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ISA as an Approach to Personality Disorder

ISA as an Approach to Personality Disorder. Anne Malone Undergraduate Dissertation, UUJ. Format. Definition of personality disorder Aims Method Key ISA concepts Theoretical postulates Results Reflections Conclusion. Definition of Personality Disorder.

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ISA as an Approach to Personality Disorder

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  1. ISA as an Approach to Personality Disorder Anne Malone Undergraduate Dissertation, UUJ

  2. Format • Definition of personality disorder • Aims • Method • Key ISA concepts • Theoretical postulates • Results • Reflections • Conclusion

  3. Definition of Personality Disorder • Inflexible and maladaptive patterns of personality that begin by early adulthood and result in either social or occupational problems or distress to the individual • 10 Subgroups: Paranoid, Schizoid, Schizotypal, Antisocial, Borderline, Histrionic, Narcissistic, Avoidant, Dependent, Obsessive-Compulsive

  4. Aims • Investigate utility of ISA as an approach to ‘personality disorder’ • Capture complexity of complex psychological difficulties • Focus on biographical experience and identity formation

  5. Method • Four respondents identified as having a diagnosis of PD- Borderline PD - PD NOS • Customised Identity Instrument – based on existing literature on PD and past ISA research in clinical areas • Also completed EPQ-R short version

  6. Customised Identity Instrument • Entities and Constructs • E.g. of bipolar construct: …is trustworthy/is not trustworthy • E.g. of entities: Me as I am now Me at my best Me at my worst

  7. Key ISA Concepts • Empathetic identification: The degree of similarity between the qualities one attributes to the other, whether ‘good’ or ‘bad’, and those of one’s current self-image

  8. Key ISA Concepts • Metaperspectives of Self: Respondent’s interpretations of other people’s perspectives of them • Me as my mother/father sees me • Me as most other people see me

  9. Key ISA Concepts • Identification Conflicts: function of the respondent’s empathetic identification with an entity and the degree of contra-identification with that entity

  10. Theoretical Postulates • (1)The PD group will display dissociative states of identity, with markedly different patterns of empathetic identifications with others across identity states, in contrast to the comparison group. • Psychoanalytic object relations theory (Kernberg 2005)

  11. Theoretical Postulates • (2)Higher conflicted identifications with metaperspectives of self will be evident for the PD group than the comparison group • Evidence for interpersonal problems as core pathology of PD (Pincus, 2005)

  12. Overall Results • Individual case analyses revealed quantifiable evidence of underlying psychological processes • Explain clinical presentation and symptomology in terms of past biographical experiences and resultant identity structure • EPQ-R: no conflicting findings, but ISA provides much greater depth of info

  13. Postulate (1) • PD group displayed markedly different patterns of empathetic identification across self states, in contrast with the comparison group • Results in each case reveal processes underlying current difficulties

  14. Postulate 1 • Example from case study: • Presenting problems include recurrent suicide attempts and history of perpetrating domestic violence • Reports history of severe physical abuse by mother • ISA results indicate defensive identification with ‘mother as abuser’ when at worst

  15. Postulate (2) • PD group displayed highly conflicted identifications with parental and general metaperspectives of self, in contrast to the comparison group • Problematic identifications with caregivers as risk factor for PD?

  16. Postulate 2 • Example from case studies: • 2 cases: antisocial behaviour • ‘Me at my worst’ involves partial resolution of identification conflict • Fulfilling deviant social role? • Both reported being bullied at school

  17. Reflections • Respondents found format engaging • Assesses emotions associated with discourses • Quantified info regarding belief system • Use with interventions such as CAT? • Dynamic – indicates direction of identity processes

  18. Conclusion • Indicates that ISA can provide insight into the psychological processes underlying PD, both within and across individual cases • Research tool that could potentially uncover the psychological processes underlying the development and maintenance of personality disorders

  19. Quotes from respondents • “I remember asking her if she would have fired the gun. She just shrugged her shoulders and kept on washing the dishes” • “They said in court I have a Personality Disorder. What does that mean? Am I sick? Will I be able to work?”

  20. Thank you for listening Any questions?

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