Affect in early memories of borderline patients

Psychoanalytically oriented observers using the framework of object relations theory noted that patients with borderline personality organization manifest serious pathology in their capacity to use internalized imagery to cope with the vicissitudes of separation-individuation. This study examined one source of such imagery, the affect associated with a specific sample of early memories, including the earliest recollections of parents. Patients with borderline personality disorder were compared with paranoid schizophrenics and patients with neurotic character pathology. Forty-five outpatients, 15 in each group, participated in the study. It was found that borderline patients had significantly fewer positively toned early memories than neurotics or paranoid schizophrenics. Only the neurotic group, had a majority of affectively positive memories. The results are generally consistent with object relations theories of borderline psychopathology.     

Qualitative and Quantitative Szondi Diagnosis

Psychoanalytically oriented observers using the framework of object relations theory noted that patients with borderline personality organization manifest serious pathology in their capacity to use internalized imagery to cope with the vicissitudes of separation-individuation. This study examined one source of such imagery, the affect associated with a specific sample of early memories, including the earliest recollections of parents. Patients with borderline personality disorder were compared with paranoid schizophrenics and patients with neurotic character pathology. Forty-five outpatients, 15 in each group, participated in the study. It was found that borderline patients had significantly fewer positively toned early memories than neurotics or paranoid schizophrenics. Only the neurotic group, had a majority of affectively positive memories. The results are generally consistent with object relations theories of borderline psychopathology.     

The Present Status of Group Therapy in United States Correctional Institutions

A time-limited group treatment program focusing on mothers of toddlers with a borderline personality disorder is reported. The project involved two intersecting groups—the toddler group and the mother group. The focus of the work with the children was to promote their social interests and skills to an expanded world beyond the maternal dyad. The focus of the work with the mothers was on their difficulties with emotional separation-individuation and on strengthening their ego functioning, particularly in the area of mothering so that they could participate positively in their child's separation-individuation phase.

Representative group process is presented as it organized around three distinct phases. The initial phase was marked by intense resistance, and ambivalence. During the middle phase, group cohesion developed around shared feelings and issues. The termination phase focused insistently on issues of separation. Conclusions drawn from the project include the utility of a group approach in influencing maternal behavior.     

An Exploration of Separation-Individuation Themes in the Borderline Personality Disorder

In an attempt to test hypotheses derived from Mahler's theory of borderline development, Rorschach protocols of borderline and schizophrenic patients were studied for the presence of themes related to the separation-individuation process. A specially constructed Separation-individuation Theme Scale was used with a 96% reliability of agreement between two raters. The borderline group attained more separation-individuation themes than the schizophrenic group, whereas the schizophrenics showed more preseparation-individuation themes. The results were interpreted as a validation of Mahler's theory. In addition, the results tended to confirm a developmental model for the understanding of psychopathology.     

An exploration of separation-individuation themes in the borderline personality disorder

In an attempt to test hypotheses derived from Mahler's theory of borderline development, Rorschach protocols of borderline and schizophrenic patients were studied for the presence of themes related to the separation-individuation process. A specially constructed Separation-Individuation Theme Scale was used with a 96% reliability of agreement between two raters. The borderline group attained more separation-individuation themes than the schizophrenic group, whereas the schizophrenics showed more preseparation-individuation themes. The results were interpreted as a validation of Mahler's theory. In addition, the results tended to confirm a developmental model for the understanding of psychopathology.     

Aloneness and borderline psychopathology: the possible relevance of child development issues.

The experience of intense painful aloneness is a common event in the lives of borderline patients, especially those closer to the psychotic spectrum. This experience is defined as an intrinsic aspect of the borderline personality defect and consists of a relative or total inability to remember positive images or fantasies of sustaining people in the patient's present or past life, or being overwhelmed by negative memories and images of these people. The development of borderline aloneness is related to a possible developmental failure, defined by Piaget, Fraiberg, and A.-M. Sandler. These workers describe the child's development of object permanence and evocative memory capacity (Piaget's sensori-motor stage VI). We postulate that a major borderline vulnerability is the tenuous achievement of the capacity for affective object permanence and its regressive loss to recognition memory or earlier when under specific stresses. We relate our hypotheses to possible empathic parental failures during the substages of separation-individuation, especially the rapprochement sub-phase. The treatment implications of our formulations are discussed, with an emphasis on the clarification of the need for the therapist's availability and the use of transitional objects during times of the patient's loss of his affective cognitive capacities. These regressive experiences often emerge as a core transference manifestation during psychoanalytic therapy with borderline patients, and often become the basis of significant therapeutic work.     

Assessment of mindfulness by self-report: the Kentucky inventory of mindfulness skills

A self-report inventory for the assessment of mindfulness skills was developed, and its psychometric characteristics and relationships with other constructs were examined. Participants included three samples of undergraduate students and a sample of outpatients with borderline personality disorder Based on discussions of mindfulness in the current literature, four mindfulness skills were specified: observing, describing, acting with awareness, and accepting without judgment. Scales designed to measure each skill were developed and evaluated. Results showed good internal consistency and test-retest reliability and a clear factor structure. Most expected relationships with other constructs were significant. Findings suggest that mindfulness skills are differentially related to aspects of personality and mental health, including neuroticism, psychological symptoms, emotional intelligence, alexithymia, experiential avoidance, dissociation, and absorption.     

Occupational Therapy Treatment

This paper describes borderline phenomenon as it relates to occupational therapy treatment groups. The author discusses the genesis of the syndrome from the separation-individuation phase, its relation to adult functioning, subsequent treatment design and recommended therapeutic interventions. A case illustration will highlight these elements.     

Shall we continue or stop disapproving of self-presentation? Evidence on impression management and faking in a selection context and their relation to job performance

The self-presentation tactics of candidates during job interviews and on personality inventories have been a focal topic in selection research. The current study investigated self-presentation across these two selection devices. Specifically, we examined whether candidates who use impression management (IM) tactics during an interview show more faking on a personality inventory and whether the relation to job performance is similar for both forms of self-presentation. Data were collected in a simulated selection process with an interview under applicant conditions and a personality inventory that was administered under applicant conditions and thereafter for research purposes. Because all participants were employed, we were also able to collect job performance ratings from their supervisors. Candidates who used IM in the interview also showed more faking in a personality inventory. Importantly, faking was positively related to supervisors’ job performance ratings, but IM was unrelated. Hence, this study gives rise to arguments for a more balanced view of self-presentation.     

Borderline personality disorder from the perspective of general personality functioning

The authors extended previous work on the hypothesis that borderline personality disorder (BPD) can be understood as a maladaptive variant of personality traits included within the 5-factor model (FFM) of personality. In each of 3 samples, an empirically derived prototypic FFM borderline profile was correlated with individuals' FFM profiles to yield a similarity score, an FFM borderline index. Results across all samples indicated that the FFM borderline index correlated as highly with existing borderline measures as they correlated with one another, and the FFM borderline index correlated as highly with measures of dysfunction, history of childhood abuse, and parental psychopathology as did traditional measures of BPD. Findings support the hypothesis that BPD is a maladaptive variant of FFM personality traits.     

Suicide as a resolution of separation-individuation among adolescent girls

The purpose of this study was to discover if there is a relationship between suicidal adolescent girls and borderline phenomena, and to examine separation anxiety in suicidal girls. Hansburg's Separation Anxiety Test and Gunderson's Diagnostic Interview for Borderline Disorder were administered to 40 adolescent girls. Only those girls that had attempted suicide were included in this study. The findings of this research suggested that adolescent suicide is a borderline phenomena that has its roots in the early separation-individuation phase of development, resulting in separation anxiety. The adolescent girl gets relief from the abandonment depression and feelings of separateness by using suicide as a vehicle for regression to a symbiotic state where she earlier had experienced safety.     

The Relationship Between Forgiveness and Borderline Personality Symptomatology

The relationship between forgiveness and borderline personality symptomatology has been rarely studied. Using a consecutive cross-sectional sample of 307 internal medicine outpatients and a survey methodology, we examined correlations between the Forgiveness Scale and borderline personality symptomatology as measured by the borderline personality disorder scale of the Personality Diagnostic Questionnaire-4 and the Self-Harm Inventory. Numerous forgiveness subscales as well as the composite Forgiveness Scale score demonstrated statistically significant relationships with both measures for borderline personality symptomatology, such that individuals with this personality pathology demonstrated lower scores on these forgiveness subscales. Findings indicate that among individuals with borderline personality symptomatology, there are numerous aspects of forgiveness that are significantly lower than in individuals without this symptomatology.     

A comparison of depressed patients with and without borderline personality disorder: implications for interpreting studies of the validity of the bipolar spectrum

The nosological status of borderline personality disorder as it relates to the bipolar disorder spectrum has been controversial. Studies have supported, in part, the validity of the bipolar spectrum by demonstrating that these patients, compared to patients with nonbipolar depression, are characterized by earlier age of onset of depression, recurrent depressive episodes, comorbid anxiety and substance use disorders and increased suicidality. However, all of these factors have likewise been found to distinguish depressed patients with and without borderline personality disorder. A family history of bipolar disorder is one of the few disorder specific validators. In the present study from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we compared the demographic and clinical characteristics of depressed patients with and without borderline personality disorder. We hypothesized that many of the factors used to validate the bipolar spectrum will also distinguish depressed patients with and without borderline personality disorder except, however, a family history of bipolar disorder. Two thousand nine hundred psychiatric outpatients at Rhode Island Hospital were evaluated with the Structured Clinical Interview for DSM-IV (SCID) and Structured Interview for DSM-IV Personality Disorders (SIDP-IV). Family history information regarding first-degree relatives was obtained from the patient using the Family History Research Diagnostic Criteria. One hundred and one patients with borderline personality disorder plus major depressive disorder were compared to 947 patients with major depressive disorder alone on the prevalence of bipolar disorder validators. Compared to depressed patients without borderline personality disorder, depressed patients with borderline personality disorder had a younger age of onset, more depressive episodes, a greater likelihood of experiencing atypical symptoms and had a higher prevalence of comorbid anxiety disorders, substance use disorders, and number of previous suicide attempts. The depressed patients with borderline personality disorder did not significantly differ from the patients without borderline personality disorder on morbid risk for bipolar disorder in first degree relatives. In addition, patients with a diagnosis of bipolar disorder had a significantly higher morbid risk of bipolar disorder in first degree relatives than the borderline personality disorder group. The findings indicate that many factors used to validate the bipolar spectrum are not disorder specific. These results raise questions about studies of the validity of the broad bipolar spectrum that do not assess borderline personality disorder. Our results do not support inclusion of borderline personality disorder as part of the bipolar spectrum.     

The Utility of the MAPI in the Assessment of Depression

The relationships between the Millon Adolescent Personality inventory (MAPI; Millon, Green, & Meagher, 1982) and depression, as assessed by the Multiscore Depression Inventory (MDI; Berndt, 1968) were examined. Elevations on the MDI subscales were positively related to elevations on MAPI personality style Scale 2 (Inhibited) and Scale 8 (Sensitive) and on six of the eight MAPI expressed concerns scales. MAPI personality style Scale 4 (Sociable) and Scale 5 (Confident) were negatively correlated with the MDI. MAPI code types containing either Scale 2 or 8 were associated with a high MDI full-scale score. The subjects who received a MAPI computer-generated diagnosis of borderline personality disorder also had elevated MDI full-scale scores. The findings of this study appear consistent with the existing body of MAPI research, and the data suggest that the MAPI personality style scales may have both state and trait qualities.     

The impact of father absence on adolescent separation-individuation

The authors compared separation-individuation and psychological separation from fathers of 25 adolescent boys who were living with both biological parents with that of 25 boys who were living with their biological mothers in homes in which the fathers did not reside. The results showed that the boys in the 2 groups did not differ on measures of separation-individuation and that the quality of the mother-son relationship mediated several of the assessed separation-individuation manifestations. The authors' initial data analysis with regard to psychological separation showed that boys who lived in homes in which the father was a nonresident were more separated on 2 of the 4 dimensions assessed; however, when controlled for quality of mother-son and father-son relationship, these differences were not significant. The frequency of father contact in homes in which the father did not reside was positively correlated with healthy separation but negatively correlated with functional, attitudinal, and emotional independence from the father. The results of the study support the importance of the quality of a child's relationship with his or her mother and father as a mediator of several dimensions of the separation-individuation process.     

To stay or to return: Rapprochement processes in the migration of adolescents and young adults

The migration of adolescents and young adults is analyzed in terms of the separation-individuation process—an attempt at separation, reflecting conflictual feelings around autonomy and dependency needs. This paper focuses on the acute ambivalence typical of the rapprochement phase of personality development during childhood and applying this to understanding the adolescent and young adult during their migration experiences. The young immigrants to Israel are observed to alternate between physical approaching and then distancing in relation to both the new country (Israel) and the country of origin (the homeland). Four clinical examples of young persons are presented to illustrate the rapprochement process in some immigrants.     

The MMPI, prototypal typology, and borderline personality disorder

This study demonstrates inherent features in the DSM-III diagnostic criteria for personality disorders (i.e., overlapping diagnoses and heterogeneous symptomatology) that limit efforts to identify a sensitive and specific MMPI profile for the borderline personality disorder. A sample of 71 inpatients was administered an MMPI and a semistructured interview that systematically evaluated each of 81 symptoms for the 11 DSM-III personality disorders. Interrater reliability was substantially higher than has been obtained with unstructured interviews. The effect on the borderline MMPI profile of variation in the number of borderline symptoms and overlap with the schizotypal, histrionic, and antisocial diagnoses was demonstrated. We discuss implications with respect to a prototypal model of classification.     

The rorschach search for the borderline Holy Grail: an examination of personality structure, personality style, and situation

Much of the research on the use of the Rorschach to diagnose borderline disturbance has sought to discover a specific borderline pattern or Rorschach configuration. Given our increased understanding of borderline functioning representing a level of personality organization (or personality structure), this single pattern approach is excessively simplistic. It fails to consider the complex interaction between personality structure, personality style, and situational variables. An approach to the Rorschach assessment of borderline functioning is presented using a clinical example. The patient was tested at the onset of psychotherapy and then some 4 years into treatment. Results from the two testings were compared using Weiner and Exner's (1991) Rorschach variable clusters for assessing change in psychotherapy.     

Positive affective and cognitive states in borderline personality disorder

The aim of the current study was to compliment previous studies identifying negative states present in borderline personality disorder (BPD) by investigating the presence of positive affective and cognitive states. Ninety-six patients with criteria-defined borderline personality disorder and 24 axis II comparison participants completed the Positive Affect Scale, a 50-item self-report measure designed to assess positive states thought to be characteristic of and discriminating for BPD. Seventeen positive states (4 affective, 10 cognitive, and 3 mixed) were found to be significantly more common among axis II comparison participants than borderline patients. Twelve of these states were common to both borderline patients and axis II comparison participants. Furthermore, four positive states, when co-occurring together, were particularly strongly associated with borderline personality disorder (three negatively and one positively): (a) Fond of myself, (b) That things around me are real, (c) That I've forgiven others, and (d) Assertive. Finally, the overall mean score on the PAS significantly distinguished patients with borderline personality disorder from axis II comparison participants. Taken together, these results suggest that borderline patients are far less likely to report experiencing positive states of an affective, cognitive, and mixed nature than axis II comparison participants. They also suggest that being assertive is a positive state particularly discriminating for borderline personality disorder.     

Maternal personality, parenting cognitions, and parenting practices

A community sample of 262 European American mothers of firstborn 20-month-olds completed a personality inventory and measures of parenting cognitions (knowledge, self-perceptions, and reports about behavior) and was observed in interaction with their children from which measures of parenting practices (language, sensitivity, affection, and play) were independently coded. Factor analyses of the personality inventory replicated extraction of the 5-factor model of personality (Openness, Neuroticism, Extraversion, Agreeableness, and Conscientiousness). When controlling for sociodemographic characteristics, the 5 personality factors qua variables and in patterns qua clusters related differently to diverse parenting cognitions and practices, supporting the multidimensional, modular, and specific nature of parenting. Maternal personality in the normal range, a theoretically important but empirically neglected factor in everyday parenting, has meaning in studies of parenting, child development, and family process.