Ego Development Level and Individuation Experiences in Individuals Meeting Criteria for Borderline Personality Disorder

Christine Petit, Pace University

Abstract

Borderline personality disorder has been an enigma among diagnoses for decades. Currently this disorder affects 1-2% of the population (ten Have, Verheul, Kaasenbrood, van Dorsselaer, Tuithof, Kleinjan & de Graaf, 2016), but accounts for at least 20% of psychiatric hospitalizations (Carlson et al, 2009). Current schools of thought understand borderline personality disorder in terms of emotional lability and observable behaviors. In contrast, early psychoanalytic schools of thought focused on internal psychic difficulties that were uniquely present in borderline individuals, such as impaired ego function and identity formation (Stern 1938; Kernberg, 1967, Knight 1953). There are two evidence-based practices to treat borderline personality disorder: Dialectical Behavior Therapy, which focuses on a series of observable behavior and symptoms (Linehan, 1993), and Transference-Focused Therapy, which focuses on reduction of symptoms through addressing underlying representations of the self and others (Levy et al, 2006). Previously, empirical research has not addressed whether individuals meeting criteria for borderline personality disorder based on current behavioral & symptomatic criteria also display the unique internal psychic difficulties described by psychoanalysts such as ego weakness and difficulties with separation-individuation, and whether these concepts can be integrated to promote more accurate diagnostic screening and treatment planning.^ The present study explored the differences between individuals meeting criteria for borderline personality disorder and individuals with no diagnosis in terms of ego development and individuation, as well as whether using diagnostic measures that address psychodynamic concepts such as ego development and individuation can lead to a more accurate diagnosis of borderline personality disorder than using symptom measures alone. It was hypothesized that individuals meeting criteria for borderline personality disorder would demonstrate less ego development and identity formation and more maladaptive outcomes of separation-individuation, such as depression and counter-depressive behaviors. It was also hypothesized that using measures addressing ego development and separation-individuation experiences in addition to symptom measures would lead to a diagnosis closer to a clinical interview than using symptom measures alone.^ The sample consisted of 755 participants who sought psychological services at a university based community clinic in downtown Manhattan. Participants completed the Sentence Completion Test of Ego Development, the Profile of Adolescent Depression and Individuation, the Personality Assessment Inventory, and the Structured Clinical Interview for DSM-IV-TR Axis II Disorders. Results confirmed the hypotheses that individuals meeting criteria for borderline personality disorder would demonstrate less ego development and identity formation and more maladaptive outcomes of separation-individuation, such as depression and counter-depressive behaviors. Results varied with regards to whether using measures addressing ego development and separation-individuation experiences in addition to symptom measures would lead to a diagnosis closer to a clinical interview than using symptom measures alone- as using the Profile of Adolescent Depression and Individuation and the Sentence Completion Test of Ego Development lead to a more specific diagnosis, but a less sensitive detection of borderline personality disorder.^

Subject Area

Psychology|Clinical psychology|Personality psychology

Recommended Citation

Petit, Christine, "Ego Development Level and Individuation Experiences in Individuals Meeting Criteria for Borderline Personality Disorder" (2018). ETD Collection for Pace University. AAI10805106.
https://digitalcommons.pace.edu/dissertations/AAI10805106

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