The Clinical Significance of Single Features of Borderline Personality Disorder: Anger, Affective Instability, Impulsivity, and Chronic Emptiness in Psychiatric Outpatients

Abstract

Although dimensional models of borderline personality disorder (BPD) are consistent with findings showing that minimal levels of pathology are associated with substantial increases in psychosocial impairment, it is still unclear whether different individual BPD criteria are each clinically significant on their own. The current study uses semistructured interview data from 1,870 adults presenting for outpatient psychiatric treatment to investigate whether the BPD criteria of impulsivity, affective instability, emptiness, and anger are each related to psychosocial morbidity when met in the absence of the other eight criteria. Analyses showed that each of these criteria was associated with dysfunction in comparison with a control group meeting zero BPD criteria, but only the emptiness criterion was a marker of impairment on all indices of psychosocial morbidity: suicidality, history of suicide attempts and psychiatric hospitalizations, social and work dysfunction, Axis I comorbidity, and global functioning. Implications for the study of borderline pathology are discussed.

Gender Differences in Borderline Personality Disorder Features in an Epidemiological Sample of Adults Age 55–64: Self Versus Informant Report

“…A recent study revealed that the number of below-threshold BPD features endorsed is significantly related to six different psychosocial morbidity outcomes, including psychiatric hospitalizations and suicidal ideation (Zimmerman, Chelminski, Young, Dalrymple, & Martinez, 2013). In fact, the presence of just one BPD symptom has been found to be significantly related to clinical impairment (Ellison, Rosenstein, Chelminski, Dalrymple, & Zimmerman, 2015). …”

A 1‐year follow‐up study of capacity to love and work: What components of borderline personality disorder most impair interpersonal and vocational functioning?

“…Research examining psychosocial impairment has produced mixed results, with studies variously identifying dysphoric mood, affect dysregulation, impulsivity, suicidal behaviour, identity disturbance and chronic emptiness . Recent efforts have focused on symptoms of identity disturbance and emptiness.…”

Grandiose and Vulnerable Narcissism in Borderline Personality Disorder

“…Patients with borderline personality disorder (BPD) present with a clinically relevant heterogeneity [1] regarding severity of the disease [2] and specific features, such as anger [3], rejection sensitivity [4], personality organization [5], or depression [6]. This heterogeneity in core psychopathology has been associated with therapeutic outcome [7-9].…”