Identity disturbance in borderline personality disorder: A scoping review

Borderline personality disorder (BPD) is a complex mental health condition marked by instability in interpersonal relationships, affective dysregulation, and impulse control. A key aspect of BPD involves identity disturbance, defined by a persistently unstable self-image and sense of self. This scoping review aimed to synthesize the existing literature concerning identity disturbance in BPD, its types, and measurement methods.

Scoping review.

Search was performed in PubMed, PsycINFO, Scopus, and Web of Science Core Collection, supplemented by Google Scholar for grey literature. The search terms were adapted for every database. No restrictions on publication years were set.

The review identified 67 eligible studies, including 45 empirical works with participants with BPD. Instruments used most often were the SCID-II for Personality Disorders and the Identity Disturbance Questionnaire. Erikson's theories dominated conceptualizations of identity. The DSM-5 was the most frequently cited source for its definition of identity disturbance, with emphasis on instability in self-image, values, and interpersonal relationships. Types of identity disturbance were often described through Wilkinson-Ryan and Westen's four factor model and other multidimensional or developmental models. These models accentuate disruptions in self-coherence, stability, and continuity that impair sense of identity, goal-directed functioning, and affect regulation.

This scoping review highlights identity disturbance as a multifaceted yet central construct in BPD, characterized by diverse conceptualizations, assessment approaches, and types that reflect its developmental, relational, and psychopathological impact. Future research should aim to integrate theoretical perspectives and refine measurement tools to enhance conceptual clarity, clinical assessment, and intervention strategies.