Specificity of Insecure Attachment in Adolescents With Borderline Personality Disorder in Psychiatric Inpatient and Community-Dwelling Adolescents.

Borderline personality disorder (BPD) has been conceptualized as a disorder of attachment. However, the specificity of attachment insecurity to BPD in adolescents remains unclear. In this study, an inpatient sample (n = 521), of which 173 (33.2%) met the criteria for BPD, and a control sample of community-dwelling adolescents (n = 294) ages 12-17 were compared on a self-report measure of attachment security. In addition, hierarchical regression analyses were carried out to examine the incremental contribution of BPD symptoms, over and above internalizing and externalizing symptoms, in predicting attachment security. Results showed expected group differences such that adolescents with BPD evidenced higher levels of attachment insecurity to both fathers and mothers than psychiatric and community-dwelling controls. BPD features also incremented internalizing and externalizing problems associated with attachment security. However, because psychiatric controls also evidenced high levels of attachment insecurity, we conclude that while attachment insecurity is particularly salient for BPD, it is not necessarily specific to the disorder.

A Consumer Perspective on Personality Diagnostic Systems: One Size Does Not Fit All.

Although providers and patients may largely agree on what is essential to clinically useful assessment and diagnosis, patients have a unique voice and contribute additional information to our conceptualization of clinical utility. The current study evaluated the clinical utility of three diagnostic models (Section II categorial, Section III hybrid, and the original ICD-11 dimensional) from the consumer/user perspective. Participants included 703 undergraduate students and 154 family members or individuals with borderline personality disorder. Participants rated mock diagnostic reports on six indices of clinical utility. Results indicated that undergraduates favored categorical reports over the original ICD-11 dimensional reports on three of six indices but rated categorical and hybrid reports as essentially equivalent. In the patient/family sample, participants favored the hybrid or categorical model on all indices. Our findings speak to the value of a clear diagnostic label and suggest that future iterations of the DSM adopting a hybrid or dimensional model should have a continued focus on simplicity in communication.

Sampling methods in personality pathology research: Some data and recommendations.

The field of personality disorder research has grown since the publication of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, in 1980; with a notable evolution in the way that personality disorders are defined and operationalized. In evaluating this research, it is necessary to consider the range of sampling practices used. The goal of this study was to describe current sampling methods in personality disorder research and provide recommendations to guide sample design in future personality disorder research. To do this, we coded sampling practices described in recent empirical articles published in four journals that showcase research on personality disorders. We summarized aspects of sampling design including the combination of study question and sample characteristics (e.g., sample size, sample source, and use of screening), study design, and demographic representation of samples. Findings reveal a need for studies to better consider whether their samples are fit for purpose and to make explicit their target population and sampling frame, as well as the specific procedures (i.e., recruitment) used to carry out sampling. We also discuss issues that arise when attempting to capture low-base rate pathology, which is often associated with high comorbidity. We emphasize a process-oriented approach to developing a sampling strategy for personality disorders research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Levels of Personality Functioning Questionnaire 12-18 (LoPF-Q 12-18): Factor Structure, Validity, and Clinical Cut-Offs.

The Levels of Personality Functioning Questionnaire 12-18 (LoPF-Q 12-18) is the only self-report measure informed by the Level of Personality Functioning (Diagnostic and Statistical Manual of Mental Disorders [5th ed.; DSM-5; American Psychiatric Association, 2013]) Alternative Model of Personality Disorders developed for adolescents. The present investigation includes two studies evaluating the English LoPF-Q 12-18. In Study 1, single-factor and bifactor structures (unidimensional severity criterion and four specific factors: identity, self-direction, empathy, intimacy) were evaluated in an ethnically diverse community sample (N = 453; age 10-18; 57% female). Study 2 used a community control (n = 298; age 10-18; 54.4% female) and clinical sample (n = 94; age 11-18; 58.5% female) to examine reliability, validity, and clinical utility. Study 1 results supported the bifactor model, with a robust general factor and little multidimensionality caused by the group factors, suggesting an essentially unidimensional structure. Study 2 revealed good internal consistency and construct validity and provided clinical cut-offs, supporting the use of the LoPF-Q 12-18 total score in research and clinical applications.

Psychometric Properties of the Parent and Youth Versions of the Inadequate Boundaries Questionnaire in Community and Clinical Samples of Adolescents.

The Inadequate Boundaries Questionnaire (IBQ) was created as a multi-dimensional measure of boundary violations in parent-child relationships. Use of the IBQ has been increasing; however, its psychometric properties, including its proposed five-factor structure, have yet to be comprehensively evaluated. The current study examined the factor structure, reliability, mother-adolescent agreement, and convergent and discriminant validity of the IBQ-Parent and -Youth English versions among community and clinical adolescents and their mothers. Confirmatory factor analysis most strongly supported four factors: Guilt Induction-Psychological Control, Parentification, No Boundaries (Enmeshment), and Triangulation. The scales showed acceptable to excellent reliability. Mother-adolescent agreement was moderate in the healthy community sample and weaker in the clinical sample. Convergent and discriminant associations supported the validity of the Guilt Induction-Psychological Control scale, with a more complex picture emerging for other scales. Implications of these findings and directions for future research with the IBQ are discussed.

Screening for borderline personality pathology on college campuses.

Although borderline symptoms show a normative decline throughout adulthood, severe psychosocial impairment often remains. Identifying personality pathology in college-age students may help prevent "adaptive failure" that can occur during the critical period of development from puberty through the late 20s and thus reduce impairment later in life. The aims of the current study were to estimate the prevalence of borderline personality disorder (BPD) in a diverse college sample, determine which symptoms confer the greatest relative risk of screening positive for BPD and examine the utility of the Personality Inventory for DSM-5 brief form (PID-5-BF) in identifying BPD. Participants were 1456 undergraduate students, and 312 individuals (21.4% of the sample) screened positive for BPD. Chronic feelings of emptiness conferred the greatest relative risk of any symptom; students who endorsed this symptom were 15 times more likely to screen positive for BPD than those who did not. Scales and composite scores of the PID-5-BF demonstrated diagnostic accuracy ranging from sufficient to excellent. The current study contributes to literature concerning best practices in screening for personality pathology in young adults. Results suggest that chronic feelings of emptiness are significant for detecting at-risk students and implications for the use of the PID-5-BF are discussed.