Organization of co‐occurring Axis II features in borderline personality disorder

Abstract

Clinically meaningful subtypes can be identified for BPD based on co-occurring Axis II features. Further research is needed to replicate and further establish base-rates of these subtypes as well as their differential implications for treatment.

Clinical Phenomenology of Childhood Abuse–Related Complex PTSD in a Population of Female Patients: Patterns of Personality Disturbance

“…Similar dimensions have also been described in populations of alcoholics (Cloninger, 1987) and BPD patients (Critchfield, Clarkin, Levy, & Kernberg, 2008), suggesting a more general pattern of psychopathology.…”

Subtypes of borderline personality disorder patients: a cluster-analytic approach

“…This subtype resembles the nonaggressiveness/nonparanoid/nonantisocial subtype of Lenzenweger et al [14] and the avoidant/obsessive-compulsive subtype reported by Critchfield et al [32], in terms of the similar presence of avoidant features, and the anaclitic BPD type reported by Blatt and Auerbach [68]. The Core BPD subtype appears to represent the prototypical BPD patients for whom most evidence-based treatments seem to be initially developed.…”

“…The present study used a person-centered cluster-analytic approach to identify clusters of BPD patients based on comorbid PD dimensions, building on the study of Critchfield et al [32]. Based on these commonly available patient characteristics that are often used for treatment selection, we explore whether there are meaningful subgroups that differ based on their PD profiles.…”

“…Lenzenweger et al [14] performed a theory-based finite mixture modeling analysis, which revealed three phenotypically distinct subtypes of patients, in line with the work of Kernberg and colleagues [31]: the first group was characterized by low levels of antisocial, paranoid, and aggressive features; the second by elevated paranoid features; and the third by elevated antisocial and aggressive features. Critchfield, Clarkin Levy, and Kernberg [32] used the same sample of patients, but, by means of Q-factor analysis based on co-occurring PD criteria, they found three subtypes of BPD patients: those with co-occurring cluster A PD traits (elevated schizotypal and paranoid features), those with cluster B PD traits (elevated narcissistic and histrionic features), and those with cluster C PD traits (elevated avoidant and obsessive-compulsive features). Hallquist and Pilkonis [18], by means of finite mixture modeling, found four subtypes that differed in terms of anger/aggressiveness/antisocial behavior and mistrustfulness: an angry-aggressive type with high levels of aggression, antisocial behavior, and dysfunctional bids to maintain interpersonal relationships; an a ngry/mistrustful type, characterized by considerable concerns about being harmed or exploited in relationships, alongside inappropriate anger; a poor identity/low anger type with poor sense of self and self-injurious behaviors, but low aggressiveness; and a prototypical type with moderate levels of anger but low levels of aggression, antisocial behavior and mistrustfulness.…”

Personality Disorders and Mindreading

“…Patients with BPD can be grouped very differently according to the categorical diagnostic criteria taken into account. These groups constitute very different clinical sub-categories, which also had varied response to treatment (Critchfield et al, 2008;McMain et al, 2013). It is plausible that such clinical sub-categories present also different profiles of mindreading impairments, which have not been considered in this study.…”