Author:

Abstract:

Autobiographical memory (AM), “the aspect of memory that is concerned with the recollection of personally experienced past events” (Williams et al., 2007, p. 122), is believed to play an important role in the construction and maintenance of one’s self-concept. Compared to controls, patients with major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) have repeatedly found to show reduced memory specificity (‘overgeneral memory’, OGM). This is generally measured with a word cueing task, inviting participants to recall specific memories in response to cues, such as happy, or lazy. The aforementioned patients tend to retrieve categories of events, rather than memories that refer to a single episode. Furthermore, these patients tend to more often adopt a third-person (observer) perspective during voluntary recall. It has been suggested that OGM and observer memories dampen the emotional arousal evoked by painful memories, thereby preventing one’s self-concept to destabilise. However, in the longer term, in has been shown that both strategies increase one’s vulnerability for future complaints. Also, both strategies have found to be associated with rumination or comparison-driven processes, and OGM is found to correlate with reduced executive functioning. Borderline personality disorder (BPD) is a common mental illness with high clinical burden. Although BPD patients often have co-morbid PTSD and MDD, findings on OGM are not fully replicated in these patients. The first aim of this thesis, therefore, was to get a clearer view on the associations between OGM and (co-morbid MDD and PTSD in) BPD. The second aim was to broaden the current knowledge on vantage point during recall, which, to our knowledge, has never been studied in BPD patients. Recent findings suggest that cues that are highly discrepant towards one’s current self-concept increase the likelihood of retrieving OGMs. The third aim was to further investigate the association between self-discrepancy on the one hand, and OGM and vantage point during recall on the other hand, both in relation to BPD (features). After briefly situating our research aims (Chapter 1), we present an overview of the literature on OGM in BPD patients (Chapter 2). Our findings suggest that both depressed and traumatic state in BPD patients are unrelated to OGM (Chapters 3 and 4). Yet, OGM in BPD is predictive for depression symptom severity and trauma symptom severity at six-month follow-up (Chapter 6), and we found a negative correlation between OGM and the variety of non-suicidal self-injurious methods used (Chapter 7). Therefore, we suggest that BPD patients, as depressed and traumatised patients, may benefit from therapeutic strategies aimed at increasing memory specificity. With respect to vantage perspective, we found that (a) depressed state in BPD is unrelated to the proportion of observer memories retrieved; and (b) that BPD patients with PTSD more often adopt an observer perspective, also when retrieving non-traumatic memories (observer memory retrieval style; Chapter 4). In a non-clinical sample, we found that higher levels of observer memories (following high discrepant cues) were associated with more interpersonal and anxious-neurotic BPD complaints (Chapter 5). Finally, we developed two methods to study the impact of self-discrepancy on the AM characteristics of interest. Using novel indices, we found that self-discrepancy was negatively associated with memory specificity in depressed BPD patients (Chapter 3). However, using self-discrepant cues, we failed to replicate these findings. Also, prompting self-discrepancy had no effect on the vantage point used during recall (Chapter 4). We conclude that the current theories on AM organisation seem to apply insufficiently to BPD. We consider how the patterns observed in BPD patients with respect to OGM and vantage point during recall may be explained by emotional dysregulation and identity disturbance, both characteristic for BPD, and we reflect on the validity of the methods used to investigate the role of self-discrepancy. Finally, clinical implications and directions for future research are discussed (Chapter 8).