Year

2007

Degree Name

Doctor of Psycology(Clinical)

Department

University of Wollongong. School of Psychology

Abstract

Objective: The clinical phenomenon of self-harm is frequently recognized as a behaviour attributed to patients with borderline personality disorder (BPD). Self-harm has been found to occur in anywhere from 50 to 80% of BPD patients. This study used an attachment trauma perspective to compare BPD patients who self-harm with those who do not on a range of factors to determine if there is a possible profile for BPD patients who self-harm. Such a finding could assist towards understanding the role of self-harm in BPD patients and aid in developing the appropriate approach to treatment. Method: Study 1 (quantitative, N=69) investigated 58 BPD patients who self-harm compared with 11 BPD patients who do not self-harm. The measures investigated attachment/interpersonal problems, co-morbidity, trauma history, dissociation and impulsivity. Study 2 (qualitative, N=2 BPD self-harm patients) explored the function of self-harm behaviours through an in-depth interview analysed using interpretative phenomenological analysis. Results: Study 1 found that BPD patients who self-harmed were more likely to have a fearful attachment style, fear abandonment and have higher levels of dissociation. Increased frequency of self-harm behaviours was found in those with numerous interpersonal problems, a generalized anxiety disorder (GAD) diagnosis, higher global assessment of relational functioning (GARF) score and an intrusive or domineering interpersonal style. Unlike other studies, no link was found between self-harm in BPD patients and co-morbidity, childhood sexual abuse history and impulsivity. Study 1 findings matched the results in Study 2. Seven themes found in Study 2 provided insight into some of the functions of self-harm for BPD patients. Conclusion: The results of this current study imply that insecure-fearful attachment, fears of abandonment, dissociation and interpersonal functioning may be important aspects to assess and concentrate on in the treatment of BPD patients who self-harm. While an interpersonal component is important to include in the treatment for all BPD patients, particularly addressing interpersonal anxieties and emotional functioning for BPD patients who self-harm appears essential.

Share

COinS
 

Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.