Categorical versus dimensional status of borderline personality disorder.

Abstract

One of the many controversies concerning the borderline personality disorder (BPD) diagnosis is whether the construct refers to a categorical or dimensional variable. The current study used Meehl's (1973) maximum covariance analysis to investigate this issue. The charts of 409 psychiatric inpatients were systematically reviewed for the presence of BPD and dysthymic symptoms. Charts of 244 inpatients were also reviewed to assess the presence of indicators of male sex, a categorical variable. The results for BPD and dysthymia were consistent with a dimensional model, whereas those for male sex were consistent with a categorical model. A dimensional model of classification of BPD is recommended, and suggestions for future research are provided.

DSM-5 Borderline Personality Disorder: At the Border Between a Dimensional and a Categorical View

“…Briefly, taxometric analyses help address whether a diagnostic construct is best conceptualized as a latent class (to which individuals either do or do not belong, a categorical variable) or as a dimension of pathology (representing a continuum of severity or degree). To date, all published taxometric analyses of BPD criteria have arrived at the same conclusion: BPD, as defined by DSM-based measures, appears best conceptualized as a dimensional variable [9][10][11][12].…”

Heritability of borderline personality disorder features is similar across three countries

“…The DSM-IV-R defines personality disorders within a categorical system, but the inclusion of a dimensional model of personality is increasingly recommended (Trull et al 1990Livesley, 2007 ;Widiger & Trull, 2007). Three proposed dimensional models of personality are Livesley's 18-factor model of personality pathology (Livesley, 1986(Livesley, , 1987, which distinguishes four higher-order factors (emotional dysregulation, dissocial behaviour, inhibitedness, compulsivity), Cloninger's psychobiological model (Cloninger et al 1993), which distinguishes four dimensions of temperament (novelty seeking, harm avoidance, reward dependence and persistence) and three dimensions of character (self-directedness, cooperativeness and selftranscendence), and the Five Factor Model (FFM) of personality (Costa & McCrae, 1992), which distinguishes five personality traits (neuroticism, extraversion, openness to experience, agreeableness and conscientiousness).…”

Subgroups of Adolescent Girls With Borderline Personality Disorder Symptoms

“…Clifton & Pilkonis, 2007;Conway, Hammen, & Brennan, 2012;Shevlin et al, 2007;Trull, Widiger, & Guthrie, 1990). Clifton and Pilkonis (2007) found a 'borderline latent class' and a 'nonborderline latent class' in a mixed clinical and nonclinical sample.…”

“…One that has gained substantial support is a dimensional approach. Rather than applying a somewhat arbitrary cut-off point to determine presence or absence of a disorder, a dimensional model considers the degree of impairment and/or severity (Coyne, 2013 Widiger & Guthrie, 1990). These patients may not receive treatment using a categorical model as they would not have met criteria for a diagnosis.…”