Science

Borderline Personality Disorder and Quality of Life

Borderline personality disorder (LPT) is characterized by a recurrent and persistent pattern of instability in personal relationships, distortions of self-image, and marked impulsivity in various contexts. The symptoms inherent to this pathology, its high use of mental health services and its high suicide rate, mean that these patients may have a reduced quality of life.

This decrease in their quality of life would manifest itself in two areas: in a disability to carry out day-to-day tasks in a functional way, such as those related to work, studies or self-care, and in a deterioration of the quality of life related to health, such as physical medical conditions. This is due to the capacity of personality traits, of our way of being, to influence the general state of the subject; an example of this is neuroticism that is negatively associated with subjective well-being, or extraversion that does it positively with greater physical and mental health (Roberts, Kuncel, Shiner, Caspi, and Goldberg, 2007). A TPL personality pattern, given its repercussions on all dimensions of life and its tendency to encourage desaptavative decisions, can negatively affect both areas of quality of life.

It should be borne in mind that the relationship between a personality pattern and quality of life indicators is probably not directly related. There are mediating factors that may be regulating the relationship between the TPL and concomitant problems. A possible mediating variable of interest for its relationship with disability and health is satisfaction with life, which is translated as an evaluation, or positive subjective assessment of one’s own life.

This study sought to respond to two main objectives. On the one hand, to analyse the differences between a group of patients with LPT and a control group without physical or mental illness in the different quality of life domains; and on the other hand, to study whether vital satisfaction plays a mediating role in the relationship between pathological personality traits and these quality of life domains.

In order to achieve these two objectives, 262 women participated in the research; 138 formed the clinical group or group diagnosed with PLT, and 124 formed the control group. The average age was 30.98 years. All participants completed 4 measurement instruments that evaluated the following variables: personality traits, health-related quality of life, functionality-related quality of life, and life satisfaction.

The results showed that the clinical group had higher scores in pathological personality traits and lower quality of life in all domains, results that point to physical and functional deterioration in these patients. The obtained data confirm previous results about the great incapacitation of these patients to develop work and leisure activities and in the social relations. They also confirm that, in personality disorders, inappropriate health behaviours and their characteristic lifestyle choices tend to lead to medical problems and worsening of existing physical conditions (Douzenis, Tsopelas and Tzeferakos, 2012).

It was found that satisfaction did not measure the relationship between personality and functional disability in the patient group, although it did, partially, in the control group. In other words, the weight of pathological personality traits would overshadow the potential role of life satisfaction in explaining daily limitations. However, some of the dimensions of health-related quality of life (Vitality, Mental Health and Functioning of the Emotional Role) were mediated or affected by life satisfaction in both groups, confirming the positive association of this construct with health behaviors (Grant, Wardle and Steptoe, 2009).

In summary, TPL traits are associated with poorer quality of life and average life satisfaction only aspects of health-related quality of life in these patients.

We can conclude that knowing the impact of PLT on these dimensions can help to delimit an appropriate treatment. Therapists will be able to take into account the social difficulties of these patients by working on a solid therapeutic relationship and preparing for possible setbacks. Also, being alert to the physical problems that these people suffer will make it possible to treat them before they lead to more serious and chronic conditions. If we consider the high level of disability they show when carrying out daily tasks, we can include in their treatment tools and strategies that allow them to recover a certain degree of functionality and, therefore, increase their quality of life.

On the other hand, early detection of the borderline disorder can be encouraged: in primary care, high functional disability and health problems can be raised as possible indicators of LPT.

It is also significant to know the role that vital satisfaction can play in the relationships we have studied. It would be useful to work on life satisfaction in therapy given its relationship with health-related quality of life, and since its levels have been shown to be modifiable through positive psychology interventions (Sin and Lyubomirsky, 2009).

We can conclude that knowing the impact of LPT in these dimensions can help to delimit an appropriate treatment. Therapists will be able to take into account the social difficulties of these patients by working on a solid therapeutic relationship and preparing for possible setbacks. Likewise, being alert to the physical problems that these people suffer will make it possible to treat them before they lead to more serious and chronic conditions. If we consider the high level of disability they show when carrying out daily tasks, we can include in their treatment tools and strategies that allow them to recover a certain degree of functionality and, therefore, increase their quality of life.

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