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This study aimed to investigate predictors of vocational disengagement (referred to as Not in Employment, Education, or Training [NEET]) in young people with borderline personality disorder (BPD). The sample comprised 112 outpatients with a BPD diagnosis, aged 15–25 years, who participated in a randomized controlled trial (ANZCTR12610000100099). The proportion of participants who were NEET (39.3%) at study entry did not improve after 18 months and NEET status frequently changed. Therefore, multinomial regression analyses were used to study three groups: Non-NEET, NEET, and Unstable NEET status. NEET status was predicted by not achieving expected age-appropriate educational milestones, greater instability in identity, and emptiness. Greater instability in interpersonal relationships and identity predicted Unstable NEET status. The findings suggest that specific vocational interventions, that also incorporate a focus on interpersonal functioning, emptiness, and identity disturbance, are needed to improve functioning in youth with BPD, especially when educational milestones are not achieved.

Traditional conceptions of personality disorder (PD) view severe identity disturbance as a defining characteristic of borderline personality disorder (BPD). In the alternative DSM-5 model for PDs (AMPD) and in the outlined substantial changes to PD diagnostics in ICD-11, disturbances in self and identity are elevated from a specific diagnostic criterion for BPD to a defining criterion for PD in general. In line with Kernberg’s theory of personality organization (PO), it is expected that although identity disturbance may be characteristic of most or all PDs, severe identity diffusion is a more pronounced and defining characteristic of BPD and possibly other PDs organized on a borderline level (BPO). Here, we examined the level of identity disturbance in SCID-diagnosed patients with BPD, narcissistic PD (NPD), avoidant PD (AVPD), comorbid BPD with NPD and AVDP, as well as other specified PD (PD-OT). We found that measures of identity diffusion were higher in BPD and NPD patients compared with patients diagnosed with AVPD. Hierarchical multiple regression analyses showed that number of SCID criteria met for BPD and NPD predicted level of identity diffusion when gender, age and general symptomatology were controlled for, whereas number of SCID criteria met for AVPD did not. The presented data support severe identity diffusion as a prominent characteristic of BPD with possible implications for how we should differentiate BPD from other PDs. The findings are discussed in relation to Kernberg’s model and the AMPD.

This research study focuses on identifying whether personal narratives are effective in constructing narrative identity and reconstructing identity disturbance in adolescence and is there any association of identity disturbance seen in adolescence with features of BPD, it also tries to identify the borderline personality organization of individuals showing identity disturbance and the Gender differences in Identity disturbance, features of Borderline Personality Disorder and the Borderline Personality Organization of an individual.

Due to the relevance of identity disturbance to personality disorder this study sought to complete a network analysis of a well validated measure of identity disturbance; the personality structure questionnaire (PSQ). A multi-site and cross-national methodology created an overall sample of N = 1549. The global network structure of the PSQ was analysed and jointly estimated networks were compared across four subsamples (UK versus Italy, adults versus adolescents, clinical versus community and complex versus common presenting problems). Stability analyses assessed the robustness of identified networks. Results indicated that PSQ3 (unstable sense of self) and PSQ5 (mood variability) were the most central items in the global network structure. Network structures significantly differed between the UK and Italy. Centrality of items was largely consistent across subsamples. This study provides evidence of the potential network structure of identity disturbance and so guides clinicians in targeting interventions facilitating personality integration.

Child maltreatment is an etiological factor in borderline personality disorder (BPD), which may be transmitted to the children of mothers with BPD. We assessed maltreatment in 36 children aged 4–7 whose mothers have BPD and in 34 normative comparisons. Children whose mothers have BPD were more likely to have experienced sexual abuse, physical abuse, and neglect than were normative comparisons. Mothers’ self-reported borderline features were significantly correlated with children's maltreatment. Neglect was associated with mothers’ affective instability, identity disturbance, negative relationships, and self-harm; sexual abuse was associated with mothers’ identity disturbance, and negative relationships; and physical abuse was associated with mothers’ self-harm. Maltreatment mediated the relationship between all four of mothers’ borderline features and children's narrative representations of the caregiver–child relationship, which included fear of abandonment, role reversal, and mother–child relationship expectations. The authors discuss results in the context of risk for developing BPD in early adulthood and early preventive interventions targeting children's representations.

The current study examined the intergenerational transmission of child maltreatment in the context of maternal self-reported borderline features (affective instability, negative relationships, identity disturbance, and self-harm/impulsivity) and a maternal borderline personality disorder (BPD) diagnosis. We sampled 41 adolescents of 14 to 18 years of age and their mothers. A total of 19 mothers had a diagnosis of BPD, and 22 mothers were comparisons without the disorder. Results revealed that a maternal diagnosis of BPD was associated with physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse, but not supervisory neglect. Maternal BPD features were associated with emotional abuse, sexual abuse, and physical neglect, but not physical abuse, emotional neglect, or supervisory neglect. Results indicated that families whose mother had BPD experienced more intergenerational transmission of child maltreatment (regardless of perpetrator) between mothers and their adolescent offspring than did offspring of normative comparisons. Further, the borderline feature of negative relationships most strongly predicted transmission to the next generation. Neglect and overall maltreatment transmitted from mother to adolescent, whereas sexual abuse and physical abuse did not. Results are discussed in terms of the cascading impact of maltreatment across generations, particularly in families of mothers with BPD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Loneliness is related to mental and somatic health outcomes, including borderline personality disorder. Here, we analyze the sources of variation that are responsible for the relationship between borderline personality features (including four dimensions, affective instability, identity disturbance, negative relationships, self-harm and a total score) and loneliness. Using genetically informative data from two large nonclinical samples of adult twin pairs from Australia and the Netherlands (N = 11,329), we estimate the phenotypic, genetic and environmental correlations between self-reported borderline personality features and loneliness. Individual differences in borderline personality and loneliness were best explained by additive genetic factors with heritability estimates h2 = 41% for the borderline personality total score and h2 = 36% for loneliness, with the remaining variation explained by environmental influences that were not shared by twins from the same pair. Genetic and environmental factors influencing borderline personality (total score and four subscales separately) were also partial causes of loneliness. The correlation between loneliness and the borderline personality total score was rph = .51. The genetic correlation was estimated at rg = .64 and the environmental correlation at re = .40. Our study suggests common etiological factors in loneliness and borderline personality features.

Borderline personality disorder (BPD) involves instability in self-concept, emotions, and behavior. However, the dynamic, longitudinal relations among BPD symptoms and between these symptoms and other problematic emotional experiences are poorly understood. It is also unclear whether these dynamics are the same across persons (including across diagnostic boundaries), specific to individuals with BPD, or idiographic. The current study uses ecological momentary assessment and group iterative multiple model estimation, a novel, data-driven approach to identifying dynamic patterns in time-series data at group, subgroup, and individual levels, to investigate the dynamic connections among select features of BPD (anger, impulsivity, and identity disturbance) and anxiety-related experiences. Forty-two psychiatric outpatients diagnosed with BPD (n = 27) or with an anxiety disorder, but not BPD (n = 15), rated their anger, identity disturbance, impulsivity, anxiety, stress, and calmness states 6 times per day for 21 days, providing a total of 4,699 surveys. Only 1 dynamic link between symptoms was identified that applied at the group level, and group iterative multiple model estimation did not reveal stable subgroups of individuals with distinct symptom dynamics. Instead, these dynamics differed from individual to individual. These results suggest that connections among these BPD and anxiety symptoms do not depend on diagnosis and are somewhat idiographic. Case examples are used to illustrate the clinical utility of within-person symptom models as a supplement to traditional diagnostic information. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Objective To examine the correlation between eating disorder (ED) symptoms and borderline personality disorder (BPD) traits in a sample of adolescents with eating disorders. Method There were 168 participants (M age = 16.0 years; SD = 1.16) with a diagnosis of anorexia nervosa (AN) or Eating Disorder Not Otherwise Specified—AN type. Eating Disorder Examination (EDE) and the Borderline Personality Questionnaire (BPQ) were used to assess ED symptoms and BPD traits. Results A total of 10 participants (6.6%) scored above the clinical cut‐off for a likely diagnosis of BPD. A positive correlation was observed between BPQ total score and EDE global (r s = 0.64, p, Previous studies have demonstrated that some borderline personality disorder (BPD) traits (i.e., suicidality, impulsivity, anger) are co‐morbid with eating disorders (ED) but the link with other BPD traits have been poorly studied in adolescents and those with anorexia nervosa. This study aimed to examine the correlation between ED symptoms and all the BPD traits in a sample of adolescents.

Difficulty with boredom was eliminated from the formal diagnostic criteria for borderline personality disorder (BPD) in 1994 based on significantly limited, unpublished data. However, it is apparent in clinical practice that boredom remains relevant to BPD. This review synthesizes empirical research, with consideration of theoretical accounts, to critically examine the relevance of boredom to BPD. We first briefly review issues in defining and measuring boredom and offer an expanded conceptualization for BPD, which includes the notion of boredom reactivity, before turning to boredom’s differentiation from and overlap with feelings of emptiness, with which it was paired prior to its removal from the DSM. We then discuss perspectives on boredom’s significance in BPD, briefly touching on its relevance in other personality disorders. We propose a Boredom Cascade Model that articulates how boredom and boredom reactivity interact with identity disturbance and chronic emptiness to create escalating patterns of behavioral dysregulation and make recommendations for research and treatment.

Psychological well-being is a major global concern receiving more scholarly attention following the 2008 Great Recession, and it becomes even more relevant in the context of COVID-19 outbreak. In this study, we investigated the impact of economic uncertainty resulting from natural disasters, epidemics, and financial crisis on individuals’ mental health. As unemployment rate exponentially increases, individuals are faced with health and economic concerns. Not all society members are affected to the same extent, and marginalized groups, such as those suffering from chronic mental illnesses or low-income families cannot afford the downsizing, mass lay-offs and lack of access to public health services. Psychiatric profession is familiarized with the phenomenon of intolerance of uncertainty (IU), and we examine how this concept is associated with job uncertainty and social identity disturbance. Several studies have formally investigated the effects of IU, but to our knowledge, this is the first research integrating the psychological well-being, job uncertainty and identity disturbance caused by economic breakdown. Literature points to many reported cases of PTSD, anxiety, depression and suicidal tendencies following major social disasters. Yet, we have undertaken to analyze the subjective experiences underlying the self-harming behaviors in an attempt to fill the methodological gap by drawing insights from prominent psychological, sociological and economic theories. We find economic uncertainty to have a positive relation to job uncertainty and identity disturbance, and a negative relationship with psychological well-being. Psychological well-being depends on coherency between both abstract subjective and concrete objective identity, and when these perceptions are inconsistent, cognitive dissonance arises resulting in identity disturbance. We argue that stability is not associated with monetary advantage only, but also with a wide range of other benefits that are crucial for individuals’ growth, satisfaction and sense of identity. Therefore, we propose the implementation of social support and public welfare policies to mitigate health risks during the turbulent socio-economic changes.

Borderline personality disorder (BPD) is associated with violence toward self and others. This study aims to further identify which DSM-5 BPD criteria are independently related to violence, using data from National Epidemiologic Survey on Alcohol and Related Conditions–III, which included a total of 36,309 U.S. respondents ages 18 and older (n = 4,301 for BPD; n = 19,404 for subthreshold BPD). Multinomial logistic regression examined the associations between BPD criteria and violence categories, including suicide attempt (self-directed), violence toward others (other-directed), combined (self-/other-directed) violence, and no violence. In the total population, identity disturbance, impulsivity, and intense anger significantly characterized violence toward others, while avoidance of abandonment, self-mutilating behavior, feelings of emptiness, and intense anger significantly characterized violence toward self. These criteria (except identity disturbance) also significantly characterized combined self- and other-directed violence. Differential associations of the BPD criteria with violence among BPD and subthreshold BPD populations also are discussed.

Background : The objective of this study was to estimate the associations between specific BPD features on the risk of first onset MDD over 2 years and to investigate the roles of sex, baseline depression and anxiety in the associations. Methods : A longitudinal study of Chinese first-year university students aged between 15 and 24 years and who did not have a lifetime MDD (n = 7,627). Random effect logistic regression modeling was used to estimate the associations between specific BPD features, the number of BPD features, and the risk of MDD. Results : The feeling of emptiness (OR = 2.14, 95% CI: 1.57, 2.92), paranoid/ dissociation (OR = 2.01, 95% CI: 1.43, 2.82), affective instability (OR = 1.71, 95% CI: 1.22, 2.39) conferred significant risk of MDD. Baseline depression and anxiety interacted with unstable relationship, identity disturbance and paranoid/disassociation in relation to the risk of MDD. A higher number of BPD features is associated with an increased risk of MDD. Limitations : Data collection relied on self-report. Thus, recall and reporting biases are possible. Due to the pandemic public health restrictions, we had to change the method of data collection at second annual assessment, which resulted in a lower response rate (66.5%). Conclusions : Mental health professionals should pay attention to the presence of BPD features in youth and young adults, as they are at high risk of developing a MDD in a short time period, and the risk increases with the number of BDP features.

L'alteració de la identitat és un criteri clau en la definició del trastorn límit de la personalitat (TLP). Aquest criteri simptomàtic ocupa un lloc central des de la perspectiva dimensional per a la resta dels trastorns de la personalitat a la nova proposta de l'DSM-5. L’ Identity Disturbance Questionnaire (IDQ) (Wilkinson-Ryan i Westen, 2000) és un qüestionari hetero-aplicat que avalua quatre dimensions de la identitat pertorbada: l'absorció de rol, la incoherència dolorosa, la inconsistència i la manca de compromís. L'objectiu d'aquest treball ha estat traduir, adaptar i validar a l'espanyol la versió americana de l'IDQ, i analitzar la relació de l'alteració de la identitat amb la simptomatologia clínica del TLP, la seva simptomatologia general, la comorbiditat amb altres trastorns de la personalitat i amb la seva història de maltractament infantil. La mostra va estar composta per 36 dones amb diagnòstic de TLP i 195 subjectes no pacients. La versió espanyola de l'IDQ ha mostrat una adequada fiabilitat i validesa. El model de quatre factors segueix sent el més adequat per explicar el constructe de l'escala. La presència d'alteració de la identitat avaluada per l’IDQ en el TLP implica confusió de rols, patiment per un sentit d'incoherència i inconsistència en pensaments, així com comportaments i falta de compromís vocacional, i ocupacional. Una major alteració de la identitat implica major presència de pensaments estranys i experiències perceptuals no habituals, paranoides no delirants, i pseudopsicòtiques, i major presència de depressió, ansietat, irascibilitat i altres estats disfòrics. L'alteració de la identitat implica major comorbiditat amb trets de personalitat passiu- agressius, paranoides, depressius, esquizoides i esquizotípics, i en menor mesura narcisistes i evitatius així com, més simptomatologia de tipus sensitivitat interpersonal, hostilitat, ideació paranoide, psicoticisme i obsessions. Els antecedentes de maltractament en la infància, en concret l'abús emocional, físic i sexual i la negligència emocional i física, s'han relacionat amb l'alteració de la identitat. La alteración de la identidad es un criterio clave en la definición del trastorno límite de la personalidad (TLP). Este criterio sintomático ocupa un lugar central desde la perspectiva dimensional para el resto de los trastornos de la personalidad en la nueva propuesta del DSM-5. El Identity Disturbance Questionnaire (IDQ) (Wilkinson-Ryan y Westen, 2000) es un cuestionario hetero-aplicado que evalúa cuatro dimensiones de la identidad perturbada: la absorción de rol, la incoherencia dolorosa, la inconsistencia y la falta de compromiso. El objetivo de este trabajo ha sido traducir, adaptar y validar al español la versión americana del IDQ, y analizar la relación de la alteración de la identidad con la sintomatología clínica del TLP, su sintomatología general, la comorbilidad con otros trastornos de la personalidad y con su historia de maltrato infantil. La muestra estuvo compuesta por 36 mujeres con diagnóstico de TLP y 195 sujetos no pacientes. La versión española del IDQ ha mostrado una adecuada fiabilidad y validez. El modelo de cuatro factores sigue siendo el más adecuado para explicar el constructo de la escala. La presencia de alteración de la identidad evaluada por el IDQ en el TLP implica confusión de roles, sufrimiento por un sentido de incoherencia e inconsistencia en pensamientos, así como comportamientos y falta de compromiso vocacional, y ocupacional. Una mayor alteración de la identidad implica mayor presencia de pensamientos extraños y experiencias perceptuales no habituales, paranoides no delirantes, y pseudopsicóticas y mayor presencia de depresión, ansiedad, irascibilidad y otros estados disfóricos. La alteración de la identidad implica mayor comorbilidad con rasgos de personalidad pasivo- agresivos, paranoides, depresivos, esquizoides y esquizotípicos, y en menor medida narcisistas y evitativos así como, más sintomatología de tipo introversión social, hostilidad, ideación paranoide, psicoticismo y obsesiones. Los antecedentes de maltrato en la infancia, en concreto el abuso emocional, físico y sexual y la negligencia emocional y física, se han relacionado con problemas de identidad. Identity disturbance is a key criterion in defining borderline personality disorder (BPD). This symptomatic criterion occupies a central place from the dimensional perspective for the rest of the personality disorders in the new DSM-5 proposal. Identity Disturbance Questionnaire (IDQ) (Wilkinson-Ryan & Westen, 2000) is a hetero-applied questionnaire that assesses four dimensions of disturbed identity: role absorption, painful incoherence, inconsistency, and lack of commitment. The objective of this work has been to translate, adapt and validate the American version of the IDQ into Spanish, and to analyze the relationship between identity disturbance with clinical symptoms of BPD, its general symptoms, comorbidity with other personality disorders and with her history of child abuse. The sample consisted in 36 women diagnosed with BPD and 195 non-patient subjects. The Spanish version of the IDQ has shown reliability and validity. The four-factor model is still the most suitable to explain the scale construct. The presence of identity disturbance appears by the IDQ in the BPD implies role confusion, suffering due to a sense of incoherence and inconsistency in thoughts, as well as behaviors and lack of vocational and occupational commitment. A greater of identity disturbance implies a greater presence of strange thoughts and unusual perceptual experiences, non-delusional paranoids, and pseudo-psychotic and greater presence of depression, anxiety, irritability and other dysphoric states. Identity disturbance implies greater comorbidity with passive-aggressive, paranoid, depressive, schizoid and schizotypal personality traits, and to a lesser extent narcissistic and avoidant, as well as more symptoms of interpersonal sensitivity, hostility, paranoid ideation, psychoticism and obsessions. A history of abuse in childhood, specifically emotional, physical and sexual abuse and emotional and physical neglect, have been linked to identity disturbance.

Background Past research has established individual relationships between disordered eating behaviours (DEB) and both self-regulation difficulties and identity disturbance. However, no research has looked at the shared influence of these constructs on DEB nor at personality functioning in individuals with DEB. Methods In the present study, self-regulation was explored in terms of effortful control, impulsivity and emotion regulation while identity integration was measured in terms of impairments in self-functioning using a sample of 247 undergraduate students. Results Significant associations were found between all components of self-regulation and DEB, with the exception of impulsivity. Identity instability was also associated with self-regulation difficulties and DEB. Structural Equation Modelling analyses indicated that identity instability partially mediated the relationship between self-regulation and DEB. Lastly, disordered eating was associated with difficulties in personality functioning, with young women presenting with DEB reporting significantly greater difficulties in both self and interpersonal personality functioning. Conclusion Behavioural eating anomalies should be considered as epiphenomena secondary to a possible deeper issue that reflects difficulties related to identity integration and potential personality functioning. The clinical implications of these findings are discussed.

Individuals with bulimia nervosa often experience suicidal ideation. Identity disturbance, or unstable sense of self, has been connected both to eating disorders and to suicidality. This study sought to test whether identity problems were related to severity of current suicidal ideation in a sample of women with bulimic-spectrum pathology, above and beyond history of suicidal behavior and several symptoms of borderline personality disorder. Women (N = 204; 90.7% Caucasian; Mage = 25.7 years [SD = 8.8]) with bulimic-spectrum pathology completed self-report personality assessments and items evaluating suicidality. A hierarchical linear regression was utilized to examine the association between identity problems and severity of current suicidal ideation, before and after inclusion of relevant clinical features (i.e., suicide attempt history [Step 2], affective lability, stimulus seeking, and rejection [Step 3]). Identity problems were directly associated with severity of current suicidal ideation (β = .481, p < .001). This relationship retained significance after inclusion of suicide attempt history (β = .335, p < .001) as well as borderline personality disorder symptoms (β = .324, p < .001). Identity problems displayed a robust relationship with suicidal ideation severity in women with bulimic-spectrum pathology. Findings suggest that identity problems may be a specifically relevant personality feature regarding presence and severity of suicidal ideation in this high-risk group, even after considering the contributions of history of suicidal behavior and various symptoms of borderline personality disorder. There may be value in attending to identity problems when considering suicidal ideation in this population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Importance Borderline personality disorder (BPD) has been identified as a strong risk factor for suicidal behavior, including suicide attempts. Delineating specific features that increase risk could inform interventions. Objective To examine factors associated with prospectively observed suicide attempts among participants in the Collaborative Longitudinal Study of Personality Disorders (CLPS), over 10 years of follow-up, with a focus on BPD and BPD criteria. Design, Setting, and Participants The CLPS is a multisite, naturalistic, prospective study of adult participants with 4 personality disorders (PDs) and a comparison group of adults with major depressive disorder and minimal PD features. Participants were all treatment-seeking and recruited from inpatient, partial, and outpatient treatment settings across New York, New York, Boston, Massachusetts, New Haven, Connecticut, and Providence, Rhode Island. A total of 733 participants were recruited at baseline, with 701 completing at least 1 follow-up assessment. The cohorts were recruited from September 1996 through April 1998 and September 2001 through August 2002. Data for this study using this follow-up sample (N = 701) were analyzed between March 2019 and August 2020. Main Outcomes and Measures Participants were assessed annually using semistructured diagnostic interviews and a variety of self-report measures for up to 10 years. Multiple logistic regression analyses were used to examine baseline demographic and clinical risk factors, including BPD and individual BPD criteria, of suicide attempt assessed over 10 years of prospective follow-up. Results Of the 701 participants, 447 (64%) identified as female, 488 (70%) as White, 527 (75%) as single, 433 (62%) were unemployed, and 512 (73%) reported at least some college education. Of all disorders, BPD emerged as the most robust factor associated with prospectively observed suicide attempt(s) (odds ratio [OR], 4.18; 95% CI, 2.68-6.52), even after controlling for significant demographic (sex, employment, and education) and clinical (childhood sexual abuse, alcohol use disorder, substance use disorder, and posttraumatic stress disorder) factors. Among BPD criteria, identity disturbance (OR, 2.21; 95% CI, 1.37-3.56), chronic feelings of emptiness (OR, 1.63; 95% CI, 1.03-2.57), and frantic efforts to avoid abandonment (OR, 1.93; 95% CI, 1.17-3.16) emerged as significant independent factors associated with suicide attempt(s) over follow-up, when covarying for other significant factors and BPD criteria. Conclusions and Relevance In the multisite, longitudinal study of adults with personality disorders, identity disturbance, chronic feelings of emptiness, and frantic efforts to avoid abandonment were significantly associated with suicide attempts. Identity disturbance, chronic feelings of emptiness, and frantic efforts to avoid abandonment may be clinically overlooked features of BPD in context of suicide risk assessment. In light of the high rates of BPD diagnostic remission, our findings suggest that these criteria should be independently assessed and targeted for further study as suicide risk factors.

Chronic emptiness in borderline personality disorder (BPD) has received little empirical attention. We sought to examine basic properties of a single chronic emptiness item, including prevalence, reliability, validity, the relation of the emptiness item to other BPD criteria, and measures of personality. Undergraduates enrolled in psychology courses over 12 years' time completed the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) (N = 22,217). Subsets of participants completed the International Personality Disorder Examination-Screening Questionnaire (IPDE-SQ) (N = 2732), The Revised NEO Personality Inventory (Anxiety, Angry Hostility, Depression, Positive Emotions [reversed], and Impulsivity facets) (N = 10,506), and the Depression Anxiety Stress Scales (DASS) (N = 1110) as validity indicators; 10.0% of respondents endorsed emptiness. Reliability indices suggested moderate levels of reliability between two emptiness items (r(2730) = 0.61, p

Developmental scientists describe the role confusion that can occur for adolescents as they are forming a personal identity. Clinical psychologists describe low self-worth, lack of self-clarity, feelings of emptiness, and dissociation as the key elements of identity disturbance, and they link these to borderline personality disorder. In this study, the authors aimed to work at the juncture of these approaches by considering interrelations between four elements of identity disturbance, typical identity formation processes reflective of identity commitment and confusion, and borderline features. Australian youth (N = 505, 63% female and aged 12–20 years) recruited from clinical and community settings reported on identity commitment, exploration and reconsideration, four elements of identity disturbance, and borderline features. Identity confusion (especially reconsideration) and disturbance were associated with elevated borderline symptoms. Emptiness stood out as the strongest correlate of borderline symptoms. Youth reporting greater emptiness were nearly twice as likely to report a high borderline symptom profile.

We examined narrative identity as a possible transdiagnostic marker of psychopathology by interviewing individuals with schizophrenia, individuals with depression and a nonclinical control group about past and future chapters in their life stories. Participants were 20 patients with schizophrenia, 20 patients with depression, and 20 nonclinical control participants matched on age, gender, and education. Participants described up to 10 chapters in their past and future life stories and self-rated chapters on emotional tone and self-event connections. In addition, cognitive function and current levels of symptoms was assessed. Both patient groups self-rated their past chapters as more negative and less positive compared to the control group, but did not differ from each other. There were no group differences in positivity of future chapters, but both patient groups identified fewer future chapters with shorter temporal projections. The results are consistent with the notion that negative past aspects of narrative identity are a transdiagnostic marker of psychopathology, while also suggesting that individuals with mental illness construct a positive future, which may support hope.

Patients with borderline personality disorder (BPD) display disturbances in understanding self and others. We examined whether these disturbances extended to how patients described their personal and parents’ life stories and to measures of identity, alexithymia, empathy, and emotional intelligence. Thirty BPD patients and 30 matched control participants described personal and parents’ life stories and completed measures of identity disturbance, alexithymia, empathy, and emotional intelligence. Compared to the controls, patients with BPD described their personal and their parents’ life stories more negatively and with fewer themes of agency and communion fulfillment. Patients and controls showed equally complex reasoning about their personal life stories, but patients displayed less complexity and more self‐other confusion, when reasoning about their parents’ stories. Patients also differed from controls on identity disturbance, alexithymia, and empathy. The results suggest that patients’ storied understanding of themselves and others are disturbed and should be taken into account to better understand BPD.

This paper explores the possibility of AI-based narrative therapy for borderline personality disorder, its potential advantages, drawbacks, and limitations. It is argued that identity disturbance in this condition is strongly connected to self-narratives, and the most important features of narrative therapy, which, in a human-to-human form, is one of the more successful treatment options for BDP, could be adapted to AI. While human oversight cannot and should not be eliminated, AI support would hold forth the prospect of overcoming certain hurdles associated with patient-therapist interaction frequently marring the therapeutic process.

This study had two objectives. The first was to determine the levels of identity disturbance reported by 290 patients with borderline personality disorder (BPD) and 72 personality-disordered comparison subjects over 20 years of prospective follow-up. The second aim was to describe the levels of identity disturbance reported by 152 ever recovered vs. 138 never recovered borderline patients over 20 years of prospective follow-up. Participants were followed and re-assessed every two years for a total of 20 years of follow-up. Borderline patients reported levels of these states that were more than three times higher than personality-disordered comparison subjects, with both groups demonstrating significant declines in these states over time. For three of these inner states (“I feel like I am worthless,” “I feel like a complete failure,” and “I feel like I am evil”), recovered borderline patients had lower baseline scores and significantly different patterns of decline than non-recovered patients. For the fourth state, “I feel like I am a bad person,” recovered patients had lower scores over time, but the groups declined at the same rate. These results suggest that borderline patients report experiencing inner states related to having a negative identity less often over time. Additionally, recovery status is significantly associated with decreased time experiencing these states.