Borderline personality disorder co-morbidity: relationship to the internalizing-externalizing structure of common mental disorders

N R Eaton; R F Krueger; K M Keyes; A E Skodol; K E Markon; B F Grant; D S Hasin

doi:10.1017/S0033291710001662

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Borderline personality disorder co-morbidity: relationship to the internalizing-externalizing structure of common mental disorders

Journal article

Peer reviewed

Borderline personality disorder co-morbidity: relationship to the internalizing-externalizing structure of common mental disorders

N R Eaton, R F Krueger, K M Keyes, A E Skodol, K E Markon, B F Grant and D S Hasin

Psychological medicine, Vol.41(5), pp.1041-1050

05/2011

DOI: 10.1017/S0033291710001662

PMCID: PMC3193799

PMID: 20836905

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https://www.ncbi.nlm.nih.gov/pmc/articles/3193799View

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Abstract

Borderline personality disorder (BPD) shows high levels of co-morbidity with an array of psychiatric disorders. The meaning and causes of this co-morbidity are not fully understood. Our objective was to investigate and clarify the complex co-morbidity of BPD by integrating it into the structure of common mental disorders. We conducted exploratory and confirmatory factor analyses on diagnostic interview data from a representative US population-based sample of 34 653 civilian, non-institutionalized individuals aged ≥18 years. We modeled the structure of lifetime DSM-IV diagnoses of BPD and antisocial personality disorder (ASPD), major depressive disorder, dysthymic disorder, panic disorder with agoraphobia, social phobia, specific phobia, generalized anxiety disorder, post-traumatic stress disorder, alcohol dependence, nicotine dependence, marijuana dependence, and any other drug dependence. In both women and men, the internalizing-externalizing structure of common mental disorders captured the co-morbidity among all disorders including BPD. Although BPD was unidimensional in terms of its symptoms, BPD as a disorder showed associations with both the distress subfactor of the internalizing dimension and the externalizing dimension. The complex patterns of co-morbidity observed with BPD represent connections to other disorders at the level of latent internalizing and externalizing dimensions. BPD is meaningfully connected with liabilities shared with common mental disorders, and these liability dimensions provide a beneficial focus for understanding the co-morbidity, etiology and treatment of BPD.

Comorbidity

Adult

Aged

Aged, 80 and over

Anxiety Disorders - epidemiology

Borderline Personality Disorder - epidemiology

Borderline Personality Disorder - psychology

Factor Analysis, Statistical

Female

Humans

Interview, Psychological

Male

Mental Disorders - epidemiology

Middle Aged

Models, Psychological

Mood Disorders - epidemiology

Substance-Related Disorders - epidemiology

United States - epidemiology

Details

Title: Subtitle: Borderline personality disorder co-morbidity: relationship to the internalizing-externalizing structure of common mental disorders
Creators: N R Eaton - Department of Psychology, 75 East River Road, University of Minnesota, Minneapolis, MN 55455-0344, USA. nreaton@gmail.com
R F Krueger
K M Keyes
A E Skodol
K E Markon - University of Iowa, Psychological and Brain Sciences
B F Grant
D S Hasin
Resource Type: Journal article
Publication Details: Psychological medicine, Vol.41(5), pp.1041-1050
DOI: 10.1017/S0033291710001662
PMID: 20836905
PMCID: PMC3193799
NLM abbreviation: Psychol Med
ISSN: 0033-2917
eISSN: 1469-8978
Grant note: F31DA026689 / NIDA NIH HHS Z01 AA000449-05 / Intramural NIH HHS K05 AA014223 / NIAAA NIH HHS U01 AA018111 / NIAAA NIH HHS R01 DA018652 / NIDA NIH HHS R01DA018652 / NIDA NIH HHS K05AA014223 / NIAAA NIH HHS U01AA018111 / NIAAA NIH HHS F31 DA026689 / NIDA NIH HHS
Language: English
Date published: 05/2011
Academic Unit: Psychological and Brain Sciences
Record Identifier: 9984208550702771

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