Abstract
BackgroundIndividuals with Borderline Personality Disorder (BPD) may experience a qualitatively distinct depression which includes “mental pain.” Mental pain includes chronic, aversive emotions, negative self-concept, and a sense of pervasive helplessness. The present study investigated whether mental pain is elevated in BPD compared to Depressive Disorders (DD) without BPD.MethodsThe Orbach and Mikulincer Mental Pain Scale (OMMP) was administered to BPD (N = 57), DD (N = 22), and healthy controls (N = 31). The OMMP assesses total mental pain, comprised of nine subtypes: irreversibility, loss of control, narcissistic wounds, emotional flooding, freezing, self-estrangement, confusion, social distancing, and emptiness. Co-occurring psychiatric diagnoses, depression severity, and other potentially confounding clinical and demographic variables were also assessed.ResultsThe total Mental Pain score did not differentiate BPD from DD. Moreover, most of the subscales of the OMMP were not significantly different in BPD compared to DD. However, the elevation of mental pain subscale “narcissistic wounds,” characterized by feeling rejected and having low self-worth, was a specific predictor of BPD status and the severity of BPD symptoms.ConclusionOn OMMP total score, mental pain was similarly elevated in BPD and DD. However, the narcissistic wounds sub-type of mental pain was a sensitive and specific diagnostic indicator of BPD and, therefore, may be an important aspect of BPD in need of increased focus in assessment and theoretical models.
Highlights
Individuals with Borderline Personality Disorder (BPD) may experience a qualitatively distinct depression which includes “mental pain.” Mental pain includes chronic, aversive emotions, negative self-concept, and a sense of pervasive helplessness
The present study aims to employ the Orbach and Mikulincer Mental Pain Scale (OMMP) to evaluate the hypothesis that individuals with BPD will exhibit greater mental pain compared to individuals with DD and Healthy control (HC)
There were no significant difference between DD and BPD groups in terms of their General Assessment Functioning (GAF) scores
Summary
Individuals with Borderline Personality Disorder (BPD) may experience a qualitatively distinct depression which includes “mental pain.” Mental pain includes chronic, aversive emotions, negative self-concept, and a sense of pervasive helplessness. Studies did not show improvement in depression in BPD with treatments such as pharmacotherapy and ECT [9, 10] This treatment resistant depressive experience is characterized by a high degree of emotional sensitivity that can lead to more frequent or intense and chronic negative affective experiences [11, 12]. These experiences include turbulent aversive affects, negative core beliefs (i.e., that one is “bad” and “worthless”), incoherence of inner experience, hostility/anger, emptiness, a sense of helplessness, loneliness and self-destructiveness as well as fears of abandonment and anxiety [13,14,15,16]
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