Abstract
Purpose of Review
Identity is one of the key domains that is disturbed in people manifesting personality disorder (PD). Within the field of personality psychology, there is a robust approach to studying identity focused on narrative identity which has been largely overlooked in studying PD. In this paper, a systematic review was conducted of studies published in the past decade that focused on how individuals manifesting personality pathology craft their narrative identity.
Recent Findings
This review revealed disturbances related to several motivational/affective themes (e.g., negative valence/valence shifts and thwarted themes of agency and communion), autobiographical reasoning (negative self-inferences), and structural elements (e.g., low coherence and fewer life script events) within the narrative identity of people who manifest PD.
Summary
Narrative identity is disturbed in people experiencing personality pathology and may have crucial implications for enhancing our conceptual understanding of PD and for PD interventions. This review also points to several research limitations and gaps that we encourage the field to pursue in the future.
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Data Availability
Not applicable.
Notes
We conceptualize PD using the ICD-11 definition rather than that in Section II of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition [2] because it is more internationally applicable and addresses the well-documented problems with the DSM-5 conceptualization and operationalization of PD. [3, 4] The alternative model of personality disorder in Section III of DSM-5 has a similar definition to that of the ICD-11.
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
World Health Organization. International classification of diseases-11th Edition. 2019; https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f941859884.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Publishing; 2013.
Bornstein RF, Natoli AP. Clinical utility of categorical and dimensional perspectives on personality pathology: a meta-analytic review. Personal Disord Theory Res Treat. 2019;10(6):479–90. https://doi.org/10.1037/per0000365.
Krueger RF. Personality disorders are the vanguard of the post-DSM-5.0 era. Personal Disord Theory Res Treat. 2013;4(4):367. https://doi.org/10.1037/per0000028.
McAdams DP. Personality, modernity, and the storied self: a contemporary framework for studying persons. Psychol Inq. 1996;7(4):295–321. https://doi.org/10.1207/s15327965pli0704_1.
Adler JM, Dunlop WL, Fivush R, Lilgendahl JP, Lodi-Smith J, McAdams DP, et al. Research methods for studying narrative identity: a primer. Soc Psychol Personal Sci. 2017;8(5):519–27. https://doi.org/10.1177/1948550617698202.
McAdams DP. The LSI. Evanston, IL: The Foley Center for the Study of Lives, Northwestern University. 2008: Retrieved from http://www.sesp.northwestern.edu/foley/instruments/interview/
Adler JM, Lodi-Smith J, Philippe FL, Houle I. The incremental validity of narrative identity in predicting well-being: a review of the field and recommendations for the future. Personal Soc Psychol Rev. 2016;20(2):142–75. https://doi.org/10.1177/1088868315585068.
Reese E, Haden CA, Baker-Ward L, Bauer P, Fivush R, Ornstein PA. Coherence of personal narratives across the lifespan: a multidimensional model and coding method. J Cogn Dev. 2011;12(4):424–62. https://doi.org/10.1080/15248372.2011.587854.
Galliher RV, McLean KC, Syed M. An integrated developmental model for studying identity content in context. Dev Psychol. 2017;53(11):2011–22. https://doi.org/10.1037/dev0000299.
Alea N, Bluck S. Why are you telling me that? A conceptual model of the social function of autobiographical memory. Memory. 2003;11(2):165–78. https://doi.org/10.1080/741938207.
Krueger RF, Markon KE. The role of the DSM-5 personality trait model in moving toward a quantitative and empirically based approach to classifying personality and psychopathology. Annu Rev Clin Psychol. 2014;10:477–501. https://doi.org/10.1146/annurev-clinpsy-032813-153732.
Adler JM, Clark LA. Incorporating narrative identity into structural approaches to personality and psychopathology. J Res Pers. 2019;82:10385. https://doi.org/10.1016/j.jrp.2019.103857.
Bender DS, Skodol AE, First MB, Oldham JM. Structured clinical interview for the DSM-5® alternative model for personality disorders (SCID-5-AMPD) module I level of personality functioning scale. Washington, DC: APPI; 2018.
Silverman D. Interpreting qualitative data: methods for analyzing talk, text and interaction. 3rd ed. Thousand Oaks: Sage Publications Ltd; 2006.
Blagov PS, Singer JA. Four dimensions of self-defining memories (specificity, meaning, content, and affect) and their relationships to self-restraint, distress, and repressive defensiveness. J Pers. 2004;72(3):481–511. https://doi.org/10.1111/j.0022-3506.2004.00270.x.
Singer JA, Bonalume L. Autobiographical memory narratives in psychotherapy: a coding system applied to the case of Cynthia. Pragmat Case Stud Psychother. 2010;6(3):134–88. https://doi.org/10.14713/pcsp.v6i3.1041.
Rubin DC, Berntsen D, Hutson M. The normative and the personal life: individual differences in life scripts and life story events among USA and Danish undergraduates. Memory. 2009;17(1):54–68. https://doi.org/10.1080/09658210802541442.
•• Lind M, Jørgensen CR, Heinskou T, Simonsen S, Bøye R, Thomsen DK. Patients with borderline personality disorder show increased agency in life stories after 12 months of psychotherapy. Psychotherapy. 2019;56(2):274–84. https://doi.org/10.1037/pst0000184The study examines how multiple aspects of personal and vicarious life stories in individuals suffering from BPD change after psychodynamic therapy.
Target M, Fonagy P, Shmueli-Goetz Y, Datta A, Schneider T. The child attachment interview (CAI) protocol. Unpublished manuscript, University College London. 2007.
Murray M. Narrative psychology. Thousand Oaks: Sage Publications, Inc; 2003.
Thomsen DK, Pillemer DB. I know my story and I know your story: developing a conceptual framework for vicarious life stories. J Pers. 2017;85(4):464–80. https://doi.org/10.1111/jopy.12253.
Weston SJ, Cox KS, Condon DM, Jackson JJ. A comparison of human narrative coding of redemption and automated linguistic analysis for understanding life stories. J Pers. 2016;84(5):594–606. https://doi.org/10.1111/jopy.12183.
Bech M, Elklit A, Simonsen E. Autobiographical memory in borderline personality disorder—a systematic review. Personal Ment Health. 2015;9(2):162–71. https://doi.org/10.1002/pmh.1294.
McLean KC, Syed M, Pasupathi M, Adler JM, Dunlop WL, Drustrup D, et al. The empirical structure of narrative identity: the initial Big Three. J Pers Soc Psychol. 2019. https://doi.org/10.1037/pspp0000247.
Clark LA. Temperament as a unifying basis for personality and psychopathology. J Abnorm Psychol. 2005;114(4):505–21. https://doi.org/10.1037/0021-843X.114.4.505.
Sharp C, Wright AG, Fowler JC, Frueh BC, Allen JG, Oldham J, et al. The structure of personality pathology: both general (‘g’) and specific (‘s’) factors? J Abnorm Psychol. 2015;124(2):387–98. https://doi.org/10.1037/abn0000033.
Tackett JL, Brandes CM, Reardon KW. Leveraging the Open Science Framework in clinical psychological assessment research. Psychol Assess. 2019;31(12):1386–94. https://doi.org/10.1037/pas0000583.
•• Adler JM, Chin ED, Kolisetty AP, Oltmanns TF. The distinguishing characteristics of narrative identity in adults with features of borderline personality disorder: an empirical investigation. J Personal Disord. 2012;26(4):498–512. https://doi.org/10.1521/pedi.2012.26.4.498The study examines both structural and thematic characteristics of narrative identities within individuals with BPD compared with control participants.
•• Lind M, Thomsen DK, Bøye R, Heinskou T, Simonsen S, Jørgensen CR. Personal and parents’ life stories in patients with borderline personality disorder. Scand J Psychol. 2019. https://doi.org/10.1111/sjop.12529The study examines characteristics of personal and vicarious life stories within individuals suffering from BPD.
• Jørgensen CR, Berntsen D, Bech M, Kjølbye M, Bennedsen BE, Ramsgaard SB. Identity-related autobiographical memories and cultural life scripts in patients with Borderline Personality Disorder. Conscious Cogn Int J. 2012;21(2):788–98. https://doi.org/10.1016/j.concog.2012.01.010The study examined characteristics of significant past events in people with BPD compared with clinical and nonclinical control participants.
Guruprasad D, Bhola P. Assessment of autobiographical memory narratives in psychotherapy with borderline personality disorder: an exploratory study. Res Psychother Psychopathol Process Outcome. 2014;17(2):52–64. https://doi.org/10.4081/ripppo.2014.170.
Pagano ME, Skodol AE, Stout RL, Shea MT, Yen S, Grilo CM, et al. Stressful life events as predictors of functioning: findings from the Collaborative Longitudinal Personality Disorders Study. Acta Psychiatr Scand. 2004;110(6):421–9. https://doi.org/10.1111/j.1600-0447.2004.00398.x.
McDonald M, Pietsch T, Wilson J. Ontological insecurity: a guiding framework for borderline personality disorder. J Phenomenol Psychol. 2010;41(1):85–105. https://doi.org/10.1163/156916210X503100.
Holm AL, Severinsson E. Struggling to recover by changing suicidal behaviour: narratives from women with borderline personality disorder. Int J Ment Health Nurs. 2011;20(3):165–73. https://doi.org/10.1111/j.1447-0349.2010.00713.x.
Katsakou C, Marougka S, Barnicot K, Savill M, White H, Lockwood K, et al. Recovery in borderline personality disorder (BPD): a qualitative study of service users’ perspectives. PLoS One. 2012;7(5):8. https://doi.org/10.1371/journal.pone.0036517.
Ng FYY, Townsend ML, Miller CE, Jewell M, Grenyer BFS. The lived experience of recovery in borderline personality disorder: a qualitative study. Borderline Personal Disord Emot Dysregul. 2019;6:10. https://doi.org/10.1186/s40479-019-0107-2.
Gilbert T, Farrand P, Lankshear G. “I don’t want to live like this anymore”: disrupted habitus in young people “at risk” of diagnosis of personality disorder. Youth Soc. 2013;45(3):347–64. https://doi.org/10.1177/0011392115588564.
Morris C, Simpson J, Sampson M, Beesley F. Emotion and self-cutting: narratives of service users referred to a personality disorder service. Clin Psychol Psychother. 2015;22(2):125–32. https://doi.org/10.1002/cpp.1870.
Agnew G, Shannon C, Ryan T, Storey L, McDonnell C. Self and identity in women with symptoms of borderline personality: a qualitative study. Int J Qual Stud Health Well Being. 2016;11:9. https://doi.org/10.3402/qhw.v11.30490.
Habermas T, Bluck S. Getting a life: the emergence of the life story in adolescence. Psychol Bull. 2000;126(5):748–69. https://doi.org/10.1037/0033-2909.126.5.748.
Conway MA, Pleydell-Pearce C. The construction of autobiographical memories in the self-memory system. Psychol Rev. 2000;107(2):261–88. https://doi.org/10.1037/0033-295X.107.2.261.
•• Rasmussen AS, Jørgensen CR, O'Connor M, Bennedsen BE, Godt KD, Bøye R, et al. The structure of past and future events in borderline personality disorder, eating disorder, and obsessive–compulsive disorder. Psychol Conscious Theory Res Pract. 2017;4(2):190–210. https://doi.org/10.1037/cns0000109The study investigates characteristics of past and future events in BPD compared with clinical- and nonclinical control groups.
• Lind M, Vanwoerden S, Penner F, Sharp C. Inpatient adolescents with borderline personality disorder features: identity diffusion and narrative incoherence. Personal Disord Theory Res Treat. 2019;10(4):389–93. https://doi.org/10.1037/per0000338The study shows narrative incoherence in inpatient adolescents with BPD features.
Cruitt PJ, Boudreaux MJ, King HR, Oltmanns JR, Oltmanns TF. Examining criterion a: DSM–5 level of personality functioning as assessed through life story interviews. Personal Disord Theory Res Treat. 2019;10(3):224–34. https://doi.org/10.1037/per0000321.
Roche MJ, Jacobson NC, Phillips JJ. Expanding the validity of the Level of Personality Functioning Scale observer report and self-report versions across psychodynamic and interpersonal paradigms. J Pers Assess. 2018;100(6):571–80. https://doi.org/10.1080/00223891.2018.1475394.
Shiner RL, Klimstra TA, Denissen JJA, See AY. The development of narrative identity and the emergence of personality disorders in adolescence. Curr Opin Psychol. 2021;37:49–53. https://doi.org/10.1016/j.copsyc.2020.07.024.
Schauer M, Neuner F, Elbert T. Narrative exposure therapy: a short-term treatment for traumatic stress disorders. 2nd rev. and expanded ed. Cambridge: Hogrefe Publishing; 2011.
Madigan S. Narrative therapy. Washington, DC: American Psychological Association; 2011.
Zimmerman J. Neuro-narrative therapy: brain science, narrative therapy, poststructuralism, and preferred identities. J Syst Ther. 2017;36(2):12–26. https://doi.org/10.1521/jsyt.2017.36.2.12.
Adler JM. Living into the story: agency and coherence in a longitudinal study of narrative identity development and mental health over the course of psychotherapy. J Pers Soc Psychol. 2012;102(2):367–89. https://doi.org/10.1037/a0025289.
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The first author is funded by The Independent Research Fund Denmark (no. 8023-00029B).
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Lind, M., Adler, J.M. & Clark, L.A. Narrative Identity and Personality Disorder: an Empirical and Conceptual Review. Curr Psychiatry Rep 22, 67 (2020). https://doi.org/10.1007/s11920-020-01187-8
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DOI: https://doi.org/10.1007/s11920-020-01187-8