Dissociation and dysfunctional personality traits in patients with borderline personality disorder: A study based On DSM-5 alternative model

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry Pub Date : 2024-11-18 DOI:10.1016/j.ejpsy.2024.100283

Margherita Alfieri , Anna Caterina Leucci , Biancamaria Bortolotti , Sara Gibiino , Loredana Lia , Lorenzo Pelizza , Marco Menchetti

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引用次数: 0

Abstract

Background and objectives

Borderline Personality Disorder (BPD) and dissociative experiences are frequently co-occurring conditions. This study aimed to assess the relationship between DSM-5 Alternative Model of Personality Disorder (AMPD) maladaptive personality facets and self-report dissociation in a sample of patients with BPD.

Methods

Our sample consisted of 178 Italian adult patients who met the criteria for BPD diagnosed by Structured Clinical Interview for DSM IV-Axis II. They were administered the Personality Inventory for DSM-5 (PID-5) and the Dissociative Experiences Scale (DES). An agglomerative hierarchical cluster analysis was performed using facets as clustering variables. Multivariable regression analysis was performed to identify the PID-5 characteristics which could suggest a dissociative dimension.

Results

Our results showed the potential of PID-5 to hypothesize a dissociative dimension towards DES scores. Therefore, we theorized a specific BPD phenotype characterized by high levels of Unusual Behaviors and Beliefs, high levels of Perceptual Dysregulation, high levels of Withdrawal, low levels of Impulsivity and Irritability, low levels of Callousness and low levels of Avoidance, for which it may be assumed a dissociative framework. Moreover, it could be postulated that patients with dissociative symptoms who will be diagnosed with BPD according to the AMDP would have the domain of Psychoticism as “specifier”.

Lastly, we highlighted the role of gender as a moderator between personality traits and dissociative symptoms.

Conclusion

Consistently with this study, an initial assessment with PID-5 personality facets may detect an underlying dissociative psychopathology, suggesting significant clinical implications for both treatment and prognosis.

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边缘型人格障碍患者的解离和功能失调人格特征：基于 DSM-5 替代模型的研究

背景和目的边缘型人格障碍（BPD）和解离体验是经常并发的疾病。本研究旨在评估 DSM-5 人格障碍替代模型（AMPD）适应不良人格特征与 BPD 患者样本自我报告的解离之间的关系。方法我们的样本由 178 名意大利成年患者组成，他们符合 DSM IV 轴 II 结构化临床访谈诊断的 BPD 标准。他们接受了 DSM-5 人格量表 (PID-5) 和分离体验量表 (DES) 的测试。以面为聚类变量，进行了聚类分层聚类分析。结果我们的研究结果表明，PID-5 有可能假设 DES 分数具有分离维度。因此，我们推测出了一种特殊的 BPD 表型，其特点是高水平的异常行为和信念、高水平的知觉失调、高水平的退缩、低水平的冲动和易激惹、低水平的冷漠和低水平的回避。最后，我们强调了性别在人格特质与分离症状之间的调节作用。结论与本研究一致，使用 PID-5 人格特征进行初步评估可以发现潜在的分离性精神病理学，这对治疗和预后都具有重要的临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Psychiatry PSYCHIATRY-

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

43 days

期刊介绍： The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.