title: Is low affect consciousness related to the severity of psychopathology? A cross-sectional study of patients with avoidant and borderline personality disorder.
abstract: OBJECTIVE
  This study examined the relationships between affect consciousness (AC) and symptom distress, interpersonal problems, low self-esteem, and the number of PD traits in patients with avoidant personality disorder (APD) and borderline personality disorder (BPD).
  
  
  METHODS
  Within the setting of a treatment trial, 52 patients with APD or BPD were examined with structured interviews and self-report questionnaires before treatment and at 3-year follow-up. The evaluations included the Affect Consciousness Interview, the SCID-II interview, the Symptom Checklist 90-R, the Circumplex of Interpersonal Problems, and the Index of Self-esteem. A low global level of AC was expected to be associated with the severity of psychopathology; a low AC for interest, joy, and tenderness was expected to be associated with social detachment; and a low AC for anger, contempt, and disgust was expected to be associated with nonassertiveness.
  
  
  RESULTS
  A low AC was associated with interpersonal problems and low self-esteem, but not symptom distress or the number of fulfilled SCID-II criteria. Despite a significant reduction in the psychopathology based on most clinical variables, the associations measured at baseline were maintained after 3years. Examination of specific affect categories showed a pattern of convergent and discriminative relationships with different types of interpersonal problems. A low AC for pleasant affects was specifically related to communion problems, like cold, detached behavior, both at baseline and follow-up. In contrast, a low AC for self-boundary affects was specifically related to agency problems, like non-assertiveness, at follow-up.
  
  
  CONCLUSIONS
  Our results showed that a low AC was associated with central domains of psychopathology in patients with PDs. This suggested that AC would be an important focus for treatment and further research in PDs. Future studies are needed to examine how AC is related to various forms of personality pathology.
authors.affiliation: Vestfold Hospital Trust, Division of Mental Health, Box 2267, Tonsberg, Norway. norei2@ous-hf.no
authors.forename: Eivind
authors.initials: E
authors.lastname: Normann-Eide
authors.forename: Merete Selsbakk
authors.initials: MS
authors.lastname: Johansen
authors.forename: Tone
authors.initials: T
authors.lastname: Normann-Eide
authors.forename: Jens
authors.initials: J
authors.lastname: Egeland
authors.forename: Theresa
authors.initials: T
authors.lastname: Wilberg
mesh_terms: D000328:Adult; D000339:Affect; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010554:Personality Disorders / Q000175:diagnosis* / Q000523:psychology; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012649:Self Concept; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires