Department of Psychology, College of William and Mary.
Department of Psychology, University of California, Davis.
J Abnorm Psychol. 2018 Aug;127(6):590-601. doi: 10.1037/abn0000364. Epub 2018 Jun 28.
Borderline personality disorder (PD) has historically been cast as an unabating condition. Longitudinal data, however, support a more variable time course marked by remission and relapse. In the present study, we tested the possibility that borderline PD has both stable (i.e., consistently present across time and situation, as modern diagnostic systems stipulate) and dynamic (i.e., episodic and situational) elements. Participants were 668 patients from the Collaborative Longitudinal Personality Disorders Study who were administered semistructured diagnostic interviews 5 times over a decade. Trait-state-occasion modeling dissected borderline pathology into time-invariant (i.e., trait) and time-varying (i.e., state) components. Contradicting traditional views of PD intransigence, less than half of borderline PD variability (approximately 45%) was time-invariant (i.e., perfectly stable) over the study timeframe. Furthermore, we found that the time-invariant component of borderline pathology, which we termed borderline proneness, was very closely related (r = .81) to a previously validated Five Factor Model trait composite of borderline features. Moreover, the trait versus state components showed a clear pattern of discriminant validity in relation to several putative causal agents for borderline PD (i.e., environmental pathogens, temperament dimensions). We conclude that borderline pathology contains a stable core and sizable situational components, and that both elements relate systematically to normative personality dimensions and known risk factors. These findings have key implications for etiological research, prognosis, and treatment for borderline PD. (PsycINFO Database Record
边缘型人格障碍(PD)在历史上一直被视为一种无法缓解的疾病。然而,纵向数据支持一种更具变化性的病程,其特点是缓解和复发。在本研究中,我们检验了边缘型 PD 既具有稳定(即在时间和情境中始终存在,正如现代诊断系统所规定的)又具有动态(即阶段性和情境性)特征的可能性。参与者是来自合作纵向人格障碍研究的 668 名患者,他们在十年内接受了 5 次半结构化诊断访谈。特质-状态-场合模型将边缘病理学分解为时间不变(即特质)和时间变化(即状态)成分。与 PD 固执己见的传统观点相悖,在研究期间,边缘型 PD 变异性的不到一半(约 45%)是时间不变的(即完全稳定)。此外,我们发现,我们称之为边缘倾向的边缘病理学的时间不变成分与之前验证的五因素模型的边缘特征特质综合非常密切相关(r =.81)。此外,在与边缘型 PD 的几个潜在致病因素(即环境病原体、气质维度)相关时,特质与状态成分表现出明显的判别效度模式。我们得出结论,边缘病理学包含一个稳定的核心和相当大的情境成分,这两个元素与正常人格维度和已知风险因素系统相关。这些发现对边缘型 PD 的病因研究、预后和治疗具有关键意义。