The Role of Hopelessness in Patients With Borderline Personality Disorder

Abstract

Background: The goal of this study was to evaluate specific characteristics associated with hopelessness, potentially correlated with coping strategies, sensory profile, and alexithymia in patients with borderline personality disorder (BPD).

Materials and methods: Two hundred twenty-four (N=224) inpatients completed a clinical interview with administration of the Beck Hopelessness Scale (BHS), the Adolescent/Adult Sensory Profile (AASP), the Coping Orientation to Problems Experienced Inventory (COPE), and the Toronto Alexithymia Scale (TAS).

Results: Hopelessness was significantly associated with female gender, more hospitalizations, current suicidal ideation, number of suicide attempts, current and lifetime medication abuse, and alcohol misuse. Furthermore, patients with BHS ≥ 9 had higher scores in low registration, sensory sensitivity and sensation avoiding in AASP, higher rate of alexithymia, and the use of maladaptive coping strategies.

Conclusions: Hopelessness in BPD was associated with higher severity of illness, alternative process sensory input from the environment, reduced ability to cope with stressful events, and alexithymia. Therefore, a routine assessment of hopelessness in patients with BPD could lead to better and more specific therapeutic strategies.

FIGURE 1

BHS, TAS, COPE, and AASP score correlation matrix. AASP indicates Adolescent/Adult Sensory Profile; AC, active coping; ACC, acceptance; ADD, alcohol and drug disengagement; BD, behavioral disengagement; BHS, Beck Hopelessness Scale; COPE, Coping Orientation to Problems Experienced; DE, denial; HUM, humor; LR, low registration; MD, mental disengagement; PL, planning; PRG, positive reinterpretation and growth; RC, restraint coping; SA, sensation avoiding; SCA, suppression of competing activities; SSee, sensation seeking; SSeen, sensory sensitivity; TAS, Toronto Alexithymia Scale; TR, turning to religion; UISS, use of instrumental social support; USES, use of social-emotional support; VE, venting of emotions.