A psychometric investigation of gender differences and common processes across borderline and antisocial personality disorders.

Abstract

The comorbidity between Borderline Personality Disorder (BPD) and Antisocial Personality Disorder (ASPD) is well-established, and the two disorders share many similarities. However, there are also differences across disorders: most notably, BPD is diagnosed more frequently in females and ASPD in males. We investigated if a) comorbidity between BPD and ASPD is attributable to two discrete disorders or the expression of common underlying processes, and b) if the model of comorbidity is true across sex. Using a clinical sample of 1400 drug users in residential substance abuse treatment, we tested three competing models to explore whether the comorbidity of ASPD and BPD should be represented by a single common factor, two correlated factors, or a bifactor structure involving a general and disorder-specific factors. Next, we tested whether our resulting model was meaningful by examining its relationship with criterion variables previously reported to be associated with BPD and ASPD. The bifactor model provided the best fit and was invariant across sex. Overall, the general factor of the bifactor model significantly accounted for a large percentage of the variance in criterion variables, whereas the BPD and AAB specific factors added little to the models. The association of the general and specific factor with all criterion variables was equal for males and females. Our results suggest common underlying vulnerability accounts for both the comorbidity between BPD and AAB (across sex), and this common vulnerability drives the association with other psychopathology and maladaptive behavior. This in turn has implications for diagnostic classification systems and treatment. General scientific summary This study found that, for both males and females, borderline and antisocial personality disorders show a large degree of overlap, and little uniqueness. The commonality between BPD and ASPD mainly accounted for associations with criterion variables. This suggests that BPD and ASPD show a large common core that accounts for their comorbidity.

Specific antisocial and borderline personality disorder criteria and general substance use: A twin study.

“…A previous study on the joint structure of ASPD and BPD criteria suggested that an overarching general dimension of risk for all the criteria plus other psychopathology exists (Chun et al, 2017). Similarly, our investigation underscored the importance of such an overarching dimension of risk.…”

“…For example, the etiologic factors of ASPD and BPD appear to form a hierarchy of highest, intermediate, and lowest level of generality, as expressed in bifactor models (Figure 1a). Diagnoses of ASPD and BPD share genetic etiology with each other and with other related PDs, but they also have independent genetic influences (Chun et al, 2017; Reichborn-Kjennerud et al, 2015; Torgersen et al, 2008). Specific criteria for ASPD (respectively BPD) share many genetic influences, but also they have specific (i.e., criterion- specific) genetic and environmental influences (Kendler et al, 2012; Reichborn-Kjennerud et al, 2013; Rosenström et al, 2017).…”

Latent Triple Trajectories of Substance use as Predictors for the Onset of Antisocial Personality Disorder among Urban African American and Puerto Rican Adults: A 22-Year Longitudinal Study

“…It is estimated that 0.2−3.3% of the population are affected by ASPD 1 ; however, estimates vary markedly by gender as well as population. For example, ASPD is diagnosed more frequently in men than in women 2 . Population estimate for men was 5.5%; for women, it was 1.9% 3 .…”

Revisiting the vulnerable dark triad hypothesis using a bifactor model

“…To the best of our knowledge, only one study included an investigation of the VDT's factor structure (Edwards et al, 2017); however, only a joint DT-VDT model was tested using confirmatory factor analysis (CFA), and the joint model obtained a questionable fit (e.g., comparative fit index <0.90 and root mean square error of approximation >0.10; Hu & Bentler, 1999). Chun, Harris, Carrion et al (2017) tested the joint structure of borderline personality disorder and antisocial personality disorder in a sample of drug users, and found that a bifactor model with two group factors provided the best fit; however, their study did not focus on the VDT as it did not include the third component, vulnerable narcissism.…”

“…Chun, Harris, Carrion et al . (2017) tested the joint structure of borderline personality disorder and antisocial personality disorder in a sample of drug users, and found that a bifactor model with two group factors provided the best fit; however, their study did not focus on the VDT as it did not include the third component, vulnerable narcissism.…”