Self and informant report across the borderline personality disorder spectrum.

Abstract

Individuals with borderline personality disorder (BPD) features may be unaware of or unwilling to report their own personality or maladaptive behaviors, which complicates the assessment of BPD. Informants who know the individuals with BPD features may be uniquely suited to aid in the personality assessment of these individuals. The present study analyzed the comparative ability of individuals (targets) and informants to report BPD features across the continuum of BPD severity. The sample consisted of 1387 targets, ages 55 to 65 (56% women), who were recruited for an epidemiological longitudinal study examining the effects of PDs on health and social functioning. Each target nominated an informant who provided information about the target's personality. Results indicated relatively low levels of agreement between perspectives and that informants reported BPD symptoms with more precision and at lower levels of BPD severity than targets. The benefits of including an informant perspective when measuring the BPD continuum are discussed; these benefits may include gains in reliability and improvement in the prediction of outcomes. (PsycINFO Database Record

Self–Other Agreement on Ratings of Personality Disorder Symptoms and Traits: Three Meta-Analyses

“…Further, research considering sensitivity (i.e., from an item response theory perspective; c.f. Balsis et al, 2017) of self-versus informant-measures of personality disorder traits would be particularly important for understanding these differences. This work will continue to shed light on factors that influence levels of self-other agreement on personality disorder traits.…”

“…For example, on a scale from 1-5 (with "5" being the most maladaptive response), a "3" rating from the informantreport might be just as maladaptive as a "4" rating from the self-report. This would be evidence that informants report maladaptive personality at lower levels (Balsis and colleagues have demonstrated this; Balsis et al, 2017). This may directly reduce mean-level agreement between self-and informant-reports.…”

“…Interestingly, informant-ratings often demonstrate higher internal consistency than self-ratings (Balsis, Cooper, & Oltmanns, 2015). 3) Differential item functioning across perspectives in the assessment of personality disorder traits may also be important (Balsis, Loehle-Conger, Busch, Ungredda, & Oltmanns, 2017;Cooper, Balsis, & Oltmanns, 2012). Informant-reports of personality disorder traits have demonstrated differential item functioning, in that informants may indicate the presence of pathological traits at lower levels than self-reports (i.e., to "agree" on a maladaptive personality trait question might reflect the presence of more significant pathology in a target when it is reported by an informant than when it is reported by the target; Balsis et al, 2017).…”

“…3) Differential item functioning across perspectives in the assessment of personality disorder traits may also be important (Balsis, Loehle-Conger, Busch, Ungredda, & Oltmanns, 2017;Cooper, Balsis, & Oltmanns, 2012). Informant-reports of personality disorder traits have demonstrated differential item functioning, in that informants may indicate the presence of pathological traits at lower levels than self-reports (i.e., to "agree" on a maladaptive personality trait question might reflect the presence of more significant pathology in a target when it is reported by an informant than when it is reported by the target; Balsis et al, 2017). If this finding is replicated, it could have ramifications for understanding mean-level self-other agreement on personality disorder traits-because mean-levels on the same scales would have different meanings between self-and informant-reports.…”

Personality Disorders in Older Adults: a Review of Epidemiology, Assessment, and Treatment

“…Informant report may prove useful when verifying life-events, overcoming the possible effects of sensory and cognitive impairment troubling self-report. Additionally, it may also have incremental value by adding crucial information in PD assessment, as self-report might be biased due to the presence of severe psychopathology, limited selfawareness, distorted self-perceptions, or as a result of reluctance to disclose problems [35][36][37]. Furthermore, as the clinical presentation of PDs in late life might be more complex due to cognitive aging, psychopathology, medical conditions, and polypharmacy [18], including various sources of information to the assessment of PD, if needed complemented by medical examination (e.g.…”