Borderline personality traits in nonclinical young adults

The main purpose of this study was to explore the dimensionality of the borderline personality disorder in nonclinical young adults by means of the Borderline Personality Questionnaire (BPQ; Poreh et al., 2006). We also studied the phenotypic expression of the borderline personality traits as a function of participants' gender and age, and the relationship between BPQ subscales and measures of depressive symptoms, anxiety, stress, hallucinatory predisposition, and paranoid ideation. The sample comprised 809 young adults, 562 (69.5%) were women, with a mean age of 20.2 years (SD = 2.9). The results indicate that the BPQ self-report has adequate psychometric properties. The levels of internal consistency for the BPQ subscales ranged between .78 and .93. Analysis of the internal structure of the BPQ subscales yielded a one-dimensional solution. In contrast, second-order principal components analysis at the item level yielded a five-dimensional solution. Likewise, statistically significant differences in the mean scores of the borderline personality traits as a function of participants' gender and age were found. The BPQ subscales correlated significantly with measures of depression, anxiety, stress, paranoid ideation, and hallucinatory predisposition. These results help to improve our understanding of the dimensional structure of the borderline personality in the general population. Future research should continue to identify participants who are at risk for the development of borderline personality disorder and facilitating the development of early detection and prevention programs.     

Borderline personality disorder features and mate retention tactics

The purpose of the present study was to examine the association between features of borderline personality disorder (BPD) and mate retention tactics as a means of examining an evolutionary perspective on the association between BPD features and interpersonal problems and violence in romantic relationships. Two-hundred twenty-five college student participants completed the Personality Assessment Inventory for Borderlines (PAI-BOR; Morey, 1991) and the Mate Retention Inventory-Short Form (MRI-SF; Buss, Shackelford, & McKibbin, 2008) embedded within other measures. There was a strong association between BPD features and cost-inflicting mate retention tactics, including the specific tactics of vigilance, punishing mate's infidelity threat, intrasexual threats, and sexual inducements for both men and women. There were also gender-specific associations for additional tactics. These results contribute to our understanding of problems in romantic relationships among men and women with BPD features, including violence, and to our understanding of impulsive sexual behavior among individuals with BPD features by showing how these behaviors are used as extreme, maladaptive attempts at mate retention.     

Borderline personality disorder from the perspective of general personality functioning

The authors extended previous work on the hypothesis that borderline personality disorder (BPD) can be understood as a maladaptive variant of personality traits included within the 5-factor model (FFM) of personality. In each of 3 samples, an empirically derived prototypic FFM borderline profile was correlated with individuals' FFM profiles to yield a similarity score, an FFM borderline index. Results across all samples indicated that the FFM borderline index correlated as highly with existing borderline measures as they correlated with one another, and the FFM borderline index correlated as highly with measures of dysfunction, history of childhood abuse, and parental psychopathology as did traditional measures of BPD. Findings support the hypothesis that BPD is a maladaptive variant of FFM personality traits.     

Borderline personality disorder and emotion regulation: insights from the Polyvagal Theory

The current study provides the first published evidence that the parasympathetic component of the autonomic nervous system differentiates the response profiles between individuals diagnosed with borderline personality disorder (BPD) and controls. Respiratory sinus arrhythmia (RSA), a non-invasive marker of the influence of the myelinated vagal fibers on the heart, and heart period were collected during the presentation of film clips of varying emotional content. The BPD and control groups had similar initial levels of RSA and heart period. However, during the experiment the groups exhibited contrasting trajectories, with the BPD group decreasing RSA and heart period and the control group increasing RSA and heart period. By the end of the experiment, the groups differ significantly on both RSA and heart period. The correlation between the changes in RSA and heart period was significant only for the control group, suggesting that vagal mechanisms mediated the heart period responses only in the control group. The findings were consistent with the Polyvagal Theory [Porges, S. W. (1995). Orienting in a defensive world: Mammalian modifications of our evolutionary heritage: A Polyvagal Theory. Psychophysiology, 32, 301-318; Porges, S. W. (2001). The Polyvagal Theory: Phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42, 123-146; Porges, S. W. (2003). Social engagement and attachment: A phylogenetic perspective. Annals of the New York Academy of Sciences, 1008, 31-47.], illustrating different adaptive shifts in autonomic state throughout the course of the experiment. The BPD group ended in a physiological state that supports the mobilization behaviors of fight and flight, while the control group ended in a physiological state that supports social engagement behaviors. These finding are consistent with other published studies demonstrating atypical vagal regulation of the heart with other psychiatric disorders.     

Borderline personality disorder and age of onset in major depression

In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we tested the hypothesis that borderline personality disorder (BPD) accounts for the observed differences between early and late onset major depressive disorder (MDD). A total of 440 depressed outpatients were evaluated with semistructured interviews. Patients were subdivided by age of onset and the presence or absence of comorbid BPD. The overall pattern of clinical and demographic variables differed and two separate, multiple, logistic regression analyses addressed the association between age of onset and BPD in MDD patients. Comorbid BPD was not significant in the multivariable age of onset equation and the results of the multivariable analyses support the idea of difference between subtypes. It is concluded that although early age of onset is predictive of BPD, BPD is not a universal feature of early-onset MDD.     

Borderline personality disorder in an intermediate psychological therapies service

The intermediate psychological therapies service is provided for individuals referred with common mental health problems within the primary care psychological therapies service, but whose difficulties are longstanding and/or complex. The prevalence of borderline personality disorder (BPD) in intermediate psychological therapy services has not been researched to-date. The current study aimed to measure the prevalence of BPD amongst patients attending intermediate psychological therapies (n?=?63). The prevalence of BPD was established by identifying the number of patients who met DSM-IV criteria. BPD prevalence amongst patients attending an intermediate psychological therapy service was 37%. The high proportion of patients presenting with BPD indicates the potential need for staff training and supervision in how to manage such high levels of need at this service level. This is the first study to report prevalence rates of BPD specifically in an intermediate care psychological therapy service.     

Borderline personality disorder and laboratory-induced cold pressor pain: Evidence of stress-induced analgesia

Behavioral neuroscience findings regarding stress-induced analgesia may be an appropriate model for the paradoxical effects of self-mutilative pain of patients with borderline personality disorder (BPD). We hypothesized that BPD patients would show an exaggerated antinociceptive effect from an uncontrollable cold pressor stress, compared to persons with other personality disorders or to a nonpsychiatric control group. This hypothesis was supported. Limitations of the study and directions for future research are discussed.     

Reliability of personality disorder symptoms and personality traits in substance-dependent inpatients

The authors compared the internal consistency, 1-year temporal stability, and self-informant agreement of ratings of personality trait (NEO Five-Factor Inventory; NEO-FFI; P. T. Costa & R. R. McCrae, 1992) and personality disorder symptom severity (Structured Clinical Interview for DSM-III-R Personality Disorders Questionnaire; SCID-II-Q; R. L. Spitzer, J. B. W. Williams, M. Gibbon, & M. First, 1990) in 131 substance-dependent inpatients. Internal consistency coefficients were acceptable to very good for most NEO-FFI and SCID-II-Q scales, and temporal stability correlations were significant for all measures. Agreement between patient and informant ratings was more modest. Substance abuse and depression symptom severity moderated the temporal stability and self-informant agreement of several personality trait and disorder ratings. The authors did not find that the five factors were more reliable than the Axis II symptoms. Issues related to the reliability of personality assessment in multiply diagnosed patients are discussed.     

Borderline personality disorder features and utilization of treatment over two years

This study assessed the relationship between borderline personality disorder (BPD) features and treatment utilization over a 2-year time period. Participants included 349 18-year-old nonclinical young adults, approximately one-half of whom endorsed significant borderline features. The laboratory phase of the study involved the administration of self-report and interview-based assessments of BPD psychopathology at Wave 1, as well as interviews targeting Axis I psychopathology and treatment utilization history at Wave 2 (2 years later). Results indicated that borderline features prospectively predicted utilization of psychopharmacological treatment above and beyond what was accounted for by gender, lifetime Axis I psychopathology, and nonBPD Axis II psychopathology. The borderline feature most strongly associated with treatment utilization was affective instability.     

Borderline personality disorder features predict negative outcomes 2 years later

In a sample of 351 young adults, the authors assessed whether borderline personality disorder (BPD) features prospectively predicted negative outcomes (poorer academic achievement and social maladjustment) over the subsequent 2 years, over and above gender and both Axis I and Axis II psychopathology. Borderline traits were significantly related to these outcomes, with impulsivity and affective instability the most highly associated. The present findings suggest that the impulsivity and affective instability associated with BPD leads to impairment in relating well with others, in meeting social role obligations, and in academic or occupational achievement. Therefore, these may be especially important features to target in interventions for BPD.     

Implicit self- and other-associations in obsessive-compulsive personality disorder traits

This study investigated automatic associations with the self and with others in the context of obsessive-compulsive personality disorder (OCPD). Participants scoring high (n=20) or low (n=20) on DSM-IV OCPD traits performed three irrelevant-feature tasks in which language of the words (Dutch vs. English) was the relevant stimulus feature and word content (OCPD self-view, OCPD other-view, high self-esteem and low self-esteem) the irrelevant feature. Results showed that the high and low OCPD group differed with respect to both explicit and implicit OCPD cognitions. Typically, high OCPD participants showed better performance on OCPD-congruent trials than on OCPD-incongruent trials, whereas low OCPD participants displayed the opposite pattern. This was evident from a semantic Simon effect and from a semantic priming effect. Correlations between direct and indirect measures of OCPD beliefs and of self-esteem were low. Moreover, the indirect OCPD measures contributed uniquely and independently of explicit beliefs to the prediction of OCPD.     

Borderline personality and obsessive-compulsive symptoms

Diagnostic criteria for borderline personality disorder (BPD) are diverse, covering a broad range of symptoms. One criterion, self-mutilation, is a behavioral excess that may be considered a predictor of other psychopathological states. The present study sought to determine the extent to which two groups of BPD patients, those who mutilate and those who do not, differed on measures of general psychopathology, depression, anxiety, and obsessive-compulsive symptoms. Results indicate that the only source of significant variation was the level of obsessive-compulsive symptoms, with mutilators exhibiting greater symptomatology. The findings from this study support the idea that self-mutilation is a more severe form of psychopathology relative to the rest of the BPD population. These results are interpreted based on the affect regulation model of self-mutilation, and contrasted with contemporary models of impulse control in relation to obsessive-compulsive disorder.     

Borderline personality disorder,complex trauma,and problems with self and identity: A social-communicative approach

Borderline personality disorder (BPD) is a relatively highly prevalent psychiatric disorder that is associated with very high personal and socioeconomic costs. This paper provides a state-of-the-art review of the relationship between complex trauma and key features of BPD, with a focus on problems with self-coherence and self-continuity. We first review evidence for the high prevalence of complex trauma in BPD patients. This is followed by a discussion of emerging knowledge concerning the biobehavioral mechanisms involved in problems related to self and identity in BPD. We emphasize three biobehavioral systems that are affected by complex trauma and are centrally implicated in identify diffusion in BPD: the attachment system, mentalizing or social cognition, and the capacity for epistemic trust—that is, an openness to the reception of social communication that is personally relevant and of generalizable significance. We formulate a new approach to personality and severe personality disorders, and to problems with self and identity in these disorders, rooted in a social-communicative understanding of the foundations of selfhood. We also discuss how extant evidence-based treatments address the above-mentioned biobehavioral systems involved in identity diffusion in BPD and related disorders, and the supporting evidence. We close the paper with recommendations for future research.     

Evaluation of the SCID-II personality disorder traits for DSM-IV: coherence, discrimination, relations with general personality traits, and functional impairment

The utility of the DSM personality disorder (PD) system remains a concern. The strategy employed represents one approach designed to evaluate and improve the diagnostic efficiency of the SCID-II PDs. Using a sample of 203 patients, SCID-II PD items-based on the criterion sets of the 10 DSM-IV PDs-were evaluated with respect to (a) convergent validity; (b) divergent validity; (c) relation to general personality traits; and (d) association with functional impairment. Only Borderline PD items were satisfactory on all four evaluation criteria. Histrionic and Obsessive-Compulsive PD items met criteria for convergent and divergent validity and relation to personality dimensions of the Five-Factor Model of Personality (FFM) but were not related to functional impairment, suggesting they might be reconsidered as disorders. Schizotypal PD items met three of the four criteria but showed no relation to FFM dimensions, suggesting that it may be a candidate for reassignment to Axis I.     

Borderline personality disorder features and cognitive,emotional, and predicted behavioral reactions to teasing

Borderline personality disorder (BPD) involves interpersonal dysfunction. It is unknown to what extent these problems are due to perceptual biases, emotional reactivity, or impulsivity above and beyond emotional reactions. The present study experimentally tested these mechanisms in the context of predicted reactions to teasing. Participants completed the Personality Assessment Inventory-Borderline Features scale [PAI-BOR; Morey, L. C. (1991). Personality assessment inventory: Professional manual. Odessa, FL: Psychological Assessment Resources], and the Rejection Sensitivity Questionnaire [Downey, G., & Feldman, S. I. (1996). Implications of rejection sensitivity for intimate relationships. Journal of Personality and Social Psychology, 70(6), 1327–1343], and imagined a scenario that involved teasing. Participants rated the teaser and their own predicted emotional and behavioral reactions. Analysis of Covariance results indicated that individuals who endorsed more BPD features showed elevated emotional reactions and predicted behavioral reactions to teasing, but not perceptual biases. Ratings of predicted behavioral responses could be accounted for by emotional responses, supporting the emotional reactivity perspectives of BPD [Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford].     

Improving assessment of personality disorder traits through social network analysis

When assessing personality disorder traits, not all judges make equally valid judgments of all targets. The present study uses social network analysis to investigate factors associated with reliability and validity in peer assessment. Participants were groups of military recruits (N=809) who acted as both targets and judges in a round-robin design. Participants completed self- and informant versions of the Multisource Assessment of Personality Pathology. Social network matrices were constructed based on reported acquaintance, and cohesive subgroups were identified. Judges who shared a mutual subgroup were more reliable and had higher self-peer agreement than those who did not. Partitioning networks into two subgroups achieved more consistent improvements than multiple subgroups. We discuss implications for multiple informant assessments.