A network analysis of borderline personality disorder symptoms and disordered eating

Abstract

Objective The current study used network analysis to explore associations between specific groupings of borderline personality disorder (BPD) and eating disorder (ED) symptoms, and other transdiagnostic variables including insecure attachment, rejection sensitivity, emotion dysregulation, a theory of mind, and emotion recognition. Method Network analysis was undertaken on self‐report data from 753 adults (81.5% women), of whom 109 reported a lifetime ED diagnosis. Results Comorbidity between BPD and ED symptoms was only partially conceptualized through the transdiagnostic variables. The centrality indices from the network analysis indicated that emotion dysregulation and abandonment were the most central elements in the network. Conversely, the theory of mind and emotion recognition had very few connections with the other transdiagnostic variables in the network. Discussion The findings provide empirical insight into the nature of the observed co‐occurrence between BPD and ED symptoms and serve to improve clinical decision‐making regarding psychological interventions for both problem sets.

Psychopathological Networks in Cognitive-Behavioral Treatments for Binge-Eating Disorder

“…Limitations are that the sample size precluded analyses by treatment so that it was not possible to explore psychopathological networks as moderators. Relatedly, we focused on aggregated scores and not on single indicators as done in some [16, 49, 50] but not all [13] network studies in eating disorders. We selected scales to optimally represent the clinical presentation of BED as reflected in treatment outcome research in this disorder [2], with a focus on maintaining factors postulated by the cognitive-behavioral model [20, 45, 46] and by recent neuroscientifically informed conceptualizations [51].…”

Network-Based Methods for Psychometric Data of Eating Disorders: A Systematic Review

“…In line with the application to other mental disorders, various research goals can be identified among the existing literature about network approaches to EDs, namely: validation of the transdiagnostic model of eating disorders by comparing network characteristics across ED diagnoses (DuBois et al, 2017; Forrest et al, 2018; Goldschmidt et al, 2018; Mares et al, 2021; Monteleone, Tzischinsky, et al, 2022; Solmi et al, 2018; Solmi et al, 2019); estimation of the symptom network of EDs and identification of the core symptoms (Beauchamp et al, 2021; Forbush et al, 2016; Forrest et al, 2018; Forrest, Perkins, et al, 2019; Rodgers et al, 2018; Wang et al, 2019); identification and interaction with nonspecific ED symptoms (i.e., the external field) like general psychiatric symptoms, personality traits and other clinical variables (Monteleone, Mereu, et al, 2019; Solmi et al, 2018; Solmi et al, 2019), embodiment dimensions (Cascino et al, 2019), childhood maltreatment (Liebman et al, 2021; Monteleone, Cascino, et al, 2019; Monteleone, Tzischinsky, et al, 2022; Rodgers et al, 2019), mentalizing and empathy (Monteleone et al, 2020), vulnerability factors (Vervaet et al, 2021), suicidal thoughts and behaviors (Smith et al, 2020), perfectionism and interoceptive sensibility (Martini et al, 2021), affective and metacognitive symptoms (Aloi et al, 2021; Wong et al, 2021), interoceptive awareness (Brown et al, 2020), sleep disturbance (Ralph-Nearman et al, 2021), well-being domains (de Vos et al, 2021), inflexible and biased social interpretations, socioemotional functioning (Bronstein et al, 2022); assessment of psychiatric comorbidities such as depression and anxiety (Bronstein et al, 2022; Elliott et al, 2020; Kenny et al, 2021; Levinson et al, 2017; Sahlan, Williams, et al, 2021; Smith et al, 2019), posttraumatic stress disorder (Liebman et al, 2021; Vanzhula et al, 2019), social anxiety disorder (Levinson et al, 2018a; Sahlan, Keshishian, et al, 2021), obsessive-compulsive disorder (Giles et al, 2022; Kinkel-Ram et al, 2021; Meier et al, 2020; Vanzhula et al, 2021), trait anxiety disorder (Forrest, Sarfan, et al, 2019), autism spectrum disorder (Kerr-Gaffney et al, 2020), borderline personality disorder (De Paoli et al, 2020), and alcohol misuse (Cusack et al, 2021); comparison of estimated network structures among clinical and nonclinical (Vanzhula et al, 2019),...…”

Comparación del reconocimiento de emociones faciales en la personalidad límite y población no clínica

“…Estos resultados son similares a los presentados por la evidencia experimental que respalda la conclusión de que las expresiones faciales ambiguas o neutrales tienen una mayor probabilidad de ser interpretadas negativamente por personas con trastorno límite de la personalidad (Mitchell, Dickens & Picchioni, 2014). A partir de lo anterior, como se propone en algunos antecedentes (Bland, Williams, Scharer y Manning, 2004;De Paoli, Fuller-Tyszkiewicz, Huang & Krug, 2020;Unoka, Fogd, Füzy & Csukly, 2011;Yeh et al, 2017) es posible que se perciban como amenazantes, expresiones que pretenden manifestar otro tipo de emoción, por lo tanto la violencia es típicamente reactiva, la emoción fundamental es la ira y la motivación principal es el alivio de la tensión (Esbec & Echeburúa, 2010).…”

“…Los estudios que examinan el reconocimiento de la emoción en el trastorno de personalidad límite enfatizan que las dificultades en las relaciones interpersonales pueden estar relacionadas con una detección e identificación menos precisa del afecto facial en los otros (Bland, Williams, Scharer & Manning, 2004;De Paoli, Fuller-Tyszkiewicz, Huang & Krug, 2020;Unoka, Fogd, Füzy, & Csukly, 2011). Los resultados de estos estudios han indicado una exactitud sustancialmente más baja del reconocimiento de la expresión facial, particularmente para las emociones tales como enojo, miedo y disgusto.…”