Object relations and social cognition in borderlines, major depressives, and normals: A Thematic Apperception Test analysis.

Abstract

This study compared reliably diagnosed borderline personality disorder patients (n = 35) with major depressives (n = 25) and normals (n = 30) on 4 dimensions of object relations and social cognition coded from Thematic Apperception Test (TAT) responses: Complexity of Representations of People, Affect-Tone of Relationship Paradigms (malevolent to benevolent), Capacity for Emotional Investment in Relationships, and Understanding of Social Causality. As predicted, borderlines scored significantly lower on all 4 scales than did normals and lower on Affect-Tone and Capacity for Emotional Investment than did nonborderline major depressives. Borderlines also produced more pathological responses than did both groups on every scale, indicating more poorly differentiated representations, grossly illogical attributions, malevolent expectations, and need-gratifying relationship paradigms. The results suggest the importance of distinguishing several interdependent but distinct cognitive-affective dimensions of object relations and the potential utility of assessing object relations and social cognition from TAT responses. The psychological processes underlying the interpersonal pathology of patients with borderline personality disorder (BPD), that is, their distorted object relations, have been conceptualized in various ways by different theorists. Most argue that a disturbance in the first 3 years of life leads to the continued use of developmentally primitive modes of relating in adulthood (Kernberg, 1975; Masterson, 1976). Although theorists and clinicians (see Greenberg & Mitchell, 1983) often speak of levels of object relations as unitary phenomena, from developmentally immature to mature, the term object relations refers to a congeries of cognitive and affective functions and structures, including ways of representing people and relationships, rules of inference for interpreting the causes of people's feelings, behaviors, interpersonal wishes, conflicts, and so forth. The concept of general levels of object relations is clinically an indispensable heuristic, but these levels should be understood as being composed of several interdependent but distinct developmental lines that differ in their maturity and quality among individuals as well as within a single individual at any given time (Westen, 1989, 1990, in press-b). The aim of the present study is to explore the nature of different dimensions of the cognitive-af