Discriminating among subgroups of borderline personality disorder: an assessment of object representations.

Abstract

The purpose of this study was to identify subgroups of borderline personality disorder (BPD) by examining internalized object relations. It was predicted: (a) that the internalized object relations of borderline patients as a group can be differentiated from psychiatric patients (comparison group N = 15), and (b) that BPD subgroups significantly differ in their object-relational profiles. Fifty-seven adult borderline subjects (28 male and 29 female) were separated into three groups based on Horney's description of interpersonal styles (moving away, against, and toward). Object relations were assessed using the Bell Object Relations Inventory and from early memories. Four written early memories were scored using the Social Cognition and Object Relations Scale (SCORS). The results suggest that the malevolent inner object world of borderline patients is fundamentally different from nonborderline psychiatric patients; and that the defined BPD subgroups of moving toward, against, and away differed significantly on specific structural and thematic object-relational dimensions. Aspects from Fairbairn's object relations theory and contributions from the self/representational, ego deficit, and Kernberg's models of borderline psychopathology are used to help interpret the findings. Identifying subtypes of BPD may allow for more precise discriminations in separating BPD from other disorders and may provide meaningful therapeutic and prognostic information for the different subgroups of borderline patients.