How the stories we tell about ourselves reveal hidden personality disorders

How people construct the stories of their lives offers insight into the severity of their personality disorders. Researchers found that narrating life events with a focus on negative self-change strongly predicted everyday functional impairment. The findings were published in the Journal of Personality.

Psychiatry is currently shifting the way it diagnoses personality disorders. Instead of relying entirely on rigid categories where a patient either has a disorder or does not, newer frameworks use a sliding scale. This dimensional approach focuses on a concept known as the level of personality functioning. It assesses how well a person maintains their identity, sets life goals, and connects with others through empathy and intimacy.

Because identity is heavily shaped by the stories people tell themselves about their past, researchers wanted to see if analyzing these personal narratives could help measure personality functioning. Lead author Kennedy M. Balzen, a psychology researcher at the University of Houston, worked with colleagues Majse Lind, Paulina A. Kulesz, Estefania Fernandez, and Carla Sharp. The team aimed to determine if specific emotional and structural themes in a person’s life story could predict their degree of clinical dysfunction.

The researchers recruited 140 young adults between the ages of 18 and 25. The group included 94 college students and 46 individuals who had either been diagnosed with borderline personality disorder or showed traits of the condition. Borderline personality disorder is characterized by unstable relationships, emotional volatility, and a distorted self-image.

Participants completed an interview where they imagined their lives as a book and described two life-changing events in detail. Trained coders then evaluated these spoken stories for five specific psychological themes. The first theme was agency, which measures how much autonomy and control the narrator feels they have over their life.

The second theme was communion, which tracks feelings of love, belonging, and interpersonal connection. The coders also looked for a trait called exploratory processing. This metric captures how deeply the person analyzed an event’s meaning and worked through their changing sense of self.

Finally, the coders assessed the narratives for growth and deterioration. These two themes measure whether the narrator concluded that the event changed them for the better or revealed a permanent, negative flaw in their character. High deterioration scores suggest the individual believes an event fundamentally damaged them.

Alongside the storytelling interview, participants completed two tools to assess their overall level of personality functioning. The first was a self-report survey where participants rated their own identity and interpersonal struggles. The second was a semi-structured clinical interview conducted by trained graduate students.

This interview format bypasses the biases inherent in self-reported surveys. Participants also took a survey to measure their functional impairment. This assessment tracks a person’s level of disability in daily tasks like cognition, mobility, self-care, and getting along with others.

When comparing the narrative themes to the personality assessments, the researchers observed a distinct pattern. People who exhibited worse personality functioning tended to tell stories with lower levels of agency, communion, and personal growth. These individuals also featured higher levels of deterioration in their stories.

To illustrate narrative deterioration, the researchers highlighted a story from a participant who experienced childhood bullying. The participant described the event as a permanent blow to their ego that made them feel like they could never fit in. The participant said, “I felt like that was a result of my own personal faults, or like something that I lacked in,” and noted that the isolation eventually led to self-harm.

Next, the researchers ran statistical models to see which narrative themes best predicted a person’s level of personality functioning. They found that stories featuring high levels of agency predicted better scores on the self-reported personality surveys. Conversely, narratives high in deterioration predicted worse scores on the clinical interviews.

In fact, individuals who told stories with strong themes of deterioration were nearly three times more likely to meet the clinical threshold for a personality disorder. This threshold was based on the rigorous, interview-rated assessment. The finding highlights how different testing methods capture different aspects of a person’s psychology.

The team also tested whether exploratory processing interacted with growth or deterioration to predict personality functioning. They hypothesized that deep reflection on a negative change would yield different results than deep reflection on a positive change. The data did not support this idea, as deterioration remained the only distinct predictor of personality dysfunction in these models.

Finally, the researchers looked at everyday functional impairment. They used a statistical approach to find the most efficient combination of variables to predict a person’s daily struggles. They found that combining narrative deterioration scores with the results from the self-reported and interview-based personality assessments explained the most variance in functional impairment. The inclusion of narrative deterioration provided predictive power that the standard clinical tools missed.

The study relied on participants self-reporting their borderline personality disorder diagnoses or symptoms, which means some individuals might not have met formal clinical criteria. The tool used to measure functional impairment also captures general life disability, which is not exclusively tied to mental health challenges. Future studies will need to use outcome measures that are directly linked to psychiatric symptoms.

Another limitation involves the coding system used for exploratory processing. The coders had lower reliability when agreeing on this specific metric, which might explain why it did not predict personality functioning in the statistical models. The researchers noted that narrative coding systems were originally designed for typical populations and might need adjustment to fully capture disordered thinking.

It is possible that people with personality disorders simply experience more traumatic life events, which would naturally lead to darker life stories. However, psychological theory suggests the distinction lies in how a person derives meaning from difficult experiences and integrates that meaning into their identity. Still, subsequent studies should account for a person’s history of trauma and abuse to isolate the exact impact of life events on storytelling.

The study, “Life Stories Matter: The Contribution of Narrative Identity to Personality Functioning and Functional Impairment,” was authored by Kennedy M. Balzen, Majse Lind, Paulina A. Kulesz, Estefania Fernandez, and Carla Sharp.