الفهرس 
? Borderline Personality DisorderOnly 14 pages are availabe for public view
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Abstract
B
orderline personality disorder is one of the most common psychiatric disorders encountered in the general population as well as psychiatric settings. It is associated with high psychosocial and socioeconomic costs. BPD is associated with severe functional impairment, substantial treatment use, and high rates of mortality by suicide.
Self-esteem is one of the most widely studied topics in modern psychology. It is an important psychological construct because it is a central component of individuals’ daily experience. It refers to how people feel about themselves and reflects and affects their ongoing transactions with their environment and the people they encounter. A few clinical and non-clinical studies suggest that BPD is associated with both impaired and unstable self-esteem. Other studies found that low self-esteem is associated with increased severity of BPD symptoms. Moreover, Self-esteem has been found to be one of the strongest predictors associated with poorer global outcomes and satisfaction with life in patients with BPD.
Coping can be defined as, a set of cognitive and behavioural efforts that are applied to address the occurrence of demands considered exceeding to one’s personal resources. Positive coping creates positive feelings that foster improved communication and occupational growth. Furthermore, positive coping can inhibit the emergence of harmful health conditions, and manifest as problem-solving behaviour and positive appraisals, while negative coping can affect a person’s mindset and in return affects his life negatively. Less is known about how BPD patients cope with increased negative affect and stress.
The rationale behind our study is that, to our knowledge there has been limited studies that explored the relationship between BPD with either self-esteem or coping strategies. Gaining more knowledge about the differences in both constructs in patients with BPD compared to healthy controls, will guide clinicians towards, defects in self-esteem and coping strategies in patients with BPD. Also, it will open different targets for therapists to improve their patients’ wellbeing and functioning, aiming to decrease the overall burden that the disorder put on the community.
This study is a cross sectional comparative study that was conducted in the Institute of Psychiatry, Ain Shams University. A total of 50 patients with the diagnosis of borderline personality disorder (BPD) were recruited from the outpatient clinic of the Institute of Psychiatry, Ain Shams University Hospitals. BPD patients had to be either without any psychotropic medication or on stable psychotropic medication for more than 6 months.
50 healthy controls (HC) matched as much as possible, were recruited from the workers and relatives of the hospitals. Healthy controls had no lifetime mental illness and were not on any psychotropic medication. They had no diagnosis after assessment with both SCID I and SCID II. Both the cases and controls were between the ages of 18 to 45 years, of both sexes.
All the subjects under went assessment with the following tools, 1.A socio-demographic data sheet was designed to collect information including gender, age, years of education, and occupation, 2. The Arabic version of Structured Clinical Interview for DSM axis I disorders (SCID-I), 3. The Arabic version of Structured Clinical Interview for DSM-IV Axis II Disorders (SCID II), 4. The Arabic version of Rosenberg Self-Esteem Scale was used to assess respondents’ global self-esteem, 5. The Arabic version of COPE Inventory to assess the different ways in which people respond to stress, 6. The Global Assessment of Functioning scale of the DSM-IV (GAF).
Our study revealed that, self-esteem scores are lower in patients diagnosed with BPD compared to healthy controls. We also found that patients with BPD have more risk of having comorbid mental health disorders and less general functioning scores when compared to healthy controls.
As we explored the coping strategies, we found that patients with BPD tend to utilize different coping strategies under stress than healthy controls, in the way that they tend to use less problem-focused strategies. Patients were found to use some emotion-focused coping strategies, such as focusing on and venting of emotions, while controls were found to use religious coping and Humor more. At last, patients were found to utilize other coping strategies that are considered less useful such as substance use and behavioral disengagement.
Regarding the self-esteem in our cases, there was a significant difference between the self-esteem scores in students and employed cases. We found a weak positive correlation between the self-esteem and the years of education.
Regarding significant correlations between the self-esteem and the coping strategies used by cases; the results revealed a strong positive correlation between the self-esteem scores with all the following coping strategies, Planning, Positive reinterpretation and growth and Active coping. Moderate positive correlations were recorded with the Suppression of competing activities, Use of instrumental social support, Acceptance, Restraint, as well as Religious coping. A weak positive correlation was recorded with Humor, while a weak negative correlation was found with Substance use. The self-esteem scores positively correlated strongly with the general functioning of the cases. At last, there was a significant difference between the self-esteem scores of cases with comorbidities and cases without comorbidities.
Regarding the coping strategies correlations, some of the strategies correlated with the general such as positive reinterpretation and growth, planning and active coping. Also, in emotion focused strategies, acceptance, religious coping, and humour positively correlated with the general functioning with various magnitudes. Substance use was significantly correlated with the general functioning of our cases.
from our study, we concluded that patients with BPD tend to have lower self-esteem than healthy controls. Self-esteem scores positively correlates with the use of more useful coping strategies and with better functioning in patients with BPD. Also, patients with BPD tend to utilize different coping strategies than healthy controls. Comorbidities are significantly higher in patients with BPD, while general functioning is significantly lower in BPD patients when compared to healthy controls.