Borderline personality disorder diagnosis in a new key


Journal article


Abby L. Mulay, Mark H. Waugh, J. Parks Fillauer, Donna S. Bender, Anthony Bram, Nicole M. Cain, Eve Caligor, Miriam K. Forbes, Laurel B. Goodrich, Jan H. Kamphuis, Jared W. Keeley, Robert F. Krueger, John E. Kurtz, Peter Jacobsson, Katie C. Lewis, Gina M. P. Rossi, Jeremy M. Ridenour, Michael Roche, Martin Sellbom, Carla Sharp, Andrew E. Skodol
Borderline Personality Disorder and Emotion Dysregulation, vol. 6, Springer, Springer Nature, 2019 Dec 2


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APA   Click to copy
Mulay, A. L., Waugh, M. H., Fillauer, J. P., Bender, D. S., Bram, A., Cain, N. M., … Skodol, A. E. (2019). Borderline personality disorder diagnosis in a new key. Borderline Personality Disorder and Emotion Dysregulation, 6. https://doi.org/10.1186/s40479-019-0116-1


Chicago/Turabian   Click to copy
Mulay, Abby L., Mark H. Waugh, J. Parks Fillauer, Donna S. Bender, Anthony Bram, Nicole M. Cain, Eve Caligor, et al. “Borderline Personality Disorder Diagnosis in a New Key.” Borderline Personality Disorder and Emotion Dysregulation 6 (December 2, 2019).


MLA   Click to copy
Mulay, Abby L., et al. “Borderline Personality Disorder Diagnosis in a New Key.” Borderline Personality Disorder and Emotion Dysregulation, vol. 6, Springer, Springer Nature, Dec. 2019, doi:10.1186/s40479-019-0116-1.


BibTeX   Click to copy

@article{mulay2019a,
  title = {Borderline personality disorder diagnosis in a new key},
  year = {2019},
  month = dec,
  day = {2},
  journal = {Borderline Personality Disorder and Emotion Dysregulation},
  publisher = {Springer, Springer Nature},
  volume = {6},
  doi = {10.1186/s40479-019-0116-1},
  author = {Mulay, Abby L. and Waugh, Mark H. and Fillauer, J. Parks and Bender, Donna S. and Bram, Anthony and Cain, Nicole M. and Caligor, Eve and Forbes, Miriam K. and Goodrich, Laurel B. and Kamphuis, Jan H. and Keeley, Jared W. and Krueger, Robert F. and Kurtz, John E. and Jacobsson, Peter and Lewis, Katie C. and Rossi, Gina M. P. and Ridenour, Jeremy M. and Roche, Michael and Sellbom, Martin and Sharp, Carla and Skodol, Andrew E.},
  month_numeric = {12}
}

Abstract

Background: Conceptualizations of personality disorders (PD) are increasingly moving towards dimensional approaches. The definition and assessment of borderline personality disorder (BPD) in regard to changes in nosology are of great importance to theory and practice as well as consumers. We studied empirical connections between the traditional DSM-5 diagnostic criteria for BPD and Criteria A and B of the Alternative Model for Personality Disorders (AMPD).

Method: Raters of varied professional backgrounds possessing substantial knowledge of PDs (N = 20) characterized BPD criteria with the four domains of the Level of Personality Functioning Scale (LPFS) and 25 pathological personality trait facets. Mean AMPD values of each BPD criterion were used to support a nosological cross-walk of the individual BPD criteria and study various combinations of BPD criteria in their AMPD translation. The grand mean AMPD profile generated from the experts was compared to published BPD prototypes that used AMPD trait ratings and the DSM-5-III hybrid categorical-dimensional algorithm for BPD. Divergent comparisons with DSM-5-III algorithms for other PDs and other published PD prototypes were also examined.

Results: Inter-rater reliability analyses showed generally robust agreement. The AMPD profile for BPD criteria rated by individual BPD criteria was not isomorphic with whole-person ratings of BPD, although they were highly correlated. Various AMPD profiles for BPD were generated from theoretically relevant but differing configurations of BPD criteria. These AMPD profiles were highly correlated and showed meaningful divergence from non-BPD DSM-5-III algorithms and other PD prototypes.

Conclusions: Results show that traditional DSM BPD diagnosis reflects a common core of PD severity, largely composed of LPFS and the pathological traits of anxiousness, depressively, emotional lability, and impulsivity. Results confirm the traditional DSM criterion-based BPD diagnosis can be reliably cross-walked with the full AMPD scheme, and both approaches share substantial construct overlap. This relative equivalence suggests the vast clinical and research literatures associated with BPD may be brought forward with DSM-5-III diagnosis of BPD.


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