Understanding Dimensions and Types of Borderline Personality Disorder Through Factor Mixture Modeling

Restricted (Penn State Only)
Author:
Johnson, Benjamin Norman
Graduate Program:
Psychology
Degree:
Master of Science
Document Type:
Master Thesis
Date of Defense:
February 23, 2017
Committee Members:
  • Kenneth N. Levy, Thesis Advisor
  • Michael N. Hallquist, Committee Member
  • James M. LeBreton, Committee Member
Keywords:
  • latent variable modeling
  • factor analysis
  • latent class analysis
  • assessment
  • diagnosis
Abstract:
Objective: Borderline personality disorder (BPD) is serious and prevalent and is quite heterogeneous. Identifying subtypes of BPD promises useful diagnostic and treatment implications. Although a series of subtyping studies exist, only two have examined BPD subtypes while taking into account BPD severity. We utilize factor mixture modeling (FMM) to identify discrete BPD subtypes, simultaneously considering symptom severity, in a large nonclinical young adult sample. We also consider how identified subtypes may be reflected in individuals reliably diagnosed with BPD. Method: Undergraduate students (N = 20,010; 63.86% female; mean age=18.75, SD = 1.73) and BPD-diagnosed participants (N = 66; 97% female; mean age = 29.74, SD = 10.94) completed a dimensional version of the McLean Screening Instrument for BPD (MSI-BPD). This was condensed to measure the nine DSM BPD criteria on a True/False scale. We conducted FMM to determine classes of individuals characterized by different responses to the MSI-BPD as well as the composition of underlying BPD severity dimensions. Results: The nonclinical sample was comprised of three subtypes—Asymptomatic (70%), Impulsive/Externalizing (19%), and Identity Disturbed/Internalizing (11%)—falling along a single continuum of increasing BPD severity. In the BPD sample, a single severity dimension best captured BPD symptomatology and no subtypes were identifiable. Conclusions: Our results suggest the importance of both dimensional and categorical conceptualizations of BPD, depending on the sample and level of severity in focus. Impulsive/Externalizing and Identity Disturbed/Internalizing classes suggest different treatment targets for subthreshold BPD and potential etiologically relevant profiles for BPD development. The findings are discussed in terms of their clinical implications regarding diagnosis, treatment, and theoretical conceptualization of BPD.