Skip to main content

Perceived social support as related to social wellbeing in patients with Emotionally Unstable Personality Disorder (EUPD)

Abstract

Background

People diagnosed with EUPD also known as borderline personality disorder (BPD) experience different challenges in their lives. These challenges include compulsive behavior, irritability, depression, sadness, guilt, shame, loneliness, grandiosity, and feeling of worthlessness. It is noteworthy that such challenges trigger among them a self-destructive behaviour, in addition to social isolation, and impaired social relationships. It is also found to significantly impact their physical, mental, and social wellbeing. This study is a humble attempt to examine the role of perceived social support in improving the social wellbeing of BPD outpatients. Through the purposive sampling technique, 100 BPD outpatients were selected for the study. The mean age of the participant was 25 years.

Results

It was found that perceived social support (family, friends, and significant others) plays a vital role in the wellbeing of these participants. The correlation between the two is positive as well as statistically significant. This means higher the support these patients experience from their relatives, the better is their social wellbeing.

Conclusions

This study has practical implications for counselors, clinical psychologists, and psychiatrists working in the field.

Background

Borderline personality disorder (BPD) is a diagnostic classification defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [1]. It is a severe psychological illness specified by prevalent instability in a frame of mind, Intelligence Quotient, romantic and social relationships, and self-concept. BPD is defined as uncertainty in an association, mood swings, together with an unpredictable behavior.

Aforementioned instability frequently disturbs family relations, business, and profession, long-term foresight, as well as the particular’s sense of self-identity. Persistent maladjustment in a societal-relations is a key attribute of BPD [2]. This personality disorder has been linked to a higher degree of social disability like disability in psychological functioning, insufficient companionship and affiliation, difficulties in family connections although a drop in symptoms of BPD was connected in ameliorating of psychosocial operating pessimistic unfairness in the processing of social information detected in patients with BPD [3,4,5]. There is research by [6] which put forward that exploitation by companions in teenage enlarge the possibility of developing BPD features in the adolescence.

Studies had suggested that mutual alliance amid disproving parenting behaviours upshots in BPD features in the teenage period of an individual [7]. Particulars diagnosed with BPD have conflict in close relations, which could differently deduce robust psychological health well-being [8]. The harmful consequences of interpersonal difficulties habitually happening in conditions of attributes of BPD might share to decrease in meaning of life.

Density mentions to the level of interrelatedness amid individuals in the network, as well as it is notion to specify group cohesion [9]. On the other hand, the level of centrality is one of the most ordinal ways for measuring the place of a particular alter within a central to an individual social network. One study has observed that individuals who are experiencing depression tend to be insignificant in social networks although individuals who change to sizeable inseparability tend to afterward too came to be contented [10, 11]. Taking into consideration previously mentioned results, inseparability is expected to be insignificant amid particular diagnosed with BPD, a stigma together with relational complications, namely, acute exasperation and inconsistent connections [12]. Therefore, individuals who are attached to more inseparable figures are expected to practice more optimistic consequences [13].

Perceived social support and BPD

Social support, extracted from ancestries, boon companion and an instructional-groups, which certainly affects wellbeing [14,15,16]. Social support is a multifaceted conception, mentioning support which is social as well as subjective that particulars acquire as accessible to themselves from ancestry, peers, and the individual communal groups [17, 18].

Perceived social support indicates to the opinion that aid would be obtainable when desired [19]. There is a considerable verification that call attention to a character of social support in encouraging mental health with defensive upshots in social support [20,21,22,23,24,25,26]. Greater level of social aid has been appeared to be correlated with ameliorated mental wellbeing [27,28,29,30]. Individuals diagnosed with BPD and had poorer support have more quarrels in their connectivity and less relationships with prime individuals [31].

Social support and social interactions are crucial in adolescent folk for robust personality development [32]. Patients with BPD patients are ordinarily prone to adverse stimuli, have hardships in acknowledging a definite affective wellness in alternatives [4] together with these patients are at lower levels in perceived social support as compared to widespread population. Patients with BPD receive their social connections as more inconsistent and more unsteady as compared to healthy beings [33]. BPD patient’s level of pliability and capacity to manage with complications as well as gloomy emotions may amplify with an increment in perceived social support [34, 35]. Inpatients detected with the BPD address higher rate of rejection sensitivity detected rejection sensitivity to be crucial in individuals through which BPD attributes upshots to lower levels of social support [36].

Robust social supports and connections together with involvement in comforting and counseling, release of the past, and engagement in purposeful pursuits ease recovery, ultimately keeping dysfunctional relationships with members of a family was impairment to recovery [37].

Taking into consideration the contemporary social connections with mothers and fathers, it is detected that youngsters who are evolving with personality disorders are further expected to contact with disputes with their family members all over the transformation to maturation [38]. BPD attributes were also interconnected in boosting pessimistic connections with the mother [38]. Parental aid is a safeguarding element for dissimilar displays of mental illness and particularly in mother-daughter connections definite motherly emotional attitudes and constructive dual emotional attitudes appear to be correlated with minimizing in the female’s BPD seriousness over time [39, 40]. Thus, social support is constantly connected with fine psychological health and social wellbeing [41]. Optimistic communal interactions with members of the family decreases apprehension and advance the feeling of invulnerability and protection [42,43,44]. Individuals with more absolute moral communal connections and higher social support have the advantage of more effective interpersonal skills, and directs them aside from psychological and mental complications [45].

In the modern time, the corroboration has revealed that BPD attributes bestows in teenagers and that the recognition of BPD is as a consequence justified before to teenage [46]. For youngsters, a fundamental standard in the diagnosis of BPD—uncertainty of mutual connections [1]—might be evident not only in romantic relations perceived in person with BPD or in an association standard with ancestry of origin, but in connections with friends. Peer associations in teens and youth, the foundation of optimistic, supportive peer associations marks one of the crucial advancement jobs in teens and youth [47]. Infants and adolescents operate to obtain social competence in beginning and keeping and continuing relationships, cooperating and functioning productively with others, reducing and sorting out a quarrel, and assisting and experiencing aid when required [48]. At the comprehensive level, sufficient social competence is considered in acceptance and incorporation in a peer group. Infancy period complications in building and keeping boon companions is still a retroactive gauge for caregivers of infants who go on to evolve with BPD [49]. There is a corroboration that deficient relationships are ordinary amid adolescents with BPD. The particular intervention was encouraging, through be in need of duplication with a control group incorporated, putting forward that therapy for BPD in youngster might be constructive in ameliorating companion’s relations [50]. Behavioral economic and neuroeconomic approaches to the research of incentive valuation might be relevant to study on youngster BPD, demonstrating intense insights into neural and mental processes which may influence on positive peer associations [51]. One research has spotlighted that character of disintegration of belief and an expected refusal as drivers of defective social consequences while in specific manner as bring about irritation and hostile social communication between adolescent folk diagnosed with personality disorders [52]. The idea that particulars with BPD are tactful to refusal cues and predict social refusal [53].

Social wellbeing and BPD

Wellbeing is the systematized elements of physical, psychological, and social wellbeing which expands away from a conventional definition of health [54]. It is the capacity of an individual to be independent from a desire for primary needs and exist side by side peacefully with the chance for betterment. Therefore, Wellbeing refers to the devoid of pessimistic state and affection, the consequence of adaptation on to a dangerous society. The mental tradition begins wellbeing as the personal appraisal of life by mean of contentment and emotions [55,56,57,58].

Having an existence with a feeling of a meaning that an individual’s existence has worth, importance with motives is a salient feature of wellness [59]. A sense of meaning might have constructive upshots on particular’s wellbeing over the lifetime [60]. Individuals diagnosed with attributes of BPD, frequently fights with a feeling of void together with self-devastating action in 40% and 85% of particulars diagnosed with BPD have numerous suicidal strives [61, 62]. Research has revealed that people diagnosed with BPD have been detected to have lower levels of sense of meaning in mental existence than those who were with alternative mental illness [63]. Researches on the sense of purpose in life has revealed the existence of meaning has the sense of affect (feeling contented and accomplished in life) that individual’s existence is purposeful is strongly connected with personal wellbeing results [64]. Durkheim talked over some aspect social wellbeing and health that are social integration, social cohesion, a sense of belongingness and interdependence, and collective destiny [65]. Keyes put forward feasible aspects of social wellbeing that are social integration, social acceptance, social contribution and social actualization [66].

Social integration refers to the appraisal of the standard of individual association to societal and communal groups. It uses notion of social cohesion, cultural alienation and social isolation and class consciousness [65, 67]. It is the level to which an individual is cordially involved in a span of relations and feeling of belongingness. Cohen contended that social integration has a straight influence on wellbeing by promising the advancement of identity, meaning, self-trust and confidence together with optimistic influence. All these psychological variables are identified as complications amid particulars diagnosed with BPD. Social acceptance refers to other individuals that one, desire to incorporate in their category and connections [68]. Social accepting individuals clasp approving perspectives of person’s nature feeling cosiness with others [69, 70].

Social contribution means appraisal of the individual’s social value. Social contribution considers, to which level, individual sense that anything they carry out in this society is valued by the community and adds up to the nation [66]. Social actualization means assessment of the possibilities and the course of the community [66]. Social coherence denotes the opinion of the standard, firms, and functioning of the communal world it also incorporate a care for the significant about the society [66].

Social network approaches have been employed widely, specifically in analysis of physical health in that enumerators have observed that the attributes of a particular’s social networks have vigorous effects on numerous ailments together with health conditions [71, 72]. In developing a thought, the process of the upshot of social networks on wellbeing, numerous scholars have come up with models which could notify the investigation of the mental influence on social networks in persons with BPD. Thus, researchers have expanded a model in that societal aid, gloomy communications, together with social integration influence wellbeing through mental factors [31, 71]. In Cohen’s model, social aid is elucidated as contributory, enlightening together with affective aid from alternatives deliberated to aid a particular to handle with stress, and is notion to influence social wellbeing and well-being through the techniques of diminishing worry. A gloomy communication, consisting of contending, condemnation, and negative effect, rising stress, which expand danger of ailments and mental problems.

Attachment theory constitutes one more description of the role of close friendships and the particular’s portrayals of those friendships and relations could impact stress, coping and psychological wellbeing. Scholars identified a strong attachment with one more as looking for closeness to the individual during worry, feeling impatient and apprehension concerning serious separation, being able to employ the individual as a protected base to repay to when anxious together with concerning the individual as an asylum with whom to analyze complications [73]. Accommodating psychological models of togetherness others as sympathetic, reliable, accessible, and cooperative have been vigorously correlated with optimistic psychological fitness and wellbeing upshots [74]. Scholars and enumerators have steadily attributed BPD as an acute attachment disruption [75]. Problems in close relations, BPD symptoms are connected with struggling and sustaining a robust attachment in other individuals who are in their network [31]. This study is an attempt to examine the relationship of perceived social support with social wellbeing among the BPD outpatients.

Methods

Tools used

Perceived social support

Multifaceted scale of perceived social support developed by [18] was employed to compute the perceived social support among the BPD outpatients. This scale comprises of 12-item along with three dimensions with 7-point response format ranging from (1 = very strongly disagree to 7 = very strongly agree). Through this scale, we assess the level of support from the family, peers, and a significant alternative. Range of score is between 4 and 28. The higher score in each of these scales indicates the higher quality of perceived social support and vice versa. The scale showed good internal reliability.

Social wellbeing scale

The short form of social well-being questionnaire developed by [66] was used to measure social well-being among the patients. This scale contains of 15 items with 5 dimensions with seven-point rating scale ranging from strongly disagree to strongly agree. Participants responded to these questions using options ranging from (1 = strongly disagree to 7 = strongly agree). Pessimistic items were reversely encrypted prior to the analysis. The social well-being dimensions comprise of social integration, social coherence, social acceptance, social contribution, and social actualization. The original reliability as reported by the author of the scale was 0.84 whereas, the calculated reliability of the respective dimensions varied from 0.54 to 0.62.

McLean screening instrument for BPD (MSI-BPD)

The 10-item MSI-BPD developed by [76] was used to assess the BPD patients. A score of 7 or higher on this scale indicates that the person meets the diagnostic criteria of borderline personality disorder.

Procedure

For the data collection, participants from the Department of Psychiatry, Jawaharlal Nehru Medical College, Aligarh Muslim University-Uttar Pradesh, India, were contacted. As accessibility of the pure BPD patients is very difficult, comorbid patients were also added to the study. Patients who were already diagnosed by psychiatrists, and clinical psychologists were examined for the study. In order to further validate the diagnosis of BPD patients, these patients were screened through McLean screening instrument. Subsequently, a cordial rapport was established with all the participants. They were requested to provide preliminary information. Followed by this, all the respective scales were administered to the participants and they were advised to read the instructions carefully and provide their responses candidly. After the completion of the process, they were thanked for their cooperation and were taken for further psychological consideration.

Data analysis

Appropriate statistics like Spearman’s correlational analysis were employed to examine the association between the variables.

Results and discussion

Table 1 and Fig. 1, shows the relationship of perceived social support with social wellbeing among BPD patients. It can be seen from the table as well as the figure that a statistically significant positive correlation was erected amid overall perceived social support with overall social wellbeing (r = .41; p < .001). The results indicated that patients having the high level of perceived social support have a strong social networking, which tends to live them longer and respond better to anxiety, stress, and depression.

Table 1 Inter correlation matrix: perceived social support, emotional state and social wellbeing of BPD outpatients (N = 100)
Fig. 1
figure 1

Relationship of perceived social support and social wellbeing

Although ample studies have been conducted on these variables independently in difference settings, there is a bleak state of literature available on these two variables together in general and BPD patients in particular. In one study, a systematic review has been conducted to examine the association of loneliness and perceived social support with the outcome of psychological well-being complications [44]. They found that folk with depression who discern their social support as poor have bad outcome in terms of manifestations, recuperation, and social operating. Hence, greater isolation predicts the poor depression outcome.

Correlation of perceived social supports with social wellbeing

The present study is one of the first study to examine the association of perceived social support with social wellbeing among BPD patients. As can be seen from the table and figure also, there is a statistically significant positive relationship between perceived social support and social wellbeing among BPD patients (r = .41; p < .001). This means the higher the support BPD patients would experience from their friends, relatives, and other people, greater would be their social wellbeing. Perceived social support denotes to how individuals discern peers, members of the family and alternatives as an origin of support (material, mental along with overall support) in times of need. The results of the present study can be corroborated with the results of previous studies [25, 77]. According to Siedlecki, perceived levels of support, love, and care could give optimistic contacts and exposure [77]. An arbitrating character of self-esteem in the connections amid social support and depressive symptoms was studied. They also revealed that perceived social support from ancestry and peers were significantly associated to lower depressive symptoms. The aforementioned perceived social support was erected to be more safeguarding against depressive manifestations where the level of worry and apprehension was presented. Other researchers suggested that a high level of perceived social support is linked to stronger physical and psychological fitness consequences [25].

Accommodating psychological models of togetherness alternatives as encouraging, reliable, accessible, and together have been vigorously correlated with optimistic psychological fitness and wellbeing upshots [75]. Cohen contended that social integration has a straight influence on wellbeing by promising the advancement of identity, meaning, self-trust along with confidence together with optimistic influence [71]. Inseparability is expected to be reduced amid particular diagnosed with BPD, a stigma together with relational complications, namely, acute exasperation along with inconsistent connections [12]. Individuals who are attached to more inseparable figures are expected to contact more optimistic consequences in social support and wellbeing [13].

In another study, an association was examined between familial social support with psychological wellbeing among hepatitis C. A statistically significant moderate correlation was found between the two variables [78]. They found a moderate correlation of the family social support in psychological wellbeing. A high sense of psychological wellbeing was found among the educated patients as compared to uneducated patients. Furthermore, their study depicted a positive association of socioeconomic status with psychological wellbeing. Lastly, sufferers from the nuclear family system have a high level of familial social support as compared to those patients residing with joint families. Hence, keeping in view, the results of this study, it can be said that social support plays a very important role in psychological wellbeing. Hence, it can be said that by providing a higher level of perceived social support, the wellbeing of BPD patients can be improved.

The results of the study also illustrates a statistically significant relationship between dimensions of perceived social support and dimensions of perceived social wellbeing. When examining the relationship of the family dimension with the dimensions of social wellbeing. The results indicated a statistically significant positive relationship with social integration (r = .24; p < .05), social actualization (r = .44; p < .01), social coherence (r = .21; p < .05), and social wellbeing (r = .28; p < .01).

Similarly, when examining the relationship of the friend dimension with the social wellbeing and its dimensions, the results indicated the statistically significant positive relationships with social integration (r = .25; p < .05), social acceptance (r = .21; p < .05), social contribution (r = .26; p < .01), social actualization (r = .24; p < .05), and social wellbeing (r = .27; p < .01).

Finally, when examining the relationship of the significant other dimension with social wellbeing and its dimensions. The results indicated a statistically significant positive relationships with social integration (r = .40; p < .01), social acceptance (r = .30; p < .01), social actualization (r = .39; p < .01), social coherence (r = .34; p < .01), and social wellbeing (r = .44; p < .01).

The results of our study reflect with the review of literature; optimistic communal interactions with members of the family decreases apprehension and advance the feeling of invulnerability and protection [42,43,44]. Individuals with more absolute moral communal connections and higher social support have the advantage of more effective interpersonal skills and directs them aside from psychological and mental complications [45]. Additionally, BPD attributes were also interconnected to increased pessimistic connections with the mother [38]. Parental aid is a safeguarding element for dissimilar displays of mental illness and particularly in mother-daughter connections definite motherly emotional actions and constructive dual emotional attitudes seem to be associated with minimizing in the female’s BPD seriousness over time [39, 40]. Consequently, social support is constantly connected with fine psychological health and social wellbeing [41].

Studies that support the outcomes of our investigation reported that the prevalence of social connections with peers was notable for positive clinical recovery over a span of 2 years in the first episodes of psychosis [41, 79]. The particular intervention research by Bo and Kongerslev was encouraging, though in need of duplication with a control group incorporated, putting forward that therapy for BPD in youngsters might be constructive in ameliorating companion relations [50]. Behavioral economic and neuroeconomic approaches to the research of incentive valuation might be relevant to the study on youngster BPD, demonstrating intense insights into neural and mental processes, which may influence positive peer connections [51]. One research has spotlighted the character of disintegration of belief and an expected refusal as drivers of defective social consequences while in a specific manner as bringing about irritation and hostile social communication among adolescent folk diagnosed with personality disorders [52]. The idea is that particulars with BPD are tactful to refusal cues and predict social refusal [53].

Conclusions

This study was designed to examine the association of perceived social support with social wellbeing among BPD outpatients. Results revealed a statistically significant moderate positive correlation between perceived social support and social wellbeing. This means higher the support these patients experience from their family, friends and relatives, better will be their social wellbeing. It is noteworthy to mention here that getting support from companions and family members in times of crises will have a buffering effect on patients’ negative emotions and thoughts, which could have a significant impact on patients’ wellbeing. Hence creating such type of relationship or support from family and peers in one’s life is necessary due to its worth benefits to one’s psychological fitness and wellbeing. This study has a practical implication for counselors, clinical psychologists, and psychiatrists working in the field. Psychologists working in different clinical settings should consider perceived social support as an important means to cope up with the stressors and stress reactions. They should encourage their caregivers to maintain healthy and close relationship with their offspring. Investigation could have some suggestions for prevention and treatment for BPD patients. Our findings highlight the significance of assessing BPD attributes in medical settings, mainly in the individuals who reports perceived social support. Contemporary investigation gives a program on the significance of evolving a span of successful social aid. Certain interventions could be employed at ameliorating BPD manifestations along with social aid in a patient. For instance, dialectical behavioral therapy. Upgrading robust levels of functional variables during nursing the personality pathology could aid sufferers maintain utility along with reduction in the time required for patients to attain standard levels.

Limitations

As the sample was collected from the Department of Psychiatry, Jawaharlal Nehru Medical College, Aligarh Muslim University, Uttar Pradesh, India, only, there is a threat to external validity of the results.

This study was limited to perceived social support and social wellbeing only. Researchers should consider other variables like emotional state, etc.

Availability of data and materials

All data generated or analyzed during this study are available on request.

Abbreviations

APA:

American Psychiatric Association

BPD:

Borderline personality disorder

EUPD:

Emotionally unstable personality disorder

SPSS:

Statistical Package for Social Sciences

References

  1. American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596

  2. Choi-Kain LW, Zanarini MC, Frankenburg FR et al (2010) A longitudinal study of the 10-year course of interpersonal features in borderline personality disorder. J Personal Disord 24:365–376. https://doi.org/10.1521/pedi.2010.24.3.365

    Article  Google Scholar 

  3. Kaess M, Brunner R, Chanen A (2014) Borderline personality disorder in adolescence. Pediatrics 134:782–793. https://doi.org/10.1542/peds.2013-3677

    Article  Google Scholar 

  4. Kleindienst N, Hauschild S, Liebke L et al (2019) A negative bias in decoding positive social cues characterizes emotion processing in patients with symptom-remitted borderline personality disorder. Borderline Pers Disord Emot Dysregul 6:17. https://doi.org/10.1186/s40479-019-0114-3

    Article  Google Scholar 

  5. Wright AGC, Hallquist MN, Beeney JE, Pilkonis PA (2013) Borderline personality pathology and the stability of interpersonal problems. J Abnorm Psychol 122:1094–1100. https://doi.org/10.1037/a0034658

    Article  Google Scholar 

  6. Wolke D, Schreier A, Zanarini MC, Winsper C (2012) Bullied by peers in childhood and borderline personality symptoms at 11 years of age: a prospective study. J Child Psychol Psychiatry 53:846–855. https://doi.org/10.1111/j.1469-7610.2012.02542.x

    Article  Google Scholar 

  7. Stepp SD, Whalen DJ, Scott LN et al (2014) Reciprocal- effects of parenting and borderline personality disorder symptoms in adolescent girls. Dev Psychopathol 26:361–378. https://doi.org/10.1017/S0954579413001041

    Article  Google Scholar 

  8. Beckes L, Coan JA (2011) Social baseline theory: The role of social proximity in emotion and economy of action. Soc Personal Psychol Compass 5:976–988. https://doi.org/10.1111/j.1751-9004.2011.00400.x

    Article  Google Scholar 

  9. Wasserman S, Faust K (1994) Social network analysis: methods and applications. Cambridge University Press, New York

    Book  Google Scholar 

  10. Fowler JH, Christakis NA (2008) Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study. BMJ 337:a2338. https://doi.org/10.1136/bmj.a2338

    Article  Google Scholar 

  11. Rosenquist JN, Fowler JH, Christakis NA (2011) Social network determinants of depression. Mol Psychiatry 16:273–281. https://doi.org/10.1038/mp.2010.13

    Article  CAS  Google Scholar 

  12. Bodner E, Cohen-Fridel S, Iancu I (2011) Staff attitudes toward patients with borderline personality disorder. Compr Psychiatry 52:548–555. https://doi.org/10.1016/j.comppsych.2010.10.004

    Article  Google Scholar 

  13. Rosenfeld LB, Richman JM, Bowen GL (2000) Social support networks and school outcomes: the centrality of the teacher. Child Adolesc Soc Work J 17:205–226. https://doi.org/10.1023/A:1007535930286

    Article  Google Scholar 

  14. Brailovskaia J, Schönfeld P, Zhang XC et al (2018) A cross-cultural study in Germany, Russia, and China: are resilient and social supported students protected against depression, anxiety, and stress? Psychol Rep 121:265–281. https://doi.org/10.1177/0033294117727745

    Article  Google Scholar 

  15. Maymon R, Hall NC, Harley JM (2019) Supporting first-year students during the transition to higher education: the importance of quality and source of received support for student well-being. Stud Success 10:64–75. https://doi.org/10.5204/ssj.v10i3.1407

    Article  Google Scholar 

  16. McCoy DC, Wolf S, Godfrey EB (2014) Student motivation for learning in Ghana: Relationships with caregivers’ values toward education, attendance, and academic achievement. Sch Psychol Int 35:294–308. https://doi.org/10.1177/0143034313508055

    Article  Google Scholar 

  17. Awang MM, Kutty FM, Ahmad AR (2014) Perceived social support and well being: First-year student experience in University. IES 7:p261. https://doi.org/10.5539/ies.v7n13p261

    Article  Google Scholar 

  18. Zimet GD, Dahlem NW, Zimet SG, Farley GK (1988) The multidimensional scale of perceived social support. J Pers Assess 52:30–41. https://doi.org/10.1207/s15327752jpa5201_2

    Article  Google Scholar 

  19. Day AL, Livingstone HA (2003) Gender differences in perceptions of stressors and utilization of social support among university students. Can J Behav Sci 35:73–83. https://doi.org/10.1037/h0087190

    Article  Google Scholar 

  20. Haddadi P, Besharat MA (2010) Resilience, vulnerability and mental health. Procedia Soc Behav Sci 5:639–642. https://doi.org/10.1016/j.sbspro.2010.07.157

    Article  Google Scholar 

  21. Hartung F-M, Sproesser G, Renner B (2015) Being and feeling liked by others: how social inclusion impacts health. Psychol Health 30:1103–1115. https://doi.org/10.1080/08870446.2015.1031134

    Article  Google Scholar 

  22. Hu T, Zhang D, Wang J-L (2015) A meta-analysis of the trait resilience and mental health. Pers Individ Differ 76:18–27. https://doi.org/10.1016/J.PAID.2014.11.039

    Article  Google Scholar 

  23. Santini ZI, Koyanagi A, Tyrovolas S et al (2015) The association between social relationships and depression: a systematic review. J Affect Disord 175:53–65. https://doi.org/10.1016/j.jad.2014.12.049

    Article  Google Scholar 

  24. Tough H, Siegrist J, Fekete C (2017) Social relationships, mental health and wellbeing in physical disability: a systematic review. BMC Public Health 17:414. https://doi.org/10.1186/s12889-017-4308-6

    Article  Google Scholar 

  25. Uchino BN, Bowen K, Carlisle M, Birmingham W (2012) Psychological pathways linking social support to health outcomes: a visit with the “Ghosts” of research past, present, and future. Soc Sci Med 74:949–957. https://doi.org/10.1016/j.socscimed.2011.11.023

    Article  Google Scholar 

  26. Zhang M, Zhang J, Zhang F et al (2018) Prevalence of psychological distress and the effects of resilience and perceived social support among Chinese college students: Does gender make a difference? Psychiatry Res 267:409–413. https://doi.org/10.1016/j.psychres.2018.06.038

    Article  Google Scholar 

  27. Glozah FN (2013) Effects of academic stress and perceived social support on the psychological wellbeing of adolescents in Ghana. Open J Med Psychol 2:143–150. https://doi.org/10.4236/ojmp.2013.24022

    Article  Google Scholar 

  28. Poots A, Cassidy T (2020) Academic expectation, self-compassion, psychological capital, social support and student wellbeing. Int J Educ Res 99:101506. https://doi.org/10.1016/j.ijer.2019.101506

    Article  Google Scholar 

  29. Poudel A, Gurung B, Khanal GP (2020) Perceived social support and psychological wellbeing among Nepalese adolescents:The mediating role of self-esteem. BMC Psychol 8:43. https://doi.org/10.1186/s40359-020-00409-1

    Article  Google Scholar 

  30. Reeve KL, Shumaker CJ, Yearwood EL et al (2013) Perceived stress and social support in undergraduate nursing students’ educational experiences. Nurse Educ Today 33:419–424. https://doi.org/10.1016/j.nedt.2012.11.009

    Article  Google Scholar 

  31. Beeney JE, Hallquist MN, Clifton AD et al (2018) Social disadvantage and borderline personality disorder: a study of social networks. Personal Disord 9:62–72. https://doi.org/10.1037/per0000234

    Article  Google Scholar 

  32. Orben A, Tomova L, Blakemore S-J (2020) The effects of social deprivation on adolescent development and mental health. Lancet Child Adolesc Health 4:634–640. https://doi.org/10.1016/S2352-4642(20)30186-3

    Article  CAS  Google Scholar 

  33. Lazarus SA, Beeney JE, Howard KP et al (2020) Characterization of relationship instability in women with borderline personality disorder: A social network analysis. Personal Disord 11:312–320. https://doi.org/10.1037/per0000380

    Article  Google Scholar 

  34. Cobo-Rendón R, Pérez-Villalobos MV, Páez-Rovira D, Gracia-Leiva M (2020) A longitudinal study: Affective wellbeing, psychological wellbeing, self-efficacy and academic performance among first-year undergraduate students. Scand J Psychol 61:518–526. https://doi.org/10.1111/sjop.12618

    Article  Google Scholar 

  35. Nikmanesh Z, Honakzehi F (2016) Examining perceived social support, positive affection, and spirituality, as resilience factors, among boys of drug-dependent fathers. Shiraz E-Med J 17:1–7. https://doi.org/10.17795/semj42200

    Article  Google Scholar 

  36. Zielinski MJ, Veilleux JC (2014) Examining the relation between borderline personality features and social support: the mediating role of rejection sensitivity. Personal Individ Differ 70:235–238. https://doi.org/10.1016/j.paid.2014.07.005

    Article  Google Scholar 

  37. Larivière N, Couture É, Blackburn C et al (2015) Recovery, as experienced by women with borderline personality disorder. Psychiatr Q 86:555–568. https://doi.org/10.1007/s11126-015-9350-x

    Article  Google Scholar 

  38. Deutz MHF, Lambooy MJS, Vossen HGM et al (2022) Associations between borderline personality disorder symptoms and online self-disclosure in clinically referred youth. J Personal Disord 36:359–376. https://doi.org/10.1521/pedi.2022.36.3.359

    Article  Google Scholar 

  39. Whalen DJ, Scott LN, Jakubowski KP et al (2014) Affective behavior during mother-daughter conflict and borderline personality disorder severity across adolescence. Personal Disord 5:88–96. https://doi.org/10.1037/per0000059

    Article  Google Scholar 

  40. Wills TA, Resko JA, Ainette MG, Mendoza D (2004) Role of parent support and peer support in adolescent substance use: a test of mediated effects. Psychol Addict Behav 18:122–134. https://doi.org/10.1037/0893-164X.18.2.122

    Article  Google Scholar 

  41. Lakey B, Orehek E (2011) Relational regulation theory: a new approach to explain the link between perceived social support and mental health. Psychol Rev 118:482–495. https://doi.org/10.1037/a0023477

    Article  Google Scholar 

  42. DiMatteo MR (2004) Social support and patient adherence to medical treatment: A meta-analysis. Health Psychol 23:207–218. https://doi.org/10.1037/0278-6133.23.2.207

    Article  Google Scholar 

  43. Schwarzer R, Leppin A (1988) Social support and health: A meta-analysis. Psychol Health 3:1–15. https://doi.org/10.1080/08870448908400361

    Article  Google Scholar 

  44. Wang J, Mann F, Lloyd-Evans B et al (2018) Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry 18:156. https://doi.org/10.1186/s12888-018-1736-5

    Article  Google Scholar 

  45. Ghasemipoor M, Jahanbakhsh Ganje S (2010) The relationship between the social support and mental health in Lorestan university students in 2009. Yafteh 12:57–64

    Google Scholar 

  46. Chanen A (2017) Borderline personality disorder is not a variant of normal adolescent development. Personal Ment Health 11:147–149. https://doi.org/10.1002/pmh.1392

    Article  Google Scholar 

  47. Shantz CU, Hartup WW (1995) Conflict and friendship relations. In: Conflict in Child and Adolescent Development. Cambridge University Press

    Google Scholar 

  48. Beazidou E, Botsoglou K (2016) Peer acceptance and friendship in early childhood: the conceptual distinctions between them. Early Child Dev Care 186:1615–1631. https://doi.org/10.1080/03004430.2015.1117077

    Article  Google Scholar 

  49. Wlodarczyk J, Lawn S (2017) The developmental trajectory of borderline personality disorder and peer victimisation: Australian family carers’ perspectives. Emot Behav Diffic 22:98–110. https://doi.org/10.1080/13632752.2016.1243360

    Article  Google Scholar 

  50. Bo S, Kongerslev M (2017) Self-reported patterns of impairments in mentalization, attachment, and psychopathology among clinically referred adolescents with and without borderline personality pathology. Borderline Pers Disord Emotion Dysregul 4:4. https://doi.org/10.1186/s40479-017-0055-7

    Article  Google Scholar 

  51. Sharp C, Pane H, Ha C et al (2011) Theory of mind and emotion regulation difficulties in adolescents with borderline traits. J Am Acad Child Adolesc Psychiatry 50:563–573.e1. https://doi.org/10.1016/j.jaac.2011.01.017

    Article  Google Scholar 

  52. Poggi A, Richetin J, Preti E (2019) Trust and rejection sensitivity in personality disorders. Curr Psychiatry Rep 21:69. https://doi.org/10.1007/s11920-019-1059-3

    Article  Google Scholar 

  53. Bjorn M, Paul AP (2005) An attachment model of personality disorders. In: Clarkin JF, Lenzenweger MF (eds) Major theories of personality disorder, 2nd ed. Guilford Press, New York pp 231–281

  54. Naci H, Ioannidis JPA (2015) Evaluation of wellness determinants and interventions by citizen scientists. JAMA 314:121–122. https://doi.org/10.1001/jama.2015.6160

    Article  CAS  Google Scholar 

  55. Andrews FM, Withey SB (1976) Social indicators of well-being. Plenum Press, New York and London

    Book  Google Scholar 

  56. Bradburn NM (1969) The structure of psychological well-being. Aldine, Oxford

    Google Scholar 

  57. Campbell A (1981) The sense of well-being in America: recent patterns and trends. McGraw-Hill, New York

    Google Scholar 

  58. Campbell A, Converse PE, Rodgers WL (1976) The quality of American life: perceptions, evaluations, and satisfactions. Russell Sage Foundation, New York

    Google Scholar 

  59. King LA, Heintzelman SJ, Ward SJ (2016) Beyond the search for meaning: a contemporary science of the experience of meaning in life. Curr Dir Psychol Sci 25:211–216. https://doi.org/10.1177/0963721416656354

    Article  Google Scholar 

  60. Kim ES, Sun JK, Park N et al (2013) Purpose in life and reduced risk of myocardial infarction among older U.S. adults with coronary heart disease: a two-year follow-up. J Behav Med 36:124–133. https://doi.org/10.1007/s10865-012-9406-4

    Article  Google Scholar 

  61. Miller CE, Townsend ML, Day NJS, Grenyer BFS (2020) Measuring the shadows: a systematic review of chronic emptiness in borderline personality disorder. PLoS One 15:e0233970. https://doi.org/10.1371/journal.pone.0233970

    Article  CAS  Google Scholar 

  62. Oumaya M, Friedman S, Pham A et al (2008) Borderline personality disorder, self-mutilation and suicide: literature review. Encephale 34:452–458. https://doi.org/10.1016/j.encep.2007.10.007

    Article  CAS  Google Scholar 

  63. Weibel S, Vidal S, Olié E et al (2017) Impact of child maltreatment on meaning in life in psychiatric patients. Psychiatry Res 251:204–211. https://doi.org/10.1016/j.psychres.2017.02.026

    Article  Google Scholar 

  64. Li J-B, Dou K, Liang Y (2021) The relationship between presence of meaning, search for meaning, and subjective well-being: A three-level meta-analysis based on the meaning in life questionnaire. J Happiness Stud 22:467–489

    Article  Google Scholar 

  65. Durkheim E (1951) Suicide: a study in sociology. Free Press, Glencoe, Illinois

    Google Scholar 

  66. Keyes CLM (1998) Social well-being. Soc Psychol Q 61:121–140. https://doi.org/10.2307/2787065

    Article  Google Scholar 

  67. Seeman M (1975) Alienation studies. Annu Rev Sociol 1:91–123

    Article  Google Scholar 

  68. Allen AB, Leary MR (2010) Self-compassion, stress, and coping. Soc Personal Psychol Compass 4:107–118. https://doi.org/10.1111/j.1751-9004.2009.00246.x

    Article  Google Scholar 

  69. Horney K (1945) Our inner conflicts; a constructive theory of neurosis. W W Norton & Co, New York

    Google Scholar 

  70. Wrightsman LS (1991) Interpersonal trust and attitudes toward human nature. In: Measures of personality and social psychological attitudes. Academic Press, San Diego, pp 373–412

    Chapter  Google Scholar 

  71. Cohen S (2004) Social relationships and health. Am Psychol 59:676–684. https://doi.org/10.1037/0003-066X.59.8.676

    Article  Google Scholar 

  72. House JS, Landis KR, Umberson D (1988) Social relationships and health. Science 241:540–545. https://doi.org/10.1126/science.3399889

    Article  CAS  Google Scholar 

  73. Chris Fraley R, Niedenthal PM, Marks M et al (2006) Adult attachment and the perception of emotional expressions: Probing the hyperactivating strategies underlying anxious attachment. J Pers 74:1163–1190. https://doi.org/10.1111/j.1467-6494.2006.00406.x

    Article  CAS  Google Scholar 

  74. Mikulincer M, Shaver PR (2007) Boosting attachment security to promote mental health, prosocial values, and inter-group tolerance. Psychol Inq 18:139–156. https://doi.org/10.1080/10478400701512646

    Article  Google Scholar 

  75. Gunderson JG, Lyons-Ruth K (2008) BPD’s interpersonal hypersensitivity phenotype: a gene-environment-developmental model. J Personal Disord 22:22–41. https://doi.org/10.1521/pedi.2008.22.1.22

    Article  Google Scholar 

  76. Zanarini MC, Vujanovic AA, Parachini EA et al (2003) A screening measure for BPD: The Mclean screening instrument for borderline personality disorder (MSI-BPD). J Personal Disord 17:568–573. https://doi.org/10.1521/pedi.17.6.568.25355

    Article  Google Scholar 

  77. Siedlecki KL, Salthouse TA, Oishi S, Jeswani S (2014) The relationship between social support and subjective well-being across age. Soc Indic Res 117:561–576. https://doi.org/10.1007/s11205-013-0361-4

    Article  Google Scholar 

  78. Kalsoom S, Masood S, Jami H (2017) Psychological well-being and perceived familial social support for patients with hepatitis c: a challenge for health practitioners. Found Univ J Psychol 1:27–47

    Google Scholar 

  79. Bjornestad J, Hegelstad WTV, Joa I et al (2017) “With a little help from my friends” social predictors of clinical recovery in first-episode psychosis. Psychiatry Res 255:209–214. https://doi.org/10.1016/j.psychres.2017.05.041

    Article  Google Scholar 

Download references

Acknowledgements

All the participants who participated in the study are highly appreciated.

Funding

This research work is part of Post-Doctoral fellowship (F-No. 3-174/19-20/PDF/GEN) and was supported by Indian Council of Social Science Research (ICSSR), New Delhi-India.

Author information

Authors and Affiliations

Authors

Contributions

MG designed the study, conceptualized, collected, and analyzed the data. NK wrote the introduction and discussion. DA designed the study. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mubashir Gull.

Ethics declarations

Ethics approval and consent to participate

Drafted agreement was taken from BPD patients, after describing the motive along with the significance of the investigation. Patients were self-confident about the confidentiality of the collected details and that it would be employed only for the investigation purpose.

Consent for publication

The participants consented to publishing their data result.

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Gull, M., Kaur, N. & Akhouri, D. Perceived social support as related to social wellbeing in patients with Emotionally Unstable Personality Disorder (EUPD). Middle East Curr Psychiatry 29, 104 (2022). https://doi.org/10.1186/s43045-022-00264-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s43045-022-00264-3

Keywords

  • BPD
  • Wellbeing
  • Borderline personality disorder
  • EUPD
  • Suicide
  • Social support
  • India