The Role of Basic Symptoms and Aberrant Salience in Borderline Personality Disorder

Carmela Mento, Amelia Rizzo, Rossella Alfa, Viviana Carlotta, Enza Lipari, Antonio Bruno, Clemente Cedro, Gianluca Pandolfo, Maria Rosaria Anna Muscatello, Rocco Antonio Zoccali

Abstract


Background: The prevalence of pre-psychotic symptoms and aberrant salience in BPD has not been systematically studied. The present study aims to investigate the intensity, frequency and correlation between basic symptoms, aberrant salience and borderline personality traits, in subjects that have not yet developed a frank psychotic episode. 


Methods: Twenty-eight subjects, 8 males and 20 females, aged between 24 and 55 years (M = 41.36 ± 9.9) has been individually tested throughout the Frankfurt Complaint Questionnaire (FBF), the Aberrant Salience Inventory (ASI) and the Personality Inventory for the DSM-5- Adult (PID-5). 


Results: Findings showed that 85.7% of the sample (n = 24) reported significant scores of the aberrant salience traits, which in turn were correlated to basic symptoms. Furthermore, emerged several correlations between pre-psychotic symptoms and PID-5 personality dimensions not only with Negative Affectivity and Detachment but also with Psychoticism.


Conclusions: This study highlights the phenomenological continuity between the borderline personality traits and the attenuated manifestation of the psychotic disease.


Full Text:

PDF

References


Adams, B., & Sanders, T. (2011). Experiences of psychosis in borderline personality disorder: a qualitative analysis. Journal of Mental Health, 20(4), 381-391. https://doi.org/10.3109/09638237.2011.577846

Badcock, J. C., & Hugdahl, K. (2012). Cognitive mechanisms of auditory verbal hallucinations in psychotic and non-psychotic groups. Neuroscience & Biobehavioral Reviews, 36(1), 431-438. https://doi.org/10.1016/j.neubiorev.2011.07.010

Bandelow, B., Krause, J., Wedekind, D., Broocks, A., Hajak, G., & Rüther, E. (2005). Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with borderline personality disorder and healthy controls. Psychiatry Research, 134(2), 169-179. https://doi.org/10.1016/j.psychres.2003.07.008

Barnow, S., Arens, E. A., Sieswerda, S., Dinu-Biringer, R., Spitzer, C., & Lang, S. (2010). Borderline personality disorder and psychosis: a review. Current Psychiatry Reports, 12(3), 186-195. https://doi.org/10.1007/s11920-010-0107-9

Cicero, D.C., Kerns, J.G., McCarthy, D.M. (2010). The Aberrant Salience Inventory: A new measure of psychosis proneness. Psychological Assessment, 22, 688-701. https://doi.org/10.1037/a0019913

Crepulja, M. L. (2014). Borderline personality disorder and psychotic symptoms. Pregled bibliografske jedinice broj: 718726

D’Agostino, A., Monti, M. R., & Starcevic, V. (2019). Psychotic symptoms in borderline personality disorder: an update. Current opinion in psychiatry, 32(1), 22-26. https://doi.org/10.1097/YCO.0000000000000462

Dorahy, M. J., & Palmer, R. C. (2016). Auditory hallucinations in chronic trauma disorders: phenomenology and psychological mechanisms. Comprehensive Guide to Post-Traumatic Stress Disorders, 1223-1239. https://doi.org/10.1007/978-3-319-08359-9_45

Francey, S. M., Jovev, M., Phassouliotis, C., Cotton, S. M., & Chanen, A. M. (2018). Does co‐occurring borderline personality disorder influence acute phase treatment for first‐episode psychosis?. Early intervention in psychiatry, 12(6), 1166-1172. https://doi.org/10.1111/eip.12435

Friedmann, C., & Badic, A. (2019). Cluster of psychotic symptoms in a current clinical approach in borderline personality disorder. Acta Medica Marisiensis, 65.

Gawęda, L. (2018). The role of self-disturbances and cognitive biases in the relationship between traumatic life events and psychosis proneness in a non-clinical sample. Schizophrenia Research, 193, 218-224. https://doi.org/10.1016/j.schres.2017.07.023

Genovese, G., Cicciarelli, C., Rizzo, A., & Crucitti, M. (2015). Perceptual derailment and confabulation in the Rorschach projective technique: A clinical report. Mediterranean Journal of Clinical Psychology, 3(3). https://doi.org/10.6092/2282-1619/2015.3.1117

Godini, L., Lelli L., Campione B., Ciampi E., Corsi E., Ramella Cravaro V, & Ballerini A. (2015). The clinical, psychopathological and neurobiological features of salience, Rivista di Psichiatria, 50(6), 255-264 255. https://doi.org/10.1708/2098.22680

Golier, J. A., Yehuda, R., Bierer, L. M., Mitropoulou, V., New, A. S., Schmeidler, J. & Siever, L. J. (2003). The relationship of borderline personality disorder to posttraumatic stress disorder and traumatic events. American Journal of Psychiatry, 160(11), 2018-2024. https://doi.org/10.1176/appi.ajp.160.11.2018

Goodwin, G.M., Haddad, P.M., Ferrier, I.N., Aronson, J.K., Barnes, T.R.H., Cipriani, A., Coghill, D.R., Fazel, S., Geddes, J.R., Grunze, H., Holmes, E.A., Howes, O., Hudson, S., Hunt, N., Jones, I., Macmillan, I.C., McAllister-Williams, H., Miklowitz, D.R., Morriss, R., Munafò, M., Paton, C., Sahakian, B.J., Saunders, K.E.A., Sinclair, J.M.A., Taylor, D., Vieta, E., Young, A.H. (2016). Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology, 30 (6), 495-553. https://doi.org/10.1177/0269881116636545

Gras, A., Amad, A., Thomas, P., & Jardri, R. (2014). Hallucinations and borderline personality disorder: a review. L'Encephale, 40(6), 431-438. https://doi.org/10.1016/j.encep.2014.07.002

Kapur, S. (2003). Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. American journal of Psychiatry, 160(1), 13-23. https://doi.org/10.1176/appi.ajp.160.1.13

Kapur, S., Mizrahi, R., & Li, M. (2005). From dopamine to salience to psychosis—linking biology, pharmacology and phenomenology of psychosis. Schizophrenia research, 79(1), 59-68. https://doi.org/10.1016/j.schres.2005.01.003

Kate, M. A., & Dorahy, M. J. (2019). Complex Post-Traumatic Stress Disorder, Developmental Trauma Disorder, Borderline Personality Disorder, and the Dissociative Disorders. Humanising Mental Health Care in Australia: A Guide to Trauma-informed Approaches. https://doi.org/10.13109/prkk.2010.59.6.453

Klosterkötter, J. (1992). The meaning of basic symptoms for the genesis of the schizophrenic nuclear syndrome. Psychiatry and Clinical Neurosciences, 46(3), 609-630. https://doi.org/10.1111/j.1440-1819.1992.tb00535.x

Krueger, R. F., Eaton, N. R., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2011). Personality in DSM–5: Helping delineate personality disorder content and framing the metastructure. Journal of personality assessment, 93(4), 325-331. https://doi.org/10.1080/00223891.2011.577478

Lenzenweger, M. F., Clarkin, J. F., Kernberg, O. F., & Foelsch, P. A. (2001). The Inventory of Personality Organization: Psychometric properties, factorial composition, and criterion relations with affect, aggressive dyscontrol, psychosis proneness, and self-domains in a nonclinical sample. Psychological Assessment, 13(4), 577. https://doi.org/10.1037/1040-3590.13.4.577

Liebowitz, M. R. (1979). Is borderline a distinct entity?. Schizophrenia Bulletin, 5(1), 23-38. https://doi.org/10.1093/schbul/5.1.23

Linscott, R.J., & van Os, J. (2010). Systematic reviews of categorical versus continuum models in psychosis: evidence for discontinuous subpopulations underlying a psychometric continuum. Implications for DSM-V, DSM-VI, and DSM-VII. Annual Review of Clinical Psychology, 6, 391-419 https://doi.org/10.1146/annurev.clinpsy.032408.153506

Martín-Blanco, A., Ferrer, M., Soler, J., Arranz, M. J., Vega, D., Calvo, N., ... & Carmona, C. (2016). The role of hypothalamus–pituitary–adrenal genes and childhood trauma in borderline personality disorder. European archives of psychiatry and clinical neuroscience, 266(4), 307-316. https://doi.org/10.1007/s00406-015-0612-2

Myin-Germeys, I., van Os, J., Schwartz, J. E., Stone, A. A., & Delespaul, P. A. (2001). Emotional reactivity to daily life stress in psychosis. Archives of general psychiatry, 58(12), 1137-1144 https://doi.org/10.1001/archpsyc.58.12.1137

Nelson, B., Thompson, A., Chanen, A. M., Amminger, G. P., & Yung, A. R. (2013). Is basic self‐disturbance in ultra‐high risk for psychosis (‘prodromal’) patients associated with borderline personality pathology?. Early intervention in psychiatry, 7(3), 306-310. https://doi.org/10.1111/eip.12011

Noll, R. (2018). Feeling and smelling psychosis: American alienism, psychiatry, prodromes and the limits of ‘category work’. History of the Human Sciences, 31(2), 22-41. https://doi.org/10.1177/0952695117750341

Paris, J. (2018). Clinical features of borderline personality disorder. Handbook of Personality Disorders: Theory, Research, and Treatment, 2, 419.

Poletti, M., Tortorella, A., & Raballo, A. (2019). Impaired corollary discharge in psychosis and at risk states: integrating neurodevelopmental, phenomenological and clinical perspectives. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. https://doi.org/10.1016/j.bpsc.2019.05.008

Raine, A., (2006). Schizotypal Personality: Neurodevelopmental and Psychosocial Trajectories. Annual Review of Clinical Psychology, 2, 291-326. https://doi.org/10.1146/annurev.clinpsy.2.022305.095318

Reitz, S., Kluetsch, R., Niedtfeld, I., Knorz, T., Lis, S., Paret C., Kirsh P., Meyer-Lindenberg A., Treede RD, Baumgärtner U., Bohus, M., Schmahl C. (2015). Incision and stress regulation in borderline personality disorder: neurobiological mechanisms of self-injurious behaviour. The British Journal of Psychiatry, 207(2), 165-172. https://doi.org/10.1192/bjp.bp.114.153379

Rizzo, A. (2017). To the origins of psychosis. Study paths between clinic and culture. Mediterranean Journal of Clinical Psychology, 5(1). https://doi.org/10.6092/2282-1619/2017.5.1526

Rizzo, A., Della Villa, L., & Crisi, A. (2015). Can the Problematic Internet Use evolve in a pre-psychotic state? A single case study with the Wartegg. Computers in Human Behavior, 51, 532-538. https://doi.org/10.1016/j.chb.2015.04.063

Roiser J.P., Dalleyab. J.W. (2012).Dopamine, serotonin and impulsivity. Neuroscience, 215, 42-58. https://doi.org/10.1016/j.neuroscience.2012.03.065

Schroeder, K., Fisher, H. L., & Schäfer, I. (2013). Psychotic symptoms in patients with borderline personality disorder: prevalence and clinical management. Current opinion in psychiatry, 26(1), 113-119. https://doi.org/10.1097/YCO.0b013e32835a2ae7

Slotema, C. W., Daalman, K., Blom, J. D., Diederen, K. M., Hoek, H. W., & Sommer, I. E. C. (2012). Auditory verbal hallucinations in patients with borderline personality disorder are similar to those in schizophrenia. Psychological Medicine, 42(9), 1873-1878. https://doi.org/10.1017/S0033291712000165

Stanghellini G, Quercioli L, Ricca V, Strik WK, Cabras P. (1991). Basic symptoms and negative symptoms in the light of language impairment. Comprehensive Psychiatry, 32, 141-6. https://doi.org/10.1016/0010-440X(91)90006-X

Van der Hart, O., & Witztum, E. (2008). Dissociative psychosis: Clinical and theoretical aspects. Psychosis, trauma and dissociation, 257-269.

Yee, L., Korner, A. J., McSwiggan, S., Meares, R. A., & Stevenson, J. (2005). Persistent hallucinosis in borderline personality disorder. Comprehensive Psychiatry, 46 (2), 147-154. https://doi.org/10.1016/j.comppsych.2004.07.032

Yung, A. R., Nelson, B., Baker, K., Buckby, J. A., Baksheev, G., & Cosgrave, E. M. (2009). Psychotic-like experiences in a community sample of adolescents: implications for the continuum model of psychosis and prediction of schizophrenia. Australian & New Zealand Journal of Psychiatry, 43(2), 118-128. https://doi.org/10.1080/00048670802607188




DOI: https://doi.org/10.6092/2612-4033/0110-2270

Refbacks

  • There are currently no refbacks.