Borderline personality disorder symptom networks across adolescent and adult clinical samples: examining symptom centrality and replicability.
Borderline personality disorder symptom networks across adolescent and adult clinical samples: examining symptom centrality and replicability.
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DOI：
10.1017/s0033291721004931
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发表时间：
2023-05
影响因子：
6.9
通讯作者：
Yen, Shirley
中科院分区：
文献类型：
--
作者：
Peters, Jessica R.;Crowe, Michael L.;Morgan, Theresa;Zimmerman, Mark;Sharp, Carla;Grilo, Carlos M.;Sanislow, Charles A.;Shea, M. Tracie;Zanarini, Mary C.;McGlashan, Thomas H.;Morey, Leslie C.;Skodol, Andrew E.;Yen, Shirley
关键词：
许多理论对边缘性人格障碍(BPD)提出了不同的核心特征。网络分析的最新进展提供了一种方法来检查BPD症状的相对中心性，以及检查研究结果在样本中的可重复性。此外，尽管越来越多的研究支持BPD在青少年中的有效性，但临床医生不愿在青少年中诊断BPD。确定该综合征在青少年和成人中的可复制性有助于临床实践和研究。这项研究检查了BPD症状网络的稳定性和症状在不同年龄和临床特征的样本中的中心性。对BPD症状的横断面分析来自人格障碍合作纵向研究(CLPs)、改进诊断评估和服务的方法(MIDAS)研究以及青少年临床样本的半结构化诊断性访谈。比较网络属性，包括边(部分关联)强度和节点(症状)预期影响。这三个网络在很大程度上是相似的，而且相关性很强。情感不稳定和身份认同障碍是三个样本中相对核心的症状，而成人网络中的人际关系困难。在年龄和BPD症状严重程度不同的网络之间，网络属性的差异更加明显。研究结果强调了情感症状、认同感和人际关系症状的相对重要性，这与BPD的几个主要理论一致。BPD症状的网络结构似乎在包括青少年和成人在内的多个大样本中普遍可复制，为这些发育阶段的诊断有效性提供了进一步的支持。
Numerous theories posit different core features to borderline personality disorder (BPD). Recent advances in network analysis provide a method of examining the relative centrality of BPD symptoms, as well as examine the replicability of findings across samples. Additionally, despite the increase in research supporting the validity of BPD in adolescents, clinicians are reluctant to diagnose BPD in adolescents. Establishing the replicability of the syndrome across adolescents and adults informs clinical practice and research. This study examined the stability of BPD symptom networks and centrality of symptoms across samples varying in age and clinical characteristics. Cross-sectional analyses of BPD symptoms from semi-structured diagnostic interviews from the Collaborative Longitudinal Study of Personality Disorders (CLPS), the Methods to Improve Diagnostic Assessment and Service (MIDAS) study, and an adolescent clinical sample. Network attributes, including edge (partial association) strength and node (symptom) expected influence, were compared. The three networks were largely similar and strongly correlated. Affective instability and identity disturbance emerged as relatively central symptoms across the three samples, and relationship difficulties across adult networks. Differences in network attributes were more evident between networks varying both in age and in BPD symptom severity level. Findings highlight the relative importance of affective, identity, and relationship symptoms, consistent with several leading theories of BPD. The network structure of BPD symptoms appears generally replicable across multiple large samples including adolescents and adults, providing further support for the validity of the diagnosis across these developmental phases.