Borderline functioning and life trauma: a structural approach

Aim: The general aim of this multiannual research project was the exploration of the links between traumatizing
life events and current functioning.
Material and methods: The research project was based on a sequential design. It included an exploratory
study with 206 persons experiencing exclusion and marginalization, followed by a confirmatory study with 195
persons. We present the confirmatory study results, as well as a meta-analysis of both studies. Both studies
were based on an integrated quantitative and qualitative research methodology, combining a semi-structured
biographical interview, psychometric scales (Hospital Anxiety and Depression Scale (HADS), Index of Well-
Being) and a projective test (Rotter Incomplete Sentences Blank). We developed original rating scales for the
semi-structured interview and the answers to the Rotter test, allowing a step from qualitative analysis to inferential
and multidimensional statistics.
Results: With the help of appropriate multidimensional statistical procedures applied to the semi-structured interview
(linear principal components analysis) and the Rotter test (multiple correspondence analysis), we were
able to draw out differential types of personality functioning based on the prevalent defense mechanisms and
coping strategies, linked either to a succession of traumatic events, such as neglect, maltreatment and multiple
losses occurring since childhood, or to recent catastrophes. The comparative study of the answers to the
Rotter test in the first and third person pointed to differences in the expression of conscious and unconscious
needs. Configural frequency analysis applied to HADS identified specific types that could correspond to variants
of borderline functioning. The meta-analysis of the exploratory and confirmatory findings showed convergent
results at several fundamental dimensions. Our results supported the traumatogenic hypothesis of
borderline functioning and pointed towards a partial overlapping of the concepts of splitting and dissociation.
Conclusions: More long-term evaluation studies of appropriate psychotherapeutic measures are needed. From
the methodological point of view, the most appropriate strategy might be a mixed-methods design combining
data from different sources (semi-structured interviews, psychometric scales, projective tests, etc.) and respecting
the person-centered approach. This approach combines objectivity with subjectivity in an optimal manner.