%0 Generic
%A Biermann, Miriam
%C Heidelberg
%D 2023
%F heidok:34177
%R 10.11588/heidok.00034177
%T Shame, self-criticism and fears of compassion in Borderline Personality Disorder
%U https://archiv.ub.uni-heidelberg.de/volltextserver/34177/
%X BPD is a serious mental illness characterized by instability in interpersonal relationships, self-image, affect, and marked impulsivity. Although there are evidence based therapies for BPD   that have been shown to be particularly effective in reducing severe impairments in behavioral   control and emotion regulation (S3-Guideline; Arbeitsgemeinschaft der Wissenschaftlichen   Medizinischen Fachgesellschaften, 2022), results of long-term studies show that more than   half of those affected do not achieve good social and vocational functioning even 10 years   after diagnosis (Zanarini et al., 2010, 2012). These findings suggest that further research into   the underlying pathomechanisms is needed in order to develop even more tailored treatments.   The aim of this dissertation was to contribute to a better understanding of the processing of   self-related information, a domain that is thought to contribute the poor social integration of   individuals with BPD. The focus of the underlying three studies was on the investigation of the   negative self-conscious emotion shame, self-criticism and fears of compassion, representing   major resistances in affiliative self-related processes respectively. Since there have been no   translations and validations of the corresponding measuring instruments on self-criticism and   fears of compassion to date, these were carried out within the framework of this thesis. Both,   the translation and validation of the Forms of Self-Criticizing/-Attacking and Self-Reassuring   Scale (FSCRS; Gilbert et al., 2004) and the Fears of Compassion Scales (FCS; Gilbert et al.,   2011) resulted in German versions with good to excellent psychometric quality, comparable to   those of the original English versions and offer further opportunities for research of these   concepts in German-speaking countries. With regard to self-criticism, individuals with BPD   reported higher levels of the hated self aspect of self-criticism in comparison to a mixed clinical   sample and additionally higher levels of the inadequate and lower levels of the reassured self  aspect of self-criticism compared to a sample from the general population and a healthy control   (HC) sample. In addition to the general relevance of self-criticism in BPD, these findings point   to the pronounced urge to self-attacking tendencies in the face of failure or distress, which   distinguishes individuals with BPD from other clinical disorders. In the light of previous findings   of impairments in processes of social approach and affiliation, fears of compassion seem to   be specific resistances to these processes. While individuals with BPD differed on all three   dimensions of fears of compassion (for self, for other, from others) from nonclinical participants,   there were no differences in fears of compassion towards others compared to a mixed clinical   sample. Furthermore, during an experimental paradigm addressing levels of state shame in   BPD compared to healthy control persons, the mere confrontation with the own face resulted   in higher levels of state shame and self-disgust and the confrontation with the face of another   person in higher levels of envy in BPD in comparison to healthy control persons. While levels   of state shame during the experimental confrontation with the own self was associated with   elevated proneness to shame across both samples, this relation could not be found when   analyzing the BPD and HC sample separately. This again underlines that the aversiveness of   processes directed towards the own self is of particular importance for the psychopathology of   BPD. Nevertheless, further longitudinal studies are required that capture the exact links   between these concepts and BPD psychopathology. The development and research of   treatments that are more tailored to these impairments is therefore of particular relevance.   Therapeutic approaches such as Compassion Focused Therapy (CFT; Gilbert, 2014) that   directly target shame and self-criticism have already been shown to be effective in other mental   disorders (Craig et al., 2020) and might also be a potentially promising treatment in BPD.