Subgroups of Adolescent Girls With Borderline Personality Disorder Symptoms

Abstract

This thesis examined the borderline personality disorder symptom profiles of teenage girls who were referred to a tertiary child and youth psychiatry clinic. Self-injury and unstable mood are key features of Borderline Personality Disorder (BPD) but are also associated with other disorders such as depression and anxiety disorders. The aim of the larger study was to determine whether BPD can be differentiated from other disorders in a highly comorbid adolescent sample who self-injure.To answer this question, individuals in our sample were grouped based on the pattern of BPD symptom endorsement using a latent class analysis. The subgroups that emerged from our The results indicated that only a small subset of teenage girls who presented with selfinjury and unstable mood met criteria for BPD. These girls represented a distinct and severely impaired group with high comorbidity. The subgroups that emerged from our sample provide guidance to clinicians regarding the likelihood of a personality disorder diagnosis in this population and the pattern of emotional difficulties of youth who self-injure.v

Heterogeneity of Borderline Personality Disorder Symptoms in Help-seeking Adolescents

“…First, we tted LCA models with increasing numbers of classes. Based on the literature, we estimated LCA models with one to four classes (17)(18)(19)(20)(21)(22). Next, we modeled a single-factor con rmatory factor analysis (CFA) and the three-factor CFA reported by Sanislow et al (23), which are the most replicated FA models in the BPD literature (10).…”

“…Several methodological reasons may account for these diverging results. First, the majority of studies did either apply LCA or FA on the diagnostic criteria when investigating the latent structure of BPD (17,18,21,22), while we systematically compared LCA, FA, and FMM. Second, only a few studies have systematically explored the effects of covariates, such as sex and age.…”

“…Two of them identi ed two subgroups (based on either the personality pattern scales from the Millon Adolescent Clinical Inventory (57), or the Shedler-Westen Assessment Procedure-200 for Adolescents (58)) that were clearly gendered and differed regarding the internalizingexternalizing dimensions of psychopathology (59,60), with internalizing psychopathology being more common among females and externalizing psychopathology being more common among males (61,62). The third study examined females only and identi ed four groups (based on the Borderline Personality Questionnaire (63)) with an increasing number of BPD symptoms and distinct patterns of comorbidities (17). Our results are consistent with the nding of a more female, internalizing group, and a more male, externalizing group.…”

“…Any two randomly selected individuals are thought to are either the same or different depending on whether or not they stem from the same latent class (15,16). To date, LCA has been applied to DSM BPD criteria assessed in community and clinical samples, all but one (17) consisted of adults (18)(19)(20)(21)(22). Most authors concluded that the classes re ect discrete points along a latent continuum of BPD severity (17)(18)(19)21).…”

“…To date, LCA has been applied to DSM BPD criteria assessed in community and clinical samples, all but one (17) consisted of adults (18)(19)(20)(21)(22). Most authors concluded that the classes re ect discrete points along a latent continuum of BPD severity (17)(18)(19)21). Two studies stand out from the others by reporting an "impulsive class", including patients who only endorsed impulsivity (criterion 4) and inappropriate anger (criterion 8) at high rates, along with two or three classes with increasing BPD severity (20,22).…”