Author ORCID Identifier

https://orcid.org/0000-0003-1683-2234

Date Available

11-20-2023

Year of Publication

2024

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Arts and Sciences

Department/School/Program

Psychology

First Advisor

Dr. Thomas A. Widiger

Abstract

The Alternative Model of Personality Disorders (AMPD) housed within DSM-5 Section III posits that impairments in personality functioning, operationalized by the Level of Personality Functioning Scale (LPFS) “constitute the core of personality psychopathology” (APA, 2013, p. 762). If this is the case, there should be strong associations between LPFS and DSM personality disorders, including borderline personality disorder (BPD). BPD Compass is a comprehensive CBT-based treatment for BPD which aims to reduce BPD symptoms over the course of 18 weekly sessions. This study examined if a) LPFS would be associated with changes in BPD symptoms, b) whether LPFS has incremental validity over Five Factor Model (FFM) borderline personality traits in predicting BPD symptom change, c) whether session-to-session, within-person changes in LPFS predict within-person changes in BPD symptoms and d) whether session-to-session, within-person changes in the LPFS predict within-person changes in anxiety and depressive symptoms. Measures of BPD symptoms, borderline personality traits, anxiety, and depression were collected from 52 participants prior to each of the 18 treatment sessions. Results of linear mixed-effects modeling and multilevel structural equation modeling showed that LPFS significantly predicted changes in BPD symptoms across treatment. However, LPFS no longer significantly predicted BPD symptoms once the influence of anxiety and depression were accounted for. Further, LPFS did not outperform FFM personality traits in predicting BPD symptom change. Finally, within-person changes in LPFS were not predictive of changes in symptoms of BPD, controlling for prior session BPD symptoms across treatment. Implications of these results are discussed.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2024.221

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