The stability of personality traits in borderline personality disorder

¶ … Stability of Personality Traits in Individuals with Borderline Personality Disorder

Hopwood, C.J. (et al. 2009, November). The stability of personality traits in individuals with borderline personality disorder. Abnormal Psychology, 118(4):806-15.

'Personality disorders' have a problematic diagnostic history in the literature of psychiatry. The idea of defining someone's 'character' has plagued philosophers as well as research psychologists throughout the ages. Behind the characteristics defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as Axis II 'personality disorders' (PDs) there is an assumption of a certain level of character stability in individuals classified as having schizoid personality disorder or obsessive-compulsive personality disorder. One of the most controversial disorders defined by the DSM is that of borderline personality disorder (BPD), commonly characterized by an abnormal instability of personality traits and behaviors, rather than a state of abnormal stability.

Often individuals with a diagnosis of BPD seem to defy characterization: occasionally they seem to embody the textbook criterion for the illness and at other times wildly deviate from it. They may show the characteristic idealization followed by reviling of individuals in their lives whom they attach to, followed by manifesting socially avoidant behavior, after getting hurt and seeing their impossible expectations for others unmet. This is profoundly different from socially avoidant personality types, or histrionic personality types who always seek out individuals to dramatize their real and imaginary complaints.

To re-evaluate the diagnostic criteria for borderline personality disorder and its impact upon "several domains" of functioning "including interpersonal behavior, affect, and identity" seemed essential, according to C.J. Hopwood (et al. 2009) to clarify the nature of this disorder. Hopwood embarked upon a study chronicled in the journal Abnormal Psychology entitled "The stability of personality traits in individuals with borderline personality disorder." The central hypothesis of the study was that apparent inconsistencies in personality traits of BPD patients is not an indication of a problematic or inaccurate definition of the personality disorder but rather is part of the illness (Hopwood 2009, p.806).

To test the major thesis of the study, the authors classified five types of personality trait stability using four types of assessments. 130 BPD patients took the assessments over a course of six years, and were compared with a control group of 302 patients with other types of personality disorders. The findings of the article indicated that basic, structural personality stability did not differ between the two groupings over the six years of the study. However, "differential" stability tended to be lower BPD patients, most notably in the five-factor model (FFM) in characteristics such as neuroticism and conscientiousness (with less deviation in extraversion, openness, and agreeableness). The BPD experimental grouping was also less stable in self-reported [ipsative] profiles than other personality-disordered individuals (Hopwood, 2009, p.806).

The results of the study suggest that personality trait instability is characteristic of BPD and clinicians in the field should anticipate and expect such a manifestation of personality variation over the course of treatment as part of the disorder. BPD patients may occasionally show apparent remission or normalcy in traits such as neuroticism, while hysteric or depressive personality disordered-patients will manifest these traits more consistently. This also highlights the level of 'hope' one should have about what is seen as an improving sign during treatment. While a marked reduction in neuroticism might be a sign of responsiveness in a depressive personality type, in a BPD patient it may merely be another manifestation of the illness, part of the BPD cycle, of finding someone or someone to fixate upon to ease the patient's lack of a sense of core identity. In particular, neuroticism and conscientiousness "showed greater mean-level change, with neuroticism declining faster and conscientiousness increasing faster, in the BPD group" as compared with other traits in the FFM (Hopwood 2009, p.806).

BPD's controversial nature as a diagnosis is not seriously disputed by the authors, and opponents of the diagnosis might contend that the method is tautological: the initial diagnosis of all study participants is accepted, and the methods used are merely personality inventories of a typical 'multiple choice' format for character stability that assume the consistency of all of the patient's diagnosis. However, the assessment was ipsative (self-reported) as well as based upon pre-existing diagnosis by a clinician. The longitudinal nature of the study and the multiplicity of the inventories argue in favor of the researcher's thoroughness.