Heterogeneity of borderline personality disorder symptoms in help-seeking adolescents
Abstract Background The heterogeneous presentation of borderline personality disorder (BPD) represents a clinical challenge. There is an ongoing scientific debate whether the heterogeneity can best be understood in terms of qualitative (categorical) or quantitative (dimensional) differences between...
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | Borderline Personality Disorder and Emotion Dysregulation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40479-021-00147-9 |
| _version_ | 1818649089540096000 |
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| author | Marialuisa Cavelti Stefan Lerch Denisa Ghinea Gloria Fischer-Waldschmidt Franz Resch Julian Koenig Michael Kaess |
| author_facet | Marialuisa Cavelti Stefan Lerch Denisa Ghinea Gloria Fischer-Waldschmidt Franz Resch Julian Koenig Michael Kaess |
| author_sort | Marialuisa Cavelti |
| collection | DOAJ |
| description | Abstract Background The heterogeneous presentation of borderline personality disorder (BPD) represents a clinical challenge. There is an ongoing scientific debate whether the heterogeneity can best be understood in terms of qualitative (categorical) or quantitative (dimensional) differences between individuals. The present study examined the latent structure of BPD in adolescents. Methods Five-hundred and six outpatients aged 12 to 17 years with risk-taking and/or self-harming behavior were assessed at baseline and one-year follow-up. Latent class analysis (corresponding with the categorical approach), factor analysis (corresponding with the dimensional approach), and factor mixture models (allowing for both categorical and dimensional aspects) were applied to the DSM-IV BPD criteria. Results The best fitting model distinguished between a majority class with high probabilities for all BPD criteria (“borderline group”) and a minority class with high probabilities for the impulsivity and anger criteria only (“impulsive group”). Sex significantly affected latent class membership, and both a latent factor and age explained within-class variability. The borderline group primarily consisted of females, frequently reported adverse childhood experiences, scored high on the emotion dysregulation and inhibitedness personality traits, and was associated with internalizing psychopathology. In contrast, the impulsive group primarily consisted of males, scored high on the dissocial behavior personality trait, and was associated with externalizing psychopathology. After one year, the two groups showed similar clinical improvement. Conclusions The study provides evidence for two distinct subgroups of adolescents with BPD features that resemble the subtypes of the ICD-10 emotionally unstable personality disorder. More research is needed to further investigate the diagnostic stability of the two groups over time and potential differential treatment indications. |
| first_indexed | 2024-12-17T01:28:47Z |
| format | Article |
| id | doaj.art-6329b6271fc0439cb0320b6b02c7cc63 |
| institution | Directory Open Access Journal |
| issn | 2051-6673 |
| language | English |
| last_indexed | 2024-12-17T01:28:47Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Borderline Personality Disorder and Emotion Dysregulation |
| spelling | doaj.art-6329b6271fc0439cb0320b6b02c7cc632022-12-21T22:08:39ZengBMCBorderline Personality Disorder and Emotion Dysregulation2051-66732021-02-018111410.1186/s40479-021-00147-9Heterogeneity of borderline personality disorder symptoms in help-seeking adolescentsMarialuisa Cavelti0Stefan Lerch1Denisa Ghinea2Gloria Fischer-Waldschmidt3Franz Resch4Julian Koenig5Michael Kaess6University Hospital for Child and Adolescent Psychiatry and Psychotherapy, University of BernUniversity Hospital for Child and Adolescent Psychiatry and Psychotherapy, University of BernSection for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of HeidelbergSection for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of HeidelbergClinic for Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of HeidelbergUniversity Hospital for Child and Adolescent Psychiatry and Psychotherapy, University of BernUniversity Hospital for Child and Adolescent Psychiatry and Psychotherapy, University of BernAbstract Background The heterogeneous presentation of borderline personality disorder (BPD) represents a clinical challenge. There is an ongoing scientific debate whether the heterogeneity can best be understood in terms of qualitative (categorical) or quantitative (dimensional) differences between individuals. The present study examined the latent structure of BPD in adolescents. Methods Five-hundred and six outpatients aged 12 to 17 years with risk-taking and/or self-harming behavior were assessed at baseline and one-year follow-up. Latent class analysis (corresponding with the categorical approach), factor analysis (corresponding with the dimensional approach), and factor mixture models (allowing for both categorical and dimensional aspects) were applied to the DSM-IV BPD criteria. Results The best fitting model distinguished between a majority class with high probabilities for all BPD criteria (“borderline group”) and a minority class with high probabilities for the impulsivity and anger criteria only (“impulsive group”). Sex significantly affected latent class membership, and both a latent factor and age explained within-class variability. The borderline group primarily consisted of females, frequently reported adverse childhood experiences, scored high on the emotion dysregulation and inhibitedness personality traits, and was associated with internalizing psychopathology. In contrast, the impulsive group primarily consisted of males, scored high on the dissocial behavior personality trait, and was associated with externalizing psychopathology. After one year, the two groups showed similar clinical improvement. Conclusions The study provides evidence for two distinct subgroups of adolescents with BPD features that resemble the subtypes of the ICD-10 emotionally unstable personality disorder. More research is needed to further investigate the diagnostic stability of the two groups over time and potential differential treatment indications.https://doi.org/10.1186/s40479-021-00147-9AdolescenceBorderline personality disorderEmotionally unstable personality disorderCategorical and dimensional models of personalityFactor mixture models |
| spellingShingle | Marialuisa Cavelti Stefan Lerch Denisa Ghinea Gloria Fischer-Waldschmidt Franz Resch Julian Koenig Michael Kaess Heterogeneity of borderline personality disorder symptoms in help-seeking adolescents Borderline Personality Disorder and Emotion Dysregulation Adolescence Borderline personality disorder Emotionally unstable personality disorder Categorical and dimensional models of personality Factor mixture models |
| title | Heterogeneity of borderline personality disorder symptoms in help-seeking adolescents |
| title_full | Heterogeneity of borderline personality disorder symptoms in help-seeking adolescents |
| title_fullStr | Heterogeneity of borderline personality disorder symptoms in help-seeking adolescents |
| title_full_unstemmed | Heterogeneity of borderline personality disorder symptoms in help-seeking adolescents |
| title_short | Heterogeneity of borderline personality disorder symptoms in help-seeking adolescents |
| title_sort | heterogeneity of borderline personality disorder symptoms in help seeking adolescents |
| topic | Adolescence Borderline personality disorder Emotionally unstable personality disorder Categorical and dimensional models of personality Factor mixture models |
| url | https://doi.org/10.1186/s40479-021-00147-9 |
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