Abstract
Self-perception is disrupted in people with borderline personality disorder (BPD) and depersonalization disorder (DPD), fluctuating with sudden shifts in affect in BPD and experienced as detached in DPD. Measures of implicit self-esteem (ISE), free from conscious control and presentation biases, may highlight how such disruptions of self-concept differentially affect these two populations on an unconscious level. We examined ISE using the Implicit Association Test, along with measures of emotion, behavior, and temperament, in BPD (n = 18), DPD (n = 18), and healthy control (n = 35) participants. DPD participants had significantly higher ISE and were more harm avoidant than BPD and control participants, while BPD participants had more “frontal” behaviors and impulsivity and less self-directedness and cooperativeness than DPD and control participants. Thus, while BPD and DPD commonly overlap in terms of dissociative symptoms and emotional irregularities, differences in self-esteem, behavior, and temperament can help identify where they diverge in terms of their cognition, behavior, and ultimately underlying neurobiology.
Highlights
Sense of self is disrupted for individuals with borderline personality disorder (BPD) and with depersonalization disorder (DPD)
The BPD and DPD participants were outpatients, diagnosed by an independent psychiatrist using the Structured Clinical Interview for DSM-IV Axis I Disorders (First et al, 2002), the Structured Clinical Interview for DSM-IV Axis II Disorders (First et al, 1997), the Structured Clinical Interview for DSM-IV Dissociative Disorders (Steinberg, 1994), and the Wechsler Abbreviated Scales of Intelligence (WASI; Wechsler, 1999) Patients were included for the study if they met DSM-IV-TR criteria for BPD (N = 18) or DPD (N = 18), and if they had no history of schizophrenia, schizoaffective, bipolar, or other organic mental disorders, no diagnosis of substance dependence or abuse, and no unstable medical disorder
A one-way analysis of variance (ANOVA) revealed no significant differences in age, gender, or IQ between groups, and showed that BPD and DPD participants differed significantly on implicit self-esteem (ISE), frontal behaviors, impulsivity, and several temperament characteristics
Summary
Sense of self is disrupted for individuals with borderline personality disorder (BPD) and with depersonalization disorder (DPD). In BPD, this global feeling of self-identity and worth is one of several unstable attributes, which include unstable “interpersonal relationships, self-image, and affects, and marked impulsivity” Their self-image – as well as affect, cognition, and behavior – fluctuates with their perception of rejection or abandonment (American Psychiatric Association, 2000). These abandonment fears arise from unstable interpersonal relationships where they initially idealize another person, criticize, and devalue them. Given that aspects of self-representation, such as self-worth and self-concept, are disrupted in each of these disorders, we investigated how implicit self-esteem (ISE) is affected in these populations
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