The Construct of Effortful Control: An Approach to Borderline Personality Disorder Heterogeneity Hoerman, Clarkin, Hull & Levy (2005)

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Presentation transcript:

The Construct of Effortful Control: An Approach to Borderline Personality Disorder Heterogeneity Hoerman, Clarkin, Hull & Levy (2005)

Background ● Borderline Personality Disorder  Heterogeneous  DSM-IV (Diagnostic and Statistical Manual of Mental Disorders)  Have to meet 5 out of 9 criteria to be diagnosed ● Avoiding abandonment ● Unstable and intensive personal relationships ● Impulsivity ● Identity disturbance ● Feeling of emptiness ● Suicidal tendencies ● Affective instability ● Difficulty controlling anger ● Dissociation

Effortful Control ● Ability to inhibit a predominant response in favour of a subdominant one. ● Related to executive attentional network ● Positively correlated with conscious development and negatively with aggression.

Effortful Control and BPD ● Hypothesised that 3 subgroups of BPD patients can be identified, based on 3 subscales of effortful control:  Inhibitory control – capacity to suppress positively toned impulses and avoid inappropriate approach  Activation control - capacity to suppress negatively toned impulses and avoid inappropriate avoidance  Attentional control – capacity to intentionally shift attention

Methods ● Participants: 47 patients diagnosed with BPD ● Measures:  The Adult Temperament Questionnaire (Effortful Control)  The Brief Symptom Inventory (Depression, Hostility, Anxiety & Psychoticism)  The Multidimensional Personality Questionnaire (Social Potency, Social Closeness & Alienation)  The Inventory of Personality Organization (Identity Diffusion, Reality Testing & Primitive Defences)

Results

Cluster 1 (High Effortful Control) Cluster 2Cluster 3 (Low Effortful Control) Anxiety Psychoticism Alienation ID diffusion Primitive defences Low Medium Low Medium High

Conclusion ● There are 3 different levels of pathology within BPD sample, with the group with high effortful control exhibiting the least, and the group with low effortful control exhibiting the most problems in different areas of functioning

Limitations ● Small sample size N=47  Cluster I n=17  Cluster II n=19  Cluster III n=11 ● No control group ● 3 clusters chosen in advance – not empirically derived ● Self-reports – perhaps the disorder affects the way the patients perceive themselves??