Abstract

The present study is the first to examine both the implicit and explicit self-concept of identity diffusion in a sample of adolescent patients with borderline personality disorder (BPD). A clinical sample of adolescent girls with diagnosed BPD (N = 30; M age = 15.9 years) and a sample of girls with a healthy personality development (N = 33; M age = 16.6 years) completed an implicit association test (IAT) that was adjusted to identity diffusion, the core of BPD. Common domains of child and adolescent psychopathology and core components of BPD were assessed using self-reports on the Strengths and Difficulties Questionnaire (SDQ), the Borderline Personality Features Scale for Children—11 (BPFSC-11) and the Assessment of Identity Development in Adolescence (AIDA). BPD patients scored significantly higher on explicit measures of borderline pathology than girls with a healthy personality development. A crucial finding for this study was that girls with BPD had a significantly lower implicit preference for stability than their counterparts in the control group. Moreover, explicit measures of borderline personality pathology were significantly correlated with an implicit measure of identity diffusion, the core of BPD. However, when looking at the predictive ability of implicit and explicit measures, only explicit identity diffusion was significantly associated with borderline features. Our data suggests that adolescent girls with BPD differ from healthy individuals not only in their conscious representation but also in their implicit representation of the self with regard to BPD related characteristics, which further advances the need for the identification of at-risk adolescents.

Highlights

  • Adolescence is a complex developmental process, which still poses a challenge

  • Diagnosis of borderline personality disorder (BPD) was made by a certified child and adolescent psychiatrist that was treating the adolescent, and it was based on clinical experience, a checklist of BPD symptoms based on the DSM5 and verified by using the Borderline Personality Features Scale for Children-11 (BPFSC-11; 37) and the Assessment of Identity Development in Adolescence (AIDA; 33)

  • The explicit and implicit self-concept of identity diffusion was investigated for the first time in adolescent girls with diagnosed BPD compared to girls with a healthy personality development using direct (AIDA and BPFSC-11) and indirect (AIDA-implicit association test (IAT)) measures

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Summary

Introduction

Adolescence is a complex developmental process, which still poses a challenge For the adolescent, it is a period of profound biological, social, and psychological transformations and can be a tumultuous time, even when unfolding in a healthy manner. This affects other parts of personality functioning—intimacy, empathy, and self-direction [8] In light of these findings, focusing on identity diffusion seems crucial as it is among the most important symptoms leading to a correct diagnosis of borderline personality disorder (BPD) in adulthood [9], a severely impairing mental disorder characterized by a pervasive pattern of disturbed interpersonal functioning, selfimage, affects, and heightened impulsivity [10]. It seems that adolescents with prevalent borderline features struggle with many aspects of a distorted sense of self and that identity diffusion is the most important factor influencing the severity of their BPD [11]

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