Jessica R Peters1, Michael L Crowe1,2, Theresa Morgan3, Mark Zimmerman4, Carla Sharp5, Carlos M Grilo6, Charles A Sanislow7, M Tracie Shea1, Mary C Zanarini8, Thomas H McGlashan6, Leslie C Morey9, Andrew E Skodol10, Shirley Yen1,11. 1. Alpert Medical School of Brown University, Providence, USA. 2. VA Boston Healthcare System, Boston, USA. 3. Butler Hospital, Alpert Medical School of Brown University, Providence, USA. 4. Rhode Island Hospital, Alpert Medical School of Brown University, Providence, USA. 5. University of Houston,Houston, USA. 6. Yale School of Medicine, New Haven, USA. 7. Wesleyan University,Middletown, USA. 8. McLean Hospital, Harvard Medical School,Boston, USA. 9. Texas A&M University,College Station, USA. 10. University of Arizona College of Medicine,Tucson, USA. 11. Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Harvard Medical School,Boston, USA.
Abstract
BACKGROUND: Numerous theories posit different core features to borderline personality disorder (BPD). Recent advances in network analysis provide a method of examining the relative centrality of BPD symptoms, as well as examine the replicability of findings across samples. Additionally, despite the increase in research supporting the validity of BPD in adolescents, clinicians are reluctant to diagnose BPD in adolescents. Establishing the replicability of the syndrome across adolescents and adults informs clinical practice and research. This study examined the stability of BPD symptom networks and centrality of symptoms across samples varying in age and clinical characteristics. METHODS: Cross-sectional analyses of BPD symptoms from semi-structured diagnostic interviews from the Collaborative Longitudinal Study of Personality Disorders (CLPS), the Methods to Improve Diagnostic Assessment and Service (MIDAS) study, and an adolescent clinical sample. Network attributes, including edge (partial association) strength and node (symptom) expected influence, were compared. RESULTS: The three networks were largely similar and strongly correlated. Affective instability and identity disturbance emerged as relatively central symptoms across the three samples, and relationship difficulties across adult networks. Differences in network attributes were more evident between networks varying both in age and in BPD symptom severity level. CONCLUSIONS: Findings highlight the relative importance of affective, identity, and relationship symptoms, consistent with several leading theories of BPD. The network structure of BPD symptoms appears generally replicable across multiple large samples including adolescents and adults, providing further support for the validity of the diagnosis across these developmental phases.
BACKGROUND: Numerous theories posit different core features to borderline personality disorder (BPD). Recent advances in network analysis provide a method of examining the relative centrality of BPD symptoms, as well as examine the replicability of findings across samples. Additionally, despite the increase in research supporting the validity of BPD in adolescents, clinicians are reluctant to diagnose BPD in adolescents. Establishing the replicability of the syndrome across adolescents and adults informs clinical practice and research. This study examined the stability of BPD symptom networks and centrality of symptoms across samples varying in age and clinical characteristics. METHODS: Cross-sectional analyses of BPD symptoms from semi-structured diagnostic interviews from the Collaborative Longitudinal Study of Personality Disorders (CLPS), the Methods to Improve Diagnostic Assessment and Service (MIDAS) study, and an adolescent clinical sample. Network attributes, including edge (partial association) strength and node (symptom) expected influence, were compared. RESULTS: The three networks were largely similar and strongly correlated. Affective instability and identity disturbance emerged as relatively central symptoms across the three samples, and relationship difficulties across adult networks. Differences in network attributes were more evident between networks varying both in age and in BPD symptom severity level. CONCLUSIONS: Findings highlight the relative importance of affective, identity, and relationship symptoms, consistent with several leading theories of BPD. The network structure of BPD symptoms appears generally replicable across multiple large samples including adolescents and adults, providing further support for the validity of the diagnosis across these developmental phases.
Authors: Harold W Koenigsberg; Philip D Harvey; Vivian Mitropoulou; James Schmeidler; Antonia S New; Marianne Goodman; Jeremy M Silverman; Michael Serby; Frances Schopick; Larry J Siever Journal: Am J Psychiatry Date: 2002-05 Impact factor: 18.112
Authors: Eiko I Fried; Marloes B Eidhof; Sabina Palic; Giulio Costantini; Hilde M Huisman-van Dijk; Claudi L H Bockting; Iris Engelhard; Cherie Armour; Anni B S Nielsen; Karen-Inge Karstoft Journal: Clin Psychol Sci Date: 2018-01-05