Centre for Addiction and Mental Health, Toronto, Canada; Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.
Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychology, Toronto Metropolitan University, Toronto, Canada.
Psychiatry Res. 2023 May;323:115131. doi: 10.1016/j.psychres.2023.115131. Epub 2023 Feb 22.
Borderline personality disorder (BPD) is characterized by instability in interpersonal, affective, cognitive, self-identity, and behavioral domains. For a BPD diagnosis, individuals must present at least five of nine symptoms, resulting in 256 possible symptom combinations; thus, individuals diagnosed with BPD can differ substantially. Specific symptoms of BPD tend to co-occur, suggesting BPD subgroups. To explore this potential, we analyzed data from 504 participants diagnosed with BPD enrolled in one of three randomized controlled trials conducted at center for Addiction and Mental Health in Toronto, Canada from 2002 to 2018. An exploratory latent class analysis (LCA) was conducted to identify symptom subgroups of BPD. Analyses indicated three latent subgroups. The first group (n = 53) is distinguished by a lack of affective instability and low levels of dissociative symptoms (non-labile type). The second group (n = 279) is characterized by high levels of dissociative and paranoid symptoms but low abandonment fears and identity disturbance (dissociative/paranoid type). The third group (n = 172) is characterized by high efforts to avoid abandonment and interpersonal aggression (interpersonally unstable type). Homogenous symptom subgroups of BPD symptoms exist and may have important implications for how to refine BPD treatment interventions.
边缘型人格障碍(BPD)的特征是人际关系、情感、认知、自我认同和行为领域的不稳定。要做出 BPD 的诊断,个体必须表现出至少九项症状中的五项,这导致了 256 种可能的症状组合;因此,被诊断为 BPD 的个体之间存在显著差异。BPD 的特定症状往往同时出现,提示存在 BPD 亚组。为了探索这种可能性,我们分析了 504 名在加拿大多伦多成瘾和心理健康中心参加了三项随机对照试验之一的 BPD 患者的数据。进行了探索性潜在类别分析(LCA),以确定 BPD 的症状亚组。分析表明存在三个潜在亚组。第一组(n=53)的特征是缺乏情感不稳定和低水平的解离症状(非易变型)。第二组(n=279)的特征是高水平的解离和偏执症状,但低遗弃恐惧和身份障碍(解离/偏执型)。第三组(n=172)的特征是高回避遗弃和人际攻击(人际不稳定型)。存在同质的 BPD 症状亚组,这可能对如何完善 BPD 治疗干预具有重要意义。