Two operationalizations of a single construct: Overlap between borderline personality disorder and the level of...

Area of Science:

• Psychiatry
• Clinical Psychology
• Personality Disorders

Background:

• Scholarly debate exists on whether borderline personality disorder (BPD) is a distinct disorder or represents high levels of personality functioning (LPFs).
• The Diagnostic and Statistical Manual of Mental Disorders, fifth ed., Alternative Model of Personality Disorders conceptualizes LPFs.

Purpose of the Study:

• To examine the overlap between measures of LPF and BPD.
• To analyze whether BPD is a distinct categorical disorder or reflects dimensional personality functioning.

Main Methods:

• Archival data from 289 adults in community mental health treatment were analyzed.
• Clinician-rated and self-report measures of BPD symptoms, LPF, psychopathology, and personality constructs were used.
• Confirmatory factor analyses and bifactor modeling were employed.

Main Results:

• Substantial overlap was found between BPD and LPF measures.
• A dominant general factor explained most shared variance between BPD and LPF.
• BPD showed modest unique variance, primarily related to externalizing domains.

Conclusions:

• BPD largely reflects LPF, with unique features possibly stemming from the behavioral focus in diagnostic criteria.
• Resources may be better allocated to dimensional models for general personality impairment rather than BPD-specific frameworks.
• Dimensional approaches could benefit a broader range of personality pathology.