Self-disturbance is recognized as a key symptom of Borderline Personality Disorder (BPD). Although it is the source of significant distress and significant costs to society, it is still poorly specified. In addition, current research and models on the etiology of BPD do not provide sufficient evidence or predictions about who is at risk of developing BPD and self-disturbance, and why. The aim of this review is to lay the foundations of a new model inspired by recent developments at the intersection of social cognition, behavioral ecology, and developmental biology. We argue that the sense of agency is an important dimension to consider when characterizing self-disturbances in BPD. Second, we address the poorly characterized relation between self-disturbances and adverse life conditions encountered early in life. We highlight the potential relevance of Life-History Theory—a major framework in evolutionary developmental biology—to make sense of this association. We put forward the idea that the effect of early life adversity on BPD symptomatology depends on the way individuals trade their limited resources between competing biological functions during development.
ImportanceBorderline personality disorder (BPD) is often accompanied by a history of high-risk sexual behavior and somatic comorbidities. Yet, these features are most often considered in isolation and little is known about their underlying developmental pathways. Life history theory, a leading framework in evolutionary developmental biology, can help make sense of the wide range of behaviors and health issues found in BPD.ObjectiveTo examine whether the emergence of BPD is associated with the prioritization of immediate reproductive goals over longer-term somatic maintenance goals, a life strategy that can be viewed as a developmental response to adverse early life experiences, providing rapid reproductive benefits despite costs to health and well-being.Design, Setting, and ParticipantsThis study used cross-sectional data from the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions in 2004-2005 (n = 34 653). Civilian, noninstitutionalized individuals in the US, 18 years or older, and those with and without a DSM-IV diagnosis of BPD were included. Analysis took place between August 2020 and June 2021.Main Outcomes and MeasuresStructural equation models were used to examine whether early life adversity was associated with the likelihood of a BPD diagnosis, either directly or indirectly through a life strategy whereby individuals trade somatic maintenance for immediate reproduction.ResultsAnalyses were performed on a sample of 30 149 participants (females: 17 042 [52%]; mean [SE] age, 48.5 [0.09]; males: 12 747 [48%]; mean [SE] age, 47 [0.08]). Of these, 892 (2.7%) had a diagnosis of BPD and 29 257 (97.3%) did not have BPD. Mean early life adversity, metabolic disorder score, and body mass index were significantly higher among participants with a diagnosis of BPD. In an analysis adjusted for age, individuals with BPD reported having significantly more children than those without BPD (b =0.06; SE, 0.01; t = 4.09; P < .001). Having experienced greater levels of adversity in early life was significantly associated with a greater risk of being diagnosed with BPD later in life (direct relative risk = 0.268; SE, 0.067; P < .001). Importantly, this risk was further increased by 56.5% among respondents who prioritized short-term reproductive goals over somatic maintenance (indirect relative risk = 0.565; SE, 0.056; P < .001). Similar patterns of associations were found in male and female individuals.Conclusions and RelevanceThe hypothesis of a reproduction/maintenance life history trade-off mediating the association between early life adversity and BPD helps make sense of the high dimensionality that characterizes the physiological and behavioral correlates of BPD. Additional studies are needed to confirm these results using longitudinal data.
Previous work has shown that various dimensions of early life adverse experiences, such as deprivation, threat and uncertainty are associated with both physical and mental health outcomes later in life. However, the concepts and operationalizations of uncertainty vary greatly and more precision is needed in order to characterize how environmental uncertainty impacts development. In this study, we explored how two possibly distinct types of environmental uncertainty, unpredictability and volatility contribute to the development of psychopathology in the Fragile Families and Child Wellbeing Study cohort. Our results indicate that both internalising and externalising symptoms at age 9 were better accounted for by models that separated the effect of unpredictability and volatility. Whereas internalising symptoms at this age were associated with unpredictability, externalising symptoms were associated with volatility. The association of volatility with externalising symptoms was also replicated at age 15, although the association of unpredictability with internalising symptoms did not emerge at this age. Furthermore, we also found that symptoms were highest when high exposure to one type of uncertainty was coupled with low exposure on the other, an effect consistent with how these uncertainty sources impact reinforcement learning. These results were robust to alternate model specifications and were also replicated with negative binomial regressions.
ContexteLe Metacognitions Questionnaire-30 (MCQ-30), développé par Wells et Cartwright-Hatton (2004) [1], est une échelle de mesure multidimensionnelle de facteurs métacognitifs impliqués dans le développement et la persistance de troubles psychiques. La théorie définitoire inhérente à cette échelle est résumée par Wells et Matthews [2] dans le modèle Self-Regulatory Executive Function (S-REF). Dans la dépression, une rumination pathogène serait induite par des pensées (croyances métacognitives évaluées par le MCQ-30) et des stratégies de contrôle qui perpétuent une cognition et des stratégies de coping inadaptées. Le but de notre étude est d’adapter et de valider une version française du MCQ-30 en évaluant ses propriétés psychométriques dans un échantillon de patients qui ont un diagnostic de dépression.MéthodesL’adaptation française de l’instrument a été réalisée après une traduction back-forward permettant une bonne validité de face. Elle est en cours de passation dans un échantillon de patients hospitalisés ayant un diagnostic de dépression établi selon les critères du DSM 4 TR. Le nombre de sujets nécessaires est estimé à 150 [3]. Une analyse factorielle confirmatoire permettra de vérifier la structure dimensionnelle à 5 facteurs retrouvée dans l’étude de validation de la version originale. Pour l’évaluation de la validité convergente, nous étudierons la corrélation des différents facteurs du MCQ-30 avec une mesure de l’anxiété d’état (Penn State Worry Questionnaire), de la rumination (Rumination on Sadness Scale), et de la dépression (Beck Depression Inventory). Hypothèses sur le comportement de l’échelle : en accord avec les validations étrangères, nous supposerons une corrélation positive et significative de la MCQ-30 avec les échelles sus-citées.RésultatsDes résultats partiels seront présentés et discutés à la lumière de la taille de l’échantillon.
Checking behavior is a natural and adaptive strategy in uncertain situations. Here, we aimed at investigating the psychological drivers of checking and its regulation by uncertainty, in non-clinical participants and controlled experimental settings. We found that the sensitivity of participants’ explicit confidence judgments to actual performance (explicit metacognition) predicted the extent to which their checking strategy was regulated by uncertainty. This was, however, not the case of how participants used confidence to guide subsequent decision-making (implicit metacognition). Meanwhile, how participants scaled on questionnaires eliciting self-beliefs such as self-confidence and self-reported obsessive-compulsive symptoms also predicted participants’ uncertainty-guided checking tendencies. Altogether, these findings demonstrate that checking is likely the outcome of a core metacognitive process operating at the scale of single decisions, while remaining influenced by general self-beliefs. Our findings thus propose two mechanisms (micro vs. macro) through which this otherwise rational behavior could go awry in certain psychiatric disorders such as obsessive-compulsive disorder.
Background:The short form of the Metacognitions Questionnaire (MCQ-30) is a brief multi-dimensional measure which explores the metacognitive processes and beliefs about worry and cognition that are central to the vulnerability and maintenance of emotional disorders.Aims:The first aim of the study was to create and validate a French version of the MCQ-30 in a non-clinical and a clinical sample of depressed in-patients.Method:A French adaptation of the MCQ-30 was administered to a sample of 467 individuals from the general population and 73 hospitalized patients with major depressive disorder. Internal consistency was measured by Cronbach’s alpha reliability coefficients. Factor structure was assessed using a confirmatory factor analysis on the non-clinical group and a multi-trait–multi-method analysis on the psychiatric group. Criterion validity was explored by comparing the scores of the two samples. Measures of rumination, worry and depression were used to explore convergent validity.Results:Confirmatory factor analysis in the non-clinical sample indicated that the French version of the MCQ-30 has the same factor structure as the MCQ-30’s original five-factor solution. In the clinical sample, the multi-trait–multi-method analysis revealed discrepancies with the original factor structure, and the MCQ-30 and its subscales were less reliable. Our results provide evidence of a convergent validity. The MCQ-30 scores were also able to discriminate between psychiatric and non-clinical samples.Conclusions:Our results show that the French version of the MCQ-30 is a valid instrument for measuring metacognitive beliefs in non-clinical population. Further research is needed to support its use among depressed in-patients.
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