The borderline personality diagnosis in adolescents: Gender differences and subtypes

Journal of Child Psychology and Psychiatry and Allied Disciplines

Volumn 46, Issue 9, 2005, Pages 1006-1019

  Bradley, Rebekah ^a   Conklin, Carolyn Zittel ^b   Westen, Drew ^a  

^a EMORY UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b CAMBRIDGE HOSPITAL   (United States)

Author keywords

Adolescent psychopathology; Gender; Personality disorder; Q sort; Subtype; SWAP

Indexed keywords

ADOLESCENT; ADOLESCENT DISEASE; AGGRESSIVENESS; ANGER; ANTISOCIAL BEHAVIOR; ARTICLE; BORDERLINE STATE; CHILD BEHAVIOR CHECKLIST; CONTROLLED STUDY; DATA ANALYSIS; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; DISRUPTIVE BEHAVIOR; FACTORIAL ANALYSIS; FEMALE; HUMAN; MAJOR CLINICAL STUDY; MALE; PATIENT SELECTION; PHENOMENOLOGY; PSYCHIATRIC DIAGNOSIS; PSYCHOLOGIC ASSESSMENT; RANDOMIZATION; RATING SCALE; SEX DIFFERENCE; SYMPTOM; VALIDITY; AGGRESSION; ATTENTION DEFICIT DISORDER; CLASSIFICATION; COMPARATIVE STUDY; CONTROL; DEPRESSION; HISTRIONIC PERSONALITY DISORDER; PERSONALITY TEST; PSYCHOLOGICAL ASPECT; PSYCHOMETRY; STATISTICS;

ADOLESCENT; AGGRESSION; ANGER; ATTENTION DEFICIT AND DISRUPTIVE BEHAVIOR DISORDERS; BORDERLINE PERSONALITY DISORDER; DEPRESSIVE DISORDER; FEMALE; HISTRIONIC PERSONALITY DISORDER; HUMANS; INTERNAL-EXTERNAL CONTROL; MALE; PERSONALITY ASSESSMENT; PSYCHOMETRICS; Q-SORT; SEX FACTORS;

EID: 32944471315     PISSN: 00219630     EISSN: 14697610     Source Type: Journal    
DOI: 10.1111/j.1469-7610.2004.00401.x     Document Type: Article

References (57)

1. Achenbach, T.M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington: University of Vermont, Department of Psychiatry.
2. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd edn). Washington, DC: American Psychiatric Press.
3. Andreasen, N.C., Endicott, J., Spitzer, R.L., & Winokur, G. (1977). The family history method using diagnostic criteria: Reliability and validity. Archives of General Psychiatry, 34, 1229-1235.
4. Bateman, A.W., & Fonagy, P. (2003). The development of an attachment-based treatment program for borderline personality disorder. Bulletin of the Menninger Clinic, 67, 187-211.
5. Bernstein, D.P., Cohen, P., Skodol, A., Bezirganian, S., & Brook, J.S. (1996). Childhood antecedents of adolescent personality disorders. American Journal of Psychiatry, 153, 907-913.
6. Blais, M., & Norman, D. (1997). A psychometric evaluation of the DSM-IV personality disorder criteria. Journal of Personality Disorders, 11, 168-176.
7. Block, J. (1971). Lives through time. Berkeley, CA: Bancroft.
8. Block, J. (1978). The Q-Sort method in personality assessment and psychiatric research. Palo Alto, CA: Consulting Psychologists Press.
9. Brent, D., Zelenak, J.P., Bukstein, O., & Brown, R.V. (1990). Reliability and validity of the structured interview for personality disorders in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 349-354.
10. Caspi, A. (1998). Personality development across the life span. In N. Eisenberg (Ed.), Handbook of child psychology: Social emotional, personality development (vol. 3, pp. 311-388). New York: John Wiley and Sons.
11. Dutra, L., Campbell, L., & Westen, D. (2004). Quantifying clinical judgment in the assessment of adolescent psychopathology: Reliability, validity, and factor structure of the Child Behavior Checklist for Clinician-Report. Journal of Clinical Psychology, 60, 65-85.
12. Embretson, S.E., & Reise, S.P. (2000). Item response theory for psychologists. Mahwah, NJ: Lawrence Erlbaum Associates.
13. Garnet, K.E., Levy, K.N., Mattanah, J.J.F., Edell, W.S., & McGlashan, T.H. (1994). Borderline personality disorder in adolescence: Ubiquitous or specific ? American Journal of Psychiatry, 151, 1380-1382.
14. Grilo, C.M., Walker, M.L., Becker, D.F., Edell, W.S., & McGlashan, T.H. (1997). Personality disorders in adolescents with major depression, substance use disorders, and coexisting major depression and substance use disorders. Journal of Consulting and Clinical Psychology, 65, 328-332.
15. Hilsenroth, M.J., Ackerman, S.J., Blagys, M.D., Baumann, B.D., Baity, M.R., Smith, S.R., et.al. (2000). Reliability and validity of DSM-IV axis V. American Journal of Psychiatry, 157, 1858-1863.
16. Johnson, B.A., Brent, D., Connolly, J., Bridge, J., Matta, J., Constantine, D., et.al. (1995). Familial aggregation of adolescent personality disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 798-804.
17. Johnson, J.G., Cohen, P., Skodol, A., Oldham, J., Kasen, S., & Brook, J.S. (1999). Personality disorders in adolescence and risk of major mental disorders and suicidality during adulthood. Archives of General Psychiatry, 56, 805-811.
18. Johnson, J.G., Cohen, P., Smailes, E., Kasen, S., Oldham, J.M., Skodol, A. E., et.al. (2000). Adolescent personality disorders associated with violence and criminal behavior during adolescence and early adulthood. American Journal of Psychiatry, 157, 1406-1412.
19. Kernberg, O. (1967). Borderline personality organization. Journal of the American Psychoanalytic Association, 15, 641-685.
20. Kessler, R.C., Stang, P.E., Wittchen, H.-U., Ustun, T., Roy-Burne, P.P., & Walters, E.E. (1998). Lifetime panic-depression comorbidity in the National Comorbidity Survey. Archives of General Psychiatry, 55, 801-808.
21. Lenzenweger, M.F., & Clarkin, J. (1996). The personality disorders: History, classification, and research issues. In J. Clarkin & M.F. Lenzenweger (Eds.), Major theories of personality disorders (pp. 1-35). New York: Guilford.
22. Lewinsohn, P., Rohde, P., Seeley, J.R., & Klein, D.N. (1997). Axis II psychopathology as a function of Axis I disorders in childhood and adolescence. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1752-1759.
23. Linehan, M.M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford.
24. Ludolph, P., Westen, D., Misle, B., Jackson, A., Wixom, J., & Wiss, F.C. (1990). The borderline diagnosis in adolescents: Symptoms and developmental history. American Journal of Psychiatry, 147, 470-476.
25. McManus, M., Lerner, H., Robbins, D., & Barbour, C. (1984). Assessment of borderline symptomatology in hospitalized adolescents. Journal of the American Academy of Child Psychiatry, 23, 685-694.
26. Meijer, M., Goedhart, A.W., & Treffers, P.D.A. (1998). The persistence of borderline personality disorder in adolescence. Journal of Personality Disorders, 12, 13-22.
27. Morey, L.C. (1988). Personality disorders in DSM-III and DSM-III-R: Convergence, coverage, and internal consistency. American Journal of Psychiatry, 145, 573-577.
28. Nakash-Eisikovits, O., Dutra, L., & Westen, D. (2003). The relationship between attachment patterns and personality pathology in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1111-1123.
29. Parker, G., Tupling, H., & Brown, L.B. (1979). A parental bonding instrument. British Journal of Medical Psychology, 52, 1-10.
30. Pinto, A., Grapentine, W.L., Francis, G., & Picariello, C. (1996). Borderline personality disorder in adolescents: Affective and cognitive features. Journal of American Academy of Child and Adolescent Psychiatry, 35, 1338-1343.
31. Robins, R.W., John, O., Caspi, A., Moffitt, T.E., & Stouthamer-Loeber, M. (1996). Resilient, overcontrolled, and undercontrolled boys; Three replicable personality types. Journal of Personality and Social Psychology, 70, 157-171.
32. Rosenthal, R., Rosnow, R.L., & Rubin, D.B. (2000). Contrasts and effect sizes in behavioral research. New York: Cambridge University Press.
33. Russ, E., Heim, A., & Westen, D. (2003). Parental bonding and personality pathology assessed by clinician report. Journal of Personality Disorders, 17, 522-536.
34. Shedler, J., Mayman, M., & Manis, M. (1993). The illusion of mental health. American Psychology, 48, 1117-1131.
35. Shedler, J., & Westen, D. (1998). Refining the measurement of Axis II: A Q-sort procedure for assessing personality pathology. Assessment, 5, 333-353.
36. Shedler, J., & Westen, D. (2004a). Dimensions of personality pathology: An alternative to the Five Factor model. American Journal of Psychiatry, 161, 1743-1754.
37. Shedler, J., & Westen, D. (2004b). Refining DSM-IV personality disorder diagnosis: Integrating science and practice. American Journal of Psychiatry, 161, 1-16.
38. Skodol, A.E., Gunderson, J., Pfohl, B., Widiger, T.A., Livesley, W.J., & Siever, L. (2002). The borderline diagnosis I: Psychopathology, comorbidity, and personality structures. Biological Psychiatry, 51, 936-950.
39. Thompson, B. (2000). Q-technique factor analysis: One variation on the two-mode factor analysis of variables. In L.G. Grimm & P.R. Yarnold (Eds.), Reading and understanding MORE multivariate statistics (pp. 207-226). Washington, DC: American Psychological Association.
40. Torgersen, S., Kringlen, E., & Cramer, V. (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry, 58, 590-596.
41. Westen, D. (1997). Divergences between clinical and research methods for assessing personality disorders: Implications for research and the evolution of Axis II. American Journal of Psychiatry, 154, 895-903.
42. Westen, D., & Bradley, R. (inpress). Prototype diagnosis of personality. In S. Strack (Ed.), Handbook of personology and psychopathology. New York: Wiley.
43. Westen, D., & Chang, C. (2000). Personality pathology in adolescence: A review. Adolescent Psychiatry, 25, 61-100.
44. Westen, D., & Harnden-Fischer, J. (2001). Personality profiles in eating disorders: Rethinking the distinction between Axis I and Axis II. American Journal of Psychiatry, 165, 547-562.
45. Westen, D., Heim, A.K., Morrison, K., Patterson, M., & Campbell, L. (2002). Classifying and diagnosing psychopathology: A prototype matching approach. In L. Beutler & M. Malik (Eds.), Rethinking the DSM: Psychological perspectives (pp. 221-250). Washington DC: APA Press.
46. Westen, D., Ludolph, P., Lerner, H., Ruffins, S., & Wiss, F.C. (1990). Object relations in borderline adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 338-348.
47. Westen, D., & Muderrisoglu, S. (2003). Reliability and validity of personality disorder assessment using a systematic clinical interview: Evaluating an alternative to structured interviews. Journal of Personality Disorders, 17, 350-368.
48. Westen, D., Muderrisoglu, S., Shedler, J., Fowler, C., & Koren, D. (1997). Affect regulation and affective experience: Individual differences, group differences, and measurement using a Q-sort procedure. Journal of Consulting and Clinical Psychology, 65, 429-439.
49. Westen, D., & Shedler, J. (1999a). Revising and assessing Axis II, Part 1: Developing a clinically and empirically valid assessment method. American Journal of Psychiatry, 156, 258-272.
50. Westen, D., & Shedler, J. (1999b). Revising and assessing Axis II, Part 2: Toward an empirically based and clinically useful classification of personality disorders. American Journal of Psychiatry, 156, 273-285.
51. Westen, D., & Shedler, J. (2000). A prototype matching approach to diagnosing personality disorders toward DSM-V. Journal of Personality Disorders, 14, 109-126.
52. Westen, D., Shedler, J., Durrett, C., Glass, S., & Martens, A. (2003). Personality diagnosis in adolescence: DSM-IV axis II diagnoses and an empirically derived alternative. American Journal of Psychiatry, 160, 952-966.
53. Westen, D., & Weinberger, J. (inpress). When clinical prediction becomes statistical prediction. American Psychologist.
54. Wilkinson-Ryan, T., & Westen, D. (2000). Identity disturbance in borderline personality disorder: An empirical investigation. American Journal of Psychiatry, 157, 528-541.
55. Zinner, J., & Shapiro, R.L. (1989). Projective identification as a mode of perception and behavior in families of adolescents. In J.S. Scharff (Ed.), Foundations of object relations family therapy (pp. 109-126). Northvale, NJ: Jason Aronson.
56. Zittel, C., & Westen, D. (2004). Subtyping borderline personality disorder. Unpublished manuscript, Emony University.
57. Zittel, C., & Westen, D. (inpress). Borderline personality disorder as seen in clinical practice: Implications for DSM-V. American Journal of Psychiatry.