BORDERLINE PERSONALITY DISORDER FEATURES AND RISK FOR PRESCRIPTION OPIOID MISUSE IN A CHRONIC PAIN
SAMPLE: ROLES FOR IDENTITY DISTURBANCES AND IMPULSIVITY
Author Participants Procedure
147 patients
Caleb J. Participants:
the ages of 20 and 82
Reynolds
147 patients
recruited participants by placing informational flyers in
the waiting room of the clinic.
Instruments:
1. BPD features using the Personality Assessment
Inventory–Borderline Features scale (PAI-BOR)
2. risk for prescription opioid misuse using items
from the Revised Screener and Opioid
Assessment for Patients with Pain (SOAPP-R)
3. current misuse of prescription opioids with the
Prescription Opioid Misuse Index (POMI)
4. opioid use disorder (OUD) symptoms using the
prescription painkiller items from the National
Survey on Drug Use and Health
5. pain using the Brief Pain Inventory (BPI)
Results
A relationship between disturbed identity in BPD and
problematic prescription opioid use among pain
patients is especially pertinent in the context of a body
of literature addressing the importance of the self-
concept in the chronic pain context. Specifically, there
is considerable evidence that the experience of chronic
pain is hard on the self-concept. Chronic pain can
negatively impact a person’s sense of self (i.e.,
identity) by interrupting previously typical behavior
and functioning (Miles et al., 2005), thus leading to
losses of the roles and personal attributes that comprise
one’s identity.
We propose that our results reflect that, in the chronic
pain context, individuals with an unstable identity due
to BPD might more readily take on the identity of a
chronic pain sufferer.
 Identity Disturbance in Borderline Personality Disorder: An Empirical Investigation

Author Participants Procedure Results

Tess patients Participants:
Wilkinson- patient group consisted of 95 subjects diagnosed
Ryan with borderline personality disorder
Instruments:
1. 90 minutes or less interview
2. The use of clinicians (rather than patients)
as respondents
3. Clinicians were given a
diagnostic/demographic/developmental
history form adapted from previous studies
4. An identity questionnaire designed
expressly for the purpose of this research
(35 items)
Four identity disturbance factors were identified:
role absorption (in which patients tend to define
themselves in terms of a single role or cause),
painful incoherence (a subjective sense of lack of
coherence), inconsistency (an objective
incoherence in thought, feeling, and behavior),
and lack of commitment (e.g., to jobs or values).
All four factors, but particularly painful
incoherence, distinguished patients with
borderline personality disorder. Although sexual
abuse was associated with some of the identity
factors, particularly painful incoherence,
borderline pathology contributed unique variance
beyond abuse history to all four identity
disturbance factors. The data also provided further
evidence for an emerging empirical distinction
between two borderline personality disorder
types: one defined by emotional dysregulation
and dysphoria, the other by histrionic
characteristics
 AT THE JUNCTION OF CLINICAL AND DEVELOPMENTAL SCIENCE: ASSOCIATIONS OF BORDERLINE IDENTITY
DISTURBANCE SYMPTOMS WITH IDENTITY FORMATION PROCESSES IN ADOLESCENCE

Author Participants Procedure Results

Shawna Youth Participants: Identity confusion (especially reconsideration) and
Mastro (aged 12–20 years) 505 adolescents disturbance were associated with elevated borderline
Campbell Instruments: symptoms. Emptiness stood out as the strongest
1. Borderline Identity Disturbance. The seven- correlate of borderline symptoms. Youth reporting
item Borderline Identity Disturbance Self-Report greater emptiness were nearly twice as likely to
(BIDS report a high borderline symptom profile
2. Borderline Personality Features. The Borderline
Personality Features Scale for Children-11
(BPFSC-11)
3. Four Elements of Identity Disturbance:
Self-Esteem, Self-Concept Clarity,
Emptiness, Disassociation, four measures were
used to assess aspects of identity disturbance as
described in the DSM-5
4. To measure self-concept clarity, the 12-item
Self-Concept Clarity Scale was utilized, which
taps a clear and stable sense of self (J. D.
Campbell, 1996)

5. To assess feelings of emptiness and nonexistence,

the nine-item Subjective Experiences of Emptiness
subscale from the Emptiness/Existential Inventory
(Hazell, 1982) was utilized
6. For a measure of disassociation, the 10-item
Dissociation subscale of the Trauma Symptom
Checklist for Children (Briere)
7. Typical Identity Processes: Commitment, In-
Depth Exploration, and Reconsideration of
Commitment. The Utrecht-Management of
Identity Commitments Scale (U-MICS;
Crocettiet al., 2008
 Changes in severity of depression and borderline personality disorder symptoms from pregnancy to three years
postpartum in adolescent mothers

Author Participants Procedure Results

adolescent
Sierra Participants: There were no group differences on depression
(14-18)
Nannini severity during or after pregnancy. However, compared
307never-pregnant adolescents
with their non-pregnant peers, pregnant adolescents
307 adolescent mothers reported more severe BPD symptoms even after
comorbid depression symptoms were accounted for,
and this group difference was sustained during the
Instruments: following three years.
the PGS assessment wave in which the adolescent
mother became pregnant (labeled T0) followed by
the three subsequent annual assessments following
delivery
A demographically matched non-pregnant group of
PGS participants was selected using a systematic
pairwise matching procedure
Depression symptom severity was measured using
self-report on the Adolescent Symptom
Inventory-4 (ASI-4, Gadow & Sprafkin, 1998)
Borderline personality disorder symptom
severity was assessed via self-report using the
International Personality Disorders Examina- tion
(IPDE-BOR; Loranger et al., 1994