Meaning in life among Norwegian outpatients with personality disorders: a cross-sectional study

Abstract

Background: Meaning in life (MIL) is associated with positive health outcomes, but is generally low among people suffering from borderline personality disorder (PD). Research has shown that MIL has a buffering effect on depression, as well as borderline traits such as suicidality and self-harm. However, to date, no studies have examined Meaning in Life (MIL) in relation to other prevalent personality disorders such as avoidant PD, nor have they investigated how PD severity influences MIL or whether MIL buffers the impact of PDs on psychosocial functioning.

Methods: Norwegian outpatients (N = 1708) were assessed for PDs in specialized clinics, and measured for meaning in life, symptoms of depression, anxiety and impairment of psychosocial functioning. The data underwent correlational analyses, then grouped into sub-threshold PD, borderline PD, avoidant PD and dual PD (satisfying criteria for both) and tested for mean differences in MIL. Mean differences in MIL were explored across different levels of psychosocial functioning impairment. Finally, a moderation analysis tested whether MIL would buffer the effect that symptoms of depression had on impairment of psychosocial functioning.

Results: As expected, correlational analyses showed a negative relationship between MIL and symptoms of ill mental health. A community sample demonstrated the highest MIL, followed by the sub-threshold PDs, the single PDs (either borderline or avoidant), and the Dual PDs with the lowest MIL. Impairment in psychosocial functioning showed significant differences between each level of impairment (low, moderate, severe), with varying results between the PD-groups across these levels. The moderation analysis only showed a buffering effect for the sub-threshold PDs, and not for any other group who received a diagnosis of PD.

Conclusion: Having a PD is associated with a severe detriment to the level of MIL. There is no apparent difference in mean MIL between the two most prevalent types of PDs in healthcare (borderline and avoidant PDs). However, the current findings indicate that severity results in different levels of MIL, thus lending support to the dimensional perspective of personality disorder.

Keywords: Meaning in life; avoidant personality disorder; borderline personality disorder; dimensional model of personality disorders; dual personality disorder; personality disorder; psychosocial functioning; severity of personality disorder.