Borderline Personality Features Research Articles

Borderline Personality Features and Self-Injurious Urges: The Roles of Self-Concept Clarity and Bedtime Self-Critical Rumination

ABSTRACT Low self-concept clarity is associated with self-injurious urges among persons with borderline personality disorder (BPD). Self-critical rumination may potentially exacerbate these associations. Yet empirical research on how self-critical rumination and self-concept clarity interact is scarce. We examined near-term associations between bedtime self-critical rumination, self-concept clarity, and self-injurious urges among adolescents who met at least 3 diagnostic criteria for BPD (N = 22; 63.6% girls/women; M age = 16.45). Participants were sent five daily mobile surveys for 20 days (1691 total assessments completed). Bedtime self-critical rumination moderated concurrent associations between self-concept clarity and self-harm wishes, but not suicide desires. Lower self-concept clarity was associated with elevated self-harm wishes only among participants with moderate to high bedtime self-critical rumination. Findings provide a preliminary step toward understanding the link between self-concept clarity and self-injurious urges.

Alteration of prefrontal cortex and its associations with emotional and cognitive dysfunctions in adolescent borderline personality disorder.

The neurobiological mechanism of borderline personality disorder (BPD) in adolescents remains unclear. The study aimed to assess the alterations in neural activity within prefrontal cortex in adolescents with BPD and investigate the relationship of prefrontal activity with emotional regulation and cognitive function. This study enrolled 50 adolescents aged 12-17 years with BPD and 21 gender and age-matched healthy control (HC) participants. Study assessment for each participant included a brain resting-state functional MRI (rs-fMRI), clinical assessment questionnaires such as Borderline Personality Features Scale (BPFS), Difficulties in Emotion Regulation Scale (DERS), Ottawa Self-Injury Inventory and Childhood Trauma Questionnaire (CTQ) and cognitive testing with Stroop Color-Word Test (SCWT). Fractional amplitude of low-frequency fluctuations (fALFF) and seed-based functional connectivity (FC) were obtained from rs-fMRI analysis. Correlation analysis was also performed to evaluate the associations of the neuroimaging metrics such as fALFF and FC with clinical assessment questionnaire and cognitive testing scores. Adolescents with BPD showed increased fALFF values in the right inferior frontal gyrus and decreased activity in the left middle frontal gyrus as compared to the HC group (p < 0.05, cluster size ≥ 100, FWE correction). In adolescents with BPD, increased fALFF in the right inferior frontal gyrus was related to the BPFS (emotional dysregulation), DERS-F (lacking of emotional regulation strategies) and Ottawa Self-Injury Inventory-4C scores (internal emotional regulation function of self-injurious behavior). The reduced fALFF in the left middle frontal gyrus was associated with the SCWT-A (reading characters) and the SCWT-B (reading color) scores. Additionally, the fALFF values in the left middle frontal gyrus and the right inferior frontal gyrus were related to the CTQ-D (emotional neglect) (p < 0.05). The left middle frontal gyrus exhibited increased FC with the right hippocampus, left inferior temporal gyrus and right inferior frontal gyrus (voxel p < 0.001, cluster p < 0.05, FWE correction). The increased FC between the left middle frontal gyrus and the right hippocampus was related to the SCWT-C (cognitive flexibility) score. We observed diverging changes in intrinsic brain activity in prefrontal cortex, and neural compensatory changes to maintain function in adolescents with BPD. In addition, decreased neural function was closely associated with emotional dysregulation, while increased neural function as indicated by brain activity and FC was associated with cognitive dysfunction. These results indicated that alterations of intrinsic brain activity may be one of the underlying neurobiological markers for clinical symptoms in adolescents with BPD.

Construct Validity and Measurement Invariance of the Difficulties in Emotion Regulation Scale - Short Form (DERS-SF): Further Evidence From Community and Student Samples

The current study aimed to evaluate the psychometric properties of the Difficulties in Emotion Regulation Scale-Short Form (DERS-SF) in Iran, including testing its measurement invariance across sexes, as well as community and student populations. Two samples were recruited: a community sample of 583 participants (58.7% female; Mage = 33.55) and a university student sample of 409 participants (67.2% female; Mage = 24.48). Besides the DERS-SF, participants completed a battery of instruments online, measuring mentalizing capacity and borderline personality features. Confirmatory factor analyses supported the tenability of the five-factor model, excluding the awareness subscale. Except for the awareness subscale, acceptable to excellent internal consistencies were found for the DERS-SF and its subscales. The awareness-excluded DERS-SF was significantly and strongly associated with relevant constructs (|rs| = .49 to .59). This study also found evidence for configural, metric, and scalar invariance of the DERS-SF across sexes and community and student populations. Our findings extended the evidence for the validity and reliability of the DERS-SF and its awareness-excluded version by administering it in Iranian samples and supporting its cross-cultural applicability.

Towards understanding the direct and indirect effects of borderline personality features on identity disturbance

AbstractResearch on borderline personality disorder (BPD) in clinical populations is extensive, and its impact on nonclinical populations is developing importance. The present study examined whether the presence of borderline personality features in nonclinical young adults is associated with identity disturbance, considering the potential mediating roles of anxiety and deliberate self‐harm (DSH). A total of 162 participants completed an online survey incorporating four measures: the Borderline Symptoms List‐23, Beck Anxiety Inventory, DSH Inventory, and the Self‐Concept and Identity Measure. A parallel indirect effects analysis indicated that the indirect effects of BPD features on identity disturbance via anxiety and DSH were not significant. However, BPD features remained a significant predictor of identity disturbance, even after controlling for the influence of anxiety and DSH factors (direct effect).

Assessing Measurement Consistency: A Study of the BPFSC Invariance Across Age and Sex in Romanian Adolescents.

The Borderline Personality Feature Scale for Children (BPFSC) is a widely used instrument and currently the only dimensional measure to investigate Borderline Personality features in children and adolescents. The present study aimed to investigate the factor structure and measurement invariance across age and sex in a community sample of 634 adolescents (mean age = 16.72, standard deviation = 1.31). To test for measurement invariance, we conducted multi-group confirmatory factor analysis (MG-CFA). Analysis showed residual invariance across age and sex. Based on the results, we conclude that BPFSC is a valid and reliable instrument to assess Borderline Personality features in adolescents. Implications for evidence-based assessment of Borderline Personality features in adolescence are discussed.

Bidirectional relationship between borderline personality features and depressive symptoms in early adolescence: A school-based cohort study

Depressive symptoms is a public health concern worldwide, and adolescents may experience more depressive symptoms. Although the relationship between borderline personality features (BPFs) disorder and depressive symptoms has been established, it is unclear whether the longitudinal relationship between them is unidirectional or bidirectional and whether these symptoms are different between boys and girls. In this study, Chinese adolescents (1608 total and separately 972 for boys and 636 girls) were enrolled between September 2019 and September 2021, and we analyzed the data using a cross-lagged model. The results suggested a bidirectional relationship between BPFs and depressive symptoms in boys (β = 0.191 and 0.117, P < 0.001). However, in girls, depressive symptoms were predicted based on BPFs (β = 0.225, P < 0.001), whereas BPFs were not predicted based on depressive symptoms (β = 0.035, P = 0.535). The findings suggest that borderline personality traits and depressive symptoms are only bilaterally associated in girls, which also provides important evidence for the treatment and prevention of adolescent BPFs and depressive symptoms.

Network Analysis of Borderline Personality Features in Adolescence Using a Screening Tool in a Chinese Community Sample

Introduction: This study investigated the structure of the borderline personality features (BPFs) network and the most central BPF in adolescence. Methods: Cross-sectional self-report data from 4,866 Chinese adolescents (M = 13.96, SD = 1.64; 61.3% girls) were included in the network analysis models. BPFs were assessed with the McLean Screening Instrument for Borderline Personality Disorder. Results: Identity disturbance and affective instability emerged as the most central BPF in the current adolescent sample. In addition, chronic emptiness was also found with high centrality. The general networks of BPF were very similar between adolescent boys and girls, although some differences were detected. Discussion: This study further supports the necessity of BPD assessment and diagnosis in adolescence and identifies the distinctive importance of identity and affective dysregulation in the early development of BPD. The findings provide empirical insights into the interconnections of BPF, which resonate with therapeutic mechanisms of evidence-based treatments for BPD. However, the research was limited in its use of a screening measurement rather than a diagnostic tool. Future studies can further explore BPD psychopathology in adolescence with longitudinal data and clinical interviews.

Exploring the Complex Relationship Between Childhood Trauma and Self-Harm

ABSTRACT Previous research has linked self-harm to adverse childhood experiences (i.e. abuse and neglect). Despite the extensive literature on self-harm, it remains of high importance to examine psychological predictors of repetitive self-harming behaviors in those who report childhood trauma. This study explored the role of maladaptive emotion regulation strategies, dissociation proneness, and borderline personality (BP) features. An international sample with n = 374 participants (N = 287, 77%, reporting intentional use of self-harm), was recruited online via relevant mental health platforms and research sites. Within an anonymous survey, participants completed the Self-harm Inventory, Childhood Trauma Questionnaire, Dissociative Experience Scale, Cognitive Emotion Regulation Questionnaire, and Personality Assessment Inventory-Borderline Personality Features Scale. Structural equation modeling (SEM) was used to explore direct and indirect effects. Self-harm was positively correlated to severity of childhood trauma, maladaptive emotion regulation strategies, dissociation, and BP features. In the path-analytical model, independent indirect effects of childhood trauma severity via self-blame, catastrophizing, dissociation, as well as BP features on self-harm were found. Maladaptive emotion regulation, dissociation proneness, and BP features all seem to be important intermediary agents in the close association between childhood trauma and self-harm.

Changes in adolescents with borderline personality features and caregivers after dialectical behaviour multifamily group therapy

Changes in adolescents with borderline personality features and caregivers after dialectical behaviour multifamily group therapy

Borderline Personality Disorder and Intimate Partner Violence: A Systematic Review

Borderline personality (BPD) features and intimate partner violence (IPV) have been seen associated, focusing the research specially into perpetrators. The achievement of this systematic review is to analyze this relation in both victims and perpetrators, using 17 scientific articles published between 2017 and 2021 from different data bases. Most studies were focused on perpetrators, in which both men and women were equally represented as perpetrators. Instead, studies about victims were focused on women. Throughout this review, different factors observed in people with BPD traits who are victims or perpetrators of IPV are mentioned, finding particularities in each profile. These findings allow increase knowledge about the relationship between BPD and IPV, promoting a greater understanding that impacts positively on clinical intervention in this population.

Borderline personality features predict empathy for animals but not for children

Although empathy is not a defining feature of borderline personality disorder, there is a growing body of work suggesting deficits in some components of empathy toward humans. There is no research investigating the link between borderline personality features (BPF) and empathy toward animals, which may be less threatening to individuals that struggle in interpersonal relationships and fear rejection. We examined BPF and self-reported distress and viewing times of photographs depicting dogs and children in twelve adverse circumstances in a college student sample (N = 464) with trait empathy as a mediator in Study 1. BPF predicted distress to dog but not child photos. There were significant indirect effects of BPF on distress to dog and child photos through personal distress. In Study 2 (N = 524), we further examined the processes underlying these associations by modelling a serial mediation of BPF with distress to dog and child photos through anxious and avoidant attachment to trait empathy toward animals and humans. We replicated the finding that BPF predicted distress to dog but not child photos. BPF predicted both anxious and avoidant attachment styles, which negatively predicted empathy for humans and animals. Empathy for humans mediated the associations with distress for child photos whereas empathy for animals mediated the associations with distress for dog photos. Further research is needed to determine the causal pathways between BPF, attachment, and empathy to animals and humans.

Unpacking thep-factor. Associations Between Maladaptive Personality Traits and General Psychopathology in Female and Male Adolescents.

Adolescence is a period of rapid physical, psychological, and neural maturation that makes youth vulnerable to emerging psychopathology, highlighting the need for improved identification of psychopathology risk indicators. Recently, a higher-order latent psychopathology factor (p-factor) was identified that explains latent liability for psychopathology beyond internalizing and externalizing difficulties. However, recent proposals suggest reconceptualizing the p-factor model in terms ofimpairments in personality encompassing difficulties in both self-regulation (borderline features) and self-esteem (narcissistic features), but this remains untested. To address this, this study examined the p-factor structure and the contribution of borderline and narcissistic features using two cross-sectional data collections. In Study 1, 974 cisgender adolescents (63% assigned females at birth; age range: 13-19; Mage = 16.68,SD = 1.40) reported on internalizing and externalizing problems (YSR) to test via structural equation models (SEM) different theoretical models for adolescent psychopathology. In Study 2, 725 cisgender adolescents (64.5% assigned females at birth; age range: 13-19; Mage = 16.22,SD = 1.32) reported internalizing and externalizing problems (YSR), borderline personality features (BPFSC-11), and narcissistic personality traits (PNI), to explore, via SEM, thecontribution ofborderline and narcissistic traitsto the p-factor and accounting for gender differences.Results confirmed the utility of a bi-factor model in adolescence. Furthermore, findings highlighted the contribution of borderline features and narcissistic vulnerability to general psychopathology. The study provides the first evidence supporting a p-factor model reconceptualized in terms ofpersonality impairments encompassing difficulties in self-regulation and self-esteem in adolescents.

Borderline Personality Features and Mate Retention Behaviors: The Mediating Roles of Suspicious and Reactive Jealousy

We investigated the roles that suspicious jealousy and reactive jealousy might play in the associations between borderline personality features (BPF) and mate retention behaviors. Study 1 (N = 406) found that BPF had positive indirect associations with benefit-provisioning behaviors and cost-inflicting behaviors through suspicious jealousy but not through reactive jealousy. Study 2 (N = 334 (a dyadic sample of 167 romantic couples)) revealed actor effects such that BPF had positive indirect associations with benefit-provisioning behaviors and cost-inflicting behaviors through suspicious jealousy for both men and women. In addition, the positive association between BPF and benefit-provisioning behaviors was mediated by reactive jealousy in women but not in men. The only partner effect that emerged from these analyses showed that BPF in women were negatively associated with the benefit-provisioning behaviors reported by their male partners. Discussion focuses on the implications of these results for the function that jealousy might serve in the strategies used by individuals with BPF to maintain their romantic relationships.

Borderline personality features are associated with worse perceptions of (but not compliance with) chronic pain treatment

ABSTRACT Treating chronic illness requires ongoing patient-provider cooperation, but individual differences in patients’ negative perceptions of care can undermine this cooperation. Research suggests people high on borderline personality disorder (BPD) features may react negatively to and comply less with mental health and medical treatment. This might be particularly problematic in chronic pain treatment, where BPD features are over-represented and the dysregulation typifying BPD likely undermines consistent care. In a sample of 147 chronic pain patients, we investigated whether higher levels of BPD features – both in general and by specific facets – predicted worse perceptions of treatment and lower patient-reported compliance with treatment recommendations. Participants higher (vs. lower) on borderline features viewed treatment more negatively but did not report complying less with recommendations. We found evidence that this may reflect the unstable relationships facet of BPD. Our results indicate that, consistent with other treatment settings, BPD features may undermine care for chronic pain. Furthermore, our results highlight the importance of collaborative provider-patient relationships and patient agreement with the treatment of chronic pain, particularly among individuals higher on BPD features.

Awareness of Narrative Identity Questionnaire (ANIQ) in Early Adolescents: Psychometric Evaluation and Association with Features of Personality Disorder

Identity formation is central to adolescent development. Challenges in establishing a stable sense of self is associated with maladaptive identity function, which has been recognized as a core feature of personality pathology. The narrative identity framework offers a unique lens to garner salient information about one’s sense of self. The Awareness of Narrative Identity Questionnaire (ANIQ) is a self-report measure of narrative identity validated in adults but is yet to be validated in adolescents. The current study aimed to conduct the first psychometric evaluation of the ANIQ in a sample of 205 youth aged 10–14 years (M = 12.1 ± 1.06 years; 50.7% female; 73.7% Hispanic) recruited from a public charter school. Results confirmed the four-factor structure of the ANIQ and showed high internal consistency. Convergent validity was supported through negative associations between the ANIQ and borderline personality features and identity diffusion. Incremental validity of the ANIQ over identity diffusion in predicting borderline personality features was also examined, but not supported. Overall, results support the ANIQ as a promising instrument for the assessment of narrative identity in youth. However, some improvements to the ANIQ might be necessary in order to use it as a clinical tool in identifying youth with personality pathology.

Construction and Statistical Validation of a Path Model of the Factors Influencing Non-suicidal Self Injury (NSSI) among Female Adolescents

Introduction: Despite having innumerable literatures, there has been dearth of comprehensive model of the manifestation of non-suicidal self-injury (NSSI). Aim and Objectives: The current study aims to construct a statistically validated model to explore the theoretical connections and the pathway to NSSI among female adolescents. Material and Method: A model was proposed based on the constructs empirically associated with NSSI. The research aims to explore the direct effects of external shame, hated self, and self-compassion on NSSI, and whether this relationship is mediated by borderline personality traits and menstrual phase. A total of 168 female adolescents completed the survey, including informed assent from the adolescents. The Other as Shamer Scale-2, the Forms of Self-Criticism/Self-Reassuring Scale, Self-Compassion Scale, the Risk-Taking and Self-Harm Inventory for Adolescents, and Borderline Personality Features Scale for Children were administered to the participants. Analysis of data involved descriptive statistics and path analysis. Result: The pathway shows hated self, disturbed intrapersonal relationship, and the inability to direct compassion for self may increase NSSI. Borderline personality traits and premenstrual dysphoria form indirect but contributory factors to strengthen the association between internal traits and NSSI. Conclusion: Thus it may be concluded from the present finding that external shame has significant negative effect on self-compassion and external shame has a significant positive effect on hated self. Also, self-compassion has a significant negative effect, and hated self as well external shame have significant positive effects on borderline traits. Thus, exploring this path would help to plan a suitable preventive action.

Finding Voices: a survey of young people’s experiences of the ED

BackgroundMental health presentations in young people are increasing. Recurrence of self-harm (SH) presentations is common and of great concern since self-harm is known to be a risk factor for suicide....

Adolescent mentalizing and childhood emotional abuse: implications for depression, anxiety, and borderline personality disorder features.

There is preliminary evidence that childhood emotional abuse (CEA) is a risk factor for adolescent mentalizing difficulties (Uncertainty/Confusion about mental states) and borderline personality features and that Uncertainty/Confusion about mental states mediate the relationship between CEA and adolescent borderline personality features, but these findings need replication. Furthermore, no previous studies have examined the relationship between adolescent mentalizing deficits, anxiety, and depression in the context of CEA. This study examined the associations between CEA, adolescent borderline personality features, depression and anxiety symptoms and tested a pathway model where Uncertainty/Confusion about mental states mediates the relationships between CEA and adolescent borderline personality features, depression and anxiety symptoms. A clinical sample of 94 adolescents completed the Reflective Function Questionnaire for Youth (RFQY) to assess mentalizing, the Childhood Experiences of Care and Abuse Questionnaire (CECA-Q), the Borderline Personality Disorders Features Scale (BPFS-C), and the Beck Youth Inventories for Depression (BDI-Y) and Anxiety (BAI-Y). Uncertainty/Confusion about mental states partially mediated the relationship between CEA and borderline traits as well as anxiety. In addition, there was an indirect effect where CEA predicted Uncertainty/Confusion about mental states, which then predicted depression. The findings are consistent with the mentalizing model of psychopathology and provide new evidence that Uncertainty/Confusion about mental states might be a critical mentalizing deficit that characterizes the associations between CEA and adolescent BPD features and depression and anxiety symptoms. Uncertainty/Confusion may be a transdiagnostic risk factor for adolescent psychological distress and dysfunction. We discuss the clinical implications.

Executive functions and borderline personality features in adolescents with major depressive disorder.

Executive functions (EF) consolidate during adolescence and are impaired in various emerging psychiatric disorders, such as pediatric Major Depressive Disorder (pMDD) and Borderline Personality Disorder. Previous studies point to a marked heterogeneity of deficits in EF in pMDD. We examined the hypothesis that deficits in EF in adolescents with pMDD might be related to comorbid Borderline Personality features (BPF). We examined a sample of 144 adolescents (15.86 ± 1.32) diagnosed with pMDD. Parents rated their child's EF in everyday life with the Behavior Rating Inventory of Executive Function (BRIEF) and BPF with the Impulsivity and Emotion Dysregulation Scale (IED-27). The adolescents completed equivalent self-rating measures. Self- and parent-ratings of the BRIEF scores were compared with paired t-Tests. Correlation and parallel mediation analyses, ICC, and multiple regression analyses were used to assess symptom overlap, parent-child agreement, and the influence of depression severity. Over the whole sample, none of the self- or parent-rated BRIEF scales reached a mean score above T > 65, which would indicate clinically impaired functioning. Adolescents tended to report higher impairment in EF than their parents. Depression severity was the strongest predictor for BPF scores, with Emotional Control predicting parent-rated BPF and Inhibit predicting self-rated BPF. Furthermore, the Behavioral Regulation Index, which includes EF closely related to behavioral control, significantly mediated the relationship between depression severity and IED-27 factors emotional dysregulation and relationship difficulties but not non-suicidal self-injuries. On average, adolescents with depression show only subtle deficits in executive functioning. However, increased EF deficits are associated with the occurrence of comorbid borderline personality features, contributing to a more severe overall psychopathology. Therefore, training of executive functioning might have a positive effect on psychosocial functioning in severely depressed adolescents, as it might also improve comorbid BPF. www.ClinicalTrials.gov, identifier NCT03167307.

The social domains organization of mentalizing processes in adolescents: a contribution to the conceptualization of personality function and dysfunction in young people.

We propose and evaluate a contribution to the conceptualization and assessment of personality functioning based on social domains and mentalizing hypotheses. Social domains are distinct social contexts, such as with acquaintances and friends, with differentiated expectations regarding participants' behaviours and social attributions. The capacity to organize social participation according to these expectations requires the ability, we suggest, to modulate mentalizing processes domain by domain. Drawing on evidence that social domain organization is impaired in borderline personality disorder (BPD) and that hypermentalizing, a heightened interpretation of others' motives, thoughts or emotions, is elevated in adolescent BPD, we hypothesized that hypermentalizing levels in adolescents will vary by social domain and that elevated BPD features will be associated with impairment of this domain organization of hypermentalizing. Measures including the borderline personality features scale for children (BPFSC) and the movie for the assessment of social cognition (MASC) were administered to 171 adolescents aged 12-17 recruited from public schools and community organizations in a large metropolitan area in southwestern United States. Mean hypermentalizing scores were computed for adolescent interpretations of sequences in the MASC focusing on the social domains of acquaintance, friends and romantic interactions. There was a progressive increase in hypermentalizing scores across the acquaintance, friends and romantic interactions (repeated measures ANOVA, p < .001, all pairwise comparisons, p ≤ .02), which was markedly reduced in the presence of elevated BPD features (interaction term, p = .007). Hypermentalizing is organized according to social domain and this organization is impaired in the presence of elevated BPD features. The findings are consistent with the proposal that personality functioning entails a social domains organization of hypermentalizing, which is impaired in personality dysfunction. Identifying mentalizing processes domain by domain has the potential to create a personalized focus for the treatment of adolescents with personality difficulties.