Identity: Empirical Contribution: Changes in the Identity Integration of Adolescents in Treatment for Personality Disorders

Feenstra, Dine J.; Hutsebaut, Joost; Verheul, Roel; Limbeek, Jacques van

doi:10.1521/pedi.2014.28.1.101

Cited by 30 publications

(29 citation statements)

References 33 publications

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“…Psychotherapy research, including the present study and others, shows that identity functioning may improve over time, both in adolescents and adults (Feenstra, Hutsebaut, Verheul, & van Limbeek, 2014;Verheul et al, 2008). However, our study specifically suggests that long-term improvement among PD patients is constrained in subjects with poor AC.…”

Section: Identity Integrationsupporting

confidence: 38%

Relationship Between Affect Consciousness and Personality Functioning in Patients With Personality Disorders: A Prospective Study

Johansen¹,

Normann-Eide²,

Normann-Eide³

et al. 2016

Journal of Personality Disorders

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Emotional dysfunction is by definition central to personality disorders (PDs). In the alternative model in DSM-5, self and relational dysfunctioning constitutes the core of PD, but little is known about the relation between emotional functioning and such core aspects of personality functioning. This study investigated concurrent and prospective associations between emotional and personality functioning as assessed by affect consciousness (AC) and the Severity Indices of Personality Problems (SIPP-118), respectively. The SIPP-118 comprises five domains of personality functioning, including Identity Integration and Relation Capacities, and was applied repeatedly during 3-year follow-up of 63 PD patients who participated in a treatment study. Statistical analyses were based on linear mixed models. Lower AC levels were significantly associated with (a) lower levels of Identity Integration and Relational Capacities at baseline, and (b) poorer long-term improvement of Identity Integration. The study supports the notion that affect consciousness is related to core aspects of personality functioning.

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Section: Identity Integrationsupporting

confidence: 38%

Relationship Between Affect Consciousness and Personality Functioning in Patients With Personality Disorders: A Prospective Study

Johansen¹,

Normann-Eide²,

Normann-Eide³

et al. 2016

Journal of Personality Disorders

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“…These findings are in line with results recently reported [19, 20]. A trend was found for Relational Capacity, but with a non-significant group × time interaction.…”

Section: Discussionsupporting

confidence: 93%

Contours of a causal feedback mechanism between adaptive personality and psychosocial function in patients with personality disorders: a secondary analysis from a randomized clinical trial

2017

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BackgroundPatients with personality disorders commonly exhibit impairment in psychosocial function that persists over time even with diagnostic remission. Further causal knowledge may help to identify and assess factors with a potential to alleviate this impairment. Psychosocial function is associated with personality functioning which describes personality disorder severity in DSM-5 (section III) and which can reportedly be improved by therapy.MethodsThe reciprocal association between personality functioning and psychosocial function was assessed, in 113 patients with different personality disorders, in a secondary longitudinal analysis of data from a randomized clinical trial, over six years. Personality functioning was represented by three domains of the Severity Indices of Personality Problems: Relational Capacity, Identity Integration, and Self-control. Psychosocial function was measured by Global Assessment of Functioning. The marginal structural model was used for estimation of causal effects of the three personality functioning domains on psychosocial function, and vice versa. The attractiveness of this model lies in the ability to assess an effect of a time – varying exposure on an outcome, while adjusting for time – varying confounding.ResultsStrong causal effects were found. A hypothetical intervention to increase Relational Capacity by one standard deviation, both at one and two time-points prior to assessment of psychosocial function, would increase psychosocial function by 3.5 standard deviations (95% CI: 2.0, 4.96). Significant effects of Identity Integration and Self-control on psychosocial function, and from psychosocial function on all three domains of personality functioning, although weaker, were also found.ConclusionThis study indicates that persistent impairment in psychosocial function can be addressed through a causal pathway of personality functioning, with interventions of at least 18 months duration.

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“…Identity Integration, as defined by the SIPP-118, refers to the ability to tolerate frustration, enjoyment, and to see one’s life as stable, integrated, and purposeful [ 68 , 70 ]. Furthermore, a relationship between low scores on the Identity Integration domain and the presence of PD has been found in studies of both adults and adolescents [ 68 , 71 , 77 ]. Within the alternative model of the DSM-5 (section III) [ 13 ], identity constitutes one of two main elements of self-functioning, and the capability of experiencing, tolerating, and regulating a full range of emotions is defined as an aspect of mature, well-integrated identity.…”

Section: Discussionmentioning

confidence: 99%

Personality Disorder and Changes in Affect Consciousness: A 3-Year Follow-Up Study of Patients with Avoidant and Borderline Personality Disorder

et al. 2015

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Personality disorders (PDs) are highly prevalent in patients receiving psychiatric services, and are associated with significant personal and social costs. Over the past two decades, an increasing number of treatment studies have documented the effectiveness of treatment for patients with PDs, especially when it comes to reduction of symptom distress, risk taking behavior, self-harm, or suicide attempts. However, less is known about the more complex aims of improving the personality structure itself, such as identity- and interpersonal disturbances. Emotional dysfunction is closely associated with PD pathology. The present study investigated changes in affect consciousness (AC) in patients with avoidant or borderline PD, and how these changes were associated with clinical status after 3 years of follow-up. The study included 52 individuals; 79 percent were females, and mean age was 30 years. The evaluations included the Affect Consciousness Interview, Symptom Checklist-90-R, Circumplex of Interpersonal Problems, the Index of Self-Esteem, and three domains (Identity Integration, Relational Capacities, and Self-Control) of the Severity Indices of Personality Problems (SIPP-118). There was a significant increase in the Global AC and AC scores for most of the specific affects from baseline to follow-up. As the present study did not include a control group, it cannot be concluded that changes in AC are effects of psychotherapy, and the possibility of age-related maturation processes cannot be excluded. The change in Global AC contributed significantly to explained variance in the follow-up levels of Circumplex of Interpersonal Problems, and the two SIPP-118 domains Relational Capacities and Identity Integration. Improved AC was not associated with change in the Self-Control domain or the Global Severity Index of Symptom Checklist-90-R. The results suggest that AC may be altered for patients with borderline and avoidant PDs, and this is the first study to report that improvement in AC contribute significantly to the variance in the self- and interpersonal domains of personality functioning.

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Identity: Empirical Contribution: Changes in the Identity Integration of Adolescents in Treatment for Personality Disorders

Cited by 30 publications

References 33 publications

Relationship Between Affect Consciousness and Personality Functioning in Patients With Personality Disorders: A Prospective Study

Relationship Between Affect Consciousness and Personality Functioning in Patients With Personality Disorders: A Prospective Study

Contours of a causal feedback mechanism between adaptive personality and psychosocial function in patients with personality disorders: a secondary analysis from a randomized clinical trial

Personality Disorder and Changes in Affect Consciousness: A 3-Year Follow-Up Study of Patients with Avoidant and Borderline Personality Disorder

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