Date of Award

January 2020

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Sarah K. Fineberg

Abstract

One aspect of selfhood that may have relevance for borderline personality disorder (BPD) is sense of body ownership. In part I, sense of body ownership in BPD was manipulated using the rubber hand illusion. Illusion strength (questionnaire responses), proprioceptive drift (perceived shift in physical hand position), and symptom scales were measured in 24 BPD and 21 control (HC) participants. For subjective illusion strength, main effects of group (BPD > HC, F(1, 43) = 11.94, P = 0.001) and condition (synchronous > asynchronous, F(1, 43) = 22.80, P < 0.001) were found. There was a group × condition interaction for proprioceptive drift (F(1, 43) = 6.48, P = 0.015) such that people with BPD maintained illusion susceptibility in the asynchronous condition. Borderline symptom severity correlated with illusion strength within the BPD group, and this effect was specific to affective (r = 0.45, P < 0.01) and cognitive symptoms (r = 0.46, P < 0.01). Across all participants, trait psychoticism correlated with illusion strength (r = 0.44, P < 0.01). These results suggest that BPD is associated with a more malleable sense of body ownership. In part II, etiologic accounts of BPD are conceptually interrogated to account for disordered self-experience. Through interdisciplinary synthesis of psychoanalytic, phenomenological, and neurobiological perspectives, I present the hypothesis that disordered self-functioning in BPD result from impairments in “embodied mentalization,” that manifest foundationally as alterations in minimal embodied selfhood, i.e. the first-person experience of being an embodied subject. This account of BPD, which engages early intersubjective experiences has the potential to integrate phenomenological, developmental, and symptomatic findings in BPD, and is consistent with contemporary theories of brain function.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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