Elucidating DSM-5 and ICD-11 Diagnostic Features of Borderline Personality Disorder Using Schemas and Modes

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Abstract

BACKGROUND: Borderline personality disorder (BPD) comprises a heterogeneous constellation of problems operationalized in the DSM-5 and the forthcoming ICD-11. In schema therapy, schemas and modes are employed to conceptualize and treat these problems.

AIM: The current study investigated whether the 9 diagnostic BPD features are associated with schemas and modes.

METHOD: Psychiatric outpatients with predominant BPD features (n = 142; 68% females) were administered the Structured Clinical Interview for DSM-IV Axis II (SCID-II) and self-report inventories for schemas and modes. Associations were investigated by means of bivariate point-biserial correlations and multiple logistic regression analysis.

RESULTS: BPD features were largely associated with conceptually related schemas and modes. Consistent with the schema therapy literature and previous research, we found schemas of Abandonment/Instability and Mistrust/Abuse along with modes of Angry/Enraged Child, (internalized) Punitive Parent, and Impulsive Child to uniquely predict thematically related BPD features including fear of abandonment, self-destructiveness, feelings of emptiness, stress-related paranoid ideation, inappropriate anger, and impulsivity.

CONCLUSION: Most of the 9 BPD features were related to conceptually meaningful schemas/modes, suggesting that BPD is composed of dormant themes along with salient affective-behavioral responses. Consequently, individual BPD features may be differentially conceptualized and targeted in therapy by means of schemas and modes.

Original languageEnglish
Pages (from-to)400-407
Number of pages8
JournalPsychopathology
Volume51
Issue number6
DOIs
Publication statusPublished - 2018

Keywords

  • Borderline personality disorder
  • CONCEPTUALIZATIONS
  • CRITERIA
  • DEPRESSION
  • Diagnostic criteria
  • EARLY MALADAPTIVE SCHEMAS
  • Early maladaptive schemas
  • GERMAN VERSION
  • QUESTIONNAIRE
  • RELIABILITY
  • Schema modes
  • Schema therapy
  • TRAITS
  • VALIDATION
  • VALIDITY

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