THE PREDICTION OF OBJECT REPRESENTATION FROM PROJECTIVE DATA: BORDERLINE PERSONALITY DISORDER (DSM-III) (DREAMS)

The recent Diagnostic and Statistical Manual of Mental Disorders - DSM-III includes a new category termed Borderline Personality Disorder. The literature from which the DSM-III criteria are drawn seems to highlight serious problems with impulsivity and interpersonal relationships. In addition, there is evidence of certain patterns of ego functioning, specifically, pathological object relations development in borderline pathology. Concern has been raised regarding comparison of the Borderline Personality Disorder diagnosis with other personality disorders. The present study attempted to examine the DSM-III Borderline Personality diagnosis in terms of an individual\u27s capacity to form object representations from projective test psychology through the study of manifest dream content and Rorschach human responses. The independent variables in the design included: (1) a diagnosis of Borderline Personality Disorder; (2) all other Axis II personality disorder diagnoses. There were three independent variables: (1) Object Representation Scale for Dreams, a content-oriented analysis of manifest dreams; (2) Developmental Analysis of the Concept of the Object, a structural-developmental scale applied to Rorschach human responses; (3) Bell Object Relations Reality Testing Inventory, a behavioral self-report inventory. A multimethod approach was used in order to examine object representations from varying perspectives. Psychiatric outpatients (n = 75) who met the DSM-III criteria for an Axis II personality disorder in the absence of a major Axis I diagnosis were interviewed by one to three senior clinicians. An individual received a diagnosis of BPD if a majority of the raters felt the person met criteria for BPD and if the average number of BPD criteria was five or greater. A Hottellings T(\u272) was significant indicating that the three object relations measures differentially predicted diagnosis p .01. Univariate t tests indicated a significant difference when the Krohn scale was applied to manifest dream data. The Blatt and Bell scores were non significant. A series of phi and point biserial correlation coefficients were significant indicating a positive relationship between the criteria for impulsivity and interpersonal relationships and a diagnosis of BPD as well as the presence of other BPD criteria. The data seem to indicate that outpatients diagnosed as Borderline Personality Disorder may share certain characteristics without representing a distinct clinical entity. BPD may prove useful as a means of defining a cluster of symptoms or a subgroup within a borderline group. (Abstract shortened with permission of author.