Faggioli Ilaria, Esposito Cecilia Maria, Stanghellini Giovanni
Department of Health Sciences, University of Florence, 50121 Florence, Italy.
Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Brain Sci. 2024 Nov 30;14(12):1221. doi: 10.3390/brainsci14121221.
Borderline Personality Disorder (BPD) is a prevalent psychopathological condition, affecting 0.7-2.7% of the general population. Given the known link between identity formation and the temporal, metacognitive, and narrative processes that contribute to its coherence, the aim of the present systematic review is to synthesize the current literature about the relationship between identity diffusion and lived time in adult patients with BPD. This would enhance knowledge and treatments, leading to a better understanding of the implications of time processes on identity diffusion in BPD.
According to PRISMA guidelines, the main databases were consulted, and specific eligibility criteria were applied. The selection leads to the inclusion of 15 articles, investigating through integrated techniques the lived time, memory, self-reported narratives, and metacognition in BPD subjects.
A general agreement among researchers was found, confirming greater difficulty for BPD subjects in producing autobiographical stories, logically and temporally integrated, characterized by positive content. Functional and structural alterations were detected to explain narrative incoherence, as well as symptoms such as emotional dysregulation and cognitive biases.
The difficulty for BPD subjects in producing a coherent personal narrative has been interpreted as a correlation of anomalies in autobiographical memories and consequently identities, which were equally compromised by the experience of discontinuity in the temporal structure. This would confirm the hypothesis of the temporal fragmentation of the self in BPD. Although some limitations have been encountered, we suggest that the understanding of identity diffusion and lived time in BPD subjects could represent a useful guide for further research.
边缘型人格障碍（BPD）是一种常见的精神病理状况，影响着0.7%-2.7%的普通人群。鉴于身份形成与有助于其连贯性的时间、元认知和叙事过程之间的已知联系，本系统综述的目的是综合当前关于成年BPD患者身份弥散与体验时间之间关系的文献。这将增进知识和治疗方法，从而更好地理解时间过程对BPD中身份弥散的影响。
根据PRISMA指南，查阅了主要数据库，并应用了特定的纳入标准。筛选后纳入了15篇文章，这些文章通过综合技术研究了BPD患者的体验时间、记忆、自我报告的叙事和元认知。
研究人员达成了普遍共识，证实BPD患者在创作具有积极内容、逻辑和时间上连贯的自传性故事时困难更大。检测到功能和结构改变，以解释叙事不连贯以及情绪调节障碍和认知偏差等症状。
BPD患者在创作连贯的个人叙事方面存在困难，这被解释为自传性记忆以及由此产生的身份异常的一种关联，而这些同样受到时间结构不连续性体验的影响。这将证实BPD中自我时间碎片化的假设。尽管遇到了一些局限性，但我们认为，对BPD患者身份弥散和体验时间的理解可能为进一步研究提供有用的指导。
