A Prospective Study of Life Stress, Defenses, Psychotic Symptoms, and Depression in Borderline and Antisocial Personality Disorders and Bipolar Type II Affective Disorder

In a prospective study, borderline (BPD) but not antisocial (ASP) personality or bipoTFtype II correlated with the presence of psychotic or psychotic over a 1–year follow–up period. Psychotic symptoms were not associated with stressful life events but wenfössociated with the use of borderline defenses (splitting, projective identification) in coping with life events. Both BPD and ASP had high rates of depression recurrences, whereas concurrent ASP and BPD had significantly lower rates than expected. Self–rated estimates of stress for the year's life events generally correlated with higher annualized recurrence rates. The use of both borderline and action defenses (passive–aggression, acting out, hypochondriasis) in coping with life events correlated with higher depression rates.