Borderline personality disorder traits in adolescents with anorexia nervosa.

Edna Lekgabe,Danielle Pogos,Susan M Sawyer,Elizabeth K Hughes,Andrew Court

doi:10.1002/brb3.2443

Abstract

ObjectiveTo examine the correlation between eating disorder (ED) symptoms and borderline personality disorder (BPD) traits in a sample of adolescents with eating disorders.MethodThere were 168 participants (M age = 16.0 years; SD = 1.16) with a diagnosis of anorexia nervosa (AN) or Eating Disorder Not Otherwise Specified—AN type. Eating Disorder Examination (EDE) and the Borderline Personality Questionnaire (BPQ) were used to assess ED symptoms and BPD traits.ResultsA total of 10 participants (6.6%) scored above the clinical cut‐off for a likely diagnosis of BPD. A positive correlation was observed between BPQ total score and EDE global (r s = 0.64, p < .001). There were also positive correlations between the BPQ self‐image and emptiness subscales and all EDE subscales. Similarly, the EDE eating concern subscale was correlated with all BPQ subscales.DiscussionPrevious studies have demonstrated that some BPD traits (i.e., suicidality, impulsivity, anger) are co‐morbid with ED but the link with other BPD traits has been poorly studied in adolescents and those with AN. These findings indicate that while the prevalence of BPD in adolescents with AN may be relatively low, ED symptom severity is closely related to severity of BPD traits, particularly identity disturbance and feelings of emptiness.

Highlights

In the clinical setting, it is not uncommon to see borderline personality disorder (BPD) in patients with an eating disorder (ED)
The Eating Disorder Examination (EDE) global score range 0 to 5.39 (M = 2.44; SD = 1.74) reflects the variation in self-reported psychopathology usually seen in ED patients at presentation
This study indicated that while the prevalence of BPD in adolescents with anorexia nervosa (AN) may be relatively low, ED symptom severity is closely related to severity of BPD traits, disturbance in selfimage and feelings of emptiness

Summary

Introduction

It is not uncommon to see borderline personality disorder (BPD) in patients with an eating disorder (ED). Research consistently shows that where an ED and BPD co-exist, there is an increased level of distress, suicidal and non-suicidal self-injurious behaviors compared to having only one diagnosis (Ben-Porath et al, 2009; Chen et al, 2009; Steiger & Stotland, 1996). While a co-morbid personality disorder creates a more complex clinical picture, it negatively impacts eating disorder treatment outcomes (Ben-Porath et al, 2009; Wildes et al, 2011; Zeeck et al, 2007).

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