Personality disorders: model for conceptual approach and classification. Part I: General model

Area of Science:

• Psychiatry
• Clinical Psychology
• Personality Disorders

Background:

• Current classifications of personality disorders (PDs) in DSM-IIIR categorize them as discrete syndromes.
• There is significant overlap in diagnostic criteria among various PDs.
• A unifying dimension underlying PDs has been proposed but not fully elucidated.

Purpose of the Study:

• To investigate a common core deficit across personality disorders.
• To determine if borderline personality features represent a shared dimension distinguishing PDs from non-PDs.
• To explore the utility of this dimension as a classificatory principle for PDs.

Main Methods:

• Utilized the Millon Clinical Multiaxial Inventory (MCMI) and the Diagnostic Interview for Borderlines.
• Compared 121 subjects with PDs against 67 control subjects.
• Analyzed MCMI scales for behavior styles and specifically the MCMI borderline scale.

Main Results:

• Individuals with PDs and controls showed similar profiles on general behavior style scales.
• Subjects with PDs scored significantly higher on the MCMI borderline scale (above 75) and the Diagnostic Interview for Borderlines compared to controls.
• Borderline features were markedly more prevalent in individuals with PDs, serving as a differentiator.

Conclusions:

• Most symptoms previously considered unique to borderline personality are present in other PDs.
• Borderline features represent a common, shared dimension across various personality disorders.
• This shared borderline dimension can potentially serve as a more efficient classificatory principle for PDs.