Neither too much, nor too little. The dilemma of identifying personality disorders in adolescents patients with self-reports

Impact of borderline personality disorder traits on the association between age and health-related quality of life: A cohort study in the general population

Background

Increasing age as well as borderline personality pathology are associated with a lower level of health-related quality of life (HR-QoL). Our objective was to investigate whether the presence of borderline personality traits modifies the association between age and HR-QoL in the general population.

Methods

Cross-sectional data from 5,303 respondents (aged 21–72 years) of the Netherlands Mental Health Survey and Incidence Study-2 were analyzed. Borderline personality traits were assessed with the International Personality Disorder Examination questionnaire. Mental and physical HR-QoL were measured with the Medical Outcomes Study Short Form Health Survey. Multiple linear regression analysis was used to examine the association of borderline personality traits, age and their interaction on mental as well as physical HR-QoL, adjusted for demographic variables as well as somatic and mental disorders.

Results

A total of 1,520 (28.7%) respondents reported one or more borderline personality traits of which 58 (1.1%) reported five or more indicative of a borderline personality disorder. A higher age was associated with lower physical HR-QoL. This negative association became significantly stronger in the presence of borderline personality traits. The association between increasing age and mental HR-QoL was positive in the absence of borderline personality traits and negative in the presence of borderline personality traits.

Conclusion

Borderline personality traits negatively interfere with the association between age and HR-QoL irrespective of somatic and mental disorders. Attention of clinicians and researchers for subthreshold borderline personality pathology is needed in middle-aged and older persons.

The SAPAS, Personality Traits, and Personality Disorder

Many argue that current categorical personality disorder (PD) classification systems should be more dimensional and consider personality traits. The present study examined whether a brief PD screening tool, the Standardized Assessment of Personality: Abbreviated Scale (SAPAS) primarily screened for traits of low emotional stability, low extraversion, and low agreeableness, rather than PD per se. A general community sample (n = 237) completed the SAPAS, a personality trait measure, and the International Personality Disorder Examination (IPDE) screening questionnaire. Regressions showed that the SAPAS provided substantial incremental validity over personality trait scores in predicting total IPDE scores, indicating that the SAPAS captures variance unique to PD, rather than just extremes of general disposition. The SAPAS is an empirically valid rapid PD screen for nonclinical populations, correctly identifying 78% of individuals who screen positively for PD on the IPDE. However, the SAPAS was not effective for screening antisocial PD, limiting its utility in forensic settings.

Comparison of Three Questionnaires to Screen for Borderline Personality Disorder in Adolescents and Young Adults

Abstract. One of the most common personality disorders among adolescents and young adults is the Borderline Personality Disorder (BPD). The objective of current study was to assess three questionnaires that can reliably screen for BPD in adolescents and young adults (N = 53): the McLean Screening Instrument for BPD (MSI-BPD; Zanarini et al., 2003 ), the Personality Diagnostic Questionnaire 4th edition – BPD scale (PDQ-4 BPD; Hyler, 1994 ), and the SCID-II Patient Questionnaire – BPD scale (SCID-II-PQ BPD). The nine criteria of BPD according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV; APA, 1994 ) were measured with the Structural Clinical Interview for DSM-IV Axis II disorders – BPD scale (SCID-II; First, Spitzer, Gibbon, Williams, & Benjamin, 1995 ). Correlations between the questionnaires and the SCID-II were calculated. In addition, the sensitivity and specificity of the questionnaires were tested. All instruments predicted the BPD diagnosis equally well.

Personality psychopathology, drug use and psychological symptoms in adolescents with substance use disorders and community controls

Substance use is a risk behavior that tends to increase during adolescence, a time when part of the personality is still in development. Traditionally, personality psychopathology has been measured in terms of categories, although dimensional models have demonstrated better consistency. This study aimed to analyze differences in personality profiles between adolescents with substance use disorders (SUD n = 74) and matched community controls (MCC n = 74) using the Personality Psychopathology Five (PSY-5) dimensional model. Additionally, we compared age at first drug use, level of drug use and internalizing and externalizing symptoms between the groups. In this study, the PSY-5 model has proved to be useful for differentiating specific personality disturbances in adolescents with SUD and community adolescents. The Disconstraint scale was particularly useful for discriminating adolescents with substance use problems and the Delinquent Attitudes facet offered the best differentiation.