Acute stress-related dissociation and impulsivity are core symptoms of borderline personality disorder (BPD). Both symptoms are linked to emotional distress and non-suicidal self-injury. However,...Show moreAcute stress-related dissociation and impulsivity are core symptoms of borderline personality disorder (BPD). Both symptoms are linked to emotional distress and non-suicidal self-injury. However, it is unclear how stress-related dissociation and impulsivity are associated in BPD and whether this association is specific to BPD. This study aimed to examine whether dissociation influences impulsivity after experimental stress induction in BPD (29 patients) compared to ADHD (29 patients) and HC (30 patients). Dissociation was measured through self-reports (DES and DSS-4), while impulsivity was assessed through self-reports (STIMP) as well as experimental response inhibition and delay discounting behavioral tasks. Stress was induced with the Mannheim Multicomponent Stress Test. The BPD group reported significantly higher trait and state dissociation, before stress induction, than both the ADHD and HC groups. All groups reported significantly higher state dissociation after stress induction. Nonetheless, patients with BPD reported significantly higher state dissociation after stress induction, than the ADHD and HC groups. In general, significant correlations were found between state dissociation and all three state impulsivity measures. After adjusting for multiple comparisons, however, only the correlation within the BPD group between dissociation and self-reported impulsivity remained significant. The present study, thus, underlines the considerable role stress can have in increasing acute symptoms of dissociation specifically in patients with BPD. Moreover, it supports the idea that stress-related dissociation is associated with impulsivity, as measured by how participants view themselves in self-report questionnaires. The relation between dissociation and behavioral aspects of impulsivity remains unclear.Show less
Background: The aim of this study was to investigate the effect of acute dissociation on an emotional working memory task in a sample who reported dissociation. This study also aimed to examine the...Show moreBackground: The aim of this study was to investigate the effect of acute dissociation on an emotional working memory task in a sample who reported dissociation. This study also aimed to examine the moderating role of Borderline Personality Disorder (BPD) features and childhood trauma as a possible confounder. Methods: Eighty-nine participants with a wide spectrum of BPD features were recruited online via international mental health platforms and the website of Leiden University. Data was gathered via an online survey. Participants completed the Borderline Feature Scale, the Childhood Trauma Questionnaire and the Dissociation Stress Scale 4 and they participated in an Emotional Working Memory Task. Results: Participants who experienced more severe acute dissociation showed better performance regarding the accuracy of their answers. However, dissociation was not related to reaction times. No moderating role of BPD features was found, probably due to floor effects and lack of power. Finally, it was found that when childhood trauma severity is low, increased dissociation predicts longer reaction times. Conclusion: The current study offers a first hypothesis about different information processing mechanisms during dissociation in individuals who report dissociation and childhood trauma, but do not present a clinical diagnosis. Dissociation may have a facilitating effect on working memory in some groups, while it may impair affective-cognitive function in others.Show less
Childhood maltreatment is associated with dissociative symptoms in adulthood. However, there are only few empirical studies that differentiate between the different forms of childhood maltreatment...Show moreChildhood maltreatment is associated with dissociative symptoms in adulthood. However, there are only few empirical studies that differentiate between the different forms of childhood maltreatment which is why it continues to be unclear in what way they may have differing consequences. Moreover, the role of borderline personality disorder (BPD) symptoms in this context is not yet fully understood. In this study, the relationship between the severity of different forms of childhood maltreatment and dissociative symptoms was investigated. Further, it was investigated whether symptoms of BPD account for a significant part of these associations. Deepening this understanding may be helpful in improving prevention and intervention of dissociative disorders. Two datasets were used in this study. The first dataset was collected in The Netherlands and comprised n = 761 individuals. The second dataset was collected in Germany and comprised n = 426 individuals. Linear regression analysis was used to predict the severity of dissociation symptoms based on the severity of childhood maltreatment when accounting for BPD symptoms. Childhood maltreatment predicted dissociation in both datasets. In the first sample, emotional and physical abuse significantly predicted dissociation, with emotional abuse positively predicting dissociation and physical abuse negatively predicting dissociation. In the second dataset, emotional and sexual abuse positively predicted dissociation. In both samples, adding BPD scores accounted for up to 30% of explained variance in the dissociation scores. This study underlines the importance of childhood maltreatment and BPD in the understanding and exploration of dissociation.Show less
Research master thesis | Psychology (research) (MSc)
under embargo until 2025-01-31
2025-01-31T00:00:00Z
Dissociation is a complex trans-diagnostic phenomenon, which ranges from normative to pathological. There are multiple ways of measuring and categorising dissociation, and different theories as to...Show moreDissociation is a complex trans-diagnostic phenomenon, which ranges from normative to pathological. There are multiple ways of measuring and categorising dissociation, and different theories as to the aetiology and function of dissociation in psychological disorders. People with Borderline Personality Disorder (BPD) experience more dissociation than healthy controls and other personality disorders, and dissociation is associated with other key features of BPD. Despite this, dissociation in BPD is poorly understood. It is unclear which types of dissociation manifest in BPD, in which situations, and the function that dissociation achieves. The aim of this study was to investigate the form and function of dissociation in BPD, by identifying themes across personal narratives. A thematic analysis was performed on narratives of dissociative experiences assessed within a script-driven imagery approach. The predominant forms of dissociation were depersonalisation and derealisation. Dissociation occurred in interpersonal and threatening situations, tended to follow negative affect, and was accompanied by physical reactions consistent with sympathetic nervous system activation. Dissociation functioned as psychological escape from internal experiences or external situations. These themes are discussed within the context of prominent theories of BPD and dissociation. These findings are in line with the idea that dissociation in BPD acts as a protective mechanism against high sensitivity and reactivity to affective and interpersonal experiences in the place of normative regulation skills. This paper concludes that dissociation in BPD offers psychological escape from intolerable experiences, and is related to a low threshold for threat perception and threat response mobilisation.Show less
Abstract Background: As suicide rates are alarmingly high worldwide, finding predictors for suicide is imperative. People with borderline personality disorder (BPD) have a heightened risk of...Show moreAbstract Background: As suicide rates are alarmingly high worldwide, finding predictors for suicide is imperative. People with borderline personality disorder (BPD) have a heightened risk of attempting and dying by suicide. BPD is diagnosed using nine distinct criteria, which have all been previously linked to suicidal ideation, suicidal behavior, and suicide attempts (SA) in people with BPD. However, the results of previous studies vary greatly, and no single diagnostic criterium seemed to have a uniquely strong correlation with SA. The aim of this study was to shed more light on the associations of these criteria and SA by including a large group of people with BPD or other psychiatric illnesses, and healthy participants. Method: Diagnostic criteria and previous SA were assessed in a semi-structured interview by trained clinicians. Data was analyzed with multiple regression analyses in the three groups separately. Results: In BPD participants, the criteria of abandonment avoidance and affective instability were significantly linked to SA, while suicidal and self-harm behaviors only showed a marginally significant predictive effect. In the clinical group, all diagnostic criteria had non-significant effects on the number of SA. The analysis for the healthy group was inconclusive due to restricted range of SA. Conclusion: These findings suggest that abandonment avoidance and affective instability may be the most pronounced risk factors for people with BPD; they are more strongly linked to SA than even suicidal behavior and the remaining diagnostic criteria. In people with other psychiatric illnesses, other risk factors may be more important for SA. This may have implications for suicide prevention in clinical practice, though further research is needed.Show less
