Core conflictual relationship themes in patients diagnosed with borderline personality disorder who attempted, or who did not attempt, suicide

Abstract

Extant relational notions of suicidal behavior were examined in a sample of 22 psychiatric inpatients with a diagnosis of Borderline Personality Disorder (BPD), 11 of whom were hospitalized following a suicide attempt and 11 of whom reported no history of suicidal behavior. Relationship narratives were obtained during a psychodynamically oriented clinical interview and assessed using the Core Conflictual Relationship Theme (CCRT) coding scheme. The results did not support the relational differences of heightened dependency needs, perceived rejection by others, and subsequent anger that were hypothesized to exist between BPD persons who were hospitalized for a suicide attempt and BPD individuals who had never made an attempt. Relational patterns for both groups were similar and consistent with conventional conceptualizations of suicidal behavior and previous CCRT studies examining relational narratives among depressed psychotherapy patients. Specifically, the relational pattern most often described by all participants was a wish to be loved and understood, experiencing others as rejecting, and responding with depression and disappointment.