{June 7, 2012}   Ouch: Dissociation in borderline personality disorder

Dissociation in borderline personality disorder

New M.Anestis Photoby Michael D. Anestis, M.S.

So what do we know for certain about dissociation in individuals with BPD?  Quite a few things, actually.  For one thing, there is compelling evidence that individuals with BPD dissociate more often in proportion to the amount of tension they experience.  In a study in which “aversive tension” was defined as a vague state of unidentified negative emotions, Stiglmayr, Shapiro, Stieglitz, Limberger, and Bohus (2001) found that the duration and intensity of aversive tension was positively correlated with the experience of both somatic and cognitive dissociative symptoms.  This indicates that, consistent with the DSM-IV-TR criteria, individuals with BPD dissociate in response to intense experiences of negative affect.  Dissociation in this case likely reflects not only an inability to differentiate between emotional experiences (e.g., anger versus frustration or sadness), but also a lack of emotion regulation skills.  This is an important point to consider in light of the proneness of individuals with BPD to engage in non-suicidal self-injury (NSSI).  Remember from our discussion of Nock and Prinstein’s (2004) functional model of NSSI that individuals self-injure for a variety of reasons, one of which is to “fee something, even if it is pain (intrapersonal positive reinforcement).”  Dissociation often involves a sense of being distant or removed from one’s environment and a sense of emotional and/or physical numbness.

Additionally, Jones and colleagues (1999) reported that, in individuals diagnosed with BPD, dissociation predicted the number of general memories recalled.  In other words, the more often an individual with BPD dissociates, the more likely it is that he or she will experience difficulties recalling specific autobiographical experiences.  Similarly, several studies have found that dissociation correlates highly with a tendency to experience everyday cognitive failures such as forgetting names, being distracted from tasks, and missing road signs (Merckelbach, Muris, & Rasin, 1999).

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