Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-25T17:02:42.169Z Has data issue: false hasContentIssue false
  • English
  • Français

Predicting change in borderline personality: Using neurobehavioral systems indicators within an individual growth curve framework

Published online by Cambridge University Press:  12 December 2005

MARK F. LENZENWEGER  and
DANAEA DESANTIS CASTRO
MARK F. LENZENWEGER
Affiliation:
State University of New York at Binghamton
DANAEA DESANTIS CASTRO
Affiliation:
State University of New York at Binghamton
Get access Rights & Permissions [Opens in a new window]

Abstract

The natural history and course of borderline personality disorder (BPD) has long been the focus of speculation, typically guided by impressions from clinical work with BPD-affected individuals. Not unlike the other personality disorders (PDs), it has long been assumed that BPD is relatively stable, traitlike, and enduring in nature. The extent to which BPD is or is not a plastic construct has implications not only for understanding its longitudinal course, but also for understanding its development and, ultimately, its treatment and/or prevention. This paper consists of two parts. The first part reviews the longitudinal research corpus that bears directly upon the issue of stability of BPD in both adolescents and adults. The consistent trend in very nearly all studies, whether using a categorical or dimensional approach to assessment, is one of considerable change over time. This literature presents complexities, however, because most of the extant studies examine BPD-affected individuals who have been exposed to treatment. However, at least two large-scale longitudinal studies, which include both treated and untreated persons, also provide support for viewing BPD as a malleable disorder that declines in severity over time. The second part presents original data from the Longitudinal Study of Personality Disorders that specifically examine the predictors of change in BPD using a neurobehavioral model of personality within an individual growth curve (IGC) analytical framework. This IGC analysis revealed important predictors of both overall level of BPD features as well as rate of change in BPD features, with particularly important roles played by the agentic positive emotion (i.e., incentive motivation) and anxiety (negative emotion) systems. The benefits of the IGC approach for understanding the developmental psychopathology of BPD is also stressed.This research was supported in part by NIMH Grant MH 45448 to Mark F. Lenzenweger for the Longitudinal Study of Personality Disorders.

Type
Research Article
Information
Development and Psychopathology , Volume 17 , Issue 4 , December 2005 , pp. 1207 - 1237
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Allen, J. G. (2003). What stabilizes stable instability? Psychiatry 66, 120–123.Google Scholar
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed). Washington, DC: Author.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., revised). Washington DC: Author.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed). Washington, DC: Author.
Block, J. (1995). A contrarian view of the five-factor approach to personality description. Psychological Bulletin 117, 187–215.CrossRefGoogle Scholar
Block, J. (2001). Millenial contrarianism: The five-factor approach to personality description 5 years later. Journal of Research in Personality 35, 98–107.CrossRefGoogle Scholar
Bornstein, R. F. (2003). Behaviorally referenced experimentation and symptom validation: A paradigm for 21st-century personality disorder research. Journal of Personality Disorders 17, 1–18.CrossRefGoogle Scholar
Bryk, A. S., & Raudenbush, S. W. (1987). Application of hierarchical linear models to assessing change. Psychological Bulletin 101, 147–158.CrossRefGoogle Scholar
Buss, A. H., & Plomin, R. (1984). Temperament: Early developing personality traits. Hillsdale, NJ: Erlbaum.
Choca, J. P., & Van Denburg, E. (1997). Interpretive guide to the millon clinical multiaxial inventory (2nd ed.). Washington, DC: American Psychological Association.
Church, A. T. (1994). Relating the Tellegen and five-factor models of personality structure. Journal of Personality and Social Psychology 67, 898–909.CrossRefGoogle Scholar
Cicchetti, D., & Rogosch, F. A. (1996). Equifinality and multifinality in developmental psychopathology. Development and Psychopathology 8, 597–600.CrossRefGoogle Scholar
Cicchetti, D., & Rogosch, F. A. (2002). A developmental psychopathology perspective on adolescence. Journal of Consulting and Clinical Psychology 70, 6–20.CrossRefGoogle Scholar
Clarke, M., Hafner, R. J., & Holme, G. (1995). Borderline personality disorder: A challenge for mental health services. Australian and New Zealand Journal of Psychiatry 29, 409–414.CrossRefGoogle Scholar
Cloninger, C., Svrakic, D., & Przybeck, T. (1993). A psychobiological model of temperament and character. Archives of General Psychiatry 50, 975–990.CrossRefGoogle Scholar
Costa, P. T., & McCrae, R. R. (1985). The NEO Personality Inventory. Odessa, FL: Psychological Assessment Resources.
Depue, R. A., & Lenzenweger, M. F. (2001). A neurobehavioral dimensional model. In W. J. Livesley (Ed.), Handbook of personality disorders: Theory, research, and treatment (pp. 136–176). New York: Guilford Press.
Depue, R. A., & Lenzenweger, M. F. (2005). A neurobehavioral model of personality disturbance. In J. F. Clarkin & M. F. Lenzenweger (Eds.), Major theories of personality disorder (2nd ed., pp. 391–453). New York: Guilford Press.
Estes, W. K. (1956). The problem of inference from curves based on group data. Psychological Bulletin 53, 134–140.CrossRefGoogle Scholar
Fritsch, R. C., & Ingraham, L. J. (2003). Remission of personality or remission of symptoms? Psychiatry 66, 124–128.Google Scholar
Garnet, K. E., Levy, K. N., Mattanah, J. J. F., Edell, W. S., & McGlashan, T. H. (1994). Borderline personality disorder in adolescents: Ubiquitous or specific? The American Journal of Psychiatry 151, 1380–1382.Google Scholar
Gunderson, J. G., Bender, D., Sanislow, C., Yen, S., Rettew, J. B., Dolan–Sewell, R., et al. (2003). Plausibility and possible determinants of sudden “remissions” in borderline patients. Psychiatry 66, 111–119.CrossRefGoogle Scholar
Gunderson, J. G., Kolb, J. E., & Austin, V. (1981). The diagnostic interview for borderline patients. American Journal of Psychiatry 138, 896–903.Google Scholar
Gunderson, J. G., Shea, M. T., Skodol, A. E., McGlashan, T. H., Morey, L. C., Stout, R. L., et al. (2000). The Collaborative Longitudinal Personality Disorders Study: Development, aims, design, and sample characteristics. Journal of Personality Disorders 14, 300–315.CrossRefGoogle Scholar
Johnson, J. G., Cohen, P., Kasen, S., Skodol, A. E., Hamagan, F., & Brook, J. S. (2000). Age-related change in personality disorder trait levels between early adolescence and adulthood: A community-based longitudinal investigation. Acta Psychiatra Scandinavia 102, 265–275.CrossRefGoogle Scholar
Kessler, R., McGonagle, K., Zhao, S., Nelson, C., Hughes, M. Eshleman, S., et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry 51, 8–19.CrossRefGoogle Scholar
Lenzenweger, M. F. (1999). Stability and change in personality disorder features: The Longitudinal Study of Personality Disorders. Archives of General Psychiatry 56, 1009–1015.CrossRefGoogle Scholar
Lenzenweger, M. F., & Clarkin, J. F. (1996). The personality disorders: History, classification, and research issues. In J. F. Clarkin & M. F. Lenzenweger (Eds.), Major theories of personality disorder (pp. 1–35). New York: Guilford Press.
Lenzenweger, M. F., & Clarkin, J. F. (Eds.). (2005). Major theories of personality disorder (2nd ed.). New York: Guilford Press.
Lenzenweger, M. F., Clarkin, J. F., Fertuck, E. A., & Kernberg, O. F. (2004). Executive neurocognitive functioning and neurobehavioral systems indicators in borderline personality disorder: A preliminary study. Journal of Personality Disorders 18, 421–438.CrossRefGoogle Scholar
Lenzenweger, M. F., Clarkin, J. F., Kernberg, O. F., & Foelsch, P. (2001). The Inventory of Personality Organization: Psychometric properties, factorial composition and criterion relations with affect, aggressive dyscontrol, psychosis-proneness, and self domains. Psychological Assessment 4, 577–591.CrossRefGoogle Scholar
Lenzenweger, M. F., & Hooley, J. M. (Eds.). (2003). Principles of experimental psychopathology: Essays in honor of Brendan A. Maher. Washington, DC: American Psychological Association.
Lenzenweger, M. F., Johnson, M. D., & Willett, J. B. (2004). Individual growth curve analysis illuminates stability and change in personality disorder features: The Longitudinal Study of Personality Disorders. Archives of General Psychiatry 61, 1015–1024.CrossRefGoogle Scholar
Lenzenweger, M. F., Loranger, A. W., Korfine, L., & Neff, C. (1997). Detecting personality disorders in a nonclinical population: Application of a two-stage procedure for case identification. Archives of General Psychiatry 54, 345–351.CrossRefGoogle Scholar
Links, P. S., Heslegrave, R., & van Reekum, R. (1999). Impulsivity: Core aspect of borderline personality disorder. Journal of Personality Disorders 13, 1–9.CrossRefGoogle Scholar
Links, P. S., Mitton, M. J. E., & Steiner, M. (1992). Stability of borderline personality disorder. Canadian Journal of Psychiatry 38, 255–259.Google Scholar
Loranger, A. W. (1988). Personality disorder examination manual. Yonkers, NY: DV Communications.
Loranger, A. W. (1999). International personality disorder examination: DSM-IV and ICD-10 interviews. Odessa, FL: Psychological Assessment Resources.
Loranger, A. W., Lenzenweger, M. F., Gartner, A., Susman, V., Herzig, J., Zammit, G. K., et al. (1991). Trait-state artifacts and the diagnosis of personality disorders. Archives of General Psychiatry 48, 720–728.CrossRefGoogle Scholar
Loranger, A. W., Sartorius, N., Andreoli, A., Berger, P., Channabasavanna, S. M., Coid, B., et al. (1994). The International Personality Disorder Examination (IPDE): The World Health Organization/Alcohol, Drug Abuse, and Mental Health Administration International Pilot Study of Personality Disorders. Archives of General Psychiatry 51, 215–224.CrossRefGoogle Scholar
Ludolph, P. S., 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.Google Scholar
Masten, A. S., & Coatsworth, J. D. (1998). The development of competence in favorable and unfavorable environments: Lessons from research on successful children. American Psychologist 53, 205–220.CrossRefGoogle Scholar
McDavid, J. D., & Pilkonis, P. A. (1996). The stability of personality disorder diagnoses. Journal of Personality Disorders 10, 1–15.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
Millon, T. (1987). Millon Clinical Multiaxial Inventory-II manual. Minneapolis, MN: National Computer Systems, Inc.
Najavits, L. M., & Gunderson, J. G. (1995). Better than expected: Improvements in borderline personality disorder in a 3-year prospective outcome study. Comprehensive Psychiatry 36, 296–302.CrossRefGoogle Scholar
Nesselroade, J., & Baltes, P. (1979). Longitudinal research in the study of behavior and development. New York: Academic Press.
Nunnally, J., & Bernstein, I. H. (1994). Psychometric theory (3rd ed). New York: McGraw–Hill.
Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods (2nd ed.). Thousand Oaks, CA: Sage.
Reynolds, S. K., & Clark, L. A. (2001). Predicting dimensions of personality disorder from domains and facets of the five-factor model. Journal of Personality 69, 199–222.CrossRefGoogle Scholar
Rogosa, D., Brandt, D., & Zimowski, M. (1982). A growth curve approach to the measurement of change. Psychological Bulletin 92, 726–748.CrossRefGoogle Scholar
Rogosa, D. R., & Willett, J. B. (1985). Understanding correlates of change by modeling individual differences in growth. Psychometrika, 50, 203–228.CrossRefGoogle Scholar
Rosenthal, R., & Rosnow, R. L. (1991). Essentials of behavioral research: Methods and data analysis (2nd ed.). New York: McGraw–Hill.
Samuels, J. E., Eaton, W. W., Bienvenu, O. J., Brown, C., Costa, P. T., & Nestadt, G. (2002). Prevalence and correlates of personality disorders in a community sample. British Journal of Psychiatry 180, 536–542.CrossRefGoogle Scholar
Saulsman, L. M., & Page, A. C. (2004). The five-factor model and personality disorder empirical literature: A meta-analytic review. Clinical Psychology Review, 23, 1055–1085.CrossRefGoogle Scholar
Shea, M. T., Stout, R., Gunderson, J. G., Moery, L. C., Grilo, C. M., McGlashan, T. H., et al. (2002). Short-term diagnositc stability of schizotypal, borderline, avoidant, and obsessive–compulsive personality disorders. American Journal of Psychiatry 159, 2036–2041.CrossRefGoogle Scholar
Shedler, J., & Westen, D. (2004). Dimensions of personality pathology: An alternative to the five-factor model. American Journal of Psychiatry 161, 1743–1754.CrossRefGoogle Scholar
Siever, L. J., & Davis, K. L. (1991). A psychobiological perspective on the personality disorders. American Journal of Psychiatry 148, 1647–1658.Google Scholar
Singer, J. D., & Willett, J. B. (2003). Applied longitudinal data analysis: Modeling change and event occurrence. New York: Oxford University Press.CrossRef
Spear, L. P. (2000). The adolescent brain and age-related behavioral manifestations. Neuroscience and Biobehavioral Reviews 24, 417–463.CrossRefGoogle Scholar
Spessot, A. L., Plessen, K. J., & Peterson, B. S. (2004). Neuroimaging of developmental psychopathologies: The importance of self-regulatory and neuroplastic processes in adolescence. Annals of the New York Academy of Sciences 1021, 86–104.CrossRefGoogle Scholar
Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. (1990). Users' guide for the Structured Clinical Interview for DSM-III-R. Washington, DC: American Psychiatric Association.
Srivastava, S., John, O. P., Gosling, S. D., & Potter, J. (2003). Development of personality in early and middle adulthood: Set like plaster or persistent change? Journal of Personality and Social Psychology 84, 1041–1053.Google Scholar
Tellegen, A. (1982). Multidimensional Personality Questionnaire manual. Minneapolis, MN: University of Minnesota Press.
Tellegen, A. (1985). Structures of mood and personality and their relevance to assessing anxiety, with an emphasis on self-report. In A. H. Tuma & J. D. Maser (Eds.), Anxiety and the anxiety disorders (pp. 681–706). Hillsdale, NJ: Erlbaum.
Torgersen, S., Kringlen, E., & Cramer, V. (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry 58, 590–596.CrossRefGoogle Scholar
Vygotsky, L. S. (1978). Mind and society: The development of higher mental processes. Cambridge: Harvard University Press.
Waugaman, R. M., & Goldstein, W. N. (2003). The pivotal role of interpersonal relationships in the outcome of borderline patients. Psychiatry 66, 129–132.CrossRefGoogle Scholar
Westen, D. (1996). A model and method for uncovering the nomothetic from the idiographic: An alternative to the five factor model? Journal of Research in Personality 30, 400–413.Google Scholar
Willett, J. B. (1988). Questions and answers in the measurement of change. In E. Rothkopf (Ed.), Review of research in education (1988–1989) (pp. 345–422). Washington, DC: American Educational Research Association.
Willett, J. B., Singer, J. D., & Martin, N. C. (1998). The design and analysis of longitudinal studies of development and psychopathology in context: Statistical models and methodological recommendations. Development and Psychopathology 10, 395–426.CrossRefGoogle Scholar
Zanarini, M. C., Frankenburg, F. R., Hennen, J., & Silk, K. R. (2003). The longitudinal course of borderline psychopathology: 6-year prospective follow-up of the phenomenology of borderline personality disorder. American Journal of Psychiatry 160, 274–283.CrossRefGoogle Scholar
Zanarini, M. C., Frankenburg, F. R., Sickel, A. E., and Young, L. (1996). The Diagnostic Interview for DSM-IV personality disorders. Belmont, MA: McLean Hospital, Laboratory for the Study of Adult Development.
Zanarini, M. C., Frankenburg, F. R., & Vujanovic, A. A. (2002). The interrater and test–retest reliability of the Revised Diagnostic Interview for Borderlines (DIB-R). Journal of Personality Disorders 16, 270–276.CrossRefGoogle Scholar