Interpersonal trust in adolescents with psychiatric disorders and borderline pathology

Abstract

Background: Adolescents with features of borderline personality disorder (BPD) may experience deficits in interpersonal trust; however, a simultaneous comparison of interpersonal trust among adolescents with BPD, other psychiatric disorders, and no psychiatric conditions (healthy controls) has never been conducted. Objective: The aims of this study were to 1) explore differences in interpersonal trust (emotional trust, honesty beliefs, and reliability beliefs) between these three groups, and 2) examine the incremental value of BPD features in association with interpersonal trust over and above internalizing and externalizing. Method: Adolescents (N = 445, 67.9% female, M age = 15.13) recruited from two psychiatric hospitals (psychiatric sample, n = 280) and community organizations (healthy sample, n = 165) completed measures of BPD features, interpersonal trust, and internalizing and externalizing psychopathology. Psychiatric adolescents also completed an interview assessing BPD (n = 83 BPD). ANCOVA and hierarchical linear regression were used for analyses. Results: Emotional trust differed significantly across all three groups, with the lowest level of emotional trust in adolescents with BPD. Reliability was also lower in the two psychiatric groups relative to healthy controls. BPD features were significantly, inversely associated with emotional trust and reliability beliefs when controlling for internalizing and externalizing pathology. Post-hoc analyses testing specificity of the three forms of trust found that lower emotional trust predicted BPD diagnosis over and above the other two forms of trust. Conclusions: Findings highlight emotional trust as a correlate and important target of intervention for adolescents with BPD, and add to knowledge on interpersonal trust deficits for adolescents with psychiatric disorders more broadly.

A Model of Trust Processes in Borderline Personality Disorder: A Systematic Review

“…BPD patients self-reported lower interpersonal trust levels than non-clinical controls and patients with MDD or seasonal affective disorder [29]. Similarly, comparing adolescents with BPD with adolescents with other psychiatric conditions and a non-clinical sample, the BPD group selfreported the lowest level of emotional trust [50].…”

Improving Treatment Outcomes for Adolescents with Borderline Personality Disorder Through a Socioecological Approach

“…This will foster the necessary agency that will ensure long-term treatment gains (88, 89). While facilitating a feeling of being understood in a relational context is a cornerstone of MBT for adults, we highlight this feature as it is particularly important in adolescents, who are dealing with a normative identity crisis (90), and are especially vulnerable to feeling misunderstood and alone (91) In the previous section we also showed that common factors account for a large part of the variance in treatment outcome, implying that different evidence-based treatment modalities perform equally well (or poorly). This could be, as articulated by mentalization-based theory, that all effective psychotherapyregardless of orientation -make use of ostensive cueing to increase trust (lowers epistemic hypervigilance) and enhance social learning, which together sets the stage for therapeutic change.…”

Improving treatment outcomes for adolescents with borderline personality disorder through a socioecological approach

“…This will foster the necessary agency that will ensure long-term treatment gains [ 88 , 89 ]. While facilitating a feeling of being understood in a relational context is a cornerstone of MBT for adults, we highlight this feature as it is particularly important in adolescents, who are dealing with a normative identity crisis [ 90 ], and are especially vulnerable to feeling misunderstood and alone [ 91 ].…”