Abstract: . . .  chotic episodes, paranoia, and dissociative experiences. Zanarini, Gunderson, and Frankenburg 1990! identified three levels of cognitive im- pairment in BPD: disturbed but nonpsychotic symptoms such as dissociation, depersonaliza- tion, odd thinking, and nondelusional para- noia; quasipsychotic symptoms defined as transientless than 2 days! and circumscribed affecting one or two areas in the patient’s life! hallucination and delusions; and genuine psychotic thought including prolongedmore than 2 days! and widespread delusions or hallucinationsi.e., Schneiderian first-rank symptoms!. Genuine psychotic thought was relatively rare among borderline patients14%! and always occurred in the context of comor- bid Axis I diagnoses. However, the presence of quasipsychotic symptoms distinguished borderline patients from other groups. In multiple studies using the SWAP-200 Q-sort, the item that has best captured BPD thought disorder has been “tends to become irrational when strong emotions are stirred . . .
. . .  that interacts with contextual cues leading to aggressive behaviorsCoc- caro et al., 1989; Seroczynski, Bergeman, & Coccaro, 1999; Skodol, Siever, et al., 2002!. For example, some research links lower levels of 5-hydroxytryptophan5-HTT! with in- creased self-harmful and suicidal behaviors e.g., Mann, 1998!. Other research, however, suggests that impulsivity may not necessarily be linked to aggression in all or most patients with BPDe.g., Critchfield, Levy, & Clarkin, 2004; Depue & Lenzenweger, 2001!. Westen, Heim, and colleagues have also begun examining the multidimensional nature of impulsivity using an Impulsivity Question- naireWesten & Heim, 2005! designed for use by clinically experienced informants, based on either their knowledge of the patient over the course of treatment or a systematic, narrative-based clinical interview, the Clini- cal Diagnostic InterviewWesten, 2004; Wes- ten & Muderrisoglu, 2003, in press!. Factor analysis of the instrument yields five dimen- sions: cognitive . . .
. . .  interesting findings vis- à-vis borderline object relations pertain to the complexity and differentiation of representa- tions of people, that is, whether individuals with BPD can maintain coherent, complex, emotionally multivalenced representations of the self and others. On the one hand, results have consistently demonstrated that patients with BPD do tend to represent others’ internal states with less complexity and differentiation than patients with other disorders such as ma- jor depression and, indeed, they do tend  . . .
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