Refining the borderline personality disorder phenotype through finite mixture modeling: implications for classification

Borderline personality disorder (BPD) is characterized by considerable heterogeneity. Prior approaches to resolving heterogeneity in BPD pathology have used factor and cluster analytic as well as latent class analysis strategies. These prior studies have been atheoretical in nature, but provide an initial empirical corpus for further sub-typing efforts in BPD. A model-based taxonomy for BPD that is supported by evidence from an advanced statistical methodology would enhance investigations of BPD etiology, pathophysiology, and treatment. This study applied finite mixture modeling analysis, in a model-guided fashion, to selected dimensions of pathology within a group of well-characterized BPD patients to determine if latent groups are harbored within the disorder. Subjects with BPD (N = 90) were examined on a variety of model-relevant psychopathology dimensions. We applied finite mixture modeling to these dimensions. We then evaluated the validity of the obtained solution by reference to a variety of external measures not included in the initial mixture modeling. Three phenotypically distinct groups reside within the overall BPD category. Group-1 is characterized by low levels of antisocial, paranoid, and aggressive features. Group-2 is characterized by elevated paranoid features, whereas Group-3 is characterized by elevated antisocial and aggressive features. External correlates reveal a pattern of differences consistent with the validity of this proposed grouping structure. A theory-guided finite mixture modeling analysis supports a parsing of the BPD category into three subgroups. This proposed BPD taxonomy represents an approach to reducing heterogeneity observed among BPD patients and it may prove useful in studies seeking to understand etiologic and pathophysiologic factors as well as treatment response in BPD.     

Eating for pleasure or profit: the effect of incentives on children's enjoyment of vegetables

Parents commonly use rewards to encourage children to eat healthfully, but this practice remains controversial because rewards are suspected of undermining children's intrinsic motivation. A cluster-randomized trial examined children's acceptance of a disliked vegetable over 12 daily taste exposures. These exposures were paired with a tangible reward, a social reward, or no reward, and the findings were compared with the results from a no-treatment control condition. Liking and intake of the vegetable were assessed in a free-choice consumption task at preintervention, postintervention, 1 month after intervention, and 3 months after intervention. Liking increased more in the three intervention conditions than in the control condition, and there were no significant differences between the intervention conditions. These effects were maintained at follow-up. Children in both reward conditions increased consumption, and these effects were maintained for 3 months; however, the effects of exposure with no reward became nonsignificant by 3 months. These results indicate that external rewards do not necessarily produce negative effects and may be useful in promoting healthful eating.     

Flavour liking and preference conditioned by caffeine in humans

When caffeine consumers repeatedly experience a novel flavoured drink containing caffeine, the rated pleasantness of the drink flavour increases progressively. These results could be interpreted in terms of the flavour acting as a Pavlovian conditioned stimulus (CS) predicting the consequences of caffeine ingestion. However, all studies of this phenomenon to date have used between-subjects designs, and one criticism of this is that changes in pleasantness might have arisen from nonspecific effects. A more rigorous test is to examine changes in pleasantness for two drinks, a CS+ flavour paired with caffeine and CS- paired with placebo. Accordingly, 20 moderate caffeine consumers consumed both CS+ and CS- drinks in counterbalanced order over eight conditioning trials at breakfast, with hedonic and sensory characteristics evaluated on each trial. As predicted, the rated pleasantness of the CS+ drink increased whereas pleasantness of the CS- drink did not change. Despite this, participants did not have an overall preference for the CS+ flavour posttraining. However, both those who chose the CS+ and those who chose the CS- at the end showed the same direction and rate of change in pleasantness for the two drinks during training, but spurious differences in baseline preference obscured this effect in terms of an overall change in preference. Overall these data suggest that changes in pleasantness of drinks paired with caffeine delivery are best explained in terms of Pavlovian associations between drink flavour and the postingestive effects of caffeine.