The Course of Positive Affective and Cognitive States in Borderline Personality Disorder: A 10-year Follow-up Study.

This study had two aims. The first was to identify and define the course of positive affective and cognitive states present in borderline personality disorder (BPD) and compare them to those of comparison subjects with other personality disorders. The second was to compare the positive affective and cognitive states of borderline patients who recovered from BPD to those who did not. Two hundred ninety patients with BPD and 72 non-borderline axis II subjects (OPD) completed the Positive Affect Scale (PAS), a 50-item self-report measure designed to assess positive states thought to be common among and characteristic of BPD over a 10-year course of prospective follow-up. Affective, cognitive, and mixed PAS items were separately analyzed, based on respective subscores. Borderline patients reported positive affective, cognitive, and mixed states less frequently than OPD subjects. Additionally, affective, and cognitive subscores increased significantly for both groups taken together over 10-years of follow-up though at greater rates among borderline patients. Mixed subscores showed a significant increase over time and at similar rates for both groups. Within the BPD group, recovered patients reported more positive affective, cognitive, and mixed states compared to non-recovered patients. Results also showed a significant increase in affective and cognitive states at similar rates for both groups taken together over 10-years of follow-up. Mixed subscores also showed a significant increase for both groups taken over time, though at greater rates among recovered borderline patients. Taken together, these results suggest a characteristic profile of positive states within borderline patients that is far lower than those reported by axis II comparison subjects. They also suggest that this characteristic profile is predictive of recovery of BPD over time.