Doctor of Philosophy
Carter, Phoebe, Understanding expressive language disturbance in borderline personality disorder, Doctor of Philosophy thesis, , University of Wollongong, 2011. http://ro.uow.edu.au/theses/3509
Rationale. Borderline Personality Disorder (BPD) patients present with expressive language disturbances in the clinical setting. This context may serve as an activating interpersonal cue to these patients’ trauma-memory systems. However, there are no known controlled studies investigating this phenomenon. Aims. 1) To examine BPD expressive language disturbances in response to a clinically relevant trauma-salient stimulus, the Adult Attachment Interview (AAI) (Study 1). 2) To further validate use of this methodology in an additional BPD sample and delineate expressive language disturbances using a neutral comparative condition and pause analysis (Study 2). 3) To investigate whether specific psychosocial factors influence expressive language (Study 2). Methods. a) Study 1: 20 BPD participants and 20 matched controls were administered the AAI. Transcripts were analysed to evaluate overall impairment and lexical, syntactic and semantic impairment. Study 2: 12 additional BPD participants and 12 matched controls were administered the AAI and a neutral stimulus. Pause profiles, expressive language deficits and relationships to trauma history were investigated. Results. Compared to controls, BPD participants evidenced greater overall language impairment and reduced syntactic and lexical, but not semantic complexity. BPD participants utilised higher proportions of pauses across both conditions, but particularly when generating adjectives related to describing early relationships with their mother. Significantly, physical abuse history and Post-traumatic Stress Disorder related to some expressive language deficits. Conclusion. These linguistic profile deficits are consistent with neuroimaging and neuropsychiatric findings. Future research may discover changes in these linguistic profiles to be indices of therapeutic change.