Attributions for Rejection and Acceptance in Young Adults With Borderline and Avoidant Personality Features

Berenson, Kathy R.; Nynaes, Olga U.A.; Wakschal, Emily S.; Kapner, Laura M.; Sweeney, Erin C.

doi:10.1521/jscp.2018.37.6.431

Cited by 6 publications

(5 citation statements)

References 42 publications

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“…Two studies did not report recruitment methods. Of note, one study recruited a community sample with high levels of self‐reported BPD features (Berenson, Nynaes, Wakschal, Kapner, & Sweeney, ). Studies differed in the inclusion of individuals undergoing BPD treatment.…”

Section: Resultsmentioning

confidence: 97%

The link between rejection sensitivity and borderline personality disorder: A systematic review and meta‐analysis

Foxhall

Hamilton‐Giachritsis

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2019

British J Clinic Psychol

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Objective. People with Borderline Personality Disorder (BPD) may experience heightened rejection sensitivity (RS), a disposition developing from repeated childhood rejecting experiences. It is not known whether the full RS model accounts for the cognitive-affective experiences common in BPD. This systematic review extends upon previous reviews, firstly by assessing the link between childhood rejecting experiences and adult RS, and secondly by considering the link between BPD and RS in both nonclinical and clinical samples.Method. Two research questions were devised, and searches based on predetermined criteria were conducted using PsycNET, PubMed, SCOPUS, and Web of Science. Data were extracted by one researcher and 20% was inter-rated, with high levels of agreement. Forty-three papers were systematically reviewed, and 31 included in meta-analysis and meta-regression.Results. Studies assessing the link between childhood rejection and RS are limited; however, emotional abuse and neglect appears linked with RS. Pooled effect sizes suggest RS is linked with BPD (r = .326), with strong effect sizes when comparing clinical and control samples (r = .655). Qualitative synthesis suggests this may be mediated by executive control, although further research is required. The small number of studies considering the full RS model with regard to BPD suggests the interaction between emotional abuse and neglect affects rejection sensitivity; however, outcomes are inconsistent.Conclusions. Childhood rejection, particularly emotional abuse and neglect, appears to be linked to rejection sensitivity, and rejection sensitivity is linked to BPD. However, this may not be linear. Implications for clinical practice and research are discussed. Practitioner pointsRejection sensitivity is consistently linked with BPD, in clinical and non-clinical samples. Supporting mentalization or improved theory of mind may offer a therapeutic target for this disposition.Considering the causes and effects of rejection sensitivity may offer a non-blaming explanation of interpersonal difficulties in BPD and could be utilized as part of formulation and the therapeutic relationship.

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Section: Resultsmentioning

confidence: 97%

The link between rejection sensitivity and borderline personality disorder: A systematic review and meta‐analysis

Foxhall

Hamilton‐Giachritsis

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2019

British J Clinic Psychol

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“…These negative cognitions seem to deteriorate agency and foster underachievement ( Coon, 1994 ); “I will not be able to do things my way, and I will fail, why bother trying” ( Videler et al, 2017 ). They hold back in fear of others’ critique ( Nordahl and Stiles, 2000 ; Arntz et al, 2011 ; Bowles et al, 2013 ; Eikenæs et al, 2013 ; Rees and Pritchard, 2015 ; Berenson et al, 2018 ; Flink et al, 2019 ). Self-critique rapidly follows attempts to articulate needs, keeping agency low ( Inchausti et al, 2022 ).…”

Section: Resultsmentioning

confidence: 99%

Agency in avoidant personality disorder: a narrative review

Weme,

Sørensen,

Binder

2023

Front. Psychol.

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ObjectivesAvoidant personality disorder (AvPD) is a highly prevalent personality disorder, especially in clinical settings, yet scarcely researched. People diagnosed with AvPD have severe impairments in functioning and suffer greatly, yet we still lack meta-analytic evidence for therapy and only a few RCTs are conducted. Patient factors are the most important for outcome in therapy, in general. Lack of agency might be a core deficit in people diagnosed with AvPD. Their conditions might be improved if we understand their agency better. We review previous research regarding psychological mechanisms and interpersonal relationships that facilitate or hinder agency in AvPD in daily life and psychotherapy.MethodsSummarizing original literature in a narrative review with reflexive thematic analysis.ResultsPeople diagnosed with AvPD seem to have significant impairments in their sense of agency due to a lack of emotional awareness, an overweight of inhibiting vs. activating emotions, and difficulties regulating emotions. Difficulties also seem related to high levels of attachment avoidance and fear, creating strong ambivalence in social needs, in addition to a strong tendency to subordinate to others. A weak sense of self with a poor narrative, self-doubt, and harsh self-critique makes a reflexive and intentional stand increasingly difficult for these people.ConclusionThis review gives a clinically meaningful understanding of core strengths and deficits in the personality functioning of AvPD that can help clinicians map out important therapeutic work, identify barriers to client-agency in therapy, and work through relational difficulties in the therapeutic alliance.

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“…However, many patients with severe PDs suffered from severe relational stress traumas during critical developmental periods, stress traumas which were often also associated with focal traumas such as sexual and physical abuse, and emotional abuse and neglect (Howell & Blizard, 2009; Mosquera & Steele, 2017). These traumas are seen as having caused a severe impairment in the sense of interpersonal safety, contributing to frequent states of hypervigilance associated with a difficulty in downregulating emotions (Berenson, Nynaes, Wakschal, Kapner, & Sweeney, 2018; Bertsch et al, 2017; Fertuck, Fischer, & Beeney, 2018; Masland & Hooley, 2019; Schilling, Moritz, Schneider, Bierbrodt, & Nagel, 2015). Moreover, such traumas engender pathogenic beliefs that support a strong self-hate (Faccini & Gazzillo, in press).…”

Section: Understanding Severe Personality Pathology Through the Lens ...mentioning

confidence: 99%

Personalizing psychotherapy for personality disorders: Perspectives from control-mastery theory.

Gazzillo

Dazzi

Kealy

et al. 2021

Psychoanalytic Psychology

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While several empirically supported models for treating personality disorder (PD) are available, researchers and clinicians have continued to advocate for the personalization of psychotherapy to the particular needs and characteristics of the individual patient with severe personality pathology. Control-Mastery Theory (CMT; Gazzillo, 2016; Silberschatz, 2005; Weiss, 1993; Weiss, Sampson, & The Mount Zion Psychotherapy Research Group, 1986) provides a useful framework for understanding personality pathology, and for guiding treatment with individualized case formulation. The present article introduces the basic concepts of CMT and their application in personalizing psychotherapy for patients with severe PDs. According to CMT, patients come to therapy in order to disprove the pathogenic beliefs that obstruct their pursue of healthy and adaptive developmental goals. These pathogenic beliefs were developed to adapt to early traumatic experiences, but end up causing further suffering, inhibitions, and symptoms. For this reason, patients test these pathogenic beliefs within the therapeutic relationship in search of corrective emotional experiences that disprove them. Among patients with severe PDs, such beliefs may be reciprocally contradictory and may be enacted in therapy in multiple different ways, often challenging therapists to respond appropriately. CMT suggests that therapists’ formulation regarding a given patient’s plan—including the nature of the patient’s goals, traumas, pathogenic beliefs, and testing strategies—allow for a personalized approach that will optimize therapy effectiveness.

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Attributions for Rejection and Acceptance in Young Adults With Borderline and Avoidant Personality Features

Cited by 6 publications

References 42 publications

The link between rejection sensitivity and borderline personality disorder: A systematic review and meta‐analysis

The link between rejection sensitivity and borderline personality disorder: A systematic review and meta‐analysis

Agency in avoidant personality disorder: a narrative review

Personalizing psychotherapy for personality disorders: Perspectives from control-mastery theory.

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