Object relations, defensive operations, and affective states in narcissistic, borderline, and antisocial personality disorder.
Rorschach data were used to psychometrically "map" the internal psychological operations of three Cluster B personality disorders, listed in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987), all of which may be organized at a borderline level. Psychopathic antisocial subjects (P-APDs) and narcissistic subjects (NPDs) were highly narcissistic. NPD subjects, however, produced more indices of anxiety and attachment capacity and fewer scores related to borderline object relations and damaged identity. P-APDs and borderline subjects (BPDs) produced similar mean numbers of borderline object relations; however, the BPDs were more anxious, produced more unsublimated aggressive and libidinal drive material, and evidenced greater potential for attachment. BPDs were also less narcissistic than both P-APDs and NPDs. Nonpsychopathic antisocial subjects (NP-APDs) were less borderline than P-APDs and BPDs, less narcissistic in terms of a stable grandiose self-structure than NPD and P-APDs, produced less evidence of attachment capacity than NPDs and BPDs but more than P-APDs, and were similar to BPDs in their proneness to anxiety. The outpatient NPDs and BPDs produced more idealization responses than the incarcerated antisocial personality disorder (APD) groups. We conclude that the behavioral descriptions offered for these three Cluster B personality disorders, when used in conjunction with information such as level of personality organization (Kernberg, 1984), level of psychopathy (Hare, 1980, 1985), and outpatient versus inpatient research settings, may have greater intrapsychic specificity than previously thought.
Gacono
C B
CB
Atascadero State Hospital, CA.
Meloy
J R
JR
Berg
J L
JL
D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000523:psychology*; D000368:Aged; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000523:psychology*; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology*; D003674:Defense Mechanisms; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009289:Narcissism; D009769:Object Attachment; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics