Borderline Personality Disorder and Eating Disorders: Investigating the Role of Emotion Regulation.

Objective: Borderline personality disorder (BPD) and eating disorders (EDs) both cause significant distress and co-occur at rates higher than expected, signifying potential overlapping regulatory mechanisms between both disorders. More specifically, both disorders involve emotion regulation deficits, suggesting they may share specific maladaptive regulatory components. The present study sought to examine the predictive role of emotion dysregulation within the comorbidity between EDs and BPD.Methods: A sample of psychiatric outpatients (N = 872) collected from a longitudinal study spanning the mid-1990s to 2015 completed the Structured Clinical Interview for DSM-IV for Axis I Disorders as well as a measure of emotion regulation strategies, the Difficulties in Emotion Regulation Scale, in order to assess overall functioning.Results: In a regression analysis, BPD was significantly predicted by emotion regulation deficits and was strongly related to categories of emotion dysregulation. EDs were not significantly predicted by emotion regulation deficits but did predict BPD diagnoses (B = -0.14, P < .001). Overall, BPD demonstrated strong relationships to emotion regulation deficits.Conclusions: Results indicate that targeted treatment focusing on emotion regulation deficits may be particularly indicated with co-occurring BPD and ED diagnoses.

The alternative model of personality disorder is inadequate for capturing obsessive-compulsive personality disorder.

The alternative model of personality disorder (AMPD) included in Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) reconceptualized personality pathology in terms of pathological traits and impairments in functioning. For example, the construct of obsessive-compulsive personality disorder (OCPD) was reconceptualized via the traits of rigid perfectionism as well as at least 2 of perseveration, intimacy avoidance, and restricted affectivity. We review the literature to summarize how effectively the legacy construct of OCPD is captured by the AMPD. We conclude that although the trait of rigid perfectionism is highly related to scores on OCPD measures, the AMPD as a whole fails to adequately account for the broader features of the legacy OCPD construct. Specifically, the AMPD trait model lacks a number of traits, such as workaholism, excessive deliberation, and moral scrupulousness, which are necessary for a fulsome dimensional trait system. These limitations in the inclusion of important traits stem from the AMPD's development process that left out crucial content. We outline how the AMPD could be improved in its ability to account for problems of overcontrolled behavior. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Ratings of dimensional traits in clinical practice: Comparing therapist and client perspectives.

Research has repeatedly evidenced the structural validity of the five-factor model (FFM), but questions remain about the use of its dimensions in clinical practice. Samuel and colleagues (2018) found therapists reported their clients had lower levels of personality pathology compared with clients' own self-reports when using the unipolar Personality Inventory for the DSM-5 (PID-5) scale. The present study utilized the same sample of 54 client-therapist dyads to examine their use of the bipolar FFM Rating Form. When comparing the clinical ratings to expertly rated healthy profile ratings, clients rated themselves as more aligned with healthy than their therapists rated them. Alternatively, clients were up to 3.6 times more likely to use the extreme (i.e., theoretically pathological) ratings of the FFM Rating Form compared with their therapists. These results suggest that therapists and clients use these measures quite differently, and we cannot firmly conclude which source reports more pathology. Theoretical explanations, limitations, and future directions are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).