Level of identity diffusion in patients with borderline, narcissistic, avoidant and other specified personality disorder

TY - JOUR

T1 - Level of identity diffusion in patients with borderline, narcissistic, avoidant and other specified personality disorder

AU - Jørgensen, Carsten René

AU - Rasmussen, Anne Scharling

AU - Bøye, Rikke

PY - 2024

Y1 - 2024

N2 - 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.

AB - 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.

KW - borderline personality disorder

KW - identity diffusion

KW - identity disturbance

KW - personality disorder assessment

U2 - 10.1080/19012276.2023.2197561

DO - 10.1080/19012276.2023.2197561

M3 - Journal article

AN - SCOPUS:85152904999

SN - 1901-2276

VL - 76

SP - 302

EP - 316

JO - Nordic Psychology

JF - Nordic Psychology

IS - 3

ER -