scholarly journals Clinically useful screen for borderline personality disorder in psychiatric out-patients

2017 ◽  
Vol 210 (2) ◽  
pp. 165-166 ◽  
Author(s):  
Mark Zimmerman ◽  
Matthew D. Multach ◽  
Kristy Dalrymple ◽  
Iwona Chelminski
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Diagnostic Interview ◽  
Borderline Personality ◽  
The Other ◽  
Instability Criterion ◽  
Single Feature ◽  
Affective Instability ◽  
Dsm Iv ◽  
Structured Diagnostic Interview

SummaryA total of 3674 psychiatric out-patients were evaluated with a semi-structured diagnostic interview for DSM-IV borderline personality disorder (BPD). The affective instability criterion had a sensitivity of 92.8%, higher than the sensitivities of the other eight BPD criteria. The negative predictive value of the affective instability criterion was 99%. We recommend that clinicians screen for BPD in the same way that they screen for other psychiatric disorders: by enquiring about a single feature of the disorder (i.e. affective instability), the presence of which identifies most patients with the disorder and the absence of which rules out the disorder.

scholarly journals A psychometric evaluation of the DSM-IV borderline personality disorder criteria: age and sex moderation of criterion functioning

2009 ◽  
Vol 39 (12) ◽  
pp. 1967-1978 ◽  
Author(s):  
S. H. Aggen ◽  
M. C. Neale ◽  
E. Røysamb ◽  
T. Reichborn-Kjennerud ◽  
K. S. Kendler
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychometric Evaluation ◽  
Factor Loading ◽  
Borderline Personality ◽  
Item Response Modeling ◽  
Young Females ◽  
Affective Instability ◽  
Dsm Iv ◽  
Age And Sex

BackgroundDespite its importance as a paradigmatic personality disorder, little is known about the measurement invariance of the DSM-IV borderline personality disorder (BPD) criteria; that is, whether the criteria assess the disorder equivalently across different groups.MethodBPD criteria were evaluated at interview in 2794 young adult Norwegian twins. Analyses, based on item-response modeling, were conducted to test for differential age and sex moderation of the individual BPD criteria characteristics given factor-level covariate effects.ResultsConfirmatory factor analytic results supported a unidimensional structure for the nine BPD criteria. Compared to males, females had a higher BPD factor mean, larger factor variance and there was a significant age by sex interaction on the factor mean. Strong differential sex and age by sex interaction effects were found for the ‘impulsivity’ criterion factor loading and threshold. Impulsivity related to the BPD factor poorly in young females but improved significantly in older females. Males reported more impulsivity compared to females and this difference increased with age. The ‘affective instability’ threshold was also moderated, with males reporting less than expected.ConclusionsThe results suggest the DSM-IV BPD ‘impulsivity’ and ‘affective instability’ criteria function differentially with respect to age and sex, with impulsivity being especially problematic. If verified, these findings have important implications for the interpretation of prior research with these criteria. These non-invariant age and sex effects may be identifying criteria-level expression features relevant to BPD nosology and etiology. Criterion functioning assessed using modern psychometric methods should be considered in the development of DSM-V.

scholarly journals The contribution of familial internalizing and externalizing liability factors to borderline personality disorder

2014 ◽  
Vol 44 (11) ◽  
pp. 2397-2407 ◽  
Author(s):  
J. I. Hudson ◽  
M. C. Zanarini ◽  
K. S. Mitchell ◽  
L. W. Choi-Kain ◽  
J. G. Gunderson
Keyword(s):  
Major Depressive Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Externalizing Disorders ◽  
Diagnostic Interview ◽  
Borderline Personality ◽  
Major Depressive ◽  
Dsm Iv ◽  
Internalizing And Externalizing

BackgroundIndividuals with borderline personality disorder (BPD) frequently display co-morbid mental disorders. These disorders include ‘internalizing’ disorders (such as major depressive disorder and anxiety disorders) and ‘externalizing’ disorders (such as substance use disorders and antisocial personality disorder). It is hypothesized that these disorders may arise from latent ‘internalizing’ and ‘externalizing’ liability factors. Factor analytic studies suggest that internalizing and externalizing factors both contribute to BPD, but the extent to which such contributions are familial is unknown.MethodParticipants were 368 probands (132 with BPD; 134 without BPD; and 102 with major depressive disorder) and 885 siblings and parents of probands. Participants were administered the Diagnostic Interview for DSM-IV Personality Disorders, the Revised Diagnostic Interview for Borderlines, and the Structured Clinical Interview for DSM-IV.ResultsOn confirmatory factor analysis of within-person associations of disorders, BPD loaded moderately on internalizing (factor loading 0.53, s.e. = 0.10, p < 0.001) and externalizing latent variables (0.48, s.e. = 0.10, p < 0.001). Within-family associations were assessed using structural equation models of familial and non-familial factors for BPD, internalizing disorders, and externalizing disorders. In a Cholesky decomposition model, 84% (s.e. = 17%, p < 0.001) of the association of BPD with internalizing and externalizing factors was accounted for by familial contributions.ConclusionsFamilial internalizing and externalizing liability factors are both associated with, and therefore may mutually contribute to, BPD. These familial contributions account largely for the pattern of co-morbidity between BPD and internalizing and externalizing disorders.

Borderline personality disorder: does its clinical features show specificity to differing developmental risk factors?

2018 ◽  
Vol 26 (4) ◽  
pp. 410-413 ◽  
Author(s):  
Gordon Parker ◽  
Stacey McCraw ◽  
Adam Bayes
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Clinical Sample ◽  
Diagnostic Interview ◽  
Borderline Personality ◽  
Self Report ◽  
Therapeutic Interventions ◽  
Identity Disturbance ◽  
Developmental Factors ◽  
Dsm Iv

Objectives: To determine if differing developmental factors show specificity to differing manifestations of borderline personality disorder (BPD). Methods: A clinical sample of 73 females diagnosed with BPD undertook a psychiatrist interview and completed self-report questionnaires, including the semi-structured Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV) assessing for BPD status. A set of negative and potentially traumatic developmental factors were included in the assessment. Results: Childhood sexual abuse, affirmed by 49% of the sample, showed specificity in being linked with DIPD-defined affective instability. DIPD-defined identity disturbance also showed specificity in being associated only with reporting significant non-sexual developmental trauma. DIPD-defined anger and paranoia/dissociation showed minimal specificity and were associated with most antecedent developmental factors in adulthood. Conclusions: Differing manifestations of BPD are likely to be shaped by specific and non-specific developmental events. Clarification of such links has the potential to shape more specific therapeutic interventions.

Comparison of Three Questionnaires to Screen for Borderline Personality Disorder in Adolescents and Young Adults

2017 ◽  
Vol 33 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Anne van Alebeek ◽  
Paul T. van der Heijden ◽  
Christel Hessels ◽  
Melissa S.Y. Thong ◽  
Marcel van Aken
Keyword(s):  
Young Adults ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Adolescents And Young Adults ◽  
Patient Questionnaire ◽  
Statistical Manual ◽  
Axis Ii ◽  
Diagnostic And Statistical Manual ◽  
Dsm Iv

Abstract. One of the most common personality disorders among adolescents and young adults is the Borderline Personality Disorder (BPD). The objective of current study was to assess three questionnaires that can reliably screen for BPD in adolescents and young adults (N = 53): the McLean Screening Instrument for BPD (MSI-BPD; Zanarini et al., 2003 ), the Personality Diagnostic Questionnaire 4th edition – BPD scale (PDQ-4 BPD; Hyler, 1994 ), and the SCID-II Patient Questionnaire – BPD scale (SCID-II-PQ BPD). The nine criteria of BPD according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV; APA, 1994 ) were measured with the Structural Clinical Interview for DSM-IV Axis II disorders – BPD scale (SCID-II; First, Spitzer, Gibbon, Williams, & Benjamin, 1995 ). Correlations between the questionnaires and the SCID-II were calculated. In addition, the sensitivity and specificity of the questionnaires were tested. All instruments predicted the BPD diagnosis equally well.

scholarly journals Paliperidone ER in the Treatment of Borderline Personality Disorder: A Pilot Study of Efficacy and Tolerability

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Silvio Bellino ◽  
Paola Bozzatello ◽  
Camilla Rinaldi ◽  
Filippo Bogetto
Keyword(s):  
Borderline Personality Disorder ◽  
Pilot Study ◽  
Personality Disorder ◽  
Adverse Events ◽  
Mechanism Of Action ◽  
Severity Index ◽  
Borderline Personality ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Dsm Iv

Antipsychotics are recommended for the treatment of impulsive dyscontrol and cognitive perceptual symptoms of borderline personality disorder (BPD). Three reports supported the efficacy of oral risperidone on BPD psychopathology. Paliperidone ER is the metabolite of risperidone with a similar mechanism of action, and its osmotic release reduces plasmatic fluctuations and antidopaminergic effects. The aim of this study is to evaluate efficacy and safety of paliperidone ER in BPD patients. 18 outpatients with a DSM-IV-TR diagnosis of BPD were treated for 12 weeks with paliperidone ER (3–6 mg/day). They were assessed at baseline, week 4, and week 12, using the CGI-Severity item, the BPRS, the HDRS, the HARS, the SOFAS, the BPD Severity Index (BPDSI), and the Barratt Impulsiveness Scale (BIS-11). Adverse events were evaluated with the DOTES. Paliperidone ER was shown to be effective and well tolerated in reducing severity of global symptomatology and specific BPD symptoms, such as impulsive dyscontrol, anger, and cognitive-perceptual disturbances. Results need to be replicated in controlled trials.

scholarly journals Self-esteem instability and affective instability in everyday life after remission from borderline personality disorder

2020 ◽  
Author(s):  
Philip Samuel Santangelo ◽  
Tobias D. Kokler ◽  
Marie-Luise Zeitler ◽  
Rebekka Knies ◽  
Nikolaus Kleindienst ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Self Esteem ◽  
Borderline Personality ◽  
Specific Symptom ◽  
Affective Dysregulation ◽  
Daily Life Activities ◽  
Diary Studies ◽  
Affective Instability

Abstract Background: Borderline personality disorder (BPD) is defined by a pervasive pattern of instability. According to prior findings and clinical theories, self-esteem instability and affective instability are key features of BPD. Previous e-diary studies showed that instability in self-esteem is heightened and that it is highly intertwined with affective instability in BPD in comparison to healthy controls (HC). The present study sought to extend these findings by adding symptomatologically remitted BPD patients (BPD-REM), i.e. former patients with BPD who met four or fewer BPD criteria within the past year, as a comparison group.Methods: To examine differences regarding self-esteem instability and affective instability, we used e-diaries for repeatedly collecting data on self-esteem, valence, and tense arousal 12 times a day for four consecutive days while participants underwent their daily life activities. Determining three different state-of-the-art instability indices and applying multilevel analyses, we compared 35 BPD-REM participants with previously reported 60 acute BPD patients (BPD-ACU) and 60 HC.Results: Our results revealed that self-esteem instability was significantly lower in the BPD-REM compared to the BPD-ACU group, irrespective of the instability index. In contrast, there were no significant differences regarding affective instability between the BPD-REM participants and those in the BPD-ACU group. The comparison between the BPD-REM with the HC indicated both a significantly higher instability in self-esteem as well as significantly heightened affective instability in the BPD-REM participants. Moreover, even though the associations were not significant, we found tentative support for the assumption that affective changes that are accompanied by changes in self-esteem are experienced as more burdensome and negatively impact the quality of life of remitted BPD participants.Conclusions: This study builds on growing evidence for the importance of self-esteem instability in BPD. Whereas affective instability has been reported in various psychiatric disorders and might indeed constitute a transdiagnostic marker of affective dysregulation, our results indicate that self-esteem instability might be a specific symptom that construes the unique pathology in BPD.

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