If It Looks Like a Duck and Quacks Like a Duck: Evaluating the Validity of Borderline Personality Disorder in Adolescents

The validity of borderline personality disorder (BPD) has been a topic of much controversy in psychiatry. Over the last two decades, a wealth of empirical work has challenged long-held concerns regarding the validity of adolescent BPD. However, this research has been conducted within a traditional approach to psychiatric nosology.In this article, we aim to evaluate the validity of adolescent BPD as guided by both the Robins and Guze criteria for the validity of psychiatric constructs and the new National Institute of Mental Health Research Domain Criteria (NIMH RDoC).We used the five principles of the Robins and Guze approach to evaluate selected research from our own and other groups regarding the validity of adolescent BPD. These principles include clinical description studies, laboratory studies, studies that delimitate the disorder from other related syndromes, follow-up studies, and family studies.Within the Robins and Guze criteria framework, evidence to date supports the validity of adolescent BPD to some extent. However, limitations of the research about the construct validity of adolescent BPD have also been identified, most notably regarding the delimitation of adolescent BPD from other disorders as well as a lack of longitudinal and family studies.Given these limitations and the limitations of the Robins and Guze approach to psychiatric nosology, we recommend exploring the potential of the National Institute of Mental Health Research Domain Criteria as a complement to previous work

Current maternal depression moderates the relation between critical expressed emotion in mothers and depressive symptoms in their adolescent daughters

a b s t r a c t Prior studies have examined critical expressed emotion (EE-Crit) in mothers in the intergenerational transmission of depression. However, the potential moderating effect of maternal depression diagnostic status in relation to EE-Crit and youth depressive symptoms has yet to be determined. A total of N¼ 121 biological mother/daughter dyads that differed in maternal depression diagnostic status were recruited for the present study: (1) currently depressed mothers (current depression, n ¼29); (2) formerly depressed mothers (past depression, n ¼39); and (3) mothers free from any psychiatric history (healthy controls, n ¼53). Mothers were administered structured clinical interviews and completed self-report measures of EE-Crit and psychopathology, and daughters self-reported depressive symptoms. Results indicated no significant group differences in EE-Crit; however, current maternal depression status moderated EE-Crit such that the magnitude of the relation between EE-Crit and adolescent depressive symptoms was significantly greater in daughters of currently depressed mothers. These findings highlight the importance of considering current maternal depression, rather than a history of maternal depression, in relation to EE-Crit and adolescent depressive symptoms, providing impetus for future investigations

An Ecological Momentary Assessment (Ema) Study of Affective Reactivity within an Interpersonal Context in Young Adults with Borderline (Bpd) Traits

Borderline Personality Disorder (BPD) is a serious disorder associated with impairment across multiple domains of functioning and treatment refractory behavior. Affective reactivity is a particularly detrimental feature of BPD; however, there are limitations of using single time-point assessments to measure this symptom. Studies have therefore employed ecological momentary assessment (EMA) to measure real time affective reactivity in BPD, with findings pointing to greater affective reactivity in adults with BPD versus healthy controls. However, little is known regarding antecedents of within-person affect change in BPD. Moreover, while it has been suggested that affective reactivity in BPD occurs in reaction to interpersonal cues of rejection and abandonment, few studies have demonstrated this in the context of daily life. Interpersonal Theory, and the associated Interpersonal Circumplex, provides an empirically validated framework for this purpose. Using the Circumplex, it is possible to determine biases in person perception that may relate to affective reactivity. While Circumplex studies have examined the relation between biases in person perception and negative affect in BPD patients, Circumplex methodology has yet to be combined with electronic EMA methodology to elucidate antecedents or triggers of affective reactivity in healthy adults with BPD traits. Against this background, the overall goal of the proposed study was to examine the relation between perceptions of non-communal behavior and affective reactivity in a non-clinical sample of college students. To this end, N = 123 college students participated in twenty days of EMA during which they recorded their affective state, interpersonal perceptions, and their own interpersonal behavior six times a day. The aims for the current study were two-fold: Aim 1 was to examine whether perceptions of partner non-communal behavior and negative affect were related, and whether BPD symptoms moderated this relation. Aim 2 was to examine whether perceptions of partner non-communal behavior and participants’ self-reported non-communal behavior were related, and whether BPD symptoms moderated this relation. An ancillary aim was added to determine whether any of the PAI BOR subscales moderated the relation between perceptions of non-communality and negative affect or self-reported non-communal behavior. In partial support of our hypotheses for Aim 1, results showed that perceptions of partner non-communal behavior predicted higher ratings of negative affect at the within-person levels. However, at the between-person level these relations were not significant, and BPD symptoms had no moderating effect. In partial support of our hypotheses for Aim 2, at the within-person level, perceptions of partner non-communal behavior were associated with participants own non-communal (ie. cold) behavior. However, at the between-person level these relations were not significant, and BPD symptoms had no moderating effect. Secondary analyses revealed a trend of the PAI-BOR subscale of identity problems moderating the relation between perceptions of non-communal behavior and participants’ self-reported non-communal behavior; however, the moderating effect was not statistically significant (p = .09). Findings from this study provide support for the relation between interpersonal perceptions and affective and interpersonal behavioral reactivity. Moreover, a potential (though non-significant) moderating effect of the PAI-BOR subscale of Identity Problems suggests a greater understanding of the role of identity-related disturbance in interpersonal perceptions, affect, and behavior in BPD is warranted.Psychology, Department o

An evaluation of the construct of emotional sensitivity from the perspective of emotionally sensitive people

Abstract Background Emotional sensitivity is a construct found in major developmental models of borderline personality disorder. However, the construct remains nebulous. The patient perspective is crucially important in helping to define and conceptualize any psychological construct – especially one that plays such a large role in the developmental theories of a given disorder. The aim of the current study was to explore the meaning of emotional sensitivity from the perspective of those who identify as being emotionally sensitive. Methods Participants were from a community sample of adults (M age  = 32.05, range: 21–59) who responded to an advertisement for a study of emotional sensitivity. Participants completed surveys related to personality pathology and a semi-structured interview about emotional sensitivity. Emotional sensitivity interviews were independently coded by two research assistants trained in qualitative analyses for content and process. Coders were blind to the personality pathology status of participants. Results Regardless of level of personality pathology, qualitative results of the emotional sensitivity interview largely suggest that emotional sensitivity is a heightened emotional reactivity to stimuli, including the emotions of other individuals, or a tendency to have emotional reactions to even low impact stimuli. However, emotional sensitivity was regarded predominantly as a negative trait (i.e. burden) only by those who have high levels of borderline personality pathology. Conclusions The implications of these results for the conceptualization and utility of emotional sensitivity in borderline personality disorder are discussed