Improving self/other relationship assessment in adolescents with Borderline Personality Disorder: a cohort study - Database and Code

AbstractBackground: Adolescents with Borderline Personality Disorder (BPD) are characterized by a disrupted self/other dynamic expressed through dependence and autonomy concerns and potentially rapid shifts between positive and negative self/other perceptions. This instability significantly impacts their personal and social functioning, posing challenges for accurate assessment. Both attachment theory and psychoanalysis offer tools based on two-polarity models to explore the self/other relationship. Among these, the Relationship Questionnaire (RQ) and the Depressive Experience Questionnaire (DEQ) are widely employed, yet their categorical approach may not fully capture the nuanced instability of the self/other relationship in BPD adolescents. This study aims to compare these questionnaires and their associations with psychopathology. Furthermore, it offers and evaluates a single quantitative variable that measures the severity of self/other relationship disruption, independent of its qualitative polarity. Such an approach would enhance predictive accuracy for BPD psychopathology.Methods: The study evaluated borderline psychopathology and RQ and DEQ through a cluster analysis comparing adolescents with BPD (n = 85) with healthy controls (n = 84) aged 13–19 years from the European Research Network on BPD. The Severity of Attachment Insecurity (SAI) was derived from the RQ and assessed. Multivariate regression was conducted to determine the psychopathological prediction abilities of each of the self/other relationship assessments.Results: PCA revealed two main dimensions: dependency/self-criticism and efficacy/relatedness, correlated with RQ self and other models, respectively. 3 Clusters showing distinct psychopathological profiles of BPD arose. Findings revealed a robust correlation between combined negative self and other models of the RQ and psychopathology. Self-criticism subscale of the DEQ showed significant correlations, while the dependency scale and its subscales lacked substantial association with psychopathology. Multivariate regression models highlight the superior predictive value of the SAI over other attachment scales in determining both borderline status and global severity. Furthermore, self-criticism outperforms other variables in predicting borderline status and symptom severity.Conclusion: These findings underscore the pronounced link between BPD psychopathology and disruptions in adolescent self/other relationship. The SAI emerges as a simple and effective metric for assessing these disruptions, regardless of attachment styles. This research provides valuable insights for clinical assessments and interventions.