Longitudinal diagnostic efficiency of DSM-IV criteria for borderline personality disorder: a 2-year prospective study (original) (raw)
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Exploring the clinical validity of borderline personality disorder components
Comprehensive Psychiatry, 2013
Borderline personality disorder (BPD) is recognized as a complex syndrome, resulting in a heterogeneous diagnostic category. Besides the characteristics of the disorder itself, comorbid disorders play an important role in this complexity. The aim of the study is to analyze the clinical validity of 3 components for BPD Diagnostic and Statistical Manual of Mental Disorders criteria-called affective dysregulation, behavioral dysregulation, and disturbed relatedness-investigating differences in patterns of comorbidity. For this purpose, 365 patients with suspected BPD were included in the study. To test our hypothesis, patients were classified into 5 clusters using a K-cluster analysis to study the clinical validity of the 3 components based on the 3-factor model of BPD. Differences in comorbidity, previous suicide attempts, and self-harm behaviors among the defined clusters were analyzed. Between-cluster differences were observed for Axis I and Axis II disorders as well as in the frequency of suicide attempts and in self-harm behaviors. The study of BPD based on the 3 components seems to be more useful than the study of BPD as a unitary construct to help further our understanding of this complex disorder. In the present study, the 3 BPD components have allowed us to analyze the complex comorbidity of BPD patients. This solution could be considered an interesting way to clarify BPD etiology, diagnosis, and treatment efficacy.
Borderline personality disorder diagnosis in a new key
Borderline Personality Disorder and Emotion Dysregulation
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 ...
Psicothema, 2012
This study assesses whether patients diagnosed with Borderline Personality Disorder (BPD) according to the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) or the Revised Diagnostic Interview for Borderlines (DIB-R) present differences in factors associated with risk of poor outcome. Three hundred fifty-two patients were evaluated with SCID-II and DIB-R. Patients diagnosed as BPD according to one or both instruments were compared in BPD poor outcome risk factors. The analysis was conducted on the participants who were assigned to SCID-II (n = 135) and SCID-II/DIB-R (n = 126) groups. The group diagnosed with BPD according the combined SCID-II/DIB-R interview showed a significantly greater association with risk of poor outcome predictors, such as total number of comorbid Axis II disorders, number of BPD criteria, presence of comorbid paranoid personality disorder, and worse occupational status. No differences between groups were found in the affective instability BPD criterion, self-reported impulsivity, post-traumatic stress disorder, major depressive disorder or presence of any cluster C comorbidity. The observed differences were large enough to advise caution in generalizing findings from studies without considering what measurement was used for the BPD diagnosis.
Efficient Diagnosis of Borderline Personality Disorder
Journal of Personality Disorders, 1987
A 17-item combined criteria instrument (CCI) for the diagnosis of borderline personality disorder (BPD) utilizing criteria items common to the work of Kernberg. Grinker, and Gunderson and DSM-III was administered to 17 hospitalized BPD patients and 20 normal control subjects. The patients met criteria for BPD using DSM-III and the Diagnostic Interview for Borderline Scale. Examination of sensitivity, specificity, and the positive and negative predictive power of the combined criteria demonstrated that the items impulsivity, unstable relationships, chronic depressive emptiness, loneliness, boredom, and acting out are discriminating items for BPD. The essential features for BPD diagnosis are contained in the DSM-III. However, significantly fewer than five of eight items of DSM-III criteria adequately identified borderline patients. The results and techniques illustrate that some characteristics, and particularly some combinations of characteristics, may be more prototypical of the syndrome's expression and have a higher probability of leading to accurate diagnosis.
Borderline Personality Disorder: DSM - Diagnosing and Empirically-Based Treatment
The DSM-IV is widely used in the mental health field. Some of its many uses include providing a common language among professionals about psychopathology and delineating criteria for diagnosing individuals with mental disorders. This paper explores the purpose, history, and limitations of the DSM diagnostic approach. A case study is provided and the DSM-IV-TR is used to diagnosis borderline personality disorder. The disorder is described and an empirically-based treatment plan is offered.
Journal of Personality Disorders, 2009
A new self-rated scale to measure severity and change in persons with borderline personality disorder (BPD) is described. The Borderline Evaluation of Severity Over Time (BEST) was developed to rate the thoughts, emotions, and behaviors typical of BPD. Data were collected in the course of a randomized controlled trial (RCT) of Systems Training for Emotional Predictability and Problem Solving (STEPPS) for subjects with BPD. The instrument showed moderate testretest reliability, high internal consistency, and high discriminant validity. Its 15 separate items showed a moderate or better correlation with the total score. The BEST was also sensitive to clinical change as early as week 4 of the RCT and correlated highly with other measures of illness severity. We conclude that the new scale is both reliable and valid in measuring severity and change in persons with BPD.