Personality Assessment Inventory-Borderline Features Scale Research Articles

Interconnectedness of borderline personality pathology and affective temperaments in patients with mood disorders: a network analysis

Purpose Mood disorders frequently coexist with borderline personality pathology (BPP), presenting considerable clinical challenges. Affective temperaments (AT) play a role in modulating mood disorders and influence the manifestation of illness. BPP and AT share common characteristics, such as emotional instability, impulsivity, and difficulties in interpersonal relationships. However, research on the relationship between BPP and AT remains limited. This study employed network analysis to explore the network structure between BPP and AT in a cohort of patients with mood disorders. Materials and methods A total of 720 patients with mood disorders (major depressive disorder, n = 267; bipolar affective disorder, n = 453) were included in the analysis. The Personality Assessment Inventory-Borderline Features Scale (PAI-BOR) and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire short version (TEMPS-A) were utilized. Network analysis was conducted to identify central symptoms and network structures across the five AT dimensions and 24 BPP items. Results The BPP and TEMPS-A items were intricately interwoven, with no distinct groupings. The most significant symptoms identified were “Mood shifts” and “Cyclothymic temperament.” Additionally, irritable temperament was strongly linked to "Little control over anger," while anxious temperament was closely associated with "Worry about people leaving.” Conclusion The overlap of BPP and AT in the network, without a clear separation, suggests a significant interconnection between these clinical concepts. The centrality of “Mood shifts” and “Cyclothymic temperament” in this network underscores the importance of targeting these symptoms in the treatment of patients with prominent BPP and AT.

Clusters of borderline personality disorder traits and functional life outcomes: A novel person-centered approach

Individuals with borderline personality disorder (BPD) experience significant distress in daily life. However, the symptoms and functional impairment presented varies across affected individuals. The present study sought to parse out the heterogeneity within BPD by clarifying clusters of BPD traits and examining how they predict functional outcomes. Undergraduates (N = 504) completed the Personality Assessment Inventory-Borderline Features Scale (PAI-BOR) and several self-report questionnaires to assess functioning across life domains (i.e., global life functioning, social functioning, romantic functioning [trust and attachment], and emotional functioning [emotional intelligence and emotion regulation]). Confirmatory factor analysis revealed a five-factor structure within the PAI-BOR, consisting of Impulsivity, Mood Instability, Chronic Emptiness, Separation Concerns, and Negative Relationships. Using these BPD factors, a person-centered approach identified three distinct clusters in the data and how they relate to functional life outcomes: (1) High Functioning (i.e., low scores on factors and best outcomes), (2) Moderate Functioning (i.e., average scores on factors and outcomes), and (3) Low Functioning (i.e., high scores on factors and poorest outcomes). The findings have important implications for assessment, prognosis, and treatment planning, such as anticipating the extent of life dysfunction and emphasizing the need to comprehensively intervene with all five traits.

Clinical Utility and Diagnostic Validity of the Hierarchical Taxonomy of Psychopathology for Borderline Personality Disorder

Background: The hierarchical taxonomy of psychopathology (HiTOP) aims to address the limitations of traditional nosologies. This model organizes borderline personality disorder (BPD) along two dimensions: The distress sub-factor of negative affectivity and antagonism. Objectives: For the HiTOP model to be effectively integrated into clinical practice, its clinical utility must be established. This study aimed to assess the clinical utility and diagnostic validity of HiTOP in diagnosing BPD. Methods: This cross-sectional study included 113 inpatients with a primary diagnosis of BPD and 100 nonclinical individuals. The Structured Clinical Interview for diagnostic and statistical manual of mental disorders (DSM-5) Personality Disorders, Structured Clinical Interview for DSM-5-Screening Personality Questionnaire, Personality Inventory for DSM-5, and the Personality Assessment Inventory–Borderline Features Scale were used for BPD diagnosis and severity assessment. Multiple regression analyses were conducted on BPD-HiTOP-related and other maladaptive personality domains to identify the best predictive factors for BPD. Borderline personality disorder scales were created based on the regression algorithms. Receiver operating characteristic (ROC) analyses and diagnostic efficiency statistics were used to assess the relative diagnostic efficiency of these scales. Results: Regression analyses indicated that negative affectivity and disinhibition significantly predicted BPD severity, whereas antagonism did not. The ROC analysis demonstrated that both the HiTOP-BPD algorithm (antagonism/negative affectivity) and the proposed BPD algorithm (disinhibition/negative affectivity) showed excellent accuracy. Regarding diagnostic validity, the proposed BPD algorithm exhibited higher sensitivity and specificity levels compared to the HiTOP-BPD algorithm. Conclusions: These findings support the clinical utility of the disinhibition-negative affectivity algorithm in diagnosing BPD.

The Pathology of Borderline Personality Disorder Symptomatology in a Nonclinical Sample: The Role of Mental Pain, Cognitive Emotion Regulation, Self-compassion, and Depression

Objectives: Patients with borderline personality disorder (BPD) often develop a certain depression that may be accompanied by “mental pain.” A negative self-concept, aversive chronic emotions, and pervasive helplessness characterize mental pain. This research aims to explore the pathology of BPD symptomatology in a nonclinical sample. Also, the role of mental pain, cognitive emotion regulation, self-compassion, and depression are assessed. Methods: Following a correlational study, 300 university students were selected via the multi-stage random cluster sampling method. The study data were collected by the personality assessment inventory-borderline features scale, Orbach and Mikulincer mental pain questionnaire, cognitive emotion regulation questionnaire, self-compassion scale (SCS-SF), and Beck depression inventory version 2. Results: Multiple regression analyses indicated that components of putting into perspective, rumination, loss of control, refocus on planning, catastrophizing, irreversibility, somatic, and isolation (ΔR2=0.507, P<0.001) significantly predicted BPD symptomatology. Discussion: The results support the biosocial model dimensions in an Iranian context. In addition, it shows a strong association between mental pain, cognitive emotion regulation, self-compassion, depression, and BPD symptoms.

Validation of the Short Form of the Mood Instability Questionnaire-Trait (MIQ-T-SF) in the Korean General Population.

Mood instability (MI) is a clinically significant trait associated with psychiatric disorders. However, there are no concise measurements to evaluate MI. The initial Mood Instability Questionnaire-Trait (MIQ-T) was developed to fill this gap. The current study aimed to create a short form of MIQ-T (MIQ-T-SF) that measures MI with high validity and reliability in the Korean general population. Of the 59 items in the MIQ-T, 17 items were chosen for the MIQ-T-SF following the factor analysis process. In total, 540 participants completed the MIQ-T-SF. Cronbach's alpha and McDonald's omega were used to evaluate reliability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to determine construct validity. Concurrent validity was confirmed via comparisons with Personality Assessment Inventory-Borderline Features Scale. Measurement invariance across gender and age groups was confirmed before analyzing differences in scores using Kruskal-Wallis test. The MIQ-T-SF displayed expected correlations and high internal consistency (α=0.71-0.90, Ωt=0.72-0.92). Using EFA and CFA, a five-factor structure was confirmed. Measurement invariance was supported, and gender differences were observed. The MIQ-T-SF is an accurate and reliable method to detect MI in the Korean general population. The study's results offer new perspectives for future studies on MI.

The psychometric properties of the Personality Assessment Inventory-Adolescent's Borderline Features Scale across two high-risk samples.

The present study sought to assess the performance of the Borderline Features (BOR) Scale of the adolescent version of the Personality Assessment Inventory (Morey, 2007b) in 2 high-risk samples: inpatient and justice-involved adolescents. This study is the first to evaluate the BOR scale in high-risk adolescent samples, outside the initial standardization studies. Across both samples (NClinical = 327, NForensic = 151), results indicated good internal consistency. Confirmatory factor analysis indicated poor fit of the 4-factor structure proposed by the measure's authors. Convergent validity and receiver-operating characteristics analyses, conducted in the clinical sample, indicated that the adolescent version of the Personality Assessment Inventory BOR scale had good diagnostic accuracy for predicting a borderline personality disorder diagnosis (via structured interview). Findings suggest that the BOR scale has adequate internal consistency, convergent validity, and clinical utility, although areas for future measure evaluation (including factor structure) remain. Still, the BOR scale may partially address the current hesitation to assess borderline personality disorder features in high-risk youth because it is embedded within a broadband psychopathology measure. (PsycINFO Database Record

Acetaminophen Reduces Distrust in Individuals With Borderline Personality Disorder Features

People with borderline personality disorder (BPD) tend to distrust others. We hypothesized that acetaminophen might reduce distrust in people with high BPD features because disordered affective responses are partially responsible for the interpersonal difficulties of people with BPD features, and acetaminophen has been shown in multiple studies to reduce negative affect. Using a double-blind, parallel-arm design, 284 young adult participants were administered either acetaminophen (1,000 mg; acute) or placebo and subsequently completed an economic trust game. BPD features were assessed with the Personality Assessment Inventory–Borderline Features scale. Participants with elevated BPD features showed less trust in their partners in the placebo condition but increased trust in the acetaminophen condition. Acetaminophen did not change expectations of trustee’s trustworthiness and did not impact trusting behavior in participants low in BPD features. Our results indicate that acetaminophen may reduce the behavioral distrust exhibited at high levels of BPD features.

경계선 성격 성향과 부정 긴급성이 반응적 공격성에 미치는 영향: 주의편향의 조절된 매개효과

The purpose of this study was to examine the moderated mediating effect of attentional bias via negative urgency on the relationship between borderline personality trait and reactive aggression. A total of 126 Korean university students completed the following questionnaires and a dot probe task to measure attentional bias towards threatening faces: Personality Assessment Inventory-Borderline Features Scale (PAI-BOR), Reactive-Proactive Aggression Questionnaire (RPQ), and Korean UPPS-P Impulsive Behavior Scale. The main findings were as follows: First, the results of bootstrapping indicated that negative urgency mediated the relationship between borderline personality trait and reactive aggression. Second, the moderation effect of attentional bias on the relationship between negative urgency and reactive aggression was discovered using a hierarchical regression and slope analyses. Finally, attentional bias also moderated the mediating effect of borderline personality trait on reactive aggression through negative urgency. Implications, limitations, and suggestions for future research are also discussed.

The Effect of Trauma Severity on Borderline Personality: Self-Esteem as Mediator

The aim of this study was to examine the effect of trauma experience severity on borderline personality characteristics and to examine as well the mediation effect of self-esteem. To measure traumatic experience severity, the Trauma Experience Questionnaire-Revised (TEQ-R) was developed and validated. The TEQ-R, Rosenberg Self-Esteem Scale, and the personality assessment inventory-borderline features scale (PAI-BOR) were administered to 400 normal subjects. According to structural equation model analysis, trauma experience severity was positively associated with borderline characteristics, and the mediation effect of self-esteem was significant. Both trauma severity and borderline characteristics were negatively related to self-esteem. Thus, self-esteem seemed to have a buffering effect on the path between trauma and borderline personality.

Borderline features are associated with inaccurate trait self-estimations.

BackgroundMany treatments for Borderline Personality Disorder (BPD) are based upon the hypothesis that gross distortion in perceptions and attributions related to self and others represent a core mechanism for the enduring difficulties displayed by such patients. However, available experimental evidence of such distortions provides equivocal results, with some studies suggesting that BPD is related to inaccuracy in such perceptions and others indicative of enhanced accuracy in some judgments. The current study uses a novel methodology to explore whether individuals with BPD features are less accurate in estimating their levels of universal personality characteristics as compared to community norms.MethodOne hundred and four students received course instruction on the Five Factor Model of personality, and then were asked to estimate their levels of these five traits relative to community norms. They then completed the NEO-Five Factor Inventory and the Personality Assessment Inventory-Borderline Features scale (PAI-BOR). Accuracy of estimates was calculated by computing squared differences between self-estimated trait levels and norm-referenced standardized scores in the NEO-FFI.ResultsThere was a moderately strong relationship between PAI-BOR score and inaccuracy of trait level estimates. In particular, high BOR individuals dramatically overestimated their levels of Agreeableness and Conscientiousness, estimating themselves to be slightly above average on each of these characteristics but actually scoring well below average on both. The accuracy of estimates of levels of Neuroticism were unrelated to BOR scores, despite the fact that BOR scores were highly correlated with Neuroticism.ConclusionsThese findings support the hypothesis that a key feature of BPD involves marked perceptual distortions of various aspects of self in relationship to others. However, the results also indicate that this is not a global perceptual deficit, as high BOR scorers accurately estimated that their emotional responsiveness was well above average. However, such individuals appear to have limited insight into their relative disadvantages in the capacity for cooperative relationships, or their limited ability to approach life in a planful and non-impulsive manner. Such results suggest important targets for treatments addressing problems in self-other representations.

Assessing emotion sensitivity in female offenders with borderline personality symptoms: Results from a fear-potentiated startle paradigm.

An instructed fear-conditioning paradigm was used to measure fear-potentiated startle (FPS) in a sample of 80 Caucasian, female offenders assessed using the Personality Assessment Inventory-Borderline Features Scale (Morey, 1991). As predicted, women with higher levels of Borderline Personality Disorder (BPD) symptoms showed significantly greater FPS than women with lower levels when required to focus attention on the threat-relevant dimension of the experimental stimuli. However, FPS was not greater for women with higher levels of BPD symptoms in the two conditions that required participants to direct attention away from the threat-relevant dimension. These results highlight the importance of attention for moderating the association between BPD symptoms and exaggerated responses to threat-relevant information and may, therefore, help to resolve the inconsistent evidence on emotional reactivity in BPD. Moreover, the potential importance of attentional factors in BPD may shed new light on prominent symptoms of the disorder and existing theoretical perspectives on BPD.

Borderline personality traits and adult attention-deficit hyperactivity disorder symptoms: a genetic analysis of comorbidity.

Previous research has established the comorbidity of adult Attention-Deficit Hyperactivity Disorder (ADHD) with different personality disorders including Borderline Personality Disorder (BPD). The association between adult ADHD and BPD has primarily been investigated at the phenotypic level and not yet at the genetic level. The present study investigates the genetic and environmental contributions to the association between borderline personality traits (BPT) and ADHD symptoms in a sample of 7,233 twins and siblings (aged 18-90 years) registered with the Netherlands Twin Register and the East Flanders Prospective Twin Survey (EFPTS) . Participants completed the Conners' Adult ADHD Rating Scales (CAARS-S:SV) and the Personality Assessment Inventory-Borderline Features Scale (PAI-BOR). A bivariate genetic analysis was performed to determine the extent to which genetic and environmental factors influence variation in BPT and ADHD symptoms and the covariance between them. The heritability of BPT and ADHD symptoms was estimated at 45 and 36%, respectively. The remaining variance in BPT and ADHD symptoms was explained by unique environmental influences. The phenotypic correlation between BPT and ADHD symptoms was estimated at r = 0.59, and could be explained for 49% by genetic factors and 51% by environmental factors. The genetic and environmental correlations between BPT and ADHD symptoms were 0.72 and 0.51, respectively. The shared etiology between BPT and ADHD symptoms is thus a likely cause for the comorbidity of the two disorders.

Clinical assessment of affective instability: Comparing EMA indices, questionnaire reports, and retrospective recall.

Traditional self-report measures of psychopathology may be influenced by a variety of recall biases. Ecological momentary assessment (EMA) reduces these biases by assessing individuals' experiences as they occur in their natural environments. This study examines the discrepancy between trait questionnaire, retrospective report, and EMA measures of affective instability in psychiatric outpatients either with a borderline personality diagnosis (n = 58) or with a current episode of major depressive disorder or dysthymia (n = 42). The authors examined the agreement of 3 trait measures of affective instability-the Affective Instability subscale of the Personality Assessment Inventory-Borderline Features scale (L. C. Morey, 1991), the Affect Intensity Measure (R. J. Larsen, E. Diener, & R. Emmons, 1986), and the Affect Lability Scales (P. D. Harvey, B. R. Greenberg, & M. R. Serper, 1989)-and 1 retrospective mood recall task with EMA indices of mood and mood instability. Results indicate only modest to moderate agreement between momentary and questionnaire assessments of trait affective instability; agreement between recalled mood changes and EMA indices was poor. Implications for clinical research and practice and possible applications of EMA methodology are discussed.

Assessment of borderline personality features in population samples: Is the Personality Assessment Inventory–Borderline Features scale measurement invariant across sex and age?

Borderline personality disorder (BPD) is more often diagnosed in women than in men, and symptoms tend to decline with age. Using a large community sample, the authors investigated whether sex and age differences in four main features of BPD, measured with the Personality Assessment Inventory-Borderline Features scale (PAI-BOR; Morey, 1991), are a result of measurement bias or if they represent true differences. The PAI-BOR was completed by four Sex x Age groups (N = 6,838). Multigroup confirmatory factor analysis showed that the PAI-BOR is measurement invariant across sex and age. Compared with men, women reported more borderline characteristics for affective instability, identity problems, and negative relationships but not for self-harm. Younger men had higher scores for identity problems and self-harm than did older men. Younger women had higher scores for identity problems and affective instability than did older women. Results suggest that the PAI-BOR can be used to study the etiology of BPD features in population-based samples and to screen for BPD features in clinical settings in both men and women of varying ages. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Reliability and validity of three screening measures of borderline personality disorder in a nonclinical population

This study explored reliability and validity of three self-report screening measures of borderline personality disorder (BPD): the Personality Assessment Inventory-Borderline Features Scale (PAI-BOR; Morey, 1991), Personality Diagnostic Questionnaire-4-BPD scale (PDQ4-BPD; Hyler, 1994) and Mclean Screening Instrument for BPD (MSI-BPD; Zanarini et al., 2003). Participants ( N = 523) were drawn predominantly from community and student populations. All three measures were internally consistent. Confirmatory Factor Analysis of the PAI-BOR did not support Jackson and Trull’s (2001) six-factor structure or Morey’s (1991) four-factor structure. The three measures converged highly, despite the broader theoretical basis of the PAI-BOR. Expected demographic differences on the measures supported construct validity, and concurrent validity in relation to theoretical-related criteria was also supported. Only the PAI-BOR and PDQ4-BPD showed incremental validity in predicting specific criteria, although, the amount of unique variance predicted was small.

The Effect of Dialectical Behavior Therapy Skills Use on Borderline Personality Disorder Features

We assessed the effect of DBT skills utilization on features of borderline personality disorder as measured by the Personality Assessment Inventory-Borderline Features Scale (PAI-BOR). Participants were outpatients (N = 27) enrolled in a dialectical behavior therapy (DBT) program in a university-affiliated community mental health clinic. Diary cards were collected each week to track self-reported skills use. At the beginning of each new skills training module, patients completed another PAI-BOR. Univariate and multilevel analyses indicated significant improvement on the total PAI-BOR score and on several PAI-BOR subscale scores. Results also revealed that overall DBT skills use increased significantly over time, as did individual skills related to mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. Multilevel modeling results indicated that overall skills use showed a significant effect on PAI-BOR total scores, Affective Instability scores, Identity Problems scores, and Negative Relationships scores, even after controlling for initial levels of distress and diary card compliance.

Borderline personality disorder features and cognitive, emotional, and predicted behavioral reactions to teasing

Borderline personality disorder (BPD) involves interpersonal dysfunction. It is unknown to what extent these problems are due to perceptual biases, emotional reactivity, or impulsivity above and beyond emotional reactions. The present study experimentally tested these mechanisms in the context of predicted reactions to teasing. Participants completed the Personality Assessment Inventory-Borderline Features scale [PAI-BOR; Morey, L. C. (1991). Personality assessment inventory: Professional manual. Odessa, FL: Psychological Assessment Resources], and the Rejection Sensitivity Questionnaire [Downey, G., & Feldman, S. I. (1996). Implications of rejection sensitivity for intimate relationships. Journal of Personality and Social Psychology, 70(6), 1327–1343], and imagined a scenario that involved teasing. Participants rated the teaser and their own predicted emotional and behavioral reactions. Analysis of Covariance results indicated that individuals who endorsed more BPD features showed elevated emotional reactions and predicted behavioral reactions to teasing, but not perceptual biases. Ratings of predicted behavioral responses could be accounted for by emotional responses, supporting the emotional reactivity perspectives of BPD [Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford].

The factor structure of the Personality Assessment Inventory-Borderline Features (PAI-BOR) Scale in a nonclinical sample.

We evaluated the fit of Morey's (1991) proposed 4-factor structure on Personality Assessment Inventory-Borderline Features Scale (PAI-BOR; Morey, 1991) items in a sample of approximately 5,000 nonclinical participants. The proposed model did not fit the data well. Results from a series of exploratory and confirmatory factor analyses suggested that a 6-factor model provided the best fit to the PAI-BOR item covariances.