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

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Background: Borderline personality disorder (BPD) compris- es a heterogeneous constellation of problems operational- ized in the DSM-5 and the forthcoming ICD-11. In schema therapy, schemas and modes are employed to conceptual- ize and treat these problems. Aim: The current study inves- tigated 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 bivari- ate point-biserial correlations and multiple logistic regres- sion 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 Mis- trust/Abuse along with modes of Angry/Enraged Child, (in- ternalized) 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 re- lated to conceptually meaningful schemas/modes, suggest- ing 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 languageDanish
JournalPsychopathology
Volume51
Issue number6
Pages (from-to)400-407
Number of pages8
ISSN0254-4962
DOIs
Publication statusPublished - 2018

ID: 365594259