The role of interpersonal cognitive distortions, differentiation of self and interpersonal problems in predicting the organization of borderline personality in undergraduate student

Subject Areas : Clinical

Ghasem Askarizadeh ¹ , masoud bagheri ² , Maryam Arabnejd Khanuki ³

1 - Faculty of Literature and Humanities, Department of Psychology. SHahid Bahonar University
2 - Faculty of Literature and Humanities, Department of Psychology. SHahid Bahonar University
3 - Faculty of Literature and Humanities, Department of Psychology. SHahid Bahonar University

Received: 2019-03-05 Accepted : 2021-03-07 Published : 2023-02-20

Keywords: interpersonal problems, university student, Differentiation of Self, interpersonal cognitive distortions, borderline personality trait,

Abstract :

Borderline personality disorder is characterized by features such as identity diffusion, primitive defense mechanisms, fear of intimacy, and reality-testing deficiencies. The purpose of this study was to investigate the role of components of interpersonal cognitive distortions, differentiation of self and interpersonal problems in predicting of borderline personality. For data analysis, stepwise multiple regression analysis was used. 318 undergraduate students were selected by random cluster sampling and filled the Interpersonal Cognitive Distortions (Hamamci & Büyüköztürk, 2004), Differentiation of Self (Skowron & Friedlander, 1998), Interpersonal Problems (Barkham, Hardy & Startup, 1994), and Borderline Personality Scale (Leichsenring, 1999). The results of stepwise regression analysis showed that among the components of cognitive distortions, the expectation of rejection (R2= 0.20), among the components of differentiation, emotional cutoff (R2=0.34), and among The components of interpersonal problems, aggression (R2=0/15), had the most role in explaining the borderline personality (p< 0/01), which in this study were presented as " triad spacing mechanism " in the borderline personality. Also in borderline personality organization in the component of identity diffusion, cut-off (R2=0/21) in defense mechanisms, reactivity (R2=0/22), in fear of intimacy, cut-off (R2=0/34) and in reality testing, misperception (R2=0/23), had a greater role in explanation (p< 0/01). Considering these dimensions can be useful in redefining borderline personality disorder as a distance personality in preventing and intervening in treatment.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed). Washington, DC: Author

Arntz, A., & ten Haaf, J. (2012). Social cognition in borderline personality disorder: evidence for dichotomous thinking but no evidence for less complex attributions. Behaviour Research and Therapy, 50(11), 707-718.

Arntz, A., Weertman, A., & Salet, S. (2011). Interpretation bias in cluster-c and borderline personality disorders. Behaviour Research and Therapy, 49(8), 472-481.

Baer, R. A., Peters, J. R., Eisenlohr-Moul, T. A., Geiger, P. J., & Sauer, S. E. (2012). Emotion-related cognitive processes in borderline personality disorder: A review of the empirical literature. Clinical Psychology Review, 32(5), 359-369.

Barkham, M., Hardy, G. E., & Startup, M. (1996). The IIP-32: A short version of the inventory of interpersonal problems. British Journal of Clinical Psychology, 35(1), 21-35

Beeney, J. E., Hallquist, M. N., Clifton, A. D., Lazarus, S. A., & Pilkonis, P. A. (2018). Social disadvantage and borderline personality disorder: A study of social networks. Personality Disorders: Theory, Research, and Treatment, 9(1), 62-72.

Blazek, M. (2015). Structural aspects of self in personality disorders and the quality of life. Current Issues in Personality Psychology, 3(1), 42-50.

Bowen, M. (1978). Family therapy in clinical practice. Jason Aronson, New York.

Bowen, M. (1976). Theory in the practice of psychotherapy. In: P. J. Guerin, Jr. (ed.), Family therapy: theory and practice (pp. 42-90). New York: Gamer Press.

Bridge, E. N. (2019). Review of a case study in light of Bowen theory: Differentiation of self. Yaşam Becerileri Psikoloji Dergisi, 3(5), 65-72.

Budan, G. (2019). The Relationship between borderline personality organization and time perspective (Doctoral dissertation, İstanbul Bilgi Üniversitesi).

Bungert, M., Liebke, L., Thome, J., Haeussler, K., Bohus, M., & Lis, S. (2015). Rejection sensitivity and symptom severity in patients with borderline personality disorder: effects of childhood maltreatment and self-esteem. Borderline Personality Disorder and Emotion Dysregulation, 2(1), 4.

Burbridge-James, W. (2019). How can transference-focused psychotherapy (TFP) help general psychiatrists working with patients with borderline personality disorder? BJPsych Advances, 25(4), 237-239.

Chiu, C. D., Chang, J. H., & Hui, C. M. (2017). Self-concept integration and differentiation in subclinical individuals with dissociation proneness. Self and Identity, 16(6), 664-683.

Cili, S., & Stopa, L. (2018). Autobiographical memory and the self: relationship and implications for cognitive-behavioural Therapy. Routledge.

Clarkin, J. F., Hull, J. W., & Hurt, S. W. (1993). Factor structure of borderline personality disorder criteria. Journal of Personality Disorders, 7(2), 137-143.

Clarkin, J. F., Caligor, E., Stern, B., & Kernberg, O. F. (2004). Structured interview of personality organization (STIPO). Weill Medical College of Cornell University.

Cramer P. (1991). Anger and the use of defense mechanisms in college students. Journal of Personality. 59(1):39-55.

Dammann G, Hügli C, Selinger J, Gremaud-Heitz D, Sollberger D, Wiesbeck GA, Küchenhoff J, Walter M.(2011).The self-image in borderline personality disorder: an in-depth qualitative research study. Journal of Personality Disorder. Aug; 25(4):517-27.

Del Pozo, M. A., Harbeck, S., Zahn, S., Kliem, S., & Kröger, C. (2018). Cognitive distortions in anorexia nervosa and borderline personality disorder. Psychiatry Research, 260, 164-172.

Donahue, E. M., Robins, R. W., Roberts, B. W., & John, O. P. (1993). The divided self: concurrent and longitudinal effects of psychological adjustment and social roles on self-concept differentiation. Journal of Personality and Social Psychology, 64(5), 834–846.

Dökmen, Ü. (1986) The effect of education about facial expression on the ability to recognize facial expression and the tendency to experience communication conflict. Unpublished doctoral dissertation, Ankara Üniversitesi.

Downey, G., & Feldman, S. I. (1996). Implications of rejection sensitivity for intimate relationships. Journal of Personality and Social Psychology, 70(6), 1327.

Edens, J. F., Marcus, D. K., & Ruiz, M. A. (2008). Taxometric analyses of borderline personality features in a large-scale male and female offender sample. Journal of Abnormal Psychology, 117(3), 705-711.

Ellis, A. (2003). The nature of disturbed marital interaction. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 21(3-4), 147.

Ellison, W. D., Rosenstein, L., Chelminski, I., Dalrymple, K., & Zimmerman, M. (2016). The clinical significance of single features of borderline personality disorder: Anger, affective instability, impulsivity, and chronic emptiness in psychiatric outpatients. Journal of Personality Disorders, 30(2), 261-270.

Esmaeilpour, kh., Bakhshipour Rudsari, A., & mohammazadegan, R . (2015). Determining the factor structure, validity and reliability of the interpersonal cognitive distortion scale in Tabriz university students, Two Quarterly Journal of Cognitive Strategies in Learning, 2 (3), 72-53. [In Persian]

Euler, S., Stalujanis, E., Allenbach, G., Kolly, S., De Roten, Y., Despland, J. N., & Kramer, U. (2019). Dialectical behavior therapy skills training affects defense mechanisms in borderline personality disorder: An integrative approach of mechanisms in psychotherapy. Psychotherapy Research, 29(8), 1074-1085.

Fath, N., Azadfallah, Rasoolzadeh,S., & Rahimi,Ch., (2013). Validity and reliability of the inventory of interpersonal problems (IIP-32). Journal of Clinical Psychology, 5 (3), 80- 69. [In Persian]

Geiger, P., Peters, J., & Baer, R (2014). Using a measure of cognitive distortion to examine the relationship between thought suppression and borderline personality features: A multi-method investigation. Personality Individual Differences. 59, 54–59.

Gunderson, J. G. (2007). Disturbed relationships as a phenotype for borderline personality disorder. The American Journal of Psychiatry, 164(11), 1637-1640.

Hamamci Z., & Buyukozturk, S. (2004). The interpersonal cognitive distortions scale: development and psychometric characteristics. Psychological Report, 95(1), 291-303.

Hollon, S. D., & Kendall, P. C. (1980). Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research, 4(4), 383-395.

Hörz-Sagstetter, S., Caligor, E., Preti, E., Stern, B. L., De Panfilis, C., & Clarkin, J. F. (2018). Clinician-guided assessment of personality using the structural interview and the structured interview of personality organization (STIPO). Journal of Personality Assessment, 100(1), 30-42.

Hopwood, C. J. (2008). Interpersonal process and borderline personality. Texas A&M University.

Jamshidi, M., & Sarvghad, S. (2015). The mediating role of identity styles in relationship between differentiation of self and internet addiction of non-governmental high school students. Psychological Methods and Models, 6 (20), 54-37. [Persian]

Jones, M. E., & Stanton, A. L. (1988). Dysfunctional beliefs, belief similarity, and marital distress: A comparison of models. Journal of Social and Clinical Psychology, 7(1), 1-14.

Jorgensen, C. R. (2006). Disturbed sense of identity in borderline personality disorder. Journal of Personality Disorders, 20(6), 618-644.

Kerr, I. B., Finlayson-Short, L., McCutcheon, L. K., Beard, H., & Chanen, A. M. (2015). The ‘self' and borderline personality disorder: conceptual and clinical considerations. Psychopathology, 48(5), 339-348.

Kerenberg, O. (1975). Borderline conditions and pathological narcissism. Aronson, New York.

Kerenberg, O. (1984). Severe personality disorders: psychotherapeutic strategies. New Haven, CT: Yale University Press.

Kerenberg, O. (2004). Aggressivity, narcissism, and self-destructiveness in the Psychotherapeutic relationship. New Haven: Yale University Press.

Klonsky, E. D., & Glenn, C. R. (2009). Assessing the functions of non-suicidal self-injury: psychometric properties of the inventory of statements about self-injury (ISAS). Journal of Psychopathology and Behavioral Assessment, 31(3), 215-219.

Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2012). Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychological Medicine, 42(9), 1879-1890.

Lazarus, S. A., Cheavens, J. S., Festa, F., & Rosenthal, M. Z. (2014). Interpersonal functioning in borderline personality disorder: A systematic review of behavioral and laboratory-based assessments. Clinical Psychology Review, 34(3), 193-205.

Leichsenring, F., Kunst, H., & Hoyer, J. (2003). Borderline personality organization in violent offenders: Correlations of identity diffusion and primitive defense mechanisms with antisocial features, neuroticism, and interpersonal problems. Bulletin of The Menninger Clinic, 67(4), 314-327.

Leichsenring, F. (1999). Development and first results of the borderline personality inventory: A self-report instrument for assessing borderline personality organization. Journal of Personality Assessment, 73(1), 45-63.

Lenzenweger, M. F., McClough, J. F., Clarkin, J. F., & Kernberg, O. F. (2012). Exploring the interface of neurobehaviorally linked personality dimensions and personality organization in borderline personality disorder: The multidimensional personality questionnaire and inventory of personality organization. Journal of Personality Disorders, 26(6), 902-918.

Levy, K. N., Clarkin, J. F., Yeomans, F. E., Scott, L. N., Wasserman, R. H., & Kernberg, O. F. (2006). The mechanisms of change in the treatment of borderline personality disorder with transference focused psychotherapy. Journal of Clinical Psychology, 62(4), 481-501.

Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.

Liu, S. W., Luo, L., Wu, M. C., Wang, R., & Wu, Y. P. (2016). Correlation between self-differentiation and professional adaptability among undergraduate nursing students in China. International Journal of Nursing Sciences, 3(4), 394-397.

Luyten, P., Campbell, C., & Fonagy, P. (2020). Borderline personality disorder, complex trauma, and problems with self and identity: A social‐communicative approach. Journal of Personality, 88(1), 88-105.

Meares, R., Gerull, F., Stevenson, J., & Korner, A. (2011). Is self-disturbance the core of borderline personality disorder? An outcome study of borderline personality factors. Australian and New Zealand Journal of Psychiatry, 45(3), 214-222

Meares, L., Gumst, G., Garino, A., (2006). Applied multivariate research. Translated by Sharifi, Rezakhani, Hassanabadi, Izanloo and Habibi (1395). Tehran: Roshd.

Melges, F. T., & Swartz, M. S. (1989). Oscillations of attachment in borderline personality disorder. The American Journal of Psychiatry, 146(9), 1115-1120.

Meyer, N. A., Helle, A. C., Tucker, R. P., Lengel, G. J., DeShong, H. L., Wingate, L. R., & Mullins-Sweatt, S. N. (2017). Humor styles moderate borderline personality traits and suicide ideation. Psychiatry Research, 249, 337-342.

Millon, T., Grossman, S., Millon, C., Meagher, S., & Ramnath, R. (2004). Personality disorder in modern life. (2 th ed). New Jersey: John Wiley & Sons, Inc

Millon T., Millon C., & Davis R.D. (1994) Millon clinical multiaxial inventory-III [MCMI-III]. Minneapolis, MN: National computer system.

Mohammadzadeh, A., Rezaei, A. (2011). Validation of the borderline personality questionnaire in iranian society. Journal of Behavioral Sciences.5 (3), 278-269. [In Persian]

Najaflouy, F.  (2006). The role of self-differentiation in marital relations. Journal of New Thoughts on Education, 2(3-4): 27-37. [In Persian]

Neacsiu, A. D., Herr, N. R., Fang, C. M., Rodriguez, M. A., & Rosenthal, M. Z. (2015). Identity disturbance and problems with emotion regulation are related constructs across diagnoses. Journal of Clinical Psychology, 71(4), 346-361.

Nichols, MP. Schwartz, RC. (2001). Family therapy: Concepts and methods. 5th ed. Boston: Allyn & Bacon.

Peters, J. R., Smart, L. M., & Baer, R. A. (2015). Dysfunctional responses to emotion mediate the cross-sectional relationship between rejection sensitivity and borderline personality features. Journal of Personality Disorders, 29(2), 231-240.

Peleg, O., & Zoabi, M. (2014). Social anxiety and differentiation of self: A comparison of Jewish and Arab college students. Personality and Individual Differences, 68, 221-228.

Pincus, A. L. (2018). An interpersonal perspective on criterion A of the DSM-5 alternative model for personality disorders. Current Opinion in Psychology, 21, 11-17.

Presniak, M. D., Olson, T. R., & MacGregor, M. W. (2010). The role of defense mechanisms in borderline and antisocial personalities. Journal of Personality Assessment, 92(2), 137-145.

Rahimi T., & Mohamadzade, A. (2016). The Relationship between differentiation of self with addiction potential based on the Bowen family system. Journal of Police Medicine, 5(1), 7-16. [In Persian]

Rodríguez‐González, M., Schweer‐Collins, M., Skowron, E. A., Jódar, R., Cagigal, V., & Major, S. O. (2019). Stressful life events and physical and psychological health: Mediating effects of differentiation of self in a Spanish sample. Journal of Marital and Family Therapy, 45(4), 578-591.

Russell, J. J., Moskowitz, D. S., Zuroff, D. C., Sookman, D., & Paris, J. (2007). Stability and variability of affective experience and interpersonal behavior in borderline personality disorder. Journal of Abnormal Psychology, 116(3), 578-588.

Sadikaj, G., Russell, J. J., Moskowitz, D. S., & Paris, J. (2010). Affect dysregulation in individuals with borderline personality disorder: Persistence and interpersonal triggers. Journal of Personality Assessment, 92(6), 490-500.

Sandage, S. J., Jankowski, P. J., Bissonette, C. D., & Paine, D. R. (2017). Vulnerable narcissism, forgiveness, humility, and depression: Mediator effects for differentiation of self. Psychoanalytic Psychology, 34(3), 300-310.

Sato, M., Fonagy, P., & Luyten, P. (2020). Rejection sensitivity and borderline personality disorder features: the mediating roles of attachment anxiety, need to belong, and self-criticism. Journal of Personality Disorders, 34(2), 273-288.

Skowron, E. A. (2000). The role of differentiation of self in marital adjustment. Journal of Counseling Psychology, 47(2), 229.

Skowron, E. A., & Friedlander, M. L. (1998). The Differentiation of self inventory development and initial validation. Journal of Counseling Psychology, 45(3), 235-246.

Skowron, E. A., & Schmitt, T. A. (2003). Assessing interpersonal fusion: reliability and validity of a new DSI fusion with others subscale. Journal of Marital and Family Therapy, 29(2), 209-222.

Skowron, E. A. (2004). Differentiation of self, personal adjustment, problem solving, and ethnic group belonging among persons of color. Journal of Counseling & Development, 82(4), 447-456.

Skowron, E. A., Stanley, K. L., & Shapiro, M. D. (2009). A longitudinal perspective on differentiation of self, interpersonal and psychological well-being in young adulthood. Contemporary Family Therapy: An International Journal, 31(1), 3-18.

Spanier, G. B. (1989). Dyadic adjustment scale. Toronto: multi-health systems.

Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics, 5th edn New York. NY: Allyn and Bacon.

Titelman, P. (2014).Clinical applications of Bowen family systems theory. New yourk. P.38

Vogel, M., Frenzel, L., Riediger, C., Haase, M., Frommer, J., Lohmann, C. H., & Illiger, S. (2020). The pain paradox of borderline personality and total knee arthroplasty (TKA): Recruiting borderline personality organization to predict the one-year postoperative outcome. Journal of Pain Research, 13, 49.

Walter, M., Berth, H., Selinger, J., Gerhard, U., Küchenhoff, J., Frommer, J., & Dammann, G. (2009). The lack of negative affects as an indicator for identity disturbance in borderline personality disorder: A preliminary report. Psychopathology, 42(6), 399-404.

Wei, M., Vogel, D. L., Ku, T.-Y., & Zakalik, R. A. (2005). Adult attachment, affect regulation, negative mood, and interpersonal problems: The mediating roles of emotional reactivity and emotional cutoff. Journal of Counseling Psychology, 52(1), 14-24.

Westen, D., Betan, E., & Defife, J. A. (2011). Identity disturbance in adolescence: Associations with borderline personality disorder. Development and Psychopathology, 23(1), 305-313.

Winsper, C., Bilgin, A., Thompson, A., Marwaha, S., Chanen, A. M., Singh, S. P., ... & Furtado, V. (2020). The prevalence of personality disorders in the community: a global systematic review and meta-analysis. The British Journal of Psychiatry, 216(2), 69-78.

Zimmer‐Gembeck, M. J., & Nesdale, D. (2013). Anxious and angry rejection sensitivity, social withdrawal, and retribution in high and low ambiguous situations. Journal of Personality, 81(1), 29-38.