Memory function in borderline personality disorder

Abstract

Borderline Personality Disorder (BPD) is a severe psychiatric condition that involves impairment in multiple areas of psychological functioning including disturbed cognition, impulsivity, and intense unstable relationships. Memory deficits are not recognised as a core symptom of BPD, but BPD patients have long been suspected of having inaccurate perceptions, disturbed memory processes, and an increased tendency to generate false memories about past events, interpersonal perceptions, and social interactions. The overarching goal of my PhD was to investigate potential memory differences in people with features of BPD. In particular, I examined whether people with more BPD symptoms would be more susceptible to false memories or would exhibit irregularities in autobiographical memory. In addition, I also compared the traditional conceptualisation of BPD with the alternative model of personality disorders in predicting memory performance. A total of 300 university students were recruited to participate in the main experiment. Participants were asked to complete a series of psychological assessments that measured various aspects of personality and psychopathology. In addition, each participant took part in a false memory procedure, the Deese/Roediger-McDermott (DRM) paradigm, using word lists that were developed in the course of preliminary research (Chapter 4). Participants were also asked to report about both their earliest personal memory and a memory that reflected an important turning point in their lives (see Chapter 5 for the complete Method). I then examined how BPD features are associated with false memory (Chapter 6) and how dissociation is associated with false memory (Chapter 7). In the final two empirical chapters, I investigated how BPD features are related to the qualities of autobiographical narratives (Chapter 8) and how borderline symptoms are reflected in the nature of narrative identity (Chapter 9). Overall, I found that 1) using the BPD traditional model, BPD symptoms were correlated with higher false memory for positive information, and in the alternative model of BPD, identity impairment and anxiousness were correlated with the overall false memory score; 2) irrespective of BPD, experiencing trauma and dissociation, as well as lower levels of intelligence, were associated with higher false memory; 3) trauma and dissociation mediated the relation between BPD and false memory; 4) both the traditional and alternative models of BPD were correlated with negative affect in turning-point memories, but not in earliest memories; 5) relying on the traditional model of BPD, I found no correlation between over-general memories and BPD, however, using the alternative model, over-general turning-point memories were associated with higher BPD-related impairment in self-direction; 6) participants with features of BPD were more likely to rate their earliest memories as more negative in valence and less coherent; 7) participants with features of BPD were more likely to rate their turning-point memories as negative in valence, to describe them from a 3rd-person perspective, and to reflect higher distancing, greater emotional intensity, and less accessibility; 8) participants with higher features of BPD also reported turning point memories that were also less likely to reflect their sense of agency, agency fulfilment, intimacy and empathy; and 9) narrative identity, but not narrative intimacy and coherence, was the dominant predictor of BPD features. Overall, I also found that both the traditional and alternative models of BPD predict the expected qualities of memory, with the alternative model of BPD doing better in determining which diagnostic subtypes of BPD predict the trajectories of false memory. Taken together, the current findings not only have important theoretical implications for understanding memory differences in BPD, but they also have practical implications in clinical settings.