Measurement Invariance Between Genders on Two Measures of Borderline Personality Disorder

Measurement invariance of the Personality Inventory for DSM-5 across sex

Introduction

There has been an international movement towards dimensional models of personality disorders (PDs) in the last decades, which culminated in the publication of the Alternative Model of Personality Disorders (AMPD) in the Emerging Measures and Models section of the DSM-5. This model was accompanied by a APA-sanctioned Personality Inventory for DSM-5 (PID-5) for the assessment of the AMPD pathological personality traits. One major issue with the assessment of personality disorders pertains to sex differences, and measurement invariance across sex in assessment instruments for PDs is necessary in order to ensure non-biased evaluations and to make valid comparisons between men and women. This study aimed to provide more information on measurement invariance across sex for the PID-5, using both the original scoring approach provided by the authors of the instrument and the scoring approach suggested by the APA in the published version of the PID-5.

Methods

This study was conducted with a sample of 2273 participants from the general Québec (Canada) adult population aged 18 to 90 years (M = 46.59; SD = 16.32; 51.8% women).

Results

The original scoring approach model showed good fit to data after freeing paths between certain traits and reached strict invariance. The APA scoring approach also showed good fit to data and reached strict invariance, but needed an adjustment (path freed between Emotional lability and Impulsivity in men) to reach scalar invariance.

Discussion

In line with previous research, the PID-5 is invariant across sex and the five-factor structure adjusts well to data. The APA scoring approach appears to attenuate the cross-loading problem observed with the original scoring approach. In light of these results, we recommend using the APA scoring approach to derive domain scores.

Construct Validity of the Dutch, English, French, and Spanish LPFS-BF 2.0: Measurement Invariance Across Language and Gender and Criterion Validity

With the introduction of the Alternative Model of Personality Disorders in the DSM-5, the need for short measures of the level of personality functioning has emerged, both for screening purposes and for assessing change during treatment. The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0) was constructed for this and has received support for its two-factor structure and criterion validity. The authors aimed to provide additional construct validity evidence for the LPFS-BF 2.0 by examining its factor structure and measurement invariance across the Dutch, English, French, and Spanish versions and across gender, and its criterion validity. Results showed that the two-factor model had a good fit to the data in the four linguistic versions. Configural and metric invariance were supported across linguistic versions and gender, while scalar invariance was partially supported. Reporting a mental health disorder and having consulted with a mental health professional were associated with higher LPFS-BF 2.0 scores.

The contribution of skills to the effectiveness of dialectical behavioral therapy

OBJECTIVE

The present study investigated the effectiveness of dialectical behavioral therapy (DBT) and the effect of improvement in DBT skills on clinical outcomes.

METHOD

Participants included 57 adults who attended a community mental health service and underwent one of two modes of DBT. Twenty-six adults had been diagnosed with borderline personality disorder (BPD) and participated in comprehensive DBT (DBT-C; including group skills training, individual therapy, and phone coaching). Thirty-one adults had BPD traits and participated in DBT skills training (DBT-S; group skills training only). In the present study, the DBT skills examined were mindfulness, emotion regulation, and interpersonal effectiveness; the clinical outcomes examined were borderline symptoms, psychological distress, and quality of life.

RESULTS

Six 2 × 2 analysis of covariances indicated significant improvements in psychological distress, quality of life, mindfulness, and interpersonal effectiveness (but not borderline symptoms and emotion regulation), over a 6-month period. Mode of delivery of DBT did not impact on the improvement in DBT skills and clinical outcomes over the 6-month period. Hierarchical multiple regression results indicated that improvement in DBT skills (mindfulness, emotion regulation, and interpersonal effectiveness) were associated with reductions in borderline symptoms and psychological distress, with emotion regulation the only skill uniquely associated with improvements in clinical outcomes.

CONCLUSIONS

The results of the present study support the effectiveness of DBT and the specific role of emotion regulation for favorable clinical outcomes over a 6-month period, independent of the mode of delivery of DBT.

Validation of a French Translation of the McLean Screening Instrument for Borderline Personality Disorder, Invariance Across Genders, and Association With Depression, Trauma Symptoms, and Substance Use Among University Students

The present study investigated psychometric properties of a French translation of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD; Zanarini et al., 2003) in a large sample of university students (N = 1,350). A confirmatory factor analysis supported the single-factor structure of the MSI-BPD, and its configural, metric and scalar invariance across gender was established. Internal consistency was high (tetrachoric α = .88; Ω = .88). MSI-BPD scores were significantly correlated to depressive symptoms (r = .57), trauma symptoms (r = .40), negative consequences of substance use (r = .25), and frequency of drug use (r = .11). Finally, 9.5% of the sample reached the clinical cutoff, which is similar to the pooled prevalence for BPD reported in a recent meta-analysis of university students. The present study showed that the French translation of the MSI-BPD is a psychometrically sound screening tool for BPD in both men and women.