The self-image in borderline personality disorder: an in-depth qualitative research study

Patients with borderline personality disorder (BPD) suffer from affective instability, impulsivity, and identity disturbance which particularly manifest in an unstable or insecure self-image. One main problem for studies of core psychopathology in BPD is the complex subject of identity disturbance and self-image. The purpose of this study was to investigate the self-image of BPD patients with a qualitative research approach. Twelve patients with BPD were compared to 12 patients with remitted major depressive disorder (MDD) without personality disorder, using the Structured Interview of Personality Organization (STIPO). The transcribed interviews were analyzed using a combination of content analysis and grounded theory. BPD patients described themselves predominantly as helpful and sensitive; reported typical emotions were sadness, anger, and anxiety. MDD patients on the other hand reported numerous and various characteristics and emotions, including happiness, as well as sadness and anxiety. Other persons were characterized by the BPD group as egoistic and satisfied, while the MDD group described others as being balanced and secretive. BPD patients displayed an altruistic, superficial, and suffering self-image. Aggressive tendencies were only seen in other persons. Our findings support the concept of a self and relationship disturbance in BPD which is highly relevant for psychotherapy treatment.     

Words that touch2

In this paper the author examines her own use of language as a psychoanalyst and asks: what is the best way to help analysands to find the words to express not only what they are thinking but also what they are feeling and experiencing? In common with other psychoanalysts, the author has observed that each of us simultaneously utilises both advanced psychic mechanisms that are accessible to symbolism and more archaic ones, which are less so. However, she draws a distinction between people who are able to tolerate the perception of their own heterogeneity, even if it is sometimes a source of suffering, and those whom she terms ‘heterogeneous patients’. Patients in the latter category, whose lack of internal cohesion causes them anxiety, are afraid of losing their sense of identity. The author asks how we can understand their language and how we should speak to them. She uses several clinical examples to demonstrate that ‘heterogeneous patients’ need to be touched with a language that does not confine itself to imparting thoughts verbally but also conveys feelings and the sensations that accompany those feelings. It is also an ‘incarnated’ language because the words pronounced by the analyst can awaken, or reawaken, bodily fantasies in the patient. These words may enable him to find an emotional meaning in forgotten sensory or bodily experiences, which may then become a starting point for his work of thinking and of symbolisation.     

Comparison of textual analysis applied to two lectures written three years apart by one author: the language satellites

A comparative textual analysis was carried out on two essays "Thanatol" and "Double Talk," by F. Perrier, which were originally lectures given three years apart by the author, a psychoanalyst. This study involved the use of the ALCESTE software program, a computer-assisted method of discourse analysis. It consists of modelling the distribution of the main words occurring in speeches or texts with a view toward identifying the repetitive language patterns most frequently used by a speaker or writer. This method is described in the first part of the paper. Various types of discourse emerged from analysis along with specific topics. There were three types in the case of Thanatol and four in that of Double Talk. Upon comparing the separate results obtained on each corpus, a pool of significant words observed in the corpus Thanatol was also present in Double Talk. These words were organised into groups called "language satellites" which were dispatched in the various types of discourse. Considering the underlying language structure (the enunciation), they formed another discourse running between the lines of two lectures. This supplementary discourse was recurrent and could be said to label the author and his thoughts. The ALCESTE method brings to light in the textual production of an author a recurrent pattern of discourse which might hold some clues for the analysis of texts and speech and even about the author as evident in his own ideas and thoughts.     

Organization by modality,language, and category compared

Summary An experiment was presented to test a functionalistic interpretation of the modality effect. This shows a superior recall performance for auditorily as opposed to visually presented verbal information. A total of 60 subjects were presented with mixed-mode (auditory-visual words), mixed-language (Swedish-English words), or mixed-category (category-unrelated words) lists, and were asked to recall the words of each list in any preferred order. The degree of organization according to modality, language, or category and the recall performance were measured. Organization by modality was significantly higher than organization by language or category as predicted by the functionalistic view proposed. The recall performance obtained for auditory and visual words differed in a way predicted by the functionalistic view.     

Change after long-term psychoanalytic psychotherapy

Psychoanalytic psychotherapy in clinical practice is traditionally a long-term treatment conducted by well-trained psychotherapists. However, very few studies have been published that evaluate the effects of such treatment. To redress this lack of studies, 55 individuals selected for long-term psychoanalytic psychotherapy (average, 3 years) were invited to participate in a naturalistic study. The psychotherapists had a mean of 15 years of professional experience. The 36 patients who completed psychotherapy manifested a substantial reduction in symptomatic suffering and decreased levels of character pathology, as measured by the Karolinska Psychodynamic Profile (KAPP) and the Karolinska Scales of Personality. Generally, such changes were not found in the individuals who did not engage in treatment. In the therapy group, improvements were found on eight KAPP subscales defining different aspects of character: Intimacy and Reciprocity, Frustration Tolerance, Regression in the Service of the Ego, Coping with Aggressive Affects, Conceptions of Bodily Appearance and their Significance for Self-esteem, Sexual Function, Sexual Satisfaction, and Personality Organization. The results indicate that individuals who engaged in psychotherapy improved their capacity to handle crucial aspects of life and reduced their symptomatic suffering.     

Effects of bilingual and monolingual presentations and time on concept- and language-matching tasks

Balanced Turkish-English bilingual participants viewed word pairs, presented both monolingually (English-English or Turkish-Turkish) or bilingually (English-Turkish or Turkish-English) and both for short and long durations. They made decisions on whether the simultaneously presented words in a pair were in the same language or not, or whether they denoted the same concept or not. In the short presentation condition, we found no evidence for subliminal processing. In cases in which both words were consciously identified, participants were more accurate, although not faster in the long than in the short presentation condition for both language and concept decisions. In the long presentation condition, language decisions were more accurate than concept decisions, although not faster. In addition, language decisions were not affected by whether the words were synonyms (concept identity), and concept decisions were not affected by whether the presentation was monolingual or bilingual (language identity), although in the monolingual conditions, "same" decisions were faster but not more accurate, and in the bilingual conditions a speed-accuracy trade-off was observed in that "same" decisions were faster but "different" decisions were more accurate.     

A preliminary study of Hare's “Research Scale for the Assessment of Psychopathy” in mentally-abnormal offenders

The abbreviated (15-item) version of Hare's Research Scale for the Assessment of Psychopathy (RSAP) was investigated in a sample of male admissions to Broadmoor Special Hospital (N = 50), along with five MMPI measures relevant to psychopathy (Impulsivity, Sociability, Psychopathic Deviate, Anxiety and Sociopathy). Patients were assigned to one of four clinical diagnostic groups: Personality Disorder, Mixed (personality disorder with schizophrenia), Schizophrenia and Affective Disorder. Results indicated that while both psychopathic groups (Mixed and Personality Disorder) showed high scores on almost all RSAP items, the Affective Disorder group showed low scores on almost all items. Results of a discriminant function analysis indicated that Hare's RSAP was superior to the MMPI measures at discriminating between psychopaths and non-psychopaths. Use of the discriminant function to re-allocate patients to criterion groups showed a high hit rate (94%) for psychopathic patients but a hit rate of only 61% for non-psychopathic patients. Half of the schizophrenic patients were mis-allocated to the psychopathic group. The results support the idea of an affective deficit common to psychopaths and schizophrenics, but suggest that psychopaths additionally show a deficit which may be characterized by a lack of goal-directed behaviour.     

心理咨询的LIWC语言特征对咨询效果的预测

语言是心理咨询的重要内容。语言探索和词频统计（Language Inquiry and Word Count, LIWC）被广泛用于分析语言使用的心理意义。本研究收集了28名当事人共144次有效咨询录音及每次会谈后当事人的症状自评结果。将录音转录成文本后,抽取当事人的LIWC语言特征,进行主成分降维,结果获得8个因子,解释了总体方差的75.11%。一般线性回归中,躯体感受、功能词、情绪、认知和口语赘词对当事人的症状水平具有显著的预测作用,进一步多层线性模型中,躯体感受和情绪用词显著预测咨询效果。LIWC文本特征能够呈现与当事人症状相关的信息,为未来计算机自动化监控咨询过程和结果提供了新视角。     

The discovery of a miniature linguistic system: Function words and comprehension of an unfamiliar language

Two experiments investigated two complementary hypotheses: (a) The presence of semantically unimportant function words in sentences will not slow down the way subjects, unfamiliar with the language, extract the meaning of those sentences, provided suprasegmental cues are present, and conversely (b) the omission of such function words—as in native speakers' simplified speech to nonnative speakers—will not necessarily facilitate the task of meaning extraction, contrary to popular belief. In Experiment I, Dutch adult subjects were exposed to sentences in a miniature artificial language (MAL). In Experiment II, Greek adult subjects were exposed to sentences in an unfamiliar natural language (Dutch). In both experiments, the sentences contained eight words constituting a miniature linguistic system (mls), a system that subjects discovered through an audiovisual, concept-indentification task. The rate by which subjects performed this task was investigated as a function of two linguistic variables: (a) the presence or absence of semantically unimportant function words, and (b) the presence or absence of suprasegmental cues, in the input sentences, respectively. Results from both experiments confirmed the hypotheses (p<.001) The findings are discussed with reference to the linguistic versus cognitive simplicity issue, and to the comprehension versus production issue in language acquisition research. The methodological potential of the experimental paradigm for psycholinguistic research is also discussed.This paper forms part of a doctorate research project concerned with the comprehensibility of foreigner talk, and was supported by the Foundation for Linguistic Research, which is funded by the Netherlands Organization for Scientific Research, NWO.     

Linguistic abilities in patients with prefrontal damage

The language abilities of 21 patients with prefrontal lesions (11 right and 10 left) and 15 matched normal subjects were analyzed, using a linguistic ability test designed to evaluate performance in six areas: automatic language, language production, verbal memory, syntax, derivative words, and comprehension of logical grammatical structures. Significant differences in the obtained scores of all groups were found. In spite of formal conservation of language in patients with frontal damage, their complex and conceptual verbal abilities were severely compromised.     

BRIEF REPORT Bilinguals' recall and recognition of emotion words

Recall of emotion words is superior to neutral words. Prior work reported in this journal (Anooshian & Hertel, 1994) found that this effect was absent in a second language. Words in a second language may thus lack the emotional associations of words acquired in childhood. To determine whether memory probes may be generally useful for assessing emotionality effects in a first versus a second language, Anooshian and Hertel's paradigm was extended in several ways. Recall was compared to recognition, and a variety of types of emotion words were studied, including taboo terms, and phrases likely to be learned in childhood (reprimands). Superior memory for emotion words was obtained in both the recall and recognition tasks, but this occurred in both the first and second language and indeed was stronger, for some stimuli, in the second language. This suggests that, even for bilingual speakers who acquire their second late (after age 12), words in the second language retain rich emotional associations.     

Some aspects of language comprehension in anterior aphasia

The competency of language comprehension was evaluated in three groups: anterior aphasics, posterior aphasics, and normal control subjects. Test material was divided into two sentence groups (Fill in the Blank and True/False) emphasizing either (1) semantic, “real world,” identity words or (2) syntactic, relational words, and one paragraph interpretation task. Matching auditory and visual (written) presentations were given. The control subjects performed almost flawlessly but many errors were made by each aphasia group. Qualitative study revealed a marked difference in the comprehension problem of the two groups. The anterior aphasic group performed well on semantically weighted sentences but made errors on syntactically weighted material, regardless of mode of presentation. In contrast, the posterior aphasics made almost the same number of errors on both types of material, regardless of mode of presentation. These findings support the concept of defective language comprehension in anterior aphasia and further suggest that the defect centers on the syntactical structures which are also poorly handled in expressive output.     

Are DSM-IV-TR Borderline Personality Disorder, ICD-10 Emotionally Unstable Personality Disorder, and CCMD-III Impulsive Personality Disorder Analogous Diagnostic Categories Across Psychiatric Nomenclatures?

This study examined the validity of the borderline construct which encompasses diagnostic criteria from the DSM-IV-TR Borderline Personality Disorder (BPD), ICD-10 Emotionally Unstable Personality Disorder (EUPD), and CCMD-III Impulsive Personality Disorder (IPD) in a sample of 1,419 Chinese psychiatric patients. Participants completed the Chinese Personality Disorder Inventory and the Chinese Personality Assessment Inventory-2 assessing various disordered personality features. Adequate internal consistency was found for the borderline construct (α = .83). Exploratory factor analysis revealed two components: (1) affective and cognitive disturbances, and (2) impulse dysregulation, which were replicated by confirmatory factor analysis. Item analysis indicated that the various borderline criteria displayed similar levels of diagnostic efficiency, which does not support the elimination of fear of abandonment and transient psychotic features from the EUPD and IPD criteria set. Findings of this study suggest that BPD, EUPD, and IPD may represent analogous diagnostic categories across classification systems.     

Semantic dementia and persisting Wernicke's aphasia: linguistic and anatomical profiles

Few studies have directly compared the clinical and anatomical characteristics of patients with progressive aphasia to those of patients with aphasia caused by stroke. In the current study we examined fluent forms of aphasia in these two groups, specifically semantic dementia (SD) and persisting Wernicke’s aphasia (WA) due to stroke. We compared 10 patients with SD to 10 age- and education-matched patients with WA in three language domains: language comprehension (single words and sentences), spontaneous speech and visual semantics. Neuroanatomical involvement was analyzed using disease-specific image analysis techniques: voxel-based morphometry (VBM) for patients with SD and overlays of lesion digitized lesion reconstructions in patients with WA. Patients with SD and WA were both impaired on tasks that involved visual semantics, but patients with SD were less impaired in spontaneous speech and sentence comprehension. The anatomical findings showed that different regions were most affected in the two disorders: the left anterior temporal lobe in SD and the left posterior middle temporal gyrus in chronic WA. This study highlights that the two syndromes classically associated with language comprehension deficits in aphasia due to stroke and neurodegenerative disease are clinically distinct, most likely due to distinct distributions of damage in the temporal lobe.     

Verbal and nonverbal recognition memory in aphasic and nonaphasic stroke patients

The ability to retain lists of verbal and nonverbalizable items across recurrent recognition tasks was tested in three groups: (1) stroke patients with a left-brain lesion and aphasia, (2) stroke patients with a right-brain lesion and left hemiplegia, and (3) nonneurologically impaired outpatients. As determined with signal detection measures, aphasics were deficient in discriminating words that were to be remembered from those that were not; their recognition of nonverbal visual (geometric art) or auditory (bird calls) patterns, however, was unimpaired. Left hemiplegics showed the opposite pattern. After a long-term interval (<10 min), correct recognition of words was diminished in all groups whereas recognition of visual patterns increased. Both groups of stroke patients adopted material-specific decision criteria which in part accounted for the dissociation of verbal and nonverbal recognition memory by laterality of lesion. Item analysis indicated that aphasics' verbal memory difficulties were affected by acoustic-semantic confusion of list words.     

Emerging as a Personality Disorder Service

Personality Disorder Services working along psychotherapeutic lines are gaining appeal with Health Care Commissioners following the publication of the NICE guidelines for Borderline & Antisocial Personality Disorders and the emerging successful application of psychoanalytically-derived approaches.

Establishing a new Personality Disorder Service is akin to constructing a ‘home’ within which the therapeutic work with patients can develop. As clinicians, we are required to question what facets are important to the development of this new home, and to further to endure the unfamiliar state of being ‘not at home’ while the identity of the service is established.

We address how this process parallels the task facing the patient as they struggle to establish their own identity. We also highlight some important tenets in the work of securing a robust identity for both the service and the patient suffering from a personality disorder.     

The effect of emotional context on cognitive inhibition and attentional processing in dissociative identity disorder

In light of previous research, the current study tested the hypothesis that dissociative identity disorder (DID) would be characterised by effective cognitive inhibitory functioning when tested in a neutral context, but weakened inhibition when tested in an emotionally negative context. Using a negative priming task (i.e. the flanker task) to assess inhibitory ability 11 DID, 11 depressed, and 11 general population participants were tested in the two differing experimental contexts. The contexts were manipulated by instructions and word stimuli, and following the completion of this task participants completed the Dissociative Experiences Scale and the Schizotypal Personality Scale. DID participants displayed a greater degree of self-reported anxiety in the negative context and as expected displayed a reduction in inhibition in this context but not in the neutral context. The degree of negative priming for the depressed and general population samples remained stable across contexts as did their anxiety levels. The DID sample displayed slower response times to negative compared to neutral words but this attentional bias was not evident for the two comparison groups. The relationship between increased arousal, inhibitory functioning, dissociation and information processing in DID is discussed.     

Bilingualism and Lexical Representation

Forty-eight Hindi-English bilinguals completed two blocks of trials where each trial involved presentation of a letter string requiring a lexical decision. In the first block subjects were exposed to 22 words and 11 non-words in either English or Hindi. In the second block the original words were repeated in either the same language or in the alternative language. In this block the old (repeated) words were mixed with 22 new words, and 22 non-words. Twelve subjects were included in each of the four groups given by the factorial combination of blocks and languages. Reaction time in the lexical decision task was facilitated when words were repeated in the same language (109 and 125 ms in the English-English and Hindi-Hindi groups respectively), but little or no facilitation was observed in the inter-lingual conditions (-22 and 23 ms in the Hindi-English and English-Hindi conditions respectively). The results support the view that lexical representation in bilinguals is language-specific.     

The role of reference in children's acquisition of a miniature artificial language

Nursery school children were presented with a simple miniature artificial language in one of three conditions. In the first, the stimuli to which the words referred contained an inherent lawful relationship and the language syntax reflected this relationship. In the second, the stimuli contained an inherent lawful relationship but the language syntax did not reflect this relationship. In the third, no lawful relationship existed among the stimuli to which the words referred so the language syntax imposed an arbitrary relationship among stimuli. Subjects in the first group were able to produce more correct utterances than those in the other two groups when the stimuli to which the words referred were not present, suggesting that some form of semantic mediation mechanism was being used. Evidence from novel constructions indicates that for both groups using stimuli containing an inherent lawful relation there were interactions between semantic learning mechanisms and syntax learning mechanisms.     

Changing the subject: on the subject of subjectivity

In this paper I shall attempt to argue for the simple view of personal identity. I shall first argue that we often do have warrant for our beliefs that we exist as continuing subjects of experience, and that these beliefs are justified independently of any reductionist analysis of what it means to be a person. This has two important implications that are relevant to the ongoing debate concerning the number of persons that are in existence throughout any duration in time: (1) the lack of logically or metaphysically necessary and sufficient conditions for distinguishing one person from another should imply neither that there is only one person nor that personhood is not individuative; and (2) the lack of such universally applicable identity criteria should not imply that the term ‘person’ is a folk term with no real application. In other words, lack of reductionist analysis does not entail lack of existence.