Volume 10 -
MEJDS (2020) 10: 109 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Jafari Jozani M, Monirpoor N, Mirza Hoseini H. Determining the Clinical Syndrome Severity of Borderline Personality Disorder Based on Primary Object Relations and Defense Mechanisms. MEJDS 2020; 10 :109-109
URL: http://jdisabilstud.org/article-1-1889-en.html
URL: http://jdisabilstud.org/article-1-1889-en.html
1- Department of Psychology, Qom Branch, Islamic Azad University
Abstract: (2670 Views)
Background & Objectives: Borderline Personality Disorder (BPD) is a complex mental health condition. It is characterized by characteristics, such as severe negative emotions, identity disorder, impulsive behavior, and instability in interpersonal relationships. BPD manifests with numerous failures that arise in interpersonal relationships concerning self–concept, as well as behavioral, emotional, and cognitive aspects. Females constitute 75% of all BPD cases. Its onset is in adolescence, culminates in early adulthood, and decreases in middle–age. The present study aimed to determine the severity of the clinical syndrome of BPD based on primary objective relations and defense mechanisms.
Methods: This was a correlational and structural equation modeling research. The statistical population of this study included all clients with BPD who were referred to psychology clinics in Tehran City, Iran in the last quarter of 2018. The study sample consisted of 300 patients with BPD (according to a psychiatrist’s diagnosis) who were selected by purposive sampling method. Then, the study participants completed the research questionnaires. In the sample size selection stage, 10 to 15 individuals were required for modeling and 300 individuals were selected by convenience sampling approach based on the available variables. The researchers observed all necessary ethical considerations for the present study. All study subjects received written information about the research and voluntarily participated in the research. The study participants were assured that all the obtained information remains confidential and will only be used for research purposes. The research participants' names and surnames were not recorded for privacy reasons. Besides, after the end of the study, more effective treatment was provided to the control group members. The required data were obtained using the Bell Object Relations and Reality Testing Inventory (Bell et al., 2005), Millon Clinical Multiaxial Inventory (Millon, 1992), and Defense Style Questionnaire (Andrews et al., 1993). Frequency tables and graphs, as well as central and dispersion indices, such as mean and standard deviation were employed for data expression. For the inferential analysis of structural equation modeling and proposed model fit based on Chi–squared index, Comparative Fit Index (CFI), Fit Goodness Index (GFI), Adjusted Fit Goodness Index (AGFI), Root Mean Square Error of Approximation (RMSEA), and Standardized Root Mean Squared Residual (SRMR) were evaluated. The above–mentioned analyses were performed in SPSS and LISREL. The significance level of all studied tests was considered to be 0.05.
Results: The present research results suggested that primary object relations, as an exogenous variable, affected the defense mechanisms (β=0.65, p<0.001) and the severity of clinical syndrome (β=0.26, p<0.001). The defense mechanisms also affected the severity of clinical syndrome (β=0.40, p<0.001). Primary object relations, as exogenous variables, and defense mechanisms, impacted the severity of the clinical syndrome. In the structural model, the significance of the path coefficient is determined by the T–value. In this study, the Bootstrap test was used to evaluate the mediating relationships. The hypothetical model indicated indirect and direct effects for the object–relations and defense mechanisms, respectively. The path of object relations to the severity of clinical syndrome was mediated by the defense mechanisms with a standard coefficient (β=0.26, p<0.001). In other words, a change in standard deviation highly reduced the standard deviation of the severity of clinical syndrome to 0.26.
Conclusion: Primary object relations mediated by defense mechanisms affected the severity of clinical syndrome in BPD. In conclusion, the model claimed in this study was well–suited.
Methods: This was a correlational and structural equation modeling research. The statistical population of this study included all clients with BPD who were referred to psychology clinics in Tehran City, Iran in the last quarter of 2018. The study sample consisted of 300 patients with BPD (according to a psychiatrist’s diagnosis) who were selected by purposive sampling method. Then, the study participants completed the research questionnaires. In the sample size selection stage, 10 to 15 individuals were required for modeling and 300 individuals were selected by convenience sampling approach based on the available variables. The researchers observed all necessary ethical considerations for the present study. All study subjects received written information about the research and voluntarily participated in the research. The study participants were assured that all the obtained information remains confidential and will only be used for research purposes. The research participants' names and surnames were not recorded for privacy reasons. Besides, after the end of the study, more effective treatment was provided to the control group members. The required data were obtained using the Bell Object Relations and Reality Testing Inventory (Bell et al., 2005), Millon Clinical Multiaxial Inventory (Millon, 1992), and Defense Style Questionnaire (Andrews et al., 1993). Frequency tables and graphs, as well as central and dispersion indices, such as mean and standard deviation were employed for data expression. For the inferential analysis of structural equation modeling and proposed model fit based on Chi–squared index, Comparative Fit Index (CFI), Fit Goodness Index (GFI), Adjusted Fit Goodness Index (AGFI), Root Mean Square Error of Approximation (RMSEA), and Standardized Root Mean Squared Residual (SRMR) were evaluated. The above–mentioned analyses were performed in SPSS and LISREL. The significance level of all studied tests was considered to be 0.05.
Results: The present research results suggested that primary object relations, as an exogenous variable, affected the defense mechanisms (β=0.65, p<0.001) and the severity of clinical syndrome (β=0.26, p<0.001). The defense mechanisms also affected the severity of clinical syndrome (β=0.40, p<0.001). Primary object relations, as exogenous variables, and defense mechanisms, impacted the severity of the clinical syndrome. In the structural model, the significance of the path coefficient is determined by the T–value. In this study, the Bootstrap test was used to evaluate the mediating relationships. The hypothetical model indicated indirect and direct effects for the object–relations and defense mechanisms, respectively. The path of object relations to the severity of clinical syndrome was mediated by the defense mechanisms with a standard coefficient (β=0.26, p<0.001). In other words, a change in standard deviation highly reduced the standard deviation of the severity of clinical syndrome to 0.26.
Conclusion: Primary object relations mediated by defense mechanisms affected the severity of clinical syndrome in BPD. In conclusion, the model claimed in this study was well–suited.
Keywords: Borderline personality disorder, Clinical syndrome, Primary object relations, Defense mechanisms.
Type of Study: Original Research Article |
Subject:
Psychology
References
1. Ford JD, Courtois CA. Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personal Disord Emot Dysregul. 2014;1:9. [DOI]
2. González RA, Igoumenou A, Kallis C, Coid JW. Borderline personality disorder and violence in the UK population: categorical and dimensional trait assessment. BMC Psychiatry. 2016;16:180. [DOI]
3. Gunderson JG, Sabo AN. The phenomenological and conceptual interface between borderline personality disorder and PTSD. Am J Psychiatry. 1993;150(1):19–27. [DOI]
4. Pierò A, Cairo E, Ferrero A. Personality dimensions and working alliance in subjects with borderline personality disorder. Rev Psiquiatr Salud Ment. 2013;6(1):17–25. [DOI]
5. Diamond D, Yeomans FE, Stern B, Levy KN, Hörz S, Doering S, et al. Transference focused psychotherapy for patients with comorbid narcissistic and borderline personality disorder. Psychoanalytic inquiry. 2013;33(6):527–51. [DOI]
6. Keuroghlian AS, Frankenburg FR, Zanarini MC. The relationship of chronic medical illnesses, poor health-related lifestyle choices, and health care utilization to recovery status in borderline patients over a decade of prospective follow-up. J Psychiatr Res. 2013;47(10):1499–506. [DOI]
7. Gunderson JG, Weinberg I, Choi-Kain L. Borderline Personality Disorder. FOC. 2013;11(2):129–45. [DOI]
8. Chiesa M, Larsen-Paya M, Martino M, Trinchieri M. The relationship between childhood adversity, psychiatric disorder and clinical severity: results from a multi-centre study. Psychoanalytic Psychotherapy. 2016;30(1):79–95. [DOI]
9. MacIntosh HB, Godbout N, Dubash N. Borderline personality disorder: Disorder of trauma or personality, a review of the empirical literature. Canadian Psychology. 2015;56(2):227–41. [DOI]
10. Perroud N, Badoud D, Weibel S, Nicastro R, Hasler R, Küng A-L, et al. Mentalization in adults with attention deficit hyperactivity disorder: Comparison with controls and patients with borderline personality disorder. Psychiatry Res. 2017;256:334–41. [DOI]
11. Tahirovic S, Bajric A. Child-Parent Attachment Styles and Borderline Personality Disorder Relationship. Mediterranean Journal of Clinical Psychology. 2016;4(2). [DOI]
12. Greene LR. Primitive defenses, object relations, and symptom clusters in borderline psychopathology. J Pers Assess. 1996;67(2):294–304. [DOI]
13. Ghiasi H, Mohammadi A, Zarrinfar P. An investigation into the roles of theory of mind, emotion regulation, and attachment styles in predicting the traits of borderline personality disorder. Iran J Psychiatry. 2016;11(4):206–13.
14. Ghafari M, Rezaie A. Investigating the relation of attachment and identity styles with borderline personality Disorder of adolescents. J Ilam Uni Med Sci. 2013;21(6):23–32. [Persian] [Article]
15. Besharat MA. An attachment theory explanation of personality disorders. Journal of the Iranian Psychological Association. 2007;1(2):41–8. [Persian] [Article]
16. Zanarini MC, Weingeroff JL, Frankenburg FR. Defense mechanisms associated with borderline personality disorder. J Pers Disord. 2009;23(2):113–21. [DOI]
17. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Niloufari A, Reza’ie F, Shamloo F, Farmand A, Fakhraie A, Hashemi Azar J. (Persian translator). Tehran: Arjmand Publication; 2015.
18. Ball SA, Cecero JJ. Addicted patients with personality disorders: traits, schemas, and presenting problems. J Pers Disord. 2001;15(1):72–83. [DOI]
19. Cangur S, Ercan I. Comparison of model fit indices used in structural equation modeling under multivariate normality. J Mod App Stat Meth. 2015;14(1):152–67. [DOI]
20. Millon T. Millon Clinical Multiaxial Inventory: I & II. Journal of Counseling & Development. 1992;70(3):421–6. [DOI]
21. Dadfar M, Lester D. Prevalence of personality disorders and clinical syndromes using the Millon Clinical Multiaxial Inventory III (MCMI-III) in an Iranian clinical sample. International Journal of Biomedical Engineering. 2017;3:36–47.
22. Bell MD, Zito W. Integrated versus sealed-over recovery in schizophrenia: BORRTI and executive function. J Nerv Ment Dis. 2005;193(1):3–8. [DOI]
23. Hadinezhad H, Tabatabaeian M, Dehghani. A preliminary study for validity and reliability of bell object relations and reality testing inventory. Iranian Journal of Psychiatry and Clinical Psychology. 2014;20(2):162–9. [Persian] [Article]
24. Andrews G, Singh M, Bond M. The Defense Style Questionnaire. J Nerv Ment Dis. 1993;181(4):246–56. [DOI]
25. Shabanpour R, Zahiroddin AR, Janbozorgi M, Ghaeli P. Assessment of defense styles and mechanisms in iranian patients suffering from obsessive compulsive or panic disorders versus normal controls using persian version of defense style questionnaire-40. Iran J Psychiatry. 2012;7(1):31–5.
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
