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As an element of distorted self-image, body image disturbances may be relevant to borderline personality disorder (BPD). Therefore, this systematic review aims to critically discuss and summarize empirical findings in this matter. Based on the available theoretical models, three body image components were identified: (a) perception, (b) affect and...
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... Body image, including satisfaction with the body, can be disturbed in individuals with different psychiatric diseases (3,4). Major depression (MD) and borderline personality disorder (BPD) are two complex and demanding psychiatric disorders that affect not only mood, cognition, or even quality of life (5-8) but also body image and satisfaction (9)(10)(11). The presence of cognitive distortions and maladaptive schematic thoughts in BPD (12) and MD (13) patients is well established. ...
... As a fundamental component of these disorders, most studies have investigated body image and satisfaction in individuals with eating disorders (14,15) and body dysmorphic disorders (BDD,16). However, lower satisfaction with one's body and general appearance can be observed in individuals with major depression (17) and BPD (10). Most studies concentrated solely on the overarching facets of body image and discontentment without delineating speci c areas of dissatisfaction. ...
Background: The disruption of body esteem is associated with distress and may be linked to psychiatric disorders such as Borderline Personality Disorder (BPD) and Major Depression (MD). Existing studies have primarily focused on body satisfaction as a unified concept, without delving into specific body areas or functions. Early Maladaptive Schemas (EMSs) are observed in individuals with BPD and MD. So far little is known about their potential influence on body esteem, particularly within the context of MD or BPD. This study aims to investigate the satisfaction levels pertaining to different body areas and the influence of EMSs on body esteem BPD patients and MD patients.
Methods: Our study included 31 patients diagnosed with BPD (25 women), 27 diagnosed with MD (17 women) and 25 healthy individuals (HC, 16 women) (Mage was between 29 and 33 for each groups). The SCID-5-PD and MINI was used to assess psychiatric disorders. Body esteem was measured by using an extended version of Body Esteem Scale. EMSs were measured by using Young Schema Questionnaire. Short Form 2.
Results: Regarding EMS domains and general body esteem, all groups differed significantly from each other, except in Overvigilance, where BPD differed from MD and HC. Regarding body functions, BPD group differed from MD and HC groups. For the head, BPD patients and HCs differed from each other. Regarding the upper body HCs differed from the psychiatric patients.
Following the identification of schema domains and their correlation with body variables, significant findings emerge within the BPD and MD groups. In the BPD group, Enmeshment exhibits a notable inverse association with general body esteem and body functions. Conversely, within the MD group, Entitlement displays a marked positive correlation with general body esteem. Furthermore, Vulnerability to Harm in the BPD group and Failure to Achieve in the MD group potentially contribute to disturbances in body esteem.
Conclusions: Our study suggests that both BPD and MD patients experience disturbances in body esteem. Specifically, in patients with BPD, perceptions of body functions are significantly affected. Furthermore, within both disorders, specific EMSs can be identified, which are related to impairments in body esteem.
... Specific BPD symptoms are also strongly associated with dissatisfaction with one's body. Both identity disruption and identity distress can predict appearance evaluation and body satisfaction (10,11). Patients with BPD often have negative attitudes, lower self-esteem, and a higher level of discomfort related to their bodies (12). ...
... . . Aim of our study BPD significantly influences the cognitive and affective aspects of the individual's body perception (10). Furthermore, it can be assumed that in this disorder, non-conscious body representations, which are grounded on somatosensory stimuli, may also be affected. ...
... The previous studies used self-report questionnaires or cognitive tasks to measure the internal image of one's body (10). Our research measured both body schema and perceptual body image on a somatosensory level, employing a tactile, vestibular, and visual input device. ...
Background
Borderline personality disorder (BPD) is a severe mental disorder that affects attitudes toward the body. However, whether this condition also affects body schema and perceptual body image remains unclear. Previous questionnaire-based studies found dissatisfaction with one's body in patients with BPD. In addition to attitudinal body image, our study investigates whether body schema and perceptual body image are disturbed in patients with BPD.
Method
Our study included 31 patients diagnosed with BPD (25 women) and 30 healthy individuals (19 women) (Mage = 29 for both groups). The SCID-5-PD interview was used to determine personality disorder. Attitudinal body image was measured using the Body Attitude Test (BAT) factors. Body schema and perceptual body image were measured by two conditions of a body representation task, the body portraying method (BPM).
Results
BPD patients achieved higher scores in all three BAT factors and were more susceptible to misinformation in both conditions of BPM. Based on the results, BPD patients appear to have more negative attitudes toward their bodies and worse perceptual body image and body schema.
Conclusion
The novel finding of our study is that, besides the previously found attitudinal dissatisfaction with the body, individuals with BPD also show disturbances at the levels of body schema and perceptual body image. Our findings concerning disturbances in body schema and perceptual body need further research into their etiological factors and provide new therapeutic targets for the treatment of BPD.
... Sansone et al. [78] observed that individuals with BPD tend to believe that attractiveness is an important factor for happiness and acceptance and that they show less comfort and trust in their own bodies. Considering the increasing evidence regarding the importance of body image disturbances in the psychopathology of BPD [79] and the fact that self-disgust seems to be associated with negative body image [80], we suggest that negative body image could explain another significant part of the association, however, this should be confirmed in future investigations. Our second mediational model assessed the mediational effect of the constructs mentioned above on the relationship between BPD symptoms and self-disgust. ...
Background:
Self-disgust is a negative self-conscious emotion, which has been linked with borderline personality disorder (BPD). However, it has not yet been investigated in relation to both emotion dysregulation and alexithymia, which are recognized as crucial to BPD. Therefore, the aim of our study was to measure these variables and examine the possible mediational role of emotional alterations and comorbid anxiety and depression symptoms in shaping self-disgust in patients with BPD and healthy controls (HCs).
Methods:
In total, the study included 100 inpatients with BPD and 104 HCs. Participants completed: the Self-Disgust Scale (SDS), Disgust Scale - Revised (DS-R), Toronto Alexithymia Scale (TAS-20), Emotion Dysregulation Scale short version (EDS-short), Borderline Personality Disorder Checklist (BPD Checklist), State-Trait Anxiety Inventory (STAI), and Center for Epidemiologic Studies Depression Scale (CESD-R).
Results:
Inpatients with BPD showed higher self-disgust, alexithymia, emotion dysregulation, core and comorbid symptoms levels, and lower disgust sensitivity. Alexithymia, emotion dysregulation, and trait anxiety partially mediated between BPD diagnosis and self-disgust. The relationship between the severity of BPD symptoms and self-disgust was fully mediated by alexithymia, emotion dysregulation, depressive symptoms, and trait anxiety.
Conclusions:
The results of our study may imply the contribution of emotion dysregulation, alexithymia, and comorbid psychopathology to self-referenced disgust in BPD.
... Studies exploring BPD and body image disturbances, assessed via questionnaires, show differences in perception, affect and cognition, and general body dissatisfaction (Sansone et al., 2010). See Wayda-Zaleweska et al. for a review (Wayda-Zalewska et al., 2021). Some studies have identified deficits in body ownership, defined as the sense that the body and its parts belong to oneself (Bekrater-Bodmann et al., 2016;Löffler et al., 2020). ...
Background: Attachment theory has served as an influential framework for understanding psychopathology, partly due to reliable assessment methodology. The influence of insecure attachment on attitudes towards the body and the impact this might have for the development of psychopathology is however less well elucidated. Method: 123 adolescents (35 with borderline personality disorder or BPD, 25 with other personality disorders or OPD and 63 comprising a healthy control group) were interviewed with the Adult Attachment Interview (AAI) and the Mirror Interview (MI). The MI questions respondents about how they feel about their bodies, as they look in the mirror Results : The AAIs from the BPD group were predominantly insecure-preoccupied and unresolved. Adolescents with PD but particularly BPD had significantly greater issues with negative body representations (NBR) than the control group. Insecure attachment and unresolved attachment status were significantly linked to NBR. Regression results revealed a low loving relationship with fathers, high involving anger with father, low coherence of mind & passive speech uniquely predicted 61% of variance in NBR. Conclusion: Unfavorable attachment experiences may give rise to negative body images and influence the development of psychopathology, especially BPD.
... Patients with BPD have high rates of developing comorbid depression, anxiety spectrum disorder, substance use, and an eating disorder. [6,7] Our patient also had intense emotional fluctuations, multiple self-harm attempts, substance use, and feelings of loneliness. Anti-social personality traits and alcohol use in the father increased her vulnerability to developing a personality disorder. ...
Acrogeria is a rare disorder that is characterized by premature aging of the distal extremities. It was first described by Gottron in 1941. Only about 50 cases have yet been reported worldwide. It is diagnosed clinically, and patients have a normal life expectancy. The disorder is seen from birth and could have an autosomal dominant or recessive inheritance. The classic features include a characteristic pinched face, thin lips, fine hair, skeletal defects, and thin, taut parchment-like skin of the extremities. We describe a case of Acrogeria, Gottron type, who also had a borderline personality disorder. However, there is very little information on the prevalence of psychopathology in patients having syndromes of premature aging.
Background
Attachment theory has served as an influential framework for understanding psychopathology, partly due to reliable assessment methodology. The influence of insecure attachment on attitudes toward the body and the impact this might have for the development of psychopathology is however less well elucidated.
Method
A total of 123 adolescents (35 with borderline personality disorder or BPD, 25 with other personality disorders [OPD] and 63 comprising a normative control group) were interviewed with the Adult Attachment Interview (AAI) and the Mirror Interview (MI). The MI questions respondents about how they feel about their bodies, as they look in the mirror.
Results
The AAIs from the Borderline group were predominantly insecure‐preoccupied and unresolved. These adolescents had significantly lower levels of a positive and integrated sense of self and body than the other groups. Regression results revealed a high loving relationship with fathers, low involving anger with father, high coherence of mind, slight derogation of mother & low levels of unresolved loss uniquely and additively predicted 55% of variance in the summary score assigned to MI responses, that is, the summary score for a Positive and Integrated Body Representation (PIBR).
Conclusion
Unfavorable attachment experiences and current states of mind regarding attachment may give rise to problems with establishing PIBRs, and thus play a role in the development of psychopathology, especially BPD.
Objetivo: Analisar as características do Transtorno de Personalidade Borderline (TPB). Revisão bibliográfica: O TPB é um transtorno crônico caracterizado por padrões invasivos de instabilidade afetiva, distúrbios da autoimagem, instabilidade das relações interpessoais, impulsividade acentuada e comportamento suicida (ideação e tentativa de suicídio), causando prejuízo e sofrimento significativos na vida do indivíduo. Sua fisiopatologia é uma combinação de predisposição genética associada a fatores ambientais e disfunção neurobiológica. O TPB é o transtorno de personalidade mais comumente diagnosticado em ambientes hospitalares e ambulatoriais, com prevalência entre 0,5 e 2,7% na população geral. Considerações finais: O transtorno de personalidade limítrofe é um grave problema tanto para o indíviduo, que muitas vezes fica incapacitado de realizar suas funções, tanto para a sociedade e o sistema de saúde que sofre com um grande ônus devido as inúmeras comorbidades coexistentes com o TPB. Nesse contexto, o tratamento desta condição é fundamental. A terapêutica de primeira linha para o TPB é a psicoterapia como a terapia comportamental dialética, psicoterapia orientada para a transferência, terapia baseada em mentalização e terapia do esquema. Além disso, podem ser utilizadas opções farmacológicas como os antipsicóticos e os antidepressivos.
Personality disorders are characterized by 'ego-syntonic' maladaptive behaviors that impair functioning. This contribution outlines the relevant characteristics and approach to patients with personality disorders pertaining to the dermatology setting. For patients with Cluster A personality disorders (paranoid, schizoid, and schizotypal), it is crucial to avoid being overly contradictory of eccentric beliefs and to take a straightforward, unemotional approach. Cluster B includes antisocial, borderline, histrionic, and narcissistic personality disorders. Promoting safety and boundaries is paramount when interacting with patients with an antisocial personality disorder. Patients with borderline personality disorder have higher rates of various psychodermatologic conditions and benefit from an empathetic approach and frequent follow-up. Patients with borderline, histrionic, and narcissistic personality disorders all have higher rates of body dysmorphia, and the cosmetic dermatologist needs to avoid unnecessary cosmetic procedures. Patients with Cluster C personality disorders (avoidant, dependent, and obsessive-compulsive) often have significant anxiety associated with their illness and may benefit from extensive and clear explanations of their condition and management plan. Due to the challenges posed by these patients' personality disorders, they are often undertreated or receive poorer quality care. While it is essential to acknowledge and address challenging behaviors, their dermatologic concerns should not be dismissed.
