Subtypes of Identity Disturbance and Their Impact on the Course of Borderline Personality Disorder Over 16 Years of Prospective Follow Up
Richman, Mara J.
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Identity disturbance is often described as a core sector of psychopathology in borderline personality disorder (BPD), a mental illness characterized by severe abandonment and interpersonal issues. The following study took this into account and had two objectives. The first was to determine if specific identity disturbances (suffering, internal badness, and painful sense of no identity) are more pronounced in BPD patients compared to axis II comparison participant s over the past decade and a half. The second was to determine whether the course of recovery in borderline patients (i.e., concurrent symptomatic remission and good psychosocial functioning) is influenced by a specific identity disturbance subtype: no identity, suffering, or internal badness. Identity disturbance was reassessed every two years using thirteen items from the using four items from the Dysphoric Affect Scale (DAS)— a self-report of 50 items that describes dysphonic inner states (affective and cognitive states) found to be common and/or discriminating for BPD. Both the BPD and axis II comparison group reported a 51% decrease in suffering identity over time. While all forms of identity disturbance predicted two-year recovery in bivariate analysis, only identity with a sense of badness predicted significantly slower time to two-year recovery. Taken together, the results suggest subtypes of identity disturbance exist among BPD patients, are endorsed more strongly in BPD patients than in axis II comparison participant s, and are associated with different courses of the disorder.