[Shame Proneness in Borderline Personality Disorder: Critical Reflection Based on Data from the Province of Quebec]. / La propension à la honte dans le trouble de personnalité limite : réflexion critique à partir de données québécoises.

Objectives Shame is a painful feeling that one feels when under the impression of having committed an offence or contravened to a personal or moral standard. Shame experiences are often intense and entail a global, negative self-evaluation; persons then feel like they are bad, weak, worthless, or deserving others' contempt. Some people are more prone to shame feelings. Although shame is not listed as a diagnostic criterion of borderline personality disorder (BPD) in the DSM-5, studies suggest that shame is an important feature in individuals with BPD. The aim of this study is to garner additional data to document shame proneness in individuals presenting with borderline symptomatology in the population from the Province of Quebec. Method Overall, 646 community adults from the Province of Quebec completed online the brief version of the Borderline Symptom List (BSL-23), measuring the severity of symptoms associated with BPD from a dimensional perspective, and to the Experience of Shame Scale (ESS), measuring shame proneness in various areas of a person's life. Participants were then compared on their shame scores after they were assigned to one of the four groups based on Kleindienst et al. (2020) classification of severity of borderline symptoms: (a) none or low symptoms (n = 173), (b) mild symptoms (n = 316), (c) moderate symptoms (n = 103), or (d) high, very high or extremely high symptoms (n = 54). Results Between-group differences were found with large effect sizes in all shame areas measured by the ESS, suggesting that shame feelings tend to be greater in persons presenting more borderline traits. Conclusion Results are discussed in a clinical perspective of BPD, emphasizing the importance of having shame as a clinical target in psychotherapy with these clients. Furthermore, our results raise conceptual questions regarding how to integrate shame in the assessment and treatment of BPD.

Dissociation mediates the relationship between sexual abuse and child psychological difficulties.

The aim of the present study was to evaluate, using structural equation modeling, a theoretical model in which dissociation is a core process mediating the relationship between childhood sexual abuse (CSA) and internalizing, externalizing, and sexualized behaviour difficulties in children. A total of 290 children aged 2-12 participated in this study in Québec, Canada from 1998 to 2004, including 138 children with histories of CSA and 152 non-abused children. To assess child dissociative symptoms, internalizing and externalizing difficulties, as well as sexualized behaviour difficulties, the Child Dissociative Checklist, the Child Behaviour Checklist and the Child Sexualized Behaviour Inventory were completed by parents. Dissociation mediated the relationship between CSA and internalizing, externalizing, and sexualized behaviour difficulties, with the model explaining respectively 42.5%, 49.9% and 33.9% of the variance of these difficulties. Findings are consistent with a model where dissociation is a common pathway linking CSA and child psycho-sexual difficulties.

The impact of mentalization training on the reflective function of novice therapists: a randomized controlled trial.

This study examined whether training can increase the reflective function (RF) of novice therapists about patients with Borderline Personality Disorder (BPD). A total of 48 students in clinical psychology were randomly assigned to mentalization training or didactic training. Their RF regarding patients was assessed with the Therapist Mental Activity Scale (TMAS: Normandin, Ensink, & Maheux, 2012). The RF of trainees assigned to the mentalization training improved significantly, while participants who received traditional didactic training actually became significantly less reflective. These findings show that brief mentalization training can help beginner therapists develop their mentalization capacities with challenging patients.