TRANSITIONAL OBJECTS AND BORDERLINE PERSONALITY-DISORDER

Objective: The relationship of possession of transitional objects to t he borderline personality disorder diagnosis was explored in a psychia tric inpatient setting. It was hypothesized that a greater proportion of inpatients who bring objects of special meaning with them to the ho spital have borderline personality disorder. Method: Psychiatric inpat ients (N=146) were administered a semistructured interview to determin e the presence of special (i.e., transitional) objects in the hospital , at home, or during childhood. Borderline personality disorder was de termined by criteria on a DSM-III-R borderline personality disorder ch ecklist and by DSM-III-A discharge diagnosis. Results: Significantly m ore patients who endorsed having transitional objects in the hospital or at home had the diagnosis of borderline personality disorder. Sensi tivity, specificity, positive predictive power, and negative predictiv e power of the possession of the transitional object for the borderlin e personality disorder diagnosis were calculated. Specificity was high er than sensitivity, and negative predictive power was higher than pos itive predictive power in each instance. While these results suggest t hat absence of a transitional object is more likely to be associated w ith absence of borderline personality disorder than the presence of a transitional object is with the presence of borderline personality dis order, the sensitivity of a transitional object during adulthood to pr edict a diagnosis of borderline personality disorder was 63%, and the positive predictive power was 45%. Conclusions: A transitional object brought to the hospital may help remind the inpatient with borderline personality disorder of home or provide soothing during separation fro m home. The persistence of transitional objects into adulthood may inf orm the therapist of possible transference paradigms that may develop in treatment.