1

Article Critique

Jessica Salzmann

Department of Education and Psychology, Pepperdine University

PSY 626: Research and Evaluation Methods for Mental Health Professionals

Professor Seth Madej

November 23, 2022

2

Article Critique

Abstract/Introduction

1. What was the purpose of the study? Was there a clear statement of the purpose and aims

of the research? Provide a rationale for your response.

With symptom similarities such as difficulty emotionally regulating and a history of childhood

maltreatment, this study aimed to discover where the differences lie between patients with BPD

and patients with DD. Most importantly, the authors indicate that this study is geared towards

providing more information on the relationship between individuals diagnosed with BPD, who

typically also suffer from DD, and participants who are only diagnosed with DD but do not meet

the criteria for BPD (Schaich et al., 2021). More specifically BPD criteria that is focused

towards childhood maltreatment and emotional regulation.

2. Did the authors provide enough support for why this study is important to the field?

Provide a rational for your response.

Yes, it was mentioned multiple times throughout the study that there are not many studies that

have focused on the differences between certain symptoms of BPD and DD. For example,

previous studies that have found a relationship between emotional abuse and BPD symptoms, did

not investigate which specific aspects of emotional regulation demonstrated the greatest

connection between childhood maltreatment and BPD symptoms. By being able to distinguish

the difference in severity of certain criteria, this information is important in potentially finding

and executing a more successful treatment plan for different types of mental health disorders

with similar symptomatology.

3. What theories (e.g., social learning theory) did the authors include in how they

conceptualized the study?

3

This study used the psychoanalytic approach to conceptualize their study, which would be well

in line with childhood trauma and adverse side effects such as DD and BPD. The CTQ is also

stated to be highly valid so it speaks to the efficacy of the study overall, especially when you

consider the extra work that went into assessing for and accounting the natural tendency for

confounding variables.

Furthermore, the BPD participants in this study exhibited higher scores on the DERS

scale, particularly in the areas of impulse control, coping mechanisms for emotional

dysregulation, and struggles in defining their emotions. Schaich et al. (2021), indicates that these

finding can be explained by Linehan’s biosocial theory. A theory that primarily focuses on

causes of different negative effects on emotional regulation.

4. What was the rationale for this particular study?

The rationale for this particular study, as previously mentioned, is that there lack of

research regarding the differences between patients with DD and BPD. In fact, due to the large

number of commonalities between individuals diagnosed with DD and BPD in areas including,

emotional regulation and childhood maltreatment, it can prove as difficult to properly diagnose

and treat these disorders. As a result, this study makes a purposeful attempt to find participants

representing those populations in order to more effectively determine the differences.

Method/Results

5. Were the (a) design, (b) methods, and (c) sampling strategy used in the study

appropriate to what the authors were trying to find out? Provide a rationale for your

response.

The designed used in the study is appropriate in answering the previously mentioned

research question. The aim is to get a better understanding of symptomatology and different
4

contributing aspects to those symptoms between BPD and mental health disorders. As Schaich et

al. (2021) mentions, due to depression being the highest diagnosed mental health disorder, it only

makes sense to use that sample of participants for comparison.

The method implemented in this study is also appropriate, via finding participants more

likely to have the sought out diagnoses and using measures that specifically address common

symptoms/criteria between both diagnoses. For example, all participants were found being

patients of the Department of Psychiatry and Psychotherapy at the University of Lubeck, out-

patient clinic.

The sampling strategy for this study required all patients to complete a baseline

assessment, which allowed for two specific sample groups; patients that met criteria for DD not

to have a comorbid diagnosis of BPD and patients that have BPD. By doing so results are more

easily distinguished between the measures.

6. Did the authors discuss whether or not measures/instruments used were reliable and

valid? Was their discussion sufficient?

This study used four separate measures to assess mental health disorders, childhood

trauma experiences, difficulties regulating emotions, and general symptom severity. The

measure used to assess the mental health disorders was the Structured Clinical Interview for

DSM-IV, more specially the SCID-II German version. Aside from the authors specifying how

the BPD symptoms are being defined, there is a lack of discussion regarding reliability for

validity

In assessing childhood trauma experiences, the study utilized the German version of the

Childhood Trauma Questionnaire (CTQ). Furthermore, determining the severity of symptoms

the study used the Brief Symptom Inventory. Both of these measures were mentioned in having
5

“good psychometric properties” (Schaich et al., 2021). In my opinion, simply mentioning the

measures are reliable and valid without any data points, is not a sufficient enough discussion.

The Difficulties in Emotion Regulation Scale (DERS) was used to evaluate emotional

regulation. This measure claims to have “high internal consistency, good test-retest reliability,

and adequate predictive and construct validity” (Schaich et al., 2021). Again, this was the only

mention of validity and reliability which I believe was insufficient.

7. What were the main results of the study?

This study provided results in three separate categories: demographic specifics and

participant differences regarding childhood maltreatment and emotion regulation. The sample of

participants that are diagnosed with BPD were primarily female and younger than the

participants with DD. The BPD participants also scored higher on the BSI Global Severity Index

and on all subscales of the CTQ measure. These elevated results proved to be no different for

the DERS scale, where the BPD participants struggled greater with emotional regulation.

8. Based on the sample, how generalizable are the results of this study? Provide a rational

for your response.

Focusing on the sample pool, the participants were pulled from psychotherapy outpatient

treatment programs. These programs represented a population of individuals with a complex

portfolio of symptoms and comorbid mental health disorders. As a result, the generalizability of

this study is an area of concern due to the higher symptom severity displayed compared to the

general population. Also, due to the drastic imbalance in female participants compared to male

participants in the BPD sample and the evenly distributed male-female ratio in the DD sample.

The study can not be confidently applied to a male population without more research.

9. Are the tables and figures organized and easy to understand?

6

Personally, without a strong statistical background, I believe some of the tables and

figures are not easy to understand.

Discussion

10. Were there any possible confounding variables in the design of the study?

Global symptom severity, age, and gender, were all found to be possible confounding

variables. Recognizing this, the authors implemented MANCOVA to potentially counteract the

fore mentioned confounding variables.

11. What are the limitations of this study that were not stated by the authors?

The limitations of this study, I believe, could be mostly found in the sample pool. There

is a severe lack of diversity amongst the participants, which can be shown by the large amount of

females in the BPD participants sample size. Aside from the demographics of the sample, the

authors did an amazing job of assessing and pointing out all the limitations of the study.

12. What are strengths of this study that were not stated by the authors?

A strength not noted by the authors is the utilization of a larger population, which

increases the tendency for statistical error, but also increases overall validity of results.