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Cognitive and Affective Dimensions of Difficulties in Emotional Functioning in Somatoform Disorders and Borderline Personality Disorder

van Dijke A.a · van der Hart O.b · van Son M.b · Bühring M.c · van der Heijden P.b · Ford J.D.d
aDelta Psychiatric Hospital, Poortugaal, bUtrecht University, Utrecht, and cAltrecht, Zeist, The Netherlands; dDepartment of Psychiatry, University of Connecticut School of Medicine, Farmington, Conn., USA Psychopathology 2013;46:153-162 (DOI:10.1159/000338832)


Background: To study difficulties in emotional functioning in two mental disorders that have been associated with difficulties in identifying and modulating emotions: borderline personality disorder (BPD) and somatoform disorder (SoD). Sampling and Methods: In 472 psychiatric inpatients, difficulties in emotional functioning were measured using the Bermond-Vorst Alexithymia Questionnaire. Results: Profiles of difficulties in emotional functioning were identified, suggesting that patients diagnosed with BPD with or without SoD were more likely to report difficulty identifying emotions and less likely to report reduced ability to fantasize or ‘pensée opératoire' (externally oriented thinking) than patients diagnosed with SoD only and patients with mixed anxiety and affective disorders. SoD patients were more likely to report reduced ability to phantasize or pensée opératoire than difficulty identifying emotions. Patients with mixed anxiety and affective disorders were more likely to report reduced ability to experience emotions than patients diagnosed with BPD and/or SoD. Conclusions: By using a finer-grained perspective on difficulties in emotional functioning some evidence was found for the existence of cognitive-emotional profiles that may provide more clinically relevant information than alexithymia as just a unitary construct. Further research on cognitive-emotional profiles of difficulties in emotional functioning is needed to advance the understanding, diagnosis and treatment of mental disorders.


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