Dissociative and Hallucination as Main Symptoms of Borderline Personality Disorders: A Case report

Authors

  • Aaliyah Yusmadewi Universitas Nahdlatul Ulama Surabaya
  • Ahmad Misbahul Ulum Fatwa Universitas Nahdlatul Ulama Surabaya
  • Isna Meirilla Zahara Al Makka Universitas Nahdlatul Ulama Surabaya
  • Illa Billah Universitas Nahdlatul Ulama Surabaya
  • Muhammad Istio Hadi Al Imron Universitas Nahdlatul Ulama Surabaya
  • Ariyani Sri Suwarti Rumah Sakit Radjiman Wedyodiningrat Lawang
  • Hafid Algristian Universitas Nahdlatul Ulama Surabaya

DOI:

https://doi.org/10.61978/psychosocia.v3i2.759

Keywords:

Borderline Personality Disorders, Dissociation, Auditory hallucinations

Abstract

Borderline Personality Disorder (BPD) is a complex psychiatric condition often accompanied by dissociative symptoms and hallucinations. These symptoms are not merely comorbid features but appear to be integral aspects of the disorder's pathology. This case report presents a 20-year-old female patient with a history of childhood trauma and persistent emotional distress, who exhibited dissociation and auditory hallucinations as primary clinical features. Approximately 75–80% of individuals with BPD experience dissociation, while 30–50% report hallucinations, particularly under emotional stress. In this case, dissociative states such as depersonalization and amnesia preceded hallucinatory experiences, suggesting a causal link. The patient demonstrated episodes of memory loss, out-of-conscious behavior, and auditory command hallucinations, which significantly impaired her functioning. These symptoms were exacerbated by academic pressure and unresolved trauma. The interplay between dissociation and hallucination highlights the importance of trauma-informed, emotion-regulation-focused interventions. Clinicians should assess these symptoms systematically, as their presence may indicate a more severe clinical profile and the need for integrative therapeutic strategies.

References

Alfieri, P., Pieri, M., Bellina, M., & Maffei, C. (2024). Dissociation in borderline personality disorder: Clinical features and treatment implications. Frontiers in Psychology, 15, 1251189. https://doi.org/10.3389/fpsyg.2024.1251189

Al-Shamali, A., Raju, A., & Singh, S. (2022). Dissociation in borderline personality disorder: A review of prevalence, mechanisms, and therapeutic challenges. Journal of Psychiatric Research, 151, 201–210. https://doi.org/10.1016/j.jpsychires.2022.05.014 DOI: https://doi.org/10.1016/j.jpsychires.2022.05.014

Association, A. P. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev). American Psychiatric Publishing.

Association, W. M. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 DOI: https://doi.org/10.1001/jama.2013.281053

Barnicot, K., & Crawford, M. (2019). Dialectical behaviour therapy: Implementation and effectiveness. The British Journal of Psychiatry, 214(3), 135–137. https://doi.org/10.1192/bjp.2018.298 DOI: https://doi.org/10.1192/bjp.2018.298

Barnow, S., & Arens, E. A. (2020). Borderline personality disorder and childhood trauma: Evidence for a causal link. Current Psychiatry Reports, 22(3), 20. https://doi.org/10.1007/s11920-020-1147-5

Bateman, A., & Fonagy, P. (2019). Handbook of mentalizing in mental health practice (2nd ed.). American Psychiatric Publishing. https://doi.org/10.1017/9781108653111 DOI: https://doi.org/10.1176/appi.books.9781615379019

Celban, P., & Nowacki, A. (2024). Dissociation and hallucinations in borderline personality disorder: Toward an integrative psychopathology. Psychopathology, 57(1), 33–45. https://doi.org/10.1159/000534567 DOI: https://doi.org/10.1159/000534567

Chapman, A. L., Walters, K. N., & Dixon-Gordon, K. L. (2022). Emotion dysregulation in borderline personality disorder. Annual Review of Clinical Psychology, 18, 321–348. https://doi.org/10.1146/annurev-clinpsy-072720-012228

Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2019). A biosocial developmental model of borderline personality: Elaborating and extending Linehan’s theory. Psychological Bulletin, 145(8), 834–856. https://doi.org/10.1037/bul0000190 DOI: https://doi.org/10.1037/bul0000190

Faisal, A., Mullick, M., & Karim, R. (2022). Suicidality in borderline personality disorder: Clinical correlates and risk predictors. Asian Journal of Psychiatry, 68, 102951. https://doi.org/10.1016/j.ajp.2021.102951 DOI: https://doi.org/10.1016/j.ajp.2021.102951

First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer, R. L. (2016). Structured clinical interview for DSM-5 personality disorders (SCID-5-PD. American Psychiatric Publishing.

Gunderson, J. G., & Links, P. S. (2020). Borderline personality disorder: A clinical guide (3rd ed.). American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9781615371373

Krause-Utz, A., Frost, R., Winter, D., & Elzinga, B. M. (2017). Dissociation and amygdala hyperresponsivity in borderline personality disorder. European Archives of Psychiatry and Clinical Neuroscience, 267(5), 381–393. https://doi.org/10.1007/s00406-016-0731-8

Krause-Utz, A., Vogels, L., Lobbestael, J., & Elzinga, B. M. (2021). Neural correlates of dissociation in borderline personality disorder. Frontiers in Psychiatry, 12, 640983. https://doi.org/10.3389/fpsyt.2021.640983

Linehan, M. M. (2014). DBT skills training manual (2nd ed.). Guilford Press.

McCutcheon, R. A., Marques, T. R., & Howes, O. D. (2020). Schizophrenia: An overview and considerations for treatment. The Lancet Psychiatry, 7(1), 63–77. https://doi.org/10.1016/S2215-0366(19)30417-2 DOI: https://doi.org/10.1001/jamapsychiatry.2019.3360

Meares, R. (2020). The role of trauma and dissociation in borderline personality disorder: A conceptual analysis. Psychopathology, 53(2), 65–73. https://doi.org/10.1159/000504224 DOI: https://doi.org/10.1159/000504224

Minarikova, E., Hasto, J., & Prasko, J. (2022). Psychotic-like symptoms in borderline personality disorder: A systematic review. Frontiers in Psychiatry, 13, 842796. https://doi.org/10.3389/fpsyt.2022.842796

Niemantsverdriet, M. B., Slotema, C. W., Blom, J. D., Franken, I. H., & Gaag, M. (2022). Hallucinations in borderline personality disorder: Phenomenology and treatment perspectives. Schizophrenia Bulletin, 48(6), 1301–1311. https://doi.org/10.1093/schbul/sbac029 DOI: https://doi.org/10.1093/schbul/sbac029

Paris, J. (2020). Is borderline personality disorder a valid diagnosis? Yes. Canadian Journal of Psychiatry, 65(1), 5–7. https://doi.org/10.1177/0706743719878696

Ross, C. A., Heber, S., Norton, G. R., & Anderson, G. (1989). The Dissociative Disorders Interview Schedule: A structured interview. Dissociation, 2(3), 169–189.

Schulze, L., Schmahl, C., & Niedtfeld, I. (2016). Neural correlates of disturbed emotion processing in borderline personality disorder: A multimodal meta-analysis. Biological Psychiatry, 79(2), 97–106. https://doi.org/10.1016/j.biopsych.2015.03.027 DOI: https://doi.org/10.1016/j.biopsych.2015.03.027

Sharp, C., & Wall, K. (2021). Personality pathology grows up: Adolescence as a sensitive period. Current Opinion in Psychology, 37, 125–130. https://doi.org/10.1016/j.copsyc.2020.12.006 DOI: https://doi.org/10.1016/j.copsyc.2020.12.006

Slotema, C. W., Daalman, K., Blom, J. D., Diederen, K. M., Hoek, H. W., & Sommer, I. E. (2018). Auditory verbal hallucinations in patients with borderline personality disorder are similar to those in schizophrenia. Psychological Medicine, 48(2), 251–258. https://doi.org/10.1017/S0033291717001688

Stoffers-Winterling, J. M., Storebø, O. J., & Lieb, K. (2020). Pharmacotherapy for borderline personality disorder: An update of published, unpublished and ongoing studies. Current Psychiatry Reports, 22(7), 33. https://doi.org/10.1007/s11920-020-01170-8 DOI: https://doi.org/10.1007/s11920-020-01164-1

Yen, S., & Gagnon, K. (2022). Suicidality in borderline personality disorder: Risk factors and clinical management. Harvard Review of Psychiatry, 30(2), 139–151. https://doi.org/10.1097/HRP.0000000000000316 DOI: https://doi.org/10.1097/HRP.0000000000000316

Zanarini, M. C. (2020). Childhood adversity and the course of borderline personality disorder. Journal of Personality Disorders, 34(5), 653–670. https://doi.org/10.1521/pedi_2020_34_475 DOI: https://doi.org/10.1521/pedi_2020_34_475

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Published

2025-04-30

How to Cite

Yusmadewi, A., Fatwa, A. M. U., Makka, I. M. Z. A., Billah, I., Imron, M. I. H. A., Suwarti, A. S., & Algristian, H. (2025). Dissociative and Hallucination as Main Symptoms of Borderline Personality Disorders: A Case report. Psychosocia : Journal of Applied Psychology and Social Psychology, 3(2), 90–101. https://doi.org/10.61978/psychosocia.v3i2.759

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