Dissociation in Borderline Personality Disorder: A Detailed Look

Abstract

The objective of the present study was to assess in detail the whole spectrum of normal and pathological dissociative experiences and dissociative disorder (DD) diagnoses in borderline personality disorder (BPD) as diagnosed with the Revised Diagnostic Interview for Borderlines. Dissociation was measured comprehensively in 21 BPD outpatients using the Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised, the Multidimensional Inventory of Dissociation (MID), the Dissociative Experiences Scale pathological taxon analysis, and the Somatoform Dissociation Questionnaire. The frequencies of DDs in this BPD sample were as follows: 24% no DD, 29% mild DD (dissociative amnesia and depersonalization disorder), 24% DD Not Otherwise Specified (DDNOS), and 24% dissociative identity disorder. With regard to the dissociative experiences endorsed, almost all patients reported identity confusion, unexplained mood changes, and depersonalization. Even those BPD patients with mild DD reported derealization, depersonalization, and dissociative amnesia. BPD patients with DDNOS reported frequent depersonalization, frequent amnesia, and notable experiences of identity alteration. BPD patients with dissociative identity disorder endorsed severe dissociative symptoms in all categories. Analysis of the MID pathological dissociation items revealed that 32% of the items were endorsed at a clinically significant level of frequency by more than 50% of our BPD patients. In conclusion, the frequencies of Diagnostic and Statistical Manual of Mental Disorders (4th ed.) DDs in these patients with BPD were surprisingly high. Likewise, the "average" BPD patient endorsed a wide variety of recurrent pathological dissociative symptoms.

Dissociation Predicts Poor Response to Dialectial Behavioral Therapy in Female Patients with Borderline Personality Disorder

“…In the study by Korzekwa, Dell, Links, Thabane, and Fougere (2009), almost all BPD patients reported dissociative symptoms, and the majority of BPD patients met criteria for dissociative disorder diagnoses. Dissociative symptoms have not only been found to be elevated in psychiatric disorders that include dissociative symptoms in their diagnostic criteria (e.g., BPD and posttraumatic stress disorder , DSM-IV;American Psychiatric Assocation, 2000), but also in anxiety and panic disorders (Ball, Robinson, Shekhar, & Walsh, 1997), affective disorders (Oedegaard et al, 2008), and obsessive-compulsive disorder (Watson, Wu, & Cutshal, 2004).…”

Dissociative Amnesia in Dissociative Disorders and Borderline Personality Disorder: Self-Rating Assessment in a College Population

“…Recent research has documented that for a significant proportion of these cases, dissociative experiences extend the scope of transient symptoms and warrant the diagnosis of a dissociative disorder (Korzekwa, Dell, Links, Thabane, & Fougere, 2009;Sar, Akyuz, Kugu, Ozturk, & Ertem-Vehid, 2006;Sar et al, 2003). Hence, dissociative disorders and BPD are two partially overlapping syndromes on the spectrum of trauma-related psychopathologies (Korzekwa et al, 2009;Ross, 2007;Sar et al, 2003Sar et al, , 2006.…”

Emotions and Memory in Borderline Personality Disorder

“…Patients with BPD often suffer from dissociative states [125], which are known to influence learning and memory [126,127,128,129,130,131]. One study showed remarkable neuropsychological deficits in BPD patients with pathological dissociation, including attention, working memory, executive functioning, long-term memory, and general cognitive abilities, while BPD patients without pathological dissociation only showed deficits in executive functioning [132].…”