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Digital archive of theses discussed at the University of Pisa


Thesis etd-07122017-010231

Thesis type
Tesi di specializzazione (4 anni)
Thesis title
Trauma, Mood and Ruminations in Borderline Personality Disorder
Course of study
relatore Prof.ssa Dell'Osso, Liliana
  • Ruminations
  • PTSD
  • Mood
  • Borderline Personality Disorder
  • Trauma
Graduation session start date
The inter-relation between mood diseases and Borderline Personality Disorder (BPD) has been debated since the introduction of BPD diagnosis itself. On the other hand, as studies on Post-traumatic Stress Disorder (PTSD) grew in number, the question of the close relationship between traumatic events and BPD has been posed with more and more emphasis. Moreover, only in recent times it is considered that Ruminations could have an independent role respect to other co-morbidities, like mood diseases, in the development and severity of BPD.
In this study, for the first time, we compare the weight of these three psychopathological dimensions in determining BPD condition.
METHOD: 50 patients who met the criteria for Borderline Personality Disorder, and 69 healthy controls were enrolled. Clinical diagnoses were determined by Structured Clinical Interview for DSM-5 (Scid-5). Mood Spectrum Self-Report (MOODS-SR) and Rumination Response Scale (RRS) were administered.
RESULTS: Using a logistic regression model we found that BPD risk increases by 47% (OR=1.47, P=0.19) for every increase point of RRS brooding domain score and by almost three times (OR=2.87, P<0.001) for every DSM-5 PTSD criterion satisfied. No contribution of mood spectrum was found, while reflective ruminations showed to be protective respect to BPD (B = -0,36; OR = 0,70; p = 0,047).
CONCLUSIONS: Our study confirms the very high importance of trauma and defines a possible role of ruminations in the psychopathogenesis and treatment of BPD; it shows that BPD requires an adjunctive problematization effort by investigating, at first, possible traumatic episodes.
Rumination could, moreover, constitute one of the personological nuclei of BPD, and this seems to prevail respect to the Mood Spectrum. On the other hand we could hypothesise that in BPD traumatic life events represent a determining factor in mood dysregulation.
The protective effect of reflective ruminations in BPD suggests that a targeted psychotherapeutic approach could be of help respect to the maladaptive modes with which the patient perceives himself.
Further studies are needed in order to investigate if rumination play a permissive role respect to trauma, i.e. through a continuous reproposition of the traumatic event in mind such as to crystallize it, so contributing to determine the BPD condition.