Awareness of identity alteration and diagnostic preference between borderline personality disorder and dissociative disorders.

AIM: This study inquires into identity alteration among college students and its relationship to borderline personality disorder (BPD) and/or dissociative disorders (DDs). METHODS: Steinberg Identity Alteration Questionnaire (SIAQ), Childhood Trauma Questionnaire (CTQ), and self-report screening tool of the BPD section of the Structured Clinical Interview for DSM-IV (SCID-BPD) were administered to 1301 college students. Participants who fit the diagnostic criteria of BPD (n = 80) according to the clinician-administered SCID-BPD and 111 non-BPD controls were evaluated using the Structured Clinical Interview for DSM-IV DDs (SCID-D) by two psychiatrists blind to the group membership and scale scores. RESULTS: Test-retest evaluations and internal consistency analyses suggested that SIAQ was a reliable instrument. Of the participants, 11.3% reported a SIAQ score 25 or above alongside some impairment. SIAQ scores differentiated participants who fit the diagnostic criteria for a DD from those who did not. While self-report identity alteration was correlated with all childhood trauma types, clinician-assessed identity alteration was correlated with childhood sexual abuse only. Those who fit criteria for both disorders had the highest identity alteration scores in self-report and clinician-assessment. Although both syndromes had significant effect on self-report identity alteration total scores, in contrast to DD, BPD did not have an effect on the clinician-administered evaluation. CONCLUSION: An impression of personality disorder rather than a DD may seem more likely when identity alteration remains subtle in clinical assessment, notwithstanding its presence in self-report. Lack of recognition of identity alteration may lead to overdiagnosis of BPD among individuals who have a DD.

Psychopathology and Dissociation among Boarding School Students in Eastern Turkey.

A subset of boarding schools for adolescents was established in 1993 in the rural sections of Eastern Turkey to provide equity in terms of availability of education. Even though these schools were beneficial in many respects, implementation of this institutional model gave rise to many challenges such as weaker relationships with parents and defiance of authority figures. Failure to develop a mature response to these challenges could lead to the development of psychopathologies such as depression, psychosis, and dissociation. The main objective of this study is to assess the incidence of psychopathology and dissociative experiences of the residential female students in the regional boarding schools compared to a control group. 187 female participants, 128 attending boarding school, and 59 attending day school, as the control group, were included in the study. Brief Symptom Inventory (BSI) and Adolescent Dissociative Experiences Scale (ADES) were used as measurement scales. T-test, Mann Whitney-U, Spearman correlation chi-square tests were used to evaluate the association between the variables. There was a significant difference in Interpersonal sensitivity and Psychoticism subscales of BSI. ADES score was found to be significantly higher in the Boarding school group. Boarding school students are at a higher risk of developing psychopathology as a common trauma on a group of people can result in shared dissociation, a collective defense mechanism to cope with the injury, which resembles shared delusional disorder within DSM-V (The Diagnostic and Statistical Manual of Mental Disorders). Screening measures should be implemented in boarding schools to evaluate adolescents for psychopathology and preventive measures should be taken to intervene in the early stages.