Development and validation of an experience of time alone scale for borderline personality disorder

Intolerance of aloneness as a prospective predictor of suicidal ideation during COVID-19

Background

Social distancing has been essential in mitigating the spread of the SARS-CoV-2 virus. Evidence regarding the impact of reduced social contact on mental health during the pandemic has been mixed, however, with studies suggesting that enduring personality traits and affect regulation impairments may together increase risk for suicidal distress during periods of lockdown. The present study utilized experience sampling and longitudinal follow-up methods to evaluate intolerance of aloneness (IA) as a predictor of suicidal ideation (SI) during the pandemic.

Methods

A general adult sample (n = 184) recruited online completed an 8-week experience sampling protocol via smartphone between April and September 2020. A subset of n = 69 participants completed a follow-up assessment of SI six months after the initial study period.

Results

IA was associated with suicidal ideation both at baseline and prospectively during the experience sampling period. Individuals with greater IA were more likely to report SI in the short-term context of reduced daily in-person social contact. Higher IA at baseline furthermore prospectively predicted the occurrence of SI during the 6-month follow-up period.

Limitations

The sample was relatively homogenous in terms of demographic characteristics and excluded individuals with limited access to communication technology. While statistical models accounted for current mental health treatment status, other factors that were not assessed (such as adverse events or psychiatric symptoms in non-treatment-seeking subjects) may have contributed to the development of SI.

Conclusions

Findings enhance understanding of how personality-based factors may contribute to suicide risk during periods of social distancing, informing both clinical treatment, risk assessment, and public health intervention approaches.

Measuring the shadows: A systematic review of chronic emptiness in borderline personality disorder

BACKGROUND

Chronic feelings of emptiness is an under-researched symptom of borderline personality disorder (BPD), despite indications it may be central to the conceptualisation, course, and outcome of BPD treatment. This systematic review aimed to provide a comprehensive overview of chronic feelings of emptiness in BPD, identify key findings, and clarify differences between chronic feelings of emptiness and related constructs like depression, hopelessness, and loneliness.

METHOD

A PRISMA guided systematic search of the literature identified empirical studies with a focus on BPD or BPD symptoms that discussed chronic feelings of emptiness or a related construct.

RESULTS

Ninety-nine studies met criteria for inclusion in the review. Key findings identified there were significant difficulties in defining and measuring chronic emptiness. However, based on the studies reviewed, chronic emptiness is a sense of disconnection from both self and others. When experienced at frequent and severe levels, it is associated with low remission for people with BPD. Emptiness as a construct can be separated from hopelessness, loneliness and intolerance of aloneness, however more research is needed to explicitly investigate these experiences. Chronic emptiness may be related to depressive experiences unique to people with BPD, and was associated with self-harm, suicidality, and lower social and vocational function.

CONCLUSIONS AND IMPLICATIONS

We conclude that understanding chronic feelings of emptiness is central to the experience of people with BPD and treatment focusing on connecting with self and others may help alleviate a sense of emptiness. Further research is required to provide a better understanding of the nature of chronic emptiness in BPD in order to develop ways to quantify the experience and target treatment. Systematic review registration number: CRD42018075602.