KeywordsPersonality Trait Borderline Personality Disorder Personality Disorder Insecure Attachment Borderline Personality Disorder
Separation insecurity is characterized by a fear of rejection by – and/or a separation from – significant others, related to fears of excessive dependency and a complete loss of autonomy.
Separation insecurity is a construct that is most commonly seen as a significant diagnostic criterion for borderline personality disorder. Thus, separation insecurity can best be understood by highlighting how the construct relates to borderline personality disorder and to the Five-Factor Model of Personality Disorders.
Borderline Personality Disorder
According to the DSM-5, borderline personality disorder (BPD) is a mental illness that is characterized by a number of impairments in functioning (self and interpersonal) and certain personality traits. It affects 1–2% of the population, and 10% of individuals with BPD are treated in outpatient psychiatric clinics, while 20% are treated in inpatient psychiatric clinics (Gross et al. 2002; Lenzenweger et al. 1997; Torgersen et al. 2001, as cited by Crawford et al. 2009). In addition, about 3–10% of those who have BPD commit suicide (Crawford et al. 2009).
With respect to impairments in self-functioning, an individual with this disorder will struggle with identity, such as experiencing an unstable self-image and constant feelings of emptiness. In addition, a person with BPD will typically struggle with self-direction, such as instability with goals, career plans, and aspirations. With regard to impairments in interpersonal functioning, a person with BPD will struggle with empathy and intimacy. Regarding empathy, those who suffer from BPD tend to have interpersonal hypersensitivity, such that they feel easily insulted by others. In addition, perceptions of other individuals could be selectively biased with negative attributions and vulnerabilities. With respect to intimacy, relationships are often conflicted, unstable, and intense. In addition, relationships are typically complicated with feelings of neediness, preoccupations with real or imagined scenarios of abandonment, and mistrust. Relationships with a sufferer of BPD are often experienced in extremes (American Psychiatric Association 2013).
The personality traits associated with borderline personality disorder include negative affectivity, disinhibition, and hostility. Along with negative affectivity, those who present with BPD also experience emotional lability, separation insecurity, depressivity, anxiousness, disinhibition, risk-taking, impulsivity, and antagonism. Emotional lability refers to recurrent mood changes and unstable emotions. These emotions can be intense or blown out of proportion. Separation insecurity refers to a fear of rejection or a fear of being separated from others. Depressivity refers to symptoms of depression, such as feeling miserable, hopeless, suicidal, and pessimistic about the future and having difficulty recovering from depressive states. Anxiousness refers to severe panic, nervousness, and worrying about negative events of the past and future. Disinhibition is characterized by risk-taking and impulsivity. Risk-taking refers to participating in behaviors or actions that are rotationally damaging or dangerous, without being mindful of consequences. Impulsivity refers to struggling with controlling behavior, making spur of the moment decisions, or struggling with making and following through on plans. Lastly, antagonism, another personality trait common to those with BPD, refers to frequent or ongoing anger or irritability toward insults (American Psychiatric Association 2013).
BPD and the Five-Factor Model of Personality Disorders
The Five-Factor Model of Personality Disorders (FFMPD) was developed from the five-factor model (FFM) of personality. It is often used to describe and comprehend personality disorders as they appear in the DSM-5 (Widiger and Mullins-Sweatt 2009, as cited by Trull 2012). The FFM refers to five orthogonal personality traits: openness to experience (versus closedness to experience), conscientiousness (versus negligence), extraversion (versus introversion), agreeableness (versus antagonism), and neuroticism (versus emotional stability) (Goldberg 1990; McCrae and Costa 1987). These personality traits are often seen in personality disorders. Personality disorders are defined by extreme, maladaptive adaptations of personality traits (APA 2000, as cited by Trull 2012).
Most personality disorders show elevations of introversion, negligence, neuroticism, and antagonism (Saulsman and Page 2004; Samuel and Widiger 2008, as cited by Trull 2012). In addition, many personality disorders have positive relationships with neuroticism and negative relationships with agreeableness, conscientiousness, and extraversion. These relationships of the FFM can help identify why some personality disorders are comorbid (e.g., paranoid PD, schizoid PD, and schizotypal PD) (Lynam and Widiger 2001, as cited by Trull 2012).
With relation to the FFM, individuals with borderline personality disorder tend to be low on agreeableness and conscientiousness. Thus, those with BPD show low levels of trust, compliance, self-discipline, competence, deliberation, and dutifulness. In addition, those with BPD tend to exhibit high levels of neuroticism, meaning high levels of impulsivity, depressiveness, anger, hostility, and anxiousness. These features are also associated with other personality disorders, which can make the diagnosis complex (Samuel and Widiger 2008, as cited by Trull 2012).
The Five-Factor Model of Personality Disorders
Now that it’s clear what BPD is and how it can be described in terms of the FFM, one can explore how BPD is defined according to the Five-Factor Model of Personality Disorders (FFMPD). Since the FFMPD relates directly to the DSM-5, it is instructive to reiterate the characteristics of BPD in the DSM-5. In the DSM-5, common traits of BPD include emotional lability, anxiousness, hostility, depressivity, and separation insecurity, which are seen as components of negative affectivity. In addition, other characteristics of BPD in the DSM-5 include risk-taking and impulsivity, which are seen as components of disinhibition (American Psychiatric Association 2013).
Within the FFMPD model, traits from the disorder and the FFM are combined. According to the FFMPD, the BPD symptoms of anxiousness, depressiveness, anger/hostility, vulnerability, and impulsiveness are seen as traits stemming from neuroticism. The symptom of low compliance is seen as relating to antagonism. Feelings, actions, low competence, and low deliberation are seen as stemming from struggles with openness (Lynam and Widiger 2001). Both the FFM and the FFMPD illustrate how personality disorders relate to different levels of personality traits and thus to the comorbidity of personality disorders and other mental illnesses.
Early Maternal Separation and BPD
Previous studies have shown that BPD is associated with childhood histories of abuse, neglect, and other relationship-related risk factors (Links et al. 1988; Zanarinki et al. 2002, as cited by Crawford et al. 2009). In addition, insecure attachment plays a key role in BPD (Agrawal et al. 2004; Bartholomew et al. 2001, as cited by Crawford et al. 2009). Levy (2005, as cited by Crawford et al. 2009) found a link between diagnoses of BPD and insecurely attached adults.
Aligned with this notion, John Bowlby, a renowned attachment theorist, found that early separations were significant threats to a child’s emotional development. He observed how infants were extremely traumatized when separated from their mothers; first they would cry hysterically and then fall into periods of misery. Thus, Bowlby hypothesized that extended separations weaken the emotional security of young children (1969, 1973, 1980, as cited by Crawford et al. 2009). Other research has shown that childhood separations are associated with attachment insecurity problems (Moss et al. 2005; Waters et al. 2000, as cited by Crawford et al. 2009). Therefore, this research helps explain how insecure attachment (due to separation) may be associated with various psychological problems in children, adolescents, and adults (Mikulincer and Shaver 2007, as cited by Crawford et al. 2009).
Crawford et al. (2009) investigated how early maternal separation before the age of five affects children and the parent-child relationship. Specifically, the researchers examined whether the negative effects of early maternal separation were a predictor of developing BPD. Participants in this study were 766 youth and their mothers from a previous study completed by Cohen et al. (2005, as cited by as cited by Crawford et al. 2009). All of the youth in this study were separated from their mothers before the age of five and were asked to complete two or more follow-up interviews, making this a longitudinal study. At the follow-up interviews, the average ages of the participants ranged from 13 to 33 (Crawford et al. 2009).
Both the youth and mothers were interviewed. The youth completed surveys relating to BPD and insecure attachment. BPD was measured using the Personality Diagnostic Questionnaire (Hyler et al. 1983, 1990, as cited by Crawford et al. 2009) and questions that reflected additional items from the DSM-IV (American Psychiatric Association 1994, as cited by Crawford et al. 2009). Insecure attachment was measured using attachment scales created by Crawford et al. (2006, as cited by Crawford et al. 2009).
Mothers answered questions about maternal separation, demographics, child risk factors, and maternal risk factors. Questions about maternal separation centered on the duration and reason for the separation. Demographic questions related to socioeconomic status. Child risk factors, such as temperament, were measured, as well (Chess and Thomas 1977; Thomas and Chess 1977; Thomas et al. 1970, as cited by Crawford et al. 2009). Maternal risk factors, such as maternal interpersonal conflict, marital conflict, and inconsistencies in child-rearing, were also assessed using various scales (Derogatis et al. 1974; Fincham and Osborne 1993; Schaefer 1965; Jessor et al. 1968, as cited by Crawford et al. 2009). Lastly, official records of child maltreatment were collected, and 37 of the participants met the legal criteria for neglect, physical abuse, or sexual abuse (Crawford et al. 2009).
The researchers found that extended childhood separation from the mother before the age of five was associated with symptoms of BPD up to 30 years later. In addition, BPD symptoms showed a lower rate of decline for those who experienced early extended separations. A long-term risk for BPD was associated with mothers leaving their children for personal reasons, relocating for job/educational purposes, or the children staying with another relative for an extended period of time. This aligns with Bowlby’s theory, specifically the notion of children’s internal working models. Children may have a difficult time understanding maternal separation and may blame themselves for it. This threatens children’s mental representations of themselves and others (internal working models). These separations can cause children to believe that their mothers did not want or care about them, which can then make the children believe that they are unworthy of love and should expect rejection from people (Bowlby 1969, 1973, 1980, as cited by Crawford et al. 2009).
The researchers also found that maternal reports of childhood temperament issues, like temper tantrums, predicted BPD symptoms. In addition, a history of child abuse was associated with BPD symptoms. Children, who experienced early maternal separation, formed anxious attachment styles in close/romantic relationships, which were associated with higher rates of BPD symptoms. Lastly, maternal interpersonal difficulties and parental conflicts were not associated with BPD symptoms (Crawford et al. 2009).
Limitations of this study included only investigating maternal separation. Other family dynamics could also be investigated. In addition, the data was comprised solely of self-report data, which can be affected by social desirability or bias. Though this study has its limitations, it illustrates how early maternal separation can relate to separation insecurity, which plays a pivotal role in borderline personality disorder.
Thus, separation insecurity can best be understood in the context of delineating the intricacies of early attachment patterns and borderline personality disorders. Discussing borderline personality disorder in relation to the five-factor model of personality and the FFMPD offers a more comprehensive examination of both borderline personality disorder and separation insecurity.
- American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: American Psychiatric Association.Google Scholar
- Bartholomew, K., Kwong, M. J., & Hart, S. D. (2001). Attachment. In W. J. Livesley (Ed.), Handbook of personality disorders (pp. 196–230). New York: Guilford Press.Google Scholar
- Bowlby, J. (1980). Attachment and loss: Vol. 3. Loss, sadness, and depression. New York: Basic Books.Google Scholar
- Crawford, T. N., Shaver, P. R., Cohen, P., Pilkonis, P. A., Gillath, O., & Kasen, S. (2006). Self-reported attachment, interpersonal aggression, and personality disorder in a prospective community sample of adolescents and adults. Journal of Personality Disorders, 20, 331–353.CrossRefPubMedGoogle Scholar
- Hyler, S. E., Reider, R., Spitzer, R., & Williams, J. B. (1983). Personality Diagnostic Questionnaire (PDQ). New York: New York State Psychiatric Institute. Biometrics Research.Google Scholar
- Hyler, S. E., Skodol, A. E., Kellman, H. D., Oldham, J. M., & Rosnick, L. (1990). Validity of the Personality Diagnostic Questionnaire – revised: Comparison with two structured interviews. American Journal of Psychiatry, 47, 1043–1048.Google Scholar
- Jessor, R., Graves, T. D., Hanson, R. C., & Jessor, S. L. (1968). Society, personality, and deviant behavior: A study of a tri-ethnic community. New York: Holt, Rinehart & Wilson.Google Scholar
- Mikulincer, M., & Shaver, P. R. (2007). Attachment in adulthood: Structure, dynamics, and change. New York: Guilford Press.Google Scholar
- Thomas, A., & Chess, S. (1977). Temperament and development. Oxford, UK: Brunner/Mazel.Google Scholar
- Zanarinki, M. C., Yong, L., Frankenburg, F. R., Hennen, J., Reich, D. B., Marino, M. F., & Vujanovic, A. A. (2002). Severity of reported childhood sexual abuse and its relationship to severity of borderline psychopathology and psychosocial impairment among borderline inpatients. Journal of Nervous and Mental Disease, 190, 381–387.CrossRefGoogle Scholar