Inpatient Adolescents With Borderline Personality Disorder Features: Identity Diffusion and Narrative Incoherence

Borderline personality disorder (BPD) is a severe disorder with poor prognosis. Therefore, a growing number of researchers emphasize the need to evaluate correlates of BPD present during adolescence that can be identified and targeted to prevent exacerbation over time. A core feature of BPD is a disturbed sense of self; however, such disturbances can manifest themselves in different ways in adolescence. In this study, we examined whether such disturbances would appear through self-reported identity disturbance and more indirectly through incoherent oral narratives, rated based on the content derived from the Child Attachment Interview. Thus, higher levels of identity diffusion and lower levels of narrative coherence of past events were expected to associate with BPD features in 70 inpatient adolescents. Findings confirmed hypotheses; however, when considering covariance between narrative coherence and identity diffusion, only identity diffusion remained significant. Findings are discussed in terms of how both constructs might be underlying mechanisms of a disturbed sense of self in BPD and how they speak to future treatment and a more dimensional conceptualization of personality disorders.