Identity integration and ego pathology in disturbed adolescents

Utilizing the Rorschach and the Wechsler, groups of borderline adolescents (n = 26) and adolescents with other personality disorders (n = 26) were compared to determine whether there were differences in magnitude and type of disturbances in ego functioning. The specific aspects of ego functioning that were studied included disturbances in identity integration, reliance on primitive defensive operations, vulnerability to regressive thinking, and lapses in reality appreciation. Results indicated that during adolescence the borderline personality represents a more severe form of character pathology than other personality disorders, as revealed by more disturbances in identity integration, a greater regression to primary-process thinking in unstructured settings, and more frequent lapses in reality testing. This contrast was most striking in the area of identity integration, where identity disturbances tended to be associated with lapses in reality testing in borderline adolescents, while there was essentially no relationship between these two indicators of ego pathology in non-borderline adolescents. This supports the notion that disturbances in identity integration, or the sense of self, form an important part of the borderline diagnosis, even during adolescence.