Transgender and Gender Diverse Patients Are Diagnosed with Borderline Personality Disorder More Frequently Than Cisgender Patients Regardless of Personality Pathology.

Purpose: Borderline personality disorder (BPD) is a severe form of psychopathology associated with a host of negative outcomes. Some literature suggests elevated prevalence among transgender and gender diverse (TGD) samples. Elevated BPD prevalence among TGD populations could be due to factors other than BPD-specific psychopathology.

Examining Measurement Invariance in the Personality Inventory for -5 Brief Form Across Sexual and Gender Minority Status.

The Personality Inventory for , Brief Form (PID-5-BF) was developed with an assumption of invariance across sexual and gender minority (SGM) individuals. This assumption has yet to be tested empirically. Using multigroup confirmatory factor analysis, we examined measurement invariance in the PID-5-BF across the SGM status in clinical ( = 1,174; = 254 SGM) and nonclinical ( = 1,456; = 151 SGM) samples.

Borderline personality disorder symptom networks across adolescent and adult clinical samples: examining symptom centrality and replicability.

Background: Numerous theories posit different core features to borderline personality disorder (BPD). Recent advances in network analysis provide a method of examining the relative centrality of BPD symptoms, as well as examine the replicability of findings across samples. Additionally, despite the increase in research supporting the validity of BPD in adolescents, clinicians are reluctant to diagnose BPD in adolescents.

Conducting Outcomes Research in a Clinical Practice Setting: The Effectiveness and Acceptability of Acceptance and Commitment Therapy (ACT) in a Partial Hospital Program.

Multiple challenges exist integrating research into clinical practice, particularly in acute care settings where randomized controlled trials may be impractical or unethical. Partial or day hospitals are one such setting. As compared to outpatients and inpatients, relatively little research is conducted or reported in partial hospital program (PHP) patients, leaving providers in this setting without a solid empirical basis from which to draw.

A Population-Based Examination of Criterion-Level Disparities in the Diagnosis of Borderline Personality Disorder Among Sexual Minority Adults.

Sexual minority individuals are diagnosed with borderline personality disorder (BPD) at higher proportions than heterosexual individuals regardless of presenting psychopathology. It is unclear if such bias is reflective of diagnostician idiosyncrasies or population-based diagnostic/criterion bias. Data from the National Epidemiologic Survey on Alcohol and Related Conditions-III were utilized to examine if differences in BPD endorsement were related to/independent of transdiagnostic factor differences between sexual minority and heterosexual individuals.

Is There a Bias in the Diagnosis of Borderline Personality Disorder Among Lesbian, Gay, and Bisexual Patients?

High prevalence of borderline personality disorder (BPD) diagnosis is observed among sexual minority samples. It is unclear if sexual minority individuals are systematically diagnosed with BPD at higher rates than heterosexual individuals, and if potential diagnostic disparity can be explained by differences in maladaptive personality domains. Utilizing data from partial hospital patients ( = 1,099) the current study explored (a) differences in the frequency of diagnosis of BPD based on sexual orientation, (b) whether disparities explained differences in psychopathology across groups, and (c) the congruence between traditional methods of BPD diagnosis (i.

Emotion regulation accounts for associations between mindfulness and depression across and within diagnostic categories.

Background: Previous research shows that mindfulness and emotion regulation (ER) are highly related to each other. Preliminary evidence in small clinical populations show that ER may partially account for the relationship between mindfulness and depressive symptoms. The present study aimed to investigate which diagnostic categories were associated with depressive symptoms after controlling for ER in a heterogeneous sample of treatment-seeking patients.

Associations between maladaptive personality domains and premature termination in an acute clinical setting.

Maladaptive personality has been positioned as one overarching framework with the potential to streamline conceptualization of both personality- and nonpersonality-related psychopathology. However, few studies have examined maladaptive personality in relation to (a) clinical outcomes in a naturalistic setting and (b) using measures short enough to be incorporated into standard clinical care. The goal of the current study, therefore, investigated the extent to which maladaptive personality domains-as measured by the Personality Inventory for Brief Form (PID-5 BF)-predicted premature treatment termination in one naturalistic clinical setting.

Stability and consistency of maladaptive personality domains across multiple admissions to an acute care setting.

Personality has recently been positioned as one overarching framework for conceptualizing psychopathology. Further, the put forth an alternative dimensional model of personality pathology which includes measurement of maladaptive personality domains. Few studies have examined the stability of maladaptive personality scores, and even fewer have done so using clinical samples not characterized by the diagnosis of personality disorder.

Should childhood conduct disorder be necessary to diagnose antisocial personality disorder in adults?

Background: Antisocial personality disorder (ASPD) is the only DSM personality disorder that requires a diagnosis of conduct disorder (CD) during childhood. Previous research comparing adults diagnosed with ASPD with adults who meet all ASPD criteria except for a history of CD (referred to in this study as adult antisocial syndrome [AAS]) have reported mixed results. This study sought to clarify the differences among adults with ASPD, adults with AAS, and a large psychiatric outpatient control group.

Community and Clinical Epidemiology of Borderline Personality Disorder.

Several studies of the prevalence of borderline personality disorder in community and clinical settings have been carried out to date. Although results vary according to sampling method and assessment method, median point prevalence is roughly 1%, with higher or lower rates in certain community subpopulations. In clinical settings, the prevalence is around 10% to 12% in outpatient psychiatric clinics and 20% to 22% among inpatient clinics.

The severity of psychiatric disorders.

The issue of the severity of psychiatric disorders has great clinical importance. For example, severity influences decisions about level of care, and affects decisions to seek government assistance due to psychiatric disability. Controversy exists as to the efficacy of antidepressants across the spectrum of depression severity, and whether patients with severe depression should be preferentially treated with medication rather than psychotherapy.

Psychosocial morbidity associated with bipolar disorder and borderline personality disorder in psychiatric out-patients: comparative study.

Background: The morbidity associated with bipolar disorder is, in part, responsible for repeated calls for improved detection and recognition. No such commentary exists for the improved detection of borderline personality disorder. Clinical experience suggests that it is as disabling as bipolar disorder, but no study has directly compared the two disorders.

A brief, clinically useful, clinician-rated dimensional rating system for psychiatric diagnoses: reliability and validity in psychiatric outpatients.

Background: In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we describe the development of a dimensional rating system for Axis I disorders.

Methods: We evaluated 1,600 psychiatric outpatients with a semi-structured diagnostic interview for Axis I disorders and completed a self-report measure of psychosocial morbidity. A Standardized Clinical Outcome Rating (SCOR), a 7-point dimensional rating, was made for 17 Axis I disorders and 1 symptom construct.

Does Borderline Personality Disorder Manifest Itself Differently in Patients With Bipolar Disorder and Major Depressive Disorder?

Perugi and colleagues (2013) recently reported that some features of borderline personality disorder (BPD) significantly predicted a diagnosis of bipolar disorder among depressed patients. They interpreted these findings as indicating that some BPD criteria are nonspecific and are indicators of bipolar disorder rather than BPD, whereas other criteria are more specific to BPD. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, the authors tested the hypothesis that BPD presents itself differently in psychiatric outpatients diagnosed with bipolar disorder or major depressive disorder.

An Integrated, Acceptance-Based Behavioral Approach for Depression With Social Anxiety: Preliminary Results.

Depression and social anxiety disorder (SAD) are highly comorbid, resulting in greater severity and functional impairment compared with each disorder alone. Although recently transdiagnostic treatments have been developed, no known treatments have addressed this comorbidity pattern specifically. Preliminary support exists for acceptance-based approaches for depression and SAD separately, and they may be more efficacious for comorbid depression and anxiety compared with traditional cognitive-behavioral approaches.

Problematic boundaries in the diagnosis of bipolar disorder: the interface with borderline personality disorder.

It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. The most studied question on the relationship between BPD and bipolar disorder is their diagnostic concordance. Across studies approximately 10 % of patients with BPD had bipolar I disorder and another 10 % had bipolar II disorder.

The relationship between borderline personality disorder and bipolar disorder.

It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We reviewed the most studied question on the relationship between BPD and bipolar disorder: their diagnostic concordance.

Distinguishing bipolar II depression from major depressive disorder with comorbid borderline personality disorder: demographic, clinical, and family history differences.

Objective: Because of the potential treatment implications, it is clinically important to distinguish between bipolar II depression and major depressive disorder with comorbid borderline personality disorder. The high frequency of diagnostic co-occurrence and resemblance of phenomenological features has led some authors to suggest that borderline personality disorder is part of the bipolar spectrum. Few studies have directly compared patients with bipolar disorder and borderline personality disorder.

Differences between older and younger adults with borderline personality disorder on clinical presentation and impairment.

Background: Borderline Personality Disorder (BPD) is well-known to be a clinically severe and impairing diagnosis. Research shows that BPD symptoms decrease in severity over time. However, a subset of patients with BPD continue to meet criteria for the disorder in older adulthood.

A clinically useful social anxiety disorder outcome scale.

Increasingly, emphasis is being placed on measurement-based care to improve the quality of treatment. Although much of the focus has been on depression, measurement-based care may be particularly applicable to social anxiety disorder (SAD) given its high prevalence, high comorbidity with other disorders, and association with significant functional impairment. Many self-report scales for SAD currently exist, but these scales possess limitations related to length and/or accessibility that may serve as barriers to their use in monitoring outcome in routine clinical practice.

Is dimensional scoring important only for subthreshold levels of severity in personality disorders other than borderline?

Research assessing the utility of dimensional and categorical models of personality disorders (PDs) overwhelmingly supports the use of continuous over categorical models. Using borderline PD as an example, recent studies from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project suggested that continuous (criteria count) scoring of PDs is most informative for "subthreshold" levels of pathology, but is less important once a patient meets the diagnostic threshold. Using PD criteria count, the current study compared 7 indices of psychosocial morbidity for patients above and below diagnostic threshold for 3 additional PDs: paranoid, avoidant, and obsessive-compulsive.