the construct of effortful control: an approach to borderline personality disorder heterogeneity...
TRANSCRIPT
The Construct of Effortful Control: An Approach to Borderline Personality
Disorder Heterogeneity
Hoerman, Clarkin, Hull & Levy (2005)
Background
● Borderline Personality Disorder Heterogeneous DSM-IV (Diagnostic and Statistical Manual of Mental
Disorders) Have to meet 5 out of 9 criteria to be diagnosed
● Avoiding abandonment● Unstable and intensive personal relationships● Impulsivity● Identity disturbance ● Feeling of emptiness● Suicidal tendencies● Affective instability● Difficulty controlling anger● Dissociation
Effortful Control
● Ability to inhibit a predominant response in favour of a subdominant one.
● Related to executive attentional network● Positively correlated with conscious
development and negatively with aggression.
Effortful Control and BPD
● Hypothesised that 3 subgroups of BPD patients can be identified, based on 3 subscales of effortful control: Inhibitory control – capacity to suppress positively
toned impulses and avoid inappropriate approach Activation control - capacity to suppress negatively
toned impulses and avoid inappropriate avoidance Attentional control – capacity to intentionally shift
attention
Methods
● Participants: 47 patients diagnosed with BPD● Measures:
The Adult Temperament Questionnaire (Effortful Control)
The Brief Symptom Inventory (Depression, Hostility, Anxiety & Psychoticism)
The Multidimensional Personality Questionnaire (Social Potency, Social Closeness & Alienation)
The Inventory of Personality Organization (Identity Diffusion, Reality Testing & Primitive Defences)
Results
Results
Cluster 1
(High Effortful Control)
Cluster 2 Cluster 3
(Low Effortful Control)
Anxiety
Psychoticism
Alienation
ID diffusion
Primitive defences
Low
Low
Low
Low
Low
Low
Medium
Low
Medium
Medium
High
High
High
High
High
Conclusion
● There are 3 different levels of pathology within BPD sample, with the group with high effortful control exhibiting the least, and the group with low effortful control exhibiting the most problems in different areas of functioning
Limitations
● Small sample size N=47 Cluster I n=17 Cluster II n=19 Cluster III n=11
● No control group● 3 clusters chosen in advance – not empirically
derived● Self-reports – perhaps the disorder affects the
way the patients perceive themselves??