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Latent profiles of patients with borderline pathology based on the alternative DSM-5 model for personality disorders

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Gamache, D. et Savard, C. et Leclerc, P. et Payant, M. et Côté, A. et Faucher, J. et Lampron, M. et Tremblay, M. (2021). Latent profiles of patients with borderline pathology based on the alternative DSM-5 model for personality disorders. Borderline Personality Disorder and Emotion Dysregulation, 8 (4). ISSN 2051-6673 DOI 10.1186/s40479-021-00146-w

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Résumé

Background: There have been multiple attempts to try to parse out heterogeneity within borderline pathology by
identifying patient subtypes; thus far, these works have yielded few consistent results. Recent developments in the
operationalization of borderline pathology may provide new opportunities to identify clinically and conceptually
meaningful subgroups of patients. The Alternative DSM-5 Model for Personality Disorders (AMPD) offers a
categorical-dimensional operationalization of Borderline personality disorder (BPD) that has yet to be tested for
identification of patient subgroups. The purpose of the present study is to test whether the combination of the
Criterion A elements (pertaining to level of severity) and the seven pathological facets from Criterion B that define
BPD in the AMPD can yield meaningful patient profiles.
Methods: A total of 211 outpatients from a specialized PD treatment program (133 women, Mage = 33.66, SD =
10.97) were selected based on the presence of at least moderate borderline pathology according to cutoffs recently
proposed for the Borderline Symptom List-23. Valid Criterion A (Self and Interpersonal Functioning Scale) and B
(Personality Inventory for DSM-5 Faceted Brief Form) self-reports were administered to measure elements and facets
that define BPD in the AMPD model; these variables were used as indicators in a latent profile analysis (LPA).
Results: The optimal solution generated by LPA yielded four distinct profiles: (a) Borderline traits; (b) Moderate
pathology with Impulsivity; (c) Moderate pathology with Identity problems and Depressivity; and (d) Severe pathology.
Clinically meaningful distinctions emerged among profiles on AMPD indicators and external variables relevant to
PD, especially aggression and impulsivity.
Conclusions: Profiles reflected both the “severity” and “style” components imbedded within Criterion A and B of
the AMPD, as they were mainly distinguished by a continuum of severity but also by some meaningful qualitative
differences that may have important clinical implications for treatment planning and contracting. Results also
suggest that the four Criterion A elements have independent value to identify important differences in patients
with borderline pathology. They also highlight that some Criterion B facets that define BPD in the AMPD may be
especially important to identify subgroups of patients, mainly Impulsivity and Depressivity.

Type de document: Article
Date de dépôt: 27 sept. 2021 13:27
Dernière modification: 27 sept. 2021 13:27
Version du document déposé: Version officielle de l'éditeur
URI: https://depot-e.uqtr.ca/id/eprint/9747

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