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Relationship of Personality to Dissociation and Childhood Trauma in Borderline Personality Disorder

Published online by Cambridge University Press:  07 November 2014

Abstract

Background:

Dissociation is a prominent feature in some individuals with borderline personality disorder (BPD), yet our understanding of the meanings and implications of prominent dissociation in BPD remains limited. The purpose of this study was to investigate the relationship between dissociation and childhood trauma in BPD and to explore the relationships of dissociation and trauma to various personality features of BPD.

Methods:

Twenty BPD subjects and 24 healthy comparison subjects of similar age and gender were administered the Dissociative Experiences Scale, the Childhood Trauma Questionnaire—short form, the Tridimensional Personality Questionnaire, the Defense Style Questionnaire, the Relationship Style Questionnaire, and the Schema Questionnaire.

Results:

The BPD group exhibited greater dissociation and childhood trauma, as well as greater pathology in most personality variables, compared with the healthy group. Dissociation in BPD was not significantly related to total childhood trauma, but only to emotional neglect, which accounted for 23% of the variance in dissociation scores.

Conclusion:

Within the BPD group, dissociation was associated with fearful attachment and immature defenses, while total childhood trauma and emotional neglect were associated with overconnection and disconnection schemata. This is a preliminary study with a small sample size, yet the correlates of dissociation in BPD merit further investigation.

Type
Original Research
Copyright
Copyright © Cambridge University Press 2003

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References

REFERENCES

1.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
2.Skodol, AE, Gunderson, JG, Pfohl, B, et al.The borderline diagnosis I: psychopathology, comorbidity, and personality structure. Biol Psychiatry. 2002;51:936950.CrossRefGoogle ScholarPubMed
3.Zanarini, MC, Ruser, T, Frankenburg, FR, Hennen, J. The dissociative experiences of borderline patients. Compr Psychiatry. 2000;41:223227.CrossRefGoogle ScholarPubMed
4.Zanarini, MC, Ruser, TF, Frankenburg, FR, Hennen, J, Gunderson, JG. Risk factors associated with the dissociative experiences of borderline patients. J Nerv Ment Dis. 2000;188:2630.CrossRefGoogle ScholarPubMed
5.Goodman, M, New, A, Mitropoulou, V, et al. Pathological dissociation in borderline personality disorder: the role of childhood trauma and serotonergic genes. Abstract presented at: Annual Meeting of the Society of Biological Psychiatry; May 3-5, 2001; New Orleans, LA; Abstract #248.Google Scholar
6.Brodsky, BS, Cloitre, M, Dulit, RA. Relationship of dissociation to self-mutilation and childhood abuse in borderline personality disorder. Am J Psychiatry. 1995;152:17881792.Google ScholarPubMed
7.Zlotnick, C, Mattia, JI, Zimmerman, M. Clinical correlates of self-mutilation in a sample of general psychiatric patients. J Nerv Ment Dis. 1999;187:296301.CrossRefGoogle Scholar
8.Shearer, SL. Dissociative phenomena in women with borderline personality disorder. Am J Psychiatry. 1994;151:13241328.Google ScholarPubMed
9.Wildgoose, A, Waller, G, Clarke, S, Reid, A. Psychiatric symptomatology in borderline and other personality disorders: dissociation and fragmentation as mediators. J Nerv Ment Dis. 2000;188:757763.CrossRefGoogle ScholarPubMed
10.Bohus, MJ, Landwehrmeyer, GB, Stiglmayr, CE, Limberger, MF, Bohme, R, Schmahl, CG. Naltrexone in the treatment of dissociative symptoms in patients with borderline personality disorder: an open-label trial. J Clin Psychiatry. 1999;60:598603.CrossRefGoogle ScholarPubMed
11.Kennerley, H. Cognitive therapy of dissociative symptoms associated with trauma. Br J Clin Psychol. 1996;35(pt 3):325340.CrossRefGoogle ScholarPubMed
12.Wildgoose, A, Clarke, S, Waller, G. Treating personality fragmentation and dissociation in borderline personality disorder: a pilot study of the impact of cognitive analytic therapy. Br J Med Psychol. 2001;74(pt 1):4755.CrossRefGoogle ScholarPubMed
13.Kernberg, O. Borderline Conditions and Pathological Narcissism. New York, NY: Jason Aronson; 1975.Google Scholar
14.Paris, J, H, Zweig-Frank, Bond, M, Guzder, J. Defense styles, hostility, and psychological risk factors in male patients with personality disorders. J Nerv Ment Dis. 1996;184:153158.CrossRefGoogle ScholarPubMed
15.Koenigsberg, HW, Harvey, PD, Mitropoulou, V, et al.Are the interpersonal and identity disturbances in the borderline personality disorder criteria linked to the traits of affective instability and impulsivity. J Personal Disord. 2001;15:358370.CrossRefGoogle Scholar
16.Meyer, C, Leung, N, Feary, R, Mann, B. Core beliefs and bulimic symptomatology in non-eating-disordered women: the mediating role of borderline characteristics. Int J Eat Disord. 2001;30:434440.CrossRefGoogle ScholarPubMed
17.Svrakic, DM, Whitehead, C, Przybeck, TR, Cloninger, CR. Differential diagnosis of personality disorders by the seven-factor model of temperament and character. Arch Gen Psychiatry. 1993;50:991999.CrossRefGoogle ScholarPubMed
18.Fossati, A, Donati, D, Donini, M, Novella, L, Bagnato, M, Maffei, C. Temperament, character, and attachment patterns in borderline personality disorder. J Personal Disord. 2001;15:390402.CrossRefGoogle ScholarPubMed
19.Pukrop, R. Dimensional personality profiles of borderline personality disorder in comparison with other personality disorders and healthy controls. J Personal Disord. 2002;16:135147.CrossRefGoogle ScholarPubMed
20.Grabe, HJ, Spitzer, C, Juergen Freyberger, H. Relationship of dissociation to temperament and character in men and women. Am J Psychiatry. 1999;156:18111813.CrossRefGoogle ScholarPubMed
21.Romans, SE, Martin, JL, Morris, E, Herbison, GP. Psychological defense styles in women who report childhood sexual abuse: a controlled community study. Am J Psychiatry. 1999;156:10801085.CrossRefGoogle ScholarPubMed
22.Simeon, D, Guralnik, O, Knutelska, M, Schmeidler, J. Personality factors associated with dissociation: temperament, defenses, and cognitive schemata. Am J Psychiatry. 2002;159:489491.CrossRefGoogle ScholarPubMed
23.Zanarini, MC, Frankenburg, FR. Pathways to the development of borderline personality disorder. J Personal Disord. 1997;11:93104.CrossRefGoogle Scholar
24.van Ijzendoorn, MH, Schuengel, C. The measurement of dissociation in normal and clinical populations: meta-analytic validation of the Dissociative Experiences Scale (DES). Clin Psychol Rev. 1996;16:365382.CrossRefGoogle Scholar
25.Waller, NG, Ross, CA. The prevalence and biometric structure of pathological dissociation in the general population: taxometric and behavior genetic findings. J Abnorm Psychol. 1997;106:499510.CrossRefGoogle ScholarPubMed
26.Jang, KL, Paris, J, Zweig-Frank, H, Livesley, WJ. Twin study of dissociative experience. J Nerv Ment Dis. 1998;186:345351.CrossRefGoogle ScholarPubMed
27.First, MB, Spitzer, RL, Gibbon, M, et al.Structured Clinical Interview for DSMIV Axis I Disorders, Patient Version (SCID-P). version 2. New York, NY: New York State Psychiatric Institute, Biometrics Reasearch; 1995.Google Scholar
28.Pfohl, B, Blum, N, Zimmerman, M. Structured Interview for DSM-IV Personality. Washington, DC: American Psychiatric Association; 1997.Google Scholar
29. Bernstein-Carlson E, Putnam, FW. An update on the Dissociative Experiences Scale. Dissociation. 1993;6:1627.Google Scholar
30.Bernstein, DP, Fink, L, Handelsman, L, et al.Initial reliabililty and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry. 1994;151:11321136.Google Scholar
31.Bernstein, DP, Stein, JA, Newcomb, MD, et al.Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003;27:169190.CrossRefGoogle ScholarPubMed
32.Cloninger, CR. A systematic method for clinical description and classification of personality variants. A proposal. Arch Gen Psychiatry. 1987;44:573588.CrossRefGoogle ScholarPubMed
33.Bond, M. An empirical study of defensive styles: the Defense of Style Questionnaire. In: Vaillant, GE, ed. Mechanisms of Defense. A Guide for Clinicians and Researchers. Washington, DC: American Psychiatric Association; 1992:127158.Google Scholar
34.Andrews, G, Pollock, C, Stewart, G. The determination of defense style by questionnaire. Arch Gen Psychiatry. 1989;46:455460.CrossRefGoogle ScholarPubMed
35.Schmidt, NB, Young, JE, Telch, MJ. The Schema questionnaire: investigation of psychometric properties and the hierarchical structure of a measure of maladaptive schemas. Cogn Ther Res. 1995;19:295321.CrossRefGoogle Scholar
36.Griffin, D, Bartholomew, K. The metaphysics of measurement: the case of adult attachment. In: Bartholomew, K, Perlman, D, eds. Advances in Personal Relationships. Vol. 5. Attachment Processes in Adulthood. London, England: Jessica Kingsley Publishers; 1994:1752.Google Scholar
37.Ross-Gower, J, Waller, G, Tyson, M, Elliott, P. Reported sexual abuse and subsequent psychopathology among women attending psychology clinics: the mediating role of dissociation. Br J Clin Psychol. 1998;3(pt 3):313326.CrossRefGoogle Scholar
38.Zweig-Frank, H, Paris, J. Parents' emotional neglect and overprotection according to the recollections of patients with borderline personality disorder. Am J Psychiatry. 1991;148:648651.Google Scholar
39.Timmerman, IG, Emmelkamp, PM. The relationship between traumatic experiences, dissociation, and borderline personality pathology among male forensic patients and prisoners. J Personal Disord. 2001;15:136149.CrossRefGoogle ScholarPubMed
40.Carlson, EB, Dalenberg, C, Armstrong, J, Daniels, JW, Loewenstein, R, Roth, D. Multivariate prediction of posttraumatic symptoms in psychiatric inpatients. J Trauma Stress. 2001;14:549567.CrossRefGoogle ScholarPubMed
41.Draijer, N, Langeland, W. Childhood trauma and perceived parental dysfunction in the etiology of dissociative symptoms in psychiatric inpatients. Am J Psychiatry. 1999;156:379385.CrossRefGoogle ScholarPubMed
42.Brunner, R, Parzer, P, Schuld, V, Resch, F. Dissociative symptomatology and traumatogenic factors in adolescent psychiatric patients. J Nerv Ment Dis. 2000;188:7177.CrossRefGoogle ScholarPubMed
43.Modestin, J, Lotscher, K, Erni, T. Dissociative experiences and their correlates in young non-patients. Psychol and Psychother. 2002;75:5364.CrossRefGoogle ScholarPubMed
44.Zanarini, MC, Frankenburg, FR, Reich, DB, et al.Biparental failure in the childhood experiences of borderline patients. J Personal Disord. 2000;14:264273.CrossRefGoogle ScholarPubMed
45.Zanarini, MC, Williams, AA, Lewis, RE, et al.Reported pathological childhood experiences associated with the development of borderline personality disorder. Am J Psychiatry. 1997;154:11011106.Google ScholarPubMed