BORDERLINE PERSONALITY; TRAIT AND DISORDER - PowerPoint PPT Presentation

1 / 12
About This Presentation
Title:

BORDERLINE PERSONALITY; TRAIT AND DISORDER

Description:

BORDERLINE PERSONALITY; TRAIT AND DISORDER Morey and Zanarini – PowerPoint PPT presentation

Number of Views:268
Avg rating:3.0/5.0
Slides: 13
Provided by: CMur3
Category:

less

Transcript and Presenter's Notes

Title: BORDERLINE PERSONALITY; TRAIT AND DISORDER


1
BORDERLINE PERSONALITY TRAIT AND DISORDER
  • Morey and Zanarini

2
BPD?
  • Distinct personality disorder beginning in
    childhood and characterised by pervasive pattern
    of impulsivity and unstable personal
    relationships, self-image and affect.
  • Includes
  • frantic attempts to avoid real or imagined
    abandonment
  • intense and unstable personal relationships
  • fluctuating self image
  • impulsivity and recurrent suicidal or self
    mutilating gestures or behaviour
  • emotional instability
  • transient stressrelated paranoia or dissociation
  • Clinical diagnosis must meet minimum of five of
    the DSM-IV criteria

3
TWO REPRESENTATIONS BPFFM and Categorical
Diagnosis
  • Global level BPM characterized by very high N,
    low A and low C, explaining features such as
    identity problems and fears of abandonment
  • BUT other features not associated with FFM

4
PRESENT STUDY
  • Goal One
  • Relationship FFM in a clinical sample
  • Goal Two
  • Highlight aspects of categorical diagnostic
    concept not captured by the FFM representation
  • Does FFM miss essential aspects of the BP
    diagnosis?
  • Do the residual elements of the categorical
    diagnosis add to a diagnostic understanding of
    BP?

5
CONTRIBUTION OF RESIDUAL TO DIAGNOSTIC VALIDITY
  • Antecedent validity etiological factors (family
    history of psychiatric disorders, childhood abuse
    and neglect)
  • Concurrent validity symptoms of dysphoric inner
    states and dissociative experiences
  • Predictive validity intermediate term outcomes
    at two follow-up intervals temporal patterns of
    functional behaviour.

6
Method
  • Participants
  • Inpatients at a hospital in Massachusetts
  • Aged 18-35
  • Normal or better intelligence
  • No history or current symptoms of serious organic
    condition
  • Had been assigned a definite or probable Axis II
    diagnosis by a physician
  • This resulted in 378 subjects available for
    testing

7
Instruments
  • 3 semi-structured interviews
  • Structured Clinical Interview for DSM-III-R Axis
    I Disorders
  • Revised Diagnostic Interview for Borderlines
    (DIB-R)
  • Diagnostic Interview for DSM-III-R Personality
    Disorders (DIPD-R)
  • Five Factor Model
  • Self-reported version of the NEO Five-Factor
    Inventory
  • Difficult Childhood Experiences
  • Revised Childhood Experiences Questionnaire,
    which is a semi-structured interview

8
Family History
  • Revised Family History Questionniare
  • Symptomatology Associated with BPD
  • Dissociative Experiences Scale and the Dysphoric
    Affect Scale
  • Global Outcome At Follow-up (2 and 4 years)
  • The Global Assessment of functioning scale
  • Psychosocial functioning assessed with the
    Revised Borderline Follow-up Interview

9
Results
  • Participants 290 BPD, 72 at least one other Axis
    2 disorder (control).

Nonborderline Nonborderline Borderline Borderline
Trait Mean SD Mean SD Sig
N 26.33 7.9 35.07 7.0 plt.001
E 25.66 6.7 22.59 6.9 plt.001
O 30.51 6.6 29.80 6.6 ns
A 32.68 6.5 30.35 6.7 plt.01
C 28.59 7.4 28.56 7.7 ns
10
Regression analysis
  • N seemed to be the largest differentiation
    between borderline and non-borderline patients.
  • C was the only other sig. factor but suggests
    that it is a suppressor, in that high levels of C
    removes an unwanted portion of the variance in
    the N variable.
  • FFM captures a sizable proportion of the variance
    associated with a borderline diagnosis.
  • But what about the rest of the diagnostic
    variance?

11
More than personality?
  • There were aspects within the 4 sections of the
    DIB-R that werent fully captured by the NEO-FFI.
    Impulse action patterns were the least
    represented.
  • But correlation with measures of BPD showed that
    the NEO-FFI representation explained a sig.
    proportion of the historical and outcome
    variables.
  • But also history of sexual abuse was related to
    BPD diagnosis in a way not fully captured by the
    NEO-FFI.
  • FFM factors were more highly associated with long
    term outcome than elements of BPD that were
    independent of these factors.

12
IN CONCLUSION
  • Diagnosis BP related to FFM
  • N scores elevated compared other patients PDs.
  • C discriminated BPD from other PDs but limited
    effect.
  • FFM did NOT capture all definitional aspects of
    BPD
  • DBI-R four section all included aspects not
    represented by FFM. Affect section best explained
    (N) but impulsive actions least explained.
  • 3. Diagnostic elements independent FFM are
    valid elements of the disorder and are associated
    with theoretically important correlates
    (antecedent, concurrent and predictive) of the
    disorder not error variance.
  • N as a characteristic level of personality
    dysfunction... is almost ubiquitous within
    clinical populations
  • BUT
  • Residual elements represent theoretically viable
    aspects of BPD
  • DISTINCTION DISORDER (BPD) AND TRAIT (N)
  • BPD disorder that changes in severity over time
    whereas N reflects a stable trait.
  • N represents estimate of LT outcome
  • Disorder representing meaningful predictors
    within certain sectors in response to the
    situation e.g. symptom severity.
Write a Comment
User Comments (0)
About PowerShow.com