Background: Borderline personality disorder (BPD) is one of the most puzzling psychiatric disorders. In order to improve its understanding and management, we have recently proposed an interpersonal dysphoria model that emphasizes the key role of the complex emotional state of dysphoria in BPD. The purpose of this study was to test the interpersonal dysphoria model using a structural equation modeling analysis. Sampling and Methods: The sample consisted of 105 patients with BPD and 105 healthy controls. A total of five self-report instruments and three semistructured interviews were administered to the participants. Results: The best-fitting structural model fit the data well in the BPD sample. Background dysphoria and negative interpersonal disposition were significant predictors of situational dysphoria, which in turn was a significant predictor of various symptoms of BPD. This model differs from the originally proposed one in terms of impaired empathy not being a component of negative interpersonal disposition and organizing and disorganizing BPD symptoms being replaced by interpersonal (abandonment fears, angry outbursts, and stormy relations) and affective (affective shifts and emptiness) symptoms. Conclusions: Although some revision was needed, the findings provide support to the proposed model, which needs to be further tested in a larger sample of individuals with BPD.

Introduction. Dysphoria is a complex emotional state that seems to be present in many psychiatric disorders (especially in BPD), but whose psychopathological core is still surrounded by a halo of vagueness, so that measuring its construct empirically is difficult and suitable tests to do that do not exist in Italy. Objectives. To analyze the psychometric properties of the Italian version of the Nepean Dysphoria Scale (NDS; Berle & Starcevic, 2012), a self-report questionnaire that measures dysphoria, reflecting its multidimensional nature. Aims. To validate the Italian version of the NDS for using it in routine clinical practice and to assess dysphoria in a more conceptually coherent way. Methods. The NDS was administered to 132 university students, along with other conceptually similar (Beck Depression Inventory II, Dysfunctional Attitude Scale-Form A and Toronto Alexithymia Scale) and conceptually distinct (Anxiety Sensitivity Index-3) instruments. Then, its characteristics (internal consistency, factor structure, convergent and divergent validity) were examined, comparing them with those of the original version. Results. The 22-item NDS demonstrated excellent internal consistency (alpha = 0.94). A four-factor solution was confirmed, with factors pertaining to irritability, discontent, surrender and interpersonal resentment. There were medium to strong correlations with the Beck Depression Inventory II, and weaker but still significant correlations with Dysfunctional Attitude Scale-Form A, Toronto Alexithymia Scale and Anxiety Sensitivity Index-3. Conclusions. The Italian version of the NDS shows good psychometric properties, maintaining a high equivalence with the original version. Further research on clinical samples is needed.

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