I recently came across a post on X that mentioned this study –

Levels of grit in patients with borderline personality disorder: Description and prediction

Isabel V. Glass, Frances R. Frankenburg, Garrett M. Fitzmaurice, Mary C. Zanarini

First published: 9 September 2024

Grit is for roads, I thought, and sometimes you need to show a bit of it when things get tough, but it turns out there’s an actual GRIT scale where you can measure how much you have of it. So I decided to investigate further.

Psychologist Angela Duckworth has spent much of her life working on this thing called GRIT aka ‘perseverance and passion for long-term goals.’

You can check your own GRIT score here –

https://angeladuckworth.com/grit-scale/

I scored 3.5 out of 5, which feels about right for me, though I may be fooling myself.

Anyway, I feel as if I’ve been asleep under a rock as GRIT is all around us. There’s a book –

https://www.amazon.co.uk/Grit-Passion-Perseverance-Angela-Duckworth/dp/1501111108

and all manner of other stuff online, including this very interesting (and critical) article –

https://www.newyorker.com/culture/culture-desk/the-limits-of-grit

Now that I know what Grit is, I have questions about its link to resilience, and fortitude (which is now talked about as the new resilience). But I don’t want to get bogged down as my real aim is to look at the borderline/Grit study.

Here’s a summary of the paper -

Abstract

This study describes the 6-year course of grit scores among patients with borderline personality disorder (BPD) who have and have not experienced a symptomatic and psychosocial recovery. This study also explores predictors of grittiness in BPD patients. These patients (N = 224) were assessed as part of the McLean Study of Adult Development (MSAD). Levels of grit were assessed using the Grit Scale, a self-report measure assessing overall grittiness and three sub-scales of grit: consistency of interest, perseverance, and ambition. Recovered patients reported significantly higher levels of grit on three outcomes (overall grit, perseverance, and ambition) compared to non-recovered patients across time. One temperamental factor (conscientiousness) and one childhood factor (competency) were significant multivariate predictors of overall grit scores in patients with BPD. Taken together, these results suggest that recovered BPD patients have higher levels of grit that are stable across time. These results also suggest that grit is related to both temperamental and environmental factors.

And because I wanted to know more, I paid Wiley for access. Hopefully the article will become free to read at some point soon.

I was particularly keen to see how the researchers had used the Grit concept, and to understand how they had reached their conclusions. Here are some points from the paper –

1) Four studies have already looked at Grit in relation to self-harm and suicidal behaviour, but this is the first research to look specifically at Grit and BPD.

2) Grit is regarded as a fluid trait which can be developed and improved upon over time.

3) “The concept of grit describes sustained effort and perseverance towards one’s goals over a long period of time (i.e. years) even when faced with adversity, failures or other setbacks.”

4) This study took a group of people diagnosed with BPD and followed them over 6 years.

5) The Grit levels of both recovered and non-recovered patients were measured over time. Recovery here is defined as symptomatic (relief from symptoms) and psychosocial (having a job, being in education, having friendships or relationships.)”

6) Patients who recovered (as above) had ‘’significantly higher grit scores than those who had never recovered. This includes not only overall grit scores, but two of the subscales of grit: perseverance and ambition.’’

7) The researchers weren’t surprised by their results. ‘’It could be that patients with BPD who had higher grit scores at the start of this study…were more likely to recover, as grittiness may have allowed these individuals to better handle the vicissitudes of life. Moreover, grittiness may lend itself well to the specific process of recovery from BPD.’’

8) I especially like this next paragraph as I think it expresses the ongoing borderline endeavour very well – ‘’Achieving a recovery from BPD would very likely require high levels of grit, in order to have the stamina to consistently work towards maintaining full-time work/school and emotionally sustaining relationships , even in the face of intense adversity, or setbacks, like recurrences of BPD symptoms (e.g. suicidal ideations, suicide attempts, impulsive substance use…or experiences of adult trauma). Thus, it would make sense that higher grit scores at the start of this study would be associated with a recovery from BPD.’’

9) The authors considered whether the grit shown in the recovered group had been partly developed in the recovery process but judged this less likely because grit scores for both groups remained stable throughout the study.

10) And there is this encouraging statement/commitment - ‘’It is critically important for research to focus on and study the strengths in people with BPD. It has long been the case that 1)BPD carries an intense stigma and 2) research has primarily focussed on borderline psychopathology and related psychosocial, vocational and other functional difficulties.’’

11) Grit and resilience are not the same, the authors suggest -Grit usually being linked to the achievement of goals, and resilience focussed on recovery from setbacks. Future research should look at the differences between the two qualities.

12) There are some important parts of this study that I’ve had to use a bit of Grit to get my head around. As the abstract says, the trait of conscientiousness, and the childhood protective factor of competency (success at something in youth) are predictors of higher Grit scores in BPD recoverees. And I think, although I can’t be sure, that the authors are suggesting that recovery from BPD is being driven by the factors of conscientiousness and previous competency. But I’m very confused by the latter parts of the paper, and so I’ve contacted the lead author of the study to see if she can clarify matters for me.

If I’m lucky enough to get a reply, I’ll update.

Overall, parts of this study (the parts I can understand) don’t surprise me. Managing borderline symptoms, seeking out and paying for help, and also trying to make use of psychotherapies that don’t always keep borderline issues in mind – all of this takes courage, effort, time and money. And sometimes the rewards for these efforts can seem slim, particularly when setbacks occur.

And Linehan, the creator of DBT, has said of her earliest clients -

‘Over the years they have shown marvelous patience as I fumbled around trying to develop this treatment. I have been encouraged by their courage and tenacity. In circumstances where many others would have quit long ago, not one of them has given up.”

These patients were showing Grit two decades before the term was even in the lexicon!

Interlude: a few notes on GRIT

Sixteenth Exercise: Identify Your Values and Goals