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

Abstract

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.