title: The specificity of mental pain in borderline personality disorder compared to depressive disorders and healthy controls.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychology, Clinical Psychology Doctoral Program, The City College of the City University of New York, New York, USA ; New York State Psychiatric Institute, New York, NY USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Fertuck
authors.affiliation: Department of Psychology, Clinical Psychology Doctoral Program, The City College of the City University of New York, New York, USA.
authors.forename: Esen
authors.initials: E
authors.lastname: Karan
authors.affiliation: Department of Psychiatry, Columbia University, New York, USA ; New York State Psychiatric Institute, New York, NY USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Stanley
keywords: Borderline personality disorder; Depression; Mental pain