between childhood adversity and adolescent substance misuse.","authors":"Jodie N Davies, Seth C Harty, Joseph M Boden","doi":"10.1002/pmh.1611","DOIUrl":"10.1002/pmh.1611","url":null,"abstract":"<p><p>Although the influences of extraversion and neuroticism on the relationship between childhood adversity and substance misuse have been considered in adults, they are not yet clear and have not been examined among adolescent samples. This study sought to investigate the relationship between childhood adversity and adolescent substance misuse, alongside the influences of extraversion and neuroticism, using data from a longitudinal birth cohort study. Statistical analyses were performed on a longitudinal dataset provided by the Christchurch Health and Development Study (CHDS). After controlling for confounds, childhood adversity was a significant predictor of substance use disorder symptoms in adolescence. Moderation analyses showed that experiences of childhood adversity were most strongly associated with adolescent substance use disorder symptoms at higher levels of extraversion and at higher levels of neuroticism. Among adolescents who have experienced childhood adversity, extraversion and neuroticism may be risk factors for substance use disorder. By encouraging professionals to target adolescent substance misuse intervention and prevention approaches towards those who have experienced childhood adversity and are high in extraversion and/or neuroticism, these findings may help to diminish the prevalence of adolescent substance misuse and improve the health of adolescents.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-03-25DOI: 10.1002/pmh.1607
Cameri Krasniqi, Steffen Müller, Leon P Wendt, Felix H Fischer, Carsten Spitzer, Johannes Zimmermann
The classification of personality disorder (PD) is undergoing a paradigm shift in which categorically defined specific PDs are being replaced by dimensionally defined maladaptive trait domains. To bridge the classificatory approaches, this study attempts to use items from the categorical PD model in DSM-IV to measure the maladaptive trait domains described in DSM-5 Section III/ICD-11. A general population sample comprising 1228 participants completed the Screening Questionnaire of the Structured Clinical Interview for DSM-IV Axis II (SCID-II-SQ), the Personality Inventory for DSM-5 (PID-5), and the anankastia scale of the Personality Inventory for ICD-11 (PiCD). Using item response theory models and a psychometric linking technique, SCID-II-SQ items were evaluated for their contribution to measuring maladaptive trait domains. The best discriminating items were then selected to derive proxy scales. We found that convergent validity of these proxy scales was in a similar range to that of other self-report measures for PD, except for the proxy scale for PiCD anankastia. However, only the proxy scale for negative affectivity showed acceptable reliability that would allow its application in research settings. Future studies should seek to establish a common metric between specific PDs and maladaptive trait domains using self-report measures with higher specificity or semi-structured interviews.
{"title":"Measuring maladaptive personality traits with the Structured Clinical Interview for DSM-IV Axis II Screening Questionnaire using a common metrics approach.","authors":"Cameri Krasniqi, Steffen Müller, Leon P Wendt, Felix H Fischer, Carsten Spitzer, Johannes Zimmermann","doi":"10.1002/pmh.1607","DOIUrl":"10.1002/pmh.1607","url":null,"abstract":"<p><p>The classification of personality disorder (PD) is undergoing a paradigm shift in which categorically defined specific PDs are being replaced by dimensionally defined maladaptive trait domains. To bridge the classificatory approaches, this study attempts to use items from the categorical PD model in DSM-IV to measure the maladaptive trait domains described in DSM-5 Section III/ICD-11. A general population sample comprising 1228 participants completed the Screening Questionnaire of the Structured Clinical Interview for DSM-IV Axis II (SCID-II-SQ), the Personality Inventory for DSM-5 (PID-5), and the anankastia scale of the Personality Inventory for ICD-11 (PiCD). Using item response theory models and a psychometric linking technique, SCID-II-SQ items were evaluated for their contribution to measuring maladaptive trait domains. The best discriminating items were then selected to derive proxy scales. We found that convergent validity of these proxy scales was in a similar range to that of other self-report measures for PD, except for the proxy scale for PiCD anankastia. However, only the proxy scale for negative affectivity showed acceptable reliability that would allow its application in research settings. Future studies should seek to establish a common metric between specific PDs and maladaptive trait domains using self-report measures with higher specificity or semi-structured interviews.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-02-27DOI: 10.1002/pmh.1608
Lien-Chung Wei
{"title":"Response to \"Antisocial personality traits relationship with behaviours and beliefs on COVID-19 containment measures: Investigation in a large Brazilian sample\".","authors":"Lien-Chung Wei","doi":"10.1002/pmh.1608","DOIUrl":"10.1002/pmh.1608","url":null,"abstract":"","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-03-14DOI: 10.1002/pmh.1609
Charlotte C van Schie, Kate Lewis, Karlen R Barr, Mahlie Jewell, Natalie Malcolmson, Michelle L Townsend, Brin F S Grenyer
Borderline personality disorder (BPD) is a severe mental health disorder that is subject to significant stigmatisation. With language being a key reinforcer of stigma, this co-produced study aims to explore the language use regarding BPD and its effect on those with BPD and carers. Recommendations to reduce stigmatisation are provided for both clinicians and researchers. Participants with BPD (consumer n = 33) and those supporting someone with BPD (carer n = 30) discussed their experience of hurtful and helpful language. Reflexive thematic analysis was used to analyse written and verbal responses into core conflictual relationship themes (CCRT) reflecting how different words were heard and experienced. All consumers and carers in the study reported experiences with stigmatising language. Feelings of inadequacy and frustration were common amongst consumers, specifically when they perceived others as trivialising their needs or not seeing them as a unique individual. Carers often reported feelings of frustration when they perceived others as blaming them or not acknowledging their needs. Both consumers and carers reported helpful language as being connecting, validating and accepting. Unhelpful communication patterns have negative consequences for the person's self-understanding (i.e., self-stigma) and their relationships with others, including the therapeutic alliance. A consideration of these communication patterns may foster the use of reflective positive language that is compassionate and hopeful.
边缘型人格障碍(BPD)是一种严重的心理健康障碍,受到严重的污名化。由于语言是污名化的一个关键强化因素,这项共同制作的研究旨在探讨有关 BPD 的语言使用及其对 BPD 患者和照护者的影响。为临床医生和研究人员提供了减少污名化的建议。患有 BPD 的参与者(消费者 n = 33)和为 BPD 患者提供支持的人(照护者 n = 30)讨论了他们对伤害性和帮助性语言的体验。研究采用了反思性主题分析法,将书面和口头回答分析为核心冲突关系主题(CCRT),以反映不同的语言是如何被听到和经历的。研究中的所有消费者和照护者都报告了使用污名化语言的经历。在消费者中,不足感和挫败感很常见,特别是当他们认为他人轻视他们的需求或没有将他们视为一个独特的个体时。照护者通常认为他人指责他们或不承认他们的需求,从而产生挫败感。消费者和照护者都表示,有益的语言包括沟通、认可和接受。无益的沟通模式会对患者的自我认识(即自我成见)以及他们与他人的关系(包括治疗联盟)产生负面影响。考虑到这些沟通模式,可以促进使用富有同情心和希望的反思性积极语言。
{"title":"Borderline personality disorder and stigma: Lived experience perspectives on helpful and hurtful language.","authors":"Charlotte C van Schie, Kate Lewis, Karlen R Barr, Mahlie Jewell, Natalie Malcolmson, Michelle L Townsend, Brin F S Grenyer","doi":"10.1002/pmh.1609","DOIUrl":"10.1002/pmh.1609","url":null,"abstract":"<p><p>Borderline personality disorder (BPD) is a severe mental health disorder that is subject to significant stigmatisation. With language being a key reinforcer of stigma, this co-produced study aims to explore the language use regarding BPD and its effect on those with BPD and carers. Recommendations to reduce stigmatisation are provided for both clinicians and researchers. Participants with BPD (consumer n = 33) and those supporting someone with BPD (carer n = 30) discussed their experience of hurtful and helpful language. Reflexive thematic analysis was used to analyse written and verbal responses into core conflictual relationship themes (CCRT) reflecting how different words were heard and experienced. All consumers and carers in the study reported experiences with stigmatising language. Feelings of inadequacy and frustration were common amongst consumers, specifically when they perceived others as trivialising their needs or not seeing them as a unique individual. Carers often reported feelings of frustration when they perceived others as blaming them or not acknowledging their needs. Both consumers and carers reported helpful language as being connecting, validating and accepting. Unhelpful communication patterns have negative consequences for the person's self-understanding (i.e., self-stigma) and their relationships with others, including the therapeutic alliance. A consideration of these communication patterns may foster the use of reflective positive language that is compassionate and hopeful.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-05-06DOI: 10.1002/pmh.1613
Martin Blay, Margaux Bouteloup, Miguel Duarte, Roland Hasler, Eleonore Pham, Rosetta Nicastro, Marlène Jan, Martin Debbané, Nader Perroud
Pathological narcissism (PN) is a common psychopathological issue leading to maladaptive strategies to cope with self-esteem threats, including self-enhancement and exploitation (grandiose strategies) or internalized shame, depression, and social withdrawal (vulnerable strategies). Mentalizing is a key process for regulating self and other representations and their associated emotions. Patients with PN further struggle with emotion dysregulation (ED), which during development is intertwined with the growing capacity to mentalize. We seek to contribute to emerging empirical data documenting the associations between PN and ED and between PN and mentalizing, and to provide information on the nature of their mutual relationships. In the present study, we assessed PN, ED, and three mentalizing dimensions (mentalizing self, other, and motivation to mentalize) in 183 patients consulting in our outpatient unit specialized in ED. We found that narcissistic vulnerability was negatively associated with self-mentalizing and positively associated with overall ED, both even after adjustment for borderline and attention deficit hyperactivity disorder (ADHD) symptoms. However, the association with ED was not maintained after further adjustment for self-mentalizing or overall-mentalizing, which suggests that mentalizing may play a mediating role in this relationship. On the other hand, narcissistic grandiosity was positively associated with other-mentalizing and ED and negatively associated with self-mentalizing in bivariate analyses, but these last two associations were not maintained after adjustment for comorbid borderline and/or ADHD symptomatology. This study provides new information on the link between PN and ED and on key mentalizing dimensions meaningfully relating to PN, notably through a potential role of self-mentalizing processes between PN and ED.
病态自恋(PN)是一种常见的心理病态问题,会导致采取适应不良的策略来应对自尊受到的威胁,包括自我膨胀和利用(自大策略)或内化的羞耻感、抑郁和社会退缩(脆弱策略)。心理化是调节自我和他人表象及其相关情绪的关键过程。PN 患者会进一步与情绪失调(ED)作斗争,而在成长过程中,情绪失调与心智化能力的增长是交织在一起的。我们试图为记录 PN 和 ED 之间以及 PN 和心智化之间关联的新兴实证数据做出贡献,并提供有关它们之间相互关系性质的信息。在本研究中,我们评估了 183 名在我们的 ED 专科门诊就诊的患者的自恋倾向、ED 和三个心智化维度(自我心智化、他人心智化和心智化动机)。我们发现,自恋的脆弱性与自我心智化呈负相关,而与总体 ED 呈正相关,即使在调整了边缘型和注意缺陷多动障碍(ADHD)症状后也是如此。然而,在对自我心理化或整体心理化进行进一步调整后,ED 与自恋的相关性并没有得到维持,这表明心理化可能在这种关系中起到了中介作用。另一方面,在双变量分析中,自恋型自大狂与他心化和 ED 呈正相关,与自心化呈负相关,但在调整了合并边缘型和/或多动症状后,后两种相关性没有得到维持。本研究提供了有关 PN 和 ED 之间联系的新信息,以及与 PN 有意义的关键心智化维度的新信息,特别是通过 PN 和 ED 之间自我心智化过程的潜在作用。
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Pub Date : 2024-08-01Epub Date: 2024-03-13DOI: 10.1002/pmh.1610
Piotr P Brud, Jan Cieciuch
Temperament is claimed to be the basis for personality; therefore, discovering the temperamental underpinnings of borderline personality disorder and its facets is crucial for understanding this personality disorder. In this article, we explore these underpinnings by using a new model of temperament, based on the Regulative Theory of Temperament, the Big Two of temperament, and the Circumplex of Personality Metatraits. Two studies were conducted on adults-the first was in a general population sample (N = 315) and the second was in a clinical sample (N = 113) in people with a diagnosis of borderline personality disorder. The following measurements were used: The Screening Instrument for Borderline Personality Disorder (SI-Bord), the Five-Factor Borderline Inventory-Short Form (FFBI-SF), and the Temperament Metadimensions Questionnaire (TMQ). General borderline was explained by Reactivity (high Sensitivity) and Activity (high Dynamism). At the facet level, the Borderline Internalizing Facet was mainly explained by Reactivity (high Sensitivity), while the Borderline Externalizing Facet was explained by Activity (high Dynamism) in addition to Reactivity (high Sensitivity). The results of our study revealed specific temperamental underpinnings of borderline and its facets. Reactivity underlies all borderline facets, while Activity differentiates between the Borderline Externalizing Facet and Borderline Internalizing Facet.
气质被认为是人格的基础;因此,发现边缘型人格障碍的气质基础及其特征对于理解这种人格障碍至关重要。在本文中,我们将根据气质调节理论(Regulative Theory of Temperament)、两大气质理论(Big Two of Temperament)和人格元特征复合理论(Circumplex of Personality Metatraits),使用一种新的气质模型来探索这些基础。我们对成年人进行了两项研究--第一项是普通人群样本(315 人),第二项是临床样本(113 人),对象是被诊断为边缘型人格障碍的人。研究采用了以下测量方法:边缘型人格障碍筛查工具(SI-Bord)、边缘型五因素量表-简表(FFBI-SF)和气质元问卷(TMQ)。反应性(高敏感性)和活动性(高动力性)解释了一般边缘人格。在面的层面上,边缘型内化面主要由反应性(高敏感性)解释,而边缘型外化面除了由反应性(高敏感性)解释外,还由活动性(高动力性)解释。我们的研究结果揭示了边缘型及其面相的特定气质基础。反应性是所有边缘化面相的基础,而活动性则区分了边缘化外化面相和边缘化内化面相。
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