An exploration of psychotic-like experiences in Borderline Personality Disorder

Background: Past research has shown a significant occurrence of psychotic-like experiences (PLEs) in individuals diagnosed with Borderline Personality Disorder (BPD). Young people with traits of BPD (BPD traits) whom experience PLEs had higher counts of risky behaviours and disengagement from treatment. Despite this, limited research has focused on the nature of PLEs, how they are appraised and responded to in young people with BPD traits. This is partly due to current clinical practice and diagnostic criteria which postulates that PLEs is stress-transient and do not warrant closer inspection in BPD. Design: The thesis portfolio include a systematic review involving a quantitative narrative synthesis of 12 empirical studies, which considered the relationship between psychological and psychiatric co-morbidities and the occurrence of psychotic symptoms in individuals diagnosed with BPD, and qualitative study exploring the nature, appraisals and responses towards lived experience of PLEs in seven help-seeking young people with BPD traits. Results: The systematic review findings suggest that while there was evidence for the role of childhood trauma and stressful life experiences in the relationship between psychotic symptoms and BPD, evidence lacked for other types of co-morbidities. The empirical study used an interpretative phenomenological analysis (IPA), which produced four superordinate themes to capture participants’ experiences of PLEs: the description of experiences, making sense of the experiences, deterioration of sense of self and well-being, and managing and finding respite. Conclusion: Heterogeneity of study methodologies proved difficult to provide consistent evidence for the association between co-morbidities and psychotic symptoms in BPD. The 3 poor psychological well-being and distress associated with PLEs in young people with BPD traits found in the empirical study show a need for clinical practice to make adjustments to ensure varied experiences that are of concern, such as PLEs, are captured and appropriate support are provided to these young people