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Research article
Latent Profiles of Patients with Borderline Pathology Based on the Alternative DSM-5 Model for Personality Disorders
Dominick Gamache
Université du Québec à Trois-Rivières: Universite du Quebec a Trois-Rivieres
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8735-712X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Borderline Personality Disorder and Emotion Dysregulation.
Background
There have been multiple attempts to try to parse out heterogeneity within borderline pathology by identifying patient subtypes; thus far, these works have yielded few consistent results. Recent developments in the operationalization of borderline pathology may provide new opportunities to identify clinically and conceptually meaningful subgroups of patients. The Alternative DSM-5 Model for Personality Disorders (AMPD) offers a categorical-dimensional operationalization of Borderline personality disorder (BPD) that has yet to be tested for identification of patient subgroups. The purpose of the present study is to test whether the combination of the Criterion A elements (pertaining to level of severity) and the seven pathological traits from Criterion B that define BPD in the AMPD can yield meaningful patient profiles.
Methods
A total of 211 outpatients from a specialized PD treatment program (133 women, Mage = 33.66, SD = 10.97) were selected based on the presence of at least moderate borderline pathology according to cutoffs recently proposed for the Borderline Symptom List-23. Valid Criterion A (Self and Interpersonal Functioning Scale) and B (Personality Inventory for DSM-5-Short Form) self-reports were administered to measure elements and traits that define BPD in the AMPD model; these variables were used as indicators in a Latent profile analysis (LPA).
Results
The optimal solution generated by LPA yielded four distinct profiles: (a) Borderline traits; (b) Low borderline pathology with Impulsivity; (c) Moderate borderline pathology with Identity problems and Depressivity; and (d) Severe borderline pathology. Clinically meaningful distinctions emerged between profiles on AMPD indicators and external variables relevant to PD, especially aggression and impulsivity.
Conclusions
Profiles reflected both the “severity” and “style” components imbedded within Criterion A and B of the AMPD, as they were mainly distinguished by a continuum of severity but also by some meaningful qualitative differences that may have important clinical implications for treatment planning and contracting. Results also suggest that the four Criterion A elements have independent value to identify important differences in patients with borderline pathology. They also highlight that some Criterion B traits that define BPD in the AMPD may be especially important to identify subgroups of patients, mainly Impulsivity and Depressivity.
Keywords
DSM-5, Alternative Model for Personality Disorders, borderline personality disorder, Criterion A, Criterion B, latent profile analysis
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CURRENT STATUS: Published
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Posted 19 Oct, 2020
Published
On 11 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 10 Dec, 2020
Review #2 received
Received 07 Dec, 2020
Review #1 received
Received 07 Nov, 2020
Reviewer #2 agreed
On 01 Nov, 2020
Reviewer #1 agreed
On 31 Oct, 2020
Reviewers invited
Invitations sent on 30 Oct, 2020
Editor assigned
On 12 Oct, 2020
Submission checks complete
On 11 Oct, 2020
Editor invited
On 11 Oct, 2020
First submitted
On 09 Oct, 2020
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Subject Areas
Psychology
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This preprint is under consideration at Borderline Personality Disorder and Emotion Dysregulation. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Latent Profiles of Patients with Borderline Pathology Based on the Alternative DSM-5 Model for Personality Disorders
Dominick Gamache
Université du Québec à Trois-Rivières: Universite du Quebec a Trois-Rivieres
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8735-712X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 1
Posted 19 Oct, 2020
Published
On 11 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 10 Dec, 2020
Review #2 received
Received 07 Dec, 2020
Review #1 received
Received 07 Nov, 2020
Reviewer #2 agreed
On 01 Nov, 2020
Reviewer #1 agreed
On 31 Oct, 2020
Reviewers invited
Invitations sent on 30 Oct, 2020
Editor assigned
On 12 Oct, 2020
Submission checks complete
On 11 Oct, 2020
Editor invited
On 11 Oct, 2020
First submitted
On 09 Oct, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Psychology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Borderline Personality Disorder and Emotion Dysregulation.
Background
There have been multiple attempts to try to parse out heterogeneity within borderline pathology by identifying patient subtypes; thus far, these works have yielded few consistent results. Recent developments in the operationalization of borderline pathology may provide new opportunities to identify clinically and conceptually meaningful subgroups of patients. The Alternative DSM-5 Model for Personality Disorders (AMPD) offers a categorical-dimensional operationalization of Borderline personality disorder (BPD) that has yet to be tested for identification of patient subgroups. The purpose of the present study is to test whether the combination of the Criterion A elements (pertaining to level of severity) and the seven pathological traits from Criterion B that define BPD in the AMPD can yield meaningful patient profiles.
Methods
A total of 211 outpatients from a specialized PD treatment program (133 women, Mage = 33.66, SD = 10.97) were selected based on the presence of at least moderate borderline pathology according to cutoffs recently proposed for the Borderline Symptom List-23. Valid Criterion A (Self and Interpersonal Functioning Scale) and B (Personality Inventory for DSM-5-Short Form) self-reports were administered to measure elements and traits that define BPD in the AMPD model; these variables were used as indicators in a Latent profile analysis (LPA).
Results
The optimal solution generated by LPA yielded four distinct profiles: (a) Borderline traits; (b) Low borderline pathology with Impulsivity; (c) Moderate borderline pathology with Identity problems and Depressivity; and (d) Severe borderline pathology. Clinically meaningful distinctions emerged between profiles on AMPD indicators and external variables relevant to PD, especially aggression and impulsivity.
Conclusions
Profiles reflected both the “severity” and “style” components imbedded within Criterion A and B of the AMPD, as they were mainly distinguished by a continuum of severity but also by some meaningful qualitative differences that may have important clinical implications for treatment planning and contracting. Results also suggest that the four Criterion A elements have independent value to identify important differences in patients with borderline pathology. They also highlight that some Criterion B traits that define BPD in the AMPD may be especially important to identify subgroups of patients, mainly Impulsivity and Depressivity.
Figure 1
Figure 2