The specificity of mental pain in borderline personality disorder compared to depressive disorders and healthy controls
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BACKGROUND: Individuals with Borderline Personality Disorder (BPD) may experience a qualitatively distinct depression which includes "mental pain." Mental pain includes chronic, aversive emotions, negative self-concept, and a sense of pervasive helplessness. The present study investigated whether mental pain is elevated in BPD compared to Depressive Disorders (DD) without BPD. METHODS: The Orbach and Mikulincer Mental Pain Scale (OMMP) was administered to BPD (N = 57), DD (N = 22), and healthy controls (N = 31). The OMMP assesses total mental pain, comprised of nine subtypes: irreversibility, loss of control, narcissistic wounds, emotional flooding, freezing, self-estrangement, confusion, social distancing, and emptiness. Co-occurring psychiatric diagnoses, depression severity, and other potentially confounding clinical and demographic variables were also assessed. RESULTS: The total Mental Pain score did not differentiate BPD from DD. Moreover, most of the subscales of the OMMP were not significantly different in BPD compared to DD. However, the elevation of mental pain subscale "narcissistic wounds," characterized by feeling rejected and having low self-worth, was a specific predictor of BPD status and the severity of BPD symptoms. CONCLUSION: On OMMP total score, mental pain was similarly elevated in BPD and DD. However, the narcissistic wounds sub-type of mental pain was a sensitive and specific diagnostic indicator of BPD and, therefore, may be an important aspect of BPD in need of increased focus in assessment and theoretical models.
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Psychological pain, measured by the Orbach et al. scale, was similarly elevated in borderline personality disorder and depressive disorder.
“a previous study, which has found that psychological pain, measured by the Orbach et al. scale,8 was similarly elevated in borderline personality disorder and depressive disorder.28”
From “Nothing Hurts Less Than Being Dead”: Psychological Pain in Case Descriptions of Psychiatric Euthanasia and Assisted Suicide from the Netherlands: « Rien ne fait moins mal qu’être mort »: La douleur psychologique dans les descriptions de cas d’euthanasie et de suicide assisté psychiatrique aux Pays-Bas (2020) · cites this paper as [28]
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Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Hamilton, M. (1960) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.23.1.56 · Cited by 32,817 · see citing works
Kirschbaum, C., Pirke, K.-M., & Hellhammer, D. H. (2008) · Neuropsychobiology · doi:10.1159/000119004 · Cited by 6,093 · see citing works
(1992) · Cited by 5,228 · see citing works
(1992) · Cited by 3,325 · see citing works
(1997) · American Psychiatric Press eBooks · Cited by 3,056 · see citing works
The halo effect: Evidence for unconscious alteration of judgments.
Nisbett, R. E., & Wilson, T. D. (1977) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.35.4.250 · Cited by 2,021 · see citing works
Borderline personality disorder
Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004) · The Lancet · doi:10.1016/s0140-6736(04)16770-6 · Cited by 1,369 · see citing works
Commentary: Suicide as Psychache
SHNEIDMAN, E. S. (1993) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199303000-00001 · Cited by 775 · see citing works
Zanarini, M. C., Frankenburg, F. R., Hennen, J. A., & Silk, K. R. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.2.274 · Cited by 672 · see citing works
An experimental investigation of emotion dysregulation in borderline personality disorder
Gratz, K. L., Rosenthal, M. Z., Tull, M. T., Lejuez, C. W., & Gunderson, J. G. (2006) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.115.4.850 · Cited by 518 · see citing works
Soloff, P. H., Lynch, K. G., Kelly, T. M., Malone, K. M., & Mann, J. J. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.4.601 · Cited by 456 · see citing works
Shneidman, E. S. (1977) · DigitalGeorgetown (Georgetown University Library) · Cited by 434 · see citing works
Axis I diagnostic comorbidity and borderline personality disorder
Zimmerman, M. A., & Mattia, J. I. (1999) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(99)90123-2 · Cited by 350 · see citing works
Identity Disturbance in Borderline Personality Disorder: An Empirical Investigation
Wilkinson‐Ryan, T., & Westen, D. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.4.528 · Cited by 322 · see citing works
Shame and implicit self-concept in women with borderline personality disorder
Rüsch, N., Lieb, K., Göttler, I., Hermann, C., Schramm, E., Richter, H., Jacob, G. A., Corrigan, P. W., & Bohus, M. (2007) · American Journal of Psychiatry · doi:10.1176/ajp.2007.164.3.500 · Cited by 304 · see citing works
Mental Pain: A Multidimensional Operationalization and Definition
Orbach, I., Mikulincer, M., Sirota, P., & Gilboa‐Schechtman, E. (2003) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.33.3.219.23219 · Cited by 257 · see citing works
The implications of DSM-III personality disorders for patients with major depression
PFOHL, B. M., Stangl, D. K., & Zimmerman, M. (1984) · Journal of Affective Disorders · doi:10.1016/0165-0327(84)90052-1 · Cited by 256 · see citing works
Skodol, A. E., Grilo, C. M., Keyes, K. M., Geier, T., Grant, B. F., & Hasin, D. S. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.10050695 · Cited by 225 · see citing works
Mental Pain and Its Relationship to Suicidality and Life Meaning
Orbach, I., Mikulincer, M., Gilboa‐Schechtman, E., & Sirota, P. (2003) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.33.3.231.23213 · Cited by 215 · see citing works
Major Depressive Disorder and Borderline Personality Disorder Revisited: Longitudinal Interactions
Gunderson, J. G., Morey, L. C., Stout, R. L., Skodol, A. E., Shea, M. T., McGlashan, T. H., Zanarini, M. C., Grilo, C. M., Sanislow, C. A., Yen, S., et al. (2004) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v65n0804 · Cited by 201 · see citing works
The Pain of Being Borderline: Dysphoric States Specific to Borderline Personality Disorder
Zanarini, M. C., Frankenburg, F. R., DeLuca, C. J., Hennen, J., Khera, G. S., & Gunderson, J. G. (1998) · Harvard Review of Psychiatry · doi:10.3109/10673229809000330 · Cited by 197 · cited 7× · see citing works
“At the same time, the belief that “people hate me” and the feeling that one is “abandoned” were specific to BPD compared to other personality disorder group [20].”
BackgroundResultInfluentialAffect Regulation in Borderline Personality Disorder
Conklin, C. Z., Bradley, R. G., & Westen, D. (2006) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000198138.41709.4f · Cited by 189 · see citing works
Effectiveness of Pharmacotherapy for Severe Personality Disorders
Ingenhoven, T., Lafay, P., Rinne, T., Passchier, J., & Duivenvoorden, H. J. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.08r04526gre · Cited by 166 · see citing works
AFFECT REGULATION IN WOMEN WITH BORDERLINE PERSONALITY DISORDER TRAITS
Yen, S., Zlotnick, C., & Costello, E. M. (2002) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200210000-00006 · Cited by 163 · see citing works
The Psychological Pain Assessment Scale
Shneidman, E. S. (1999) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.1999.tb00524.x · Cited by 161 · see citing works
DSM-III-R axis II comorbidity in dysthymia and major depression
Pepper, C. M., Klein, D. N., Anderson, R. L., Riso, L. P., Ouimette, P. C., & Lizardi, H. (1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.2.239 · Cited by 155 · see citing works
The Essential Nature of Borderline Psychopathology
Zanarini, M. C., & Frankenburg, F. R. (2007) · Journal of Personality Disorders · doi:10.1521/pedi.2007.21.5.518 · Cited by 146 · see citing works
Borderline Personality Disorder in Clinical Practice
Zittel Conklin, C., & Westen, D. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.5.867 · Cited by 136 · see citing works
A Multi-Attitude Suicide Tendency Scale for adolescents.
Orbach, I., Milstein, I., Har-Even, D., Apter, A., Tiano, S., & Elizur, A. (1991) · Psychological Assessment: A Journal of Consulting and Clinical Psychology · doi:10.1037/1040-3590.3.3.398 · Cited by 127 · see citing works
Mental pain and its communication in medically serious suicide attempts: an “impossible situation”
Levi, Y., Horesh, N., Fischel, T., Treves, I., Or, E., & Apter, A. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.02.022 · Cited by 125 · see citing works
Feske, U., Mulsant, B. H., Pilkonis, P. A., Soloff, P., Dolata, D., Sackeïm, H. A., & Haskett, R. F. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.11.2073 · Cited by 121 · see citing works
Westen, D., Moses, M. J., Silk, K. R., Lohr, N. E., Cohen, R., & Segal, H. G. (1992) · Journal of Personality Disorders · doi:10.1521/pedi.1992.6.4.382 · Cited by 119 · see citing works
Facial Trust Appraisal Negatively Biased in Borderline Personality Disorder
Fertuck, E. A., Grinband, J., & Stanley, B. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.01.004 · Cited by 104 · see citing works
Self-citationCoifman, K. G., Berenson, K. R., Rafaeli, E., & Downey, G. (2012) · Journal of Abnormal Psychology · doi:10.1037/a0028502 · Cited by 102 · see citing works
Never good enough – part 1: shame or borderline personality disorder?
Crowe, M. (2004) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2004.00732.x · Cited by 94 · see citing works
Miano, A., Fertuck, E. A., Arntz, A., & Stanley, B. (2013) · Journal of Personality Disorders · doi:10.1521/pedi_2013_27_096 · Cited by 94 · see citing works
Self-citationHoresh, N., Orbach, I., Gothelf, D., Efrati, M., & Apter, A. (2003) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000087184.56009.61 · Cited by 87 · see citing works
Aspects of depression associated with borderline personality disorder
Rogers, J. H., Widiger, T. A., & Krupp, A. (1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.2.268 · Cited by 84 · see citing works
Grounded Theory Analysis of Emotional Pain
Bolger, E. A. (1999) · Psychotherapy Research · doi:10.1093/ptr/9.3.342 · Cited by 84 · see citing works
The Case for Shifting Borderline Personality Disorder to Axis I
New, A. S., Triebwasser, J., & Charney, D. S. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.04.020 · Cited by 84 · see citing works
Köhling, J., Ehrenthal, J. C., Levy, K. N., Schauenburg, H., & Dinger, U. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.02.002 · Cited by 82 · see citing works
Depressive Experiences in Inpatients with Borderline Personality Disorder
Levy, K. N., Edell, W., & McGlashan, T. (2007) · Psychiatric quarterly · doi:10.1007/s11126-006-9033-8 · Cited by 81 · see citing works
Heightened Subjective Experience of Depression in Borderline Personality Disorder
Stanley, B., & Wilson, S. T. (2006) · Journal of Personality Disorders · doi:10.1521/pedi.2006.20.4.307 · Cited by 76 · see citing works
Self-citationDysphoria and Aloneness in Borderline Personality Disorder
Pazzagli, A., & Monti, M. R. (2000) · Psychopathology · doi:10.1159/000029147 · Cited by 59 · see citing works
Depression in Patients with Borderline Personality Disorder
Yoshimatsu, K., & Palmer, B. (2014) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000045 · Cited by 57 · see citing works
The Quality of Depression in Borderline Personality Disorder and the Diagnostic Process
Silk, K. R. (2010) · Journal of Personality Disorders · doi:10.1521/pedi.2010.24.1.25 · Cited by 51 · see citing works
Grounded Theory Analysis of Emotional Pain
Bolger, E. A. (1999) · Psychotherapy Research · doi:10.1080/10503309912331332801 · Cited by 44 · see citing works
The role of shame in the development and treatment of borderline personality disorder.
Rizvi, S. L., Brown, M. Z., Bohus, M., & Linehan, M. M. (2011) · Shame in the therapy hour. · doi:10.1037/12326-010 · Cited by 33 · see citing works
Subtyping Borderline Personality Disorder by Suicidal Behavior
Soloff, P. H., & Chiappetta, L. (2012) · Journal of Personality Disorders · doi:10.1521/pedi.2012.26.3.468 · Cited by 32 · see citing works
Leichsenring, F. (2004) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.68.1.9.27729 · Cited by 29 · see citing works
Goodman, J., Fertuck, E., Chesin, M., Lichenstein, S., & Stanley, B. (2014) · Personality and Individual Differences · doi:10.1016/j.paid.2014.07.038 · Cited by 27 · see citing works
Self-citationHuprich, S. K., & Nelson, S. M. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.09.017 · Cited by 27 · see citing works
Chesin, M., Fertuck, E., Goodman, J., Lichenstein, S., & Stanley, B. (2015) · Psychopathology · doi:10.1159/000365196 · Cited by 26 · see citing works
Self-citationThe 16-Year Course of Shame and Its Risk Factors in Patients with Borderline Personality Disorder
Karan, E., Niesten, I. J. M., Frankenburg, F., Fitzmaurice, G., & Zanarini, M. (2014) · Personality and Mental Health · doi:10.1002/pmh.1258 · Cited by 23 · see citing works
Self-citationMood disorders in the context of borderline personality disorder
Fertuck, E. A., Chesin, M. S., & Stanley, B. (2013) · Cambridge University Press eBooks · doi:10.1017/cbo9781139175869.014 · Cited by 1 · see citing works
Self-citation
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Research works printed but not linked: 1
- [41]First MB Spitzer RL Gibbon M Williams J Structured clinical interview for DSM-IV axis I disorders - patient edition: SCID-I/P 1996 Washington American Psychiatric Press
Cited by
Sorted by citations
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Conejero, I., Olié, E., Calati, R., Ducasse, D., & Courtet, P. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0893-z · Cited by 206 · see citing works
Johnson, B. N., Lumley, M. A., Cheavens, J. S., & McKernan, L. C. (2020) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2020.110164 · Cited by 32 · see citing works
Psychological pain and suicidal behavior: A review
Baryshnikov, I., & Isometsä, E. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.981353 · Cited by 33 · see citing works
Lengvenyte, A., Strumila, R., Courtet, P., Kim, S. Y. H., & Olié, E. (2020) · The Canadian Journal of Psychiatry · doi:10.1177/0706743720931237 · Cited by 13 · see citing works
Morales, S., & Barros, J. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.750651 · Cited by 7 · see citing works
- Authors
- Fertuck, E. A., Karan, E., & Stanley, B.
- Affiliations
- City College of New York (US)
- Corresponding author
- Fertuck, Eric A.
- ORCID
- Fertuck, Eric A.
- Venue
- Borderline Personality Disorder and Emotion Dysregulation
- Published
- 2016-02-24
- Volume
- 3
- Issue
- 1
- Pages
- 2-2
- ISSN
- 2051-6673 (ISSN-L)
- PMC
- PMC4766740
- OpenAlex
- W2281471222
- Cited by
- 40
- References
- 56
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 3 · 2023: 5 · 2022: 5 · 2021: 2 · 2020: 8 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 2
- FWCI
- 4.46
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Borderline Personality Disorder and Emotion Dysregulation (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CUNY Academic Works (City University of New York) (submittedVersion, cc-by)
- Funders
- National Institute of Mental Health (K23 MH077044, R01 MH061017)
- National Institute of Mental Health (US) (MH62665)
- American Foundation for Suicide Prevention
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- borderline personality disorder, psychological suffering, depressive disorders, narcissistic injury, diagnostic specificity, self-worth, rejection, emotional flooding, social distancing, emptiness, depression severity
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