|Type of paper:||Literature review|
Borderline personality disorder (BPD) is a mental condition characterized by frequent changes in mood, behavior, and self-image and often leads to impulsive action and relationship problems. Individuals suffering from BPD may suffer intense episodes of anxiety, anger, and depression that may last from a few hours to several days (Coolidge, Thede & Jang, 2004). These individuals have a tendency to display uncertainty with respect to how they perceive themselves and their role in the world which often leads to their values and interests changing quickly.
Identity disorder occurs in patients with BPD and develops via a diffusion of identity where one is confused about own identity that arises due to breaks in relationships to social surroundings. Flues, Resch & Moehler (2018) opine that feedback to surroundings and perception of self becomes incongruent and the resulting loss of stability or a feeling of loss of stability of identity leads to disorientation and uncertainty in actions and decisions. While it is challenging to differentiate a typical identity crisis during adolescence from the personality disorder specific diffusion. Several scholars have indicated observations of a decline in executive function in the context of BPD (Flues, Resch & Moehler, 2018).
Kumar et al (2015) defines executive functions as high order cognitive processes that comprise the ability to successfully judge, plan, make decisions, reorganize and control one's thoughts and behaviors. These functions are associated with the frontal lobes of the brain that coordinate and regulate the processes occurring in other regions of the brain. Flues, Resch & Moehler (2018) expound that executive functions unite a multidimensional complex of distinct controls and mechanism of regulation that control thinking and subsequent actions for new or unknown situations when the typical daily automatism is not useful. For the aforesaid function to be successful, Flues, Resch & Moehler (2018) explain that a working memory that updates incoming representations for current and future actions, or rather a preparation set to keep the individual or animal prepared for future actions as well as control for the ability to suppress inappropriate actions are necessary.
A study by McClure, Hawes & Dadds (2015) investigated the link between executive functioning and BPD. Although it was concluded that further research is needed, the researchers discovered that BPD occurs alongside attention deficit disorder. Another study by Gvirts et al (2012) investigated executive functions in individuals suffering from BPD and their unaffected parents. The researchers established that BPD patients exhibited deficiency in executive function processes compared to unaffected individuals in working memory, planning and sustained attention. Distinct areas of executive functions including working memory and response inhibition were considered in line with the basic cognitive process in BPD. The mistakes were high and increased significantly in individuals suffering from BPD depending on working memory load.
As earlier noted, executive function is part of the symptoms of BPD. Putnam and Silk (2005) observe that BPD is a condition of emotion regulation within emotional responses that are not flexible and is accompanied by either a decrease or an increase in the level of arousal. In this regard, it is determined that impulsivity is one of the chief elements that lead to executive dysfunction. McClure, Hawes & Dadds (2015) note that some studies that have concentrated on executive function related to BPD indicate that neurocognitive problems play part in BPD development. A comparison between schizophrenia symptoms and BPD with respect to the executive function performed by Hurtado et al (2016) showed that individuals with BPD, compared to those with schizophrenia, are more limited in their daily endeavors due to the increase in the operational capacity of the BPD. Amazingly, in the group with individuals with BPD, a substantial relationship between working memory and management was noted. Consequently, Hurtado et al concluded that issues with executive function chiefly exist in metacognitive tasks of correctly updating and managing emotional information.
Research concentrating on precision in deducing the emotional states of other individuals led to the emergence of borderline empathy: improved cognitive empathy among individuals with BPD. Roepke et al (2013) note a 1986 research by Frank & Hoffman that examined the capacity of individuals with BPD to deduce emotions of other persons as to those without BPD. The participants were shown the same female actor in different emotional states. The BPD group proved to be highly sensitive to nonverbal communication compared to that without BPD. This indicated that there is increased cognitive empathy in BPD.
Roepke et al (2013) assert that persons with BPD go through greater internal and external turmoil which allows them to be able to recognize and have a better understanding of others going through similar situations. Sharing stories of their experiences concerning emotional turmoil allows others to open and provides a sense of freedom from stigma. Dixon-Gordon et al (2017) observe that there have been studies that have proved that persons with BPD are better able to deduce the facial expressions as well as emotions of others better compared to those without BPD. In addition, being extra sensitive towards others and being in a position to read the emotions of others allows people with BPD to be more curious and creative as they put most of their emotions into music, arts, and performance.
Research by Harari et al (2010) indicated that self-reported affective aspects of empathy are higher among individuals with BPD compared to those without. Brendel et al (2005) explain that the mid-insula, a small region in the cerebral cortex, responds strongly to states of arousal of the body. There exist a relationship between the activation in the middle insula and skin conductance during emotional empathy in persons with BPD. This supports the notion of a rise in arousal when an individual is emotionally involved with others. Increased individual stress, as well as arousal, are usually apparent in persons with BPD (Brendel et al, 2005). There have been other studies that have shown that persons who are capable of regulating their emotions more often show concern for others. Therefore, the deficit in the ability to control emotions in individuals with BPD might be directly associated with an impairment in emotional empathy (Roepke et al, 2013).
Despite other studies having similar findings, there have been contradictions in findings. Research by Preibler et al (2010) examined cognitive empathy using Movie for the Assessment of Social Cognition (MASC) in 64 females with BPD and 38 without BPD as controlled. All participants had a similar level of IQ and were all the same age. Individuals with BPD exhibited diminished perception of feelings, intentions, and thoughts of the main film character. The researchers concluded that people suffering from BPD have deficits in cognitive empathy.
The formation of identity entails a developmental process in which a person synthesizes and integrates the past experiences, history, present awareness and future goals. Inline, identity can describe the goals and beliefs of an individual and their relative role to others including identification with groups. The formation of healthy identity is directly linked with high psychological well-being as well as satisfaction with relationships. On the other hand, atypical identity formation is linked with psychopathology such as BPD. Look (2017)expound that identity styles are associated with different levels of psychosocial as well as psychological adjustment and the most mature identity style linked with increased ability to solve problems, pro-social behavior, high emotional intelligence, and psychological hardiness compared less mature identity. Persons with basic executive functioning and fluid intelligence often exhibit interpersonal difficulties such as impaired social skills, poor physical health, and reduced school success. Look (2017) explains that according to research, identity formation that is not mature is associated with various psychological problems including BPD, drug use disorder, eating disorders and depressive disorder BPD, however, has been proven to be the only disorders to include identity disturbance and interpersonal instability.
Individuals with BPD experience paranoia and believe that other people want to hurt them. Chronic paranoid ideation may be a sign of a psychotic disorder such as schizophrenia and can make the person suffering from BPD feel constantly threatened by everyone around them. In addition, individuals with BPD also have dichotomous thinking where they experience difficulty in perceiving the complexity in people and situations. According to Zalewski et al (2019), the aforesaid is described as 'splitting' which means the inability to maintain a cohesive set of beliefs about self and others. These extreme thinking patterns, individuals suffering from BPD are prone to slip from one extreme to another extreme when the think. A good example is when one day an individual with BPD may think that their spouse is wonderful and loving and the next day think they are evil and are out to harm them. This can interfere with their potential to create a long-term relationship with spouse, friends, and family.
Kulacaoglu & Kose (2018) state that an individual with BPD also suffers from dissociation. While these persons have a problem with thoughts, they also have a problem with their process of perception. Dissociation with respect to BPD describes feeling unreal, numb or separate from one's own psychological experiences and body. It is important to note that dissociation in people with BPD occurs due to stress. Scholars have noted that dissociation is a way of managing or coping with emotional situations where the individual shuts down or separates from current experience. While this might be true and necessary, the distance that BPD people create cause them to take more risks as they do not perceive being connected to the current situation.
BPD is associated with various problems related to thinking. These cognitive issues usually lead to other symptoms such as lack of emotional stability, problems in their relationships and impulsive behavior among others. The various treatment options for individuals with BPD concentrate on addressing these thinking problems. Nevertheless, the irrationality and intensity from the symptoms of BPD are matched by happiness and empathy for others. Individuals with BPD are lovers and healers, and usually, end being the most creative.
Brendel, G. R., Stern, E., & Silbersweig, D. A. (2005). Defining the neurocircuitry of borderline personality disorder: Functional neuroimaging approaches. Development and Psychopathology, 17(4), 1197-1206.
Coolidge, F. L., Thede, L. L., & Jang, K. L. (2004). Are personality disorders psychological manifestations of executive function deficits? Bivariate heritability evidence from a twin study. Behavior Genetics, 34(1), 75-84.
Dixon-Gordon, K. L., Peters, J. R., Fertuck, E. A., & Yen, S. (2017). Emotional processes in borderline personality disorder: An update for clinical practice. Journal of psychotherapy integration, 27(4), 425.
Flues, L., Resch, F., & Moehler, E. (2018). Executive Function in Borderline Personality Disorder in Children and Adolescents. Res Adv Brain Disord Ther: RABDT-110. DOI, 10.
Gvirts, H. Z., Harari, H., Braw, Y., Shefet, D., Shamay-Tsoory, S. G., & Levkovitz, Y. (2012)....
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