The Facilitating Role of Borderline Personality Disorder and the Inhibiting Role of Mindfulness in Adolescents’ Tendency to Addiction

Soghra Akbari Chermahini¹, ‎Marzieh Sadat Sajadinezhad², Mahdiyeh Shafietabar²

¹Assistant professor, PhD in Cognitive Psychology, Psychology Department, Arak ‎University, Arak, Iran

²Assistant professor, PhD in Psychology, Psychology Department, Arak ‎University, Arak, Iran

Submitted: 23 December 2017

Accepted: 12 March 2018

Int J Behav Sci. 2017; 11(4): 160-165

Corresponding Author:

Soghra Akbari Chermahini,

Assistant professor,

PhD in Cognitive Psychology,

Psychology Department,

Arak ‎University,

Arak,

Iran

E-mail: akbariso@yahoo.com

Abstract

Introduction

Adolescence is the period of experiencing and personal choices. In the process of gaining independence, adolescence fantasize is believed to be an immunity system against dangers. This makes adolescents not to be afraid of making high-risk decisions. Therefore, the adolescents become vulnerable against many high-risk behaviors including drug use, unhealthy sexual behaviors, and drinking alcohol [1]. Of course, in spite of the vulnerability of adolescents to high-risk behaviors, not everyone experiences such behaviors. Meanwhile, some factors play the role of facilitators and some as inhibitors. Among the facilitators, for example, are the tendencies of a person to addiction. The beliefs and attitudes of people about drugs and its negative/positive consequences are defined as the "tendency to drug use" [2]. These tendencies are of two types in social psychology: cognitive and emotional. The former deals with the intellectual traits such as intelligence, thought, and verbal  

comprehension, and the latter with the personality traits such as attitudes, preferences, and needs [1]. As far as addiction is concerned, the Tendency Theory states that some people are susceptible to addiction, that is, if they are exposed to drugs, they become addicted, otherwise, they would not [3, 4].

There are three categories of theories about the causes of addiction. The first group believes that as drugs are easily available, people turn to it. The second category believes that social crises and disorders are the cause of tendency to addiction. Finally, the third category focuses on the psychological potentials [5]. However, some individuals with particular personality traits are more susceptible to addiction than others. Studies have identified various psychological features, including the use of emotionally avoidant coping strategies [6], poor emotional self-regulation [7], poor social skills [8], poor functioning of the family [9] and impulsivity and aggression [10]. These features, altogether, can cause a personality disorder called the borderline personality disorder.

The borderline personality disorder is a disturbance in the B-cluster of the personality disorders and is the most common personality disorder in psychiatrics. The main features of this disorder are an overwhelming pattern of instability in interpersonal relationships, self-depiction, emotions and apparent impulsivity, confusion of identity, emotional instability, chronic feeling of absurdity, fatigue, and self-harm. Impulsivity is the tendency and potential to express quick and unpredictable responses to internal or external stimuli, regardless of their negative consequences [11]. Impulsive behavior, in many cases, leads to high-risk behaviors such as gambling, spending money with no regard, overeating, substance abuse, sexual behaviors or high-risk driving [12]. Studies suggest that the borderline personality disorder has about 67% correlation with substance abuse [11, 10, 13].

The demand for drug is one of the apparent features of the borderline personality disorder [14]. The results of Jazayeri, et al.'s study [15] on addicted men indicated that the traits related to the borderline personality disorder among addicts were significantly more prevalent than the control group. The study also showed that the main aspect of the individuals’ personality disorder depends on their personality traits before being addicted.

Besides the facilitators, some factors also act as inhibitors against addiction. Some of them are mental health, negative attitude towards drug use [17], social support and coping strategies [18], tolerance [6], and mindfulness. However, mindfulness, among these, has been studied less. According to Baer (2003), mindfulness is “the nonjudgmental observation of the ongoing stream of internal and external stimuli as they arise” (p. 125). Mindfulness is a skill that allows individuals to perceive incidents as being less depressing than what they really are in the actual situation. Mindfulness plays an important role in inhibition against addiction by reinforcing factors such as effective coping strategies against emotional turmoil and momentum addiction [20], effective coping strategies against temptation of visual clues [21], and the acceptance of thoughts instead of suppressing them [22]. Accordingly, the results of several studies [23, 19, 24, 25, 26, 27] suggest that using interventions such as the training of mindfulness skill can be effective in reducing the symptoms of addiction. Therefore, it seems that the role of mindfulness can be considered as an inhibitor in the tendency to addiction. As the tendency to addiction appears more common in adolescence and early adulthood [16], the study of traits affecting addiction have always been of interest to researchers. Therefore, this study aims to investigate the relationship between the borderline personality disorder as a facilitator and mindfulness as an inhibitor in the adolescents’ tendency to addiction.

Methods

This study used a correlational and cross-sectional method. Among the undergraduate university students of Arak University (first year university students at the age of 20), 579 participants (350 women and 229 men) with a mean age of 19.2 (SD = 0.5) were selected using the purposeful sampling method. Since the aim of the study was to examine the relationship among variables in adolescents, the participants’ age was an important variable. Therefore, the participants were asked to complete a set of questionnaires. After a brief overview of the topic of the study, the participants completed the questionnaires in groups. The approximate time to complete the questionnaires was 30 minutes, and the participants were free to end their contribution at any stage of the research.

An oral informed consent was obtained from all participants included in the study. The protocol was approved by the local ethical committee (Arak University-Iran).   

The research questionnaires which were administered to the participants were as follows:

Iranian Addiction Potential Scale:  The Addiction Potential Scale was designed by Weed Butcher (1992). There have been many attempts to determine its validity in Iran. The questionnaire used in this study, is an Iranian version of the Addiction Potential Scale which is designed by Zargar (2006) regarding the psychological and social conditions of the Iranian society. It consists of two factors. It has 36 items as well as 5 lie detector items. In the first factor (the active addiction potential), the highest proportions are attributed to antisocial behavior, desire to use drugs, positive attitude to drugs, and excitement. In the second factor (the passive addiction potential), the highest proportions are attributed to the lack of self-expression and depression. The scoring procedure of each item was based on a continuum from zero (totally disagree) to 3 (totally agree). In order to assess the validity of this scale, two methods were employed. As far as the criterion validity is concerned, the addiction potential questionnaire well-differentiated both the addicted and non-addicted groups. The validity of the scale structure was assessed by correlating it with the 25-item Scale of Clinical Symptom Scale (SCL-25) 0.45, which was significant at a level less than 0.001. The reliability of the scale was assessed using Cronbach's alpha 0.9, which is optimal (28). The Cronbach's alpha value for the first factor (the active addiction potential) is 0.89, and for the second factor (the passive addiction potential) is 0.76 (29). According to the Cronbach’s alpha method in this study, the reliability of the total scale was 0.94, and it was 0.95 and 0.81 for the active and passive factors respectively.

Five-Facet Mindfulness Questionnaire: This instrument is a 39-item questionnaire using a self-report assessment method developed by Baer, Smith, Hopkins, Krietemeyer, and Tony (2006). It is developed by combining several independent mindfulness questionnaires such as: The Kentucky Inventory of Mindfulness Scale (30), the Mindful Attention Awareness Scale (31), the Freiburg Mindfulness Inventory (32), the Cognitive and Affective Mindfulness Scale-Revised (33), and the Southampton Mindfulness Questionnaire (34), based on the factor analytic approach. The analysis reveal five factors indicating different aspects of mindfulness. These factors are observation, description, acting with awareness, non-judgment of the inner experience, and non-reactivity to the inner experience. The responses were pre-coded from 1 to 5 based on a Likert’s five-point scale. Based on the results, the consistency of the factors was acceptable and the alpha coefficient ranged from 0.75 to 0.91. The correlation between the factors was moderate, and in all cases, it was significant and ranged from 0.15 to 0.34 (Neuser, 2010). Moreover, in a study on the validity and reliability of this questionnaire in Iran, the correlation coefficients of the test-retest of the above-mentioned questionnaire in the Iranian version was between 57.0 and 84.0. The alpha coefficients were also obtained at an acceptable level of 0.55 to 0.83 (35).

Borderline Personality Scale: The borderline personality scale is a part of the Schizotypal Trait Questionnaire. This questionnaire was developed by Claridge and Broks (1984) at Oxford University and then was revised by Rawlings, Claridge and Freeman (2001). Mohammadzadeh and Rezaee [36], using the edited version of this test according to the criteria of DSM-IV-TR, in addition to the 18 primary items, added another 6 items to cover the diagnostic criteria of the disorder. Thus, the borderline personality scale, used in this study, had 24 items which requires a Yes/No response. This scale measures three traits of hopelessness, impulsivity, and stress-related dissociative and paranoid symptoms. Rawlings et al. (2001) reported an alpha of 80% for the borderline personality scale. The concurrent validity of the borderline personality scale with neuroticism and psychoticism scales of Eysenck personality questionnaire in its original culture was reported to be 0.64 and 0.44, respectively. The coefficient of the test-retest reliability of the total borderline personality scale in the Iranian society was 0.84, and for the subscales of hopelessness, impulsivity, and stress-related dissociative and paranoid symptoms were reported to be 0.53, 0.72 and 0.50, respectively. Also, the alpha coefficient of the total scale was 0.77, and for the subscales of hopelessness, impulsivity, and stress-related dissociative and paranoid symptoms were 0.64, 0.58 and 0.57, respectively [36].

Results

The data analysis was performed using the scores obtained from the completed questionnaires of all the members of the groups participating in the study. In the first step, in addition to computing the mean and standard deviation of the variables under investigation, the correlation between the variables was also calculated. The results are presented in Table 1.

The results of the Pearson correlation coefficients in Table 1 indicate that there is a significant positive correlation between the borderline personality trait and tendency to addiction in the adolescents participating in this study, as well as, the active and passive addiction potential subscales. Moreover, the variable of mindfulness has a significant negative correlation with the passive addiction potential. However, there is no significant correlation between mindfulness and the active addiction potential and the total score of tendency to addiction.

The stepwise multiple regression analysis was employed in order to determine the relationship among variables more accurately and to also identify the contribution of each variable under investigation to explain the tendency to addiction. In this analysis, the borderline personality was fed as the only predictor variable in the regression equation. The results presented in Table 2 indicate that 31% of the variance of tendency to addiction is explained by the borderline personality variable. In fact, as the students’ borderline personality scores increase, their tendency to addiction will increase too. Thus, the variable of mindfulness did not play a significant role in explaining the tendency to addiction and therefore, it was not presented in the regression analysis results.

Table 1. Descriptive statistics (Mean and Standard Deviation) and Pearson correlation coefficients among variables

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Table 2. Results of multiple regressions of total score of addiction potential on borderline personality trait

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Table 3 shows the results of the stepwise regression analysis for multiple relationships among the predictive variables with the active addiction potential subscale. The borderline personality was considered as the only predictor variable in the regression equation. The results presented in Table 4 indicate that 23% of the variance of the active addiction potential is explained by the borderline personality variable. The variable of mindfulness did not indicate a significant role in explaining the tendency to addiction, and therefore, it was not available in the regression analysis results.

Table 4 shows the results of the stepwise regression analysis for multiple relationships among the predictive variables with the passive addiction potential subscale. In the first step, the borderline personality was considered as the only predictor variable in the regression equation. The results presented in Table 4 indicate that 28 % of the variance of the passive addiction potential is explained by the borderline personality variable. Moreover, the borderline personality and mindfulness together can explain 30 % of the variance of the passive addiction potential. In other words, 30 % of the variance in the passive addiction potential among adolescents is attributed to the borderline personality and mindfulness. The value of beta coefficient (β = 0.826) indicate that as the score of the borderline personality scale increases, the passive addiction potential increases too. As far as mindfulness is concerned, beta coefficient (β = 0.084) is negatively significant. In other words, as the value of mindfulness increases, the passive addiction potential decreases among adolescents.

Table3. Results of multiple regressions of active addiction potential subscales on borderline personality trait

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Table 4. Results of multiple regressions of passive addiction potential subscales on borderline personality trait and mindfulness

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