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Borderline personality disorder symptom networks across adolescent and adult clinical samples: examining symptom centrality and replicability
- Jessica R. Peters, Michael L. Crowe, Theresa Morgan, Mark Zimmerman, Carla Sharp, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Mary C. Zanarini, Thomas H. McGlashan, Leslie C. Morey, Andrew E. Skodol, Shirley Yen
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- Journal:
- Psychological Medicine / Volume 53 / Issue 7 / May 2023
- Published online by Cambridge University Press:
- 31 January 2022, pp. 2946-2953
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- Article
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Background
Numerous theories posit different core features to borderline personality disorder (BPD). Recent advances in network analysis provide a method of examining the relative centrality of BPD symptoms, as well as examine the replicability of findings across samples. Additionally, despite the increase in research supporting the validity of BPD in adolescents, clinicians are reluctant to diagnose BPD in adolescents. Establishing the replicability of the syndrome across adolescents and adults informs clinical practice and research. This study examined the stability of BPD symptom networks and centrality of symptoms across samples varying in age and clinical characteristics.
MethodsCross-sectional analyses of BPD symptoms from semi-structured diagnostic interviews from the Collaborative Longitudinal Study of Personality Disorders (CLPS), the Methods to Improve Diagnostic Assessment and Service (MIDAS) study, and an adolescent clinical sample. Network attributes, including edge (partial association) strength and node (symptom) expected influence, were compared.
ResultsThe three networks were largely similar and strongly correlated. Affective instability and identity disturbance emerged as relatively central symptoms across the three samples, and relationship difficulties across adult networks. Differences in network attributes were more evident between networks varying both in age and in BPD symptom severity level.
ConclusionsFindings highlight the relative importance of affective, identity, and relationship symptoms, consistent with several leading theories of BPD. The network structure of BPD symptoms appears generally replicable across multiple large samples including adolescents and adults, providing further support for the validity of the diagnosis across these developmental phases.
Contributors
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- By Michael H. Allen, Leora Amira, Victoria Arango, David W. Ayer, Helene Bach, Christopher R. Bailey, Ross J. Baldessarini, Kelsey Ball, Alan L. Berman, Marian E. Betz, Emily A. Biggs, R. Warwick Blood, Kathleen T. Brady, David A. Brent, Jeffrey A. Bridge, Gregory K. Brown, Anat Brunstein Klomek, A. Jacqueline Buchanan, Michelle J. Chandley, Tim Coffey, Jessica Coker, Yeates Conwell, Scott J. Crow, Collin L. Davidson, Yogesh Dwivedi, Stacey Espaillat, Jan Fawcett, Steven J. Garlow, Robert D. Gibbons, Catherine R. Glenn, Deborah Goebert, Erica Goldstein, Tina R. Goldstein, Madelyn S. Gould, Kelly L. Green, Alison M. Greene, Philip D. Harvey, Robert M. A. Hirschfeld, Donna Holland Barnes, Andres M. Kanner, Gary J. Kennedy, Stephen H. Koslow, Benoit Labonté, Alison M. Lake, William B. Lawson, Steve Leifman, Adam Lesser, Timothy W. Lineberry, Amanda L. McMillan, Herbert Y. Meltzer, Michael Craig Miller, Michael J. Miller, James A. Naifeh, Katharine J. Nelson, Charles B. Nemeroff, Alexander Neumeister, Matthew K. Nock, Jennifer H. Olson-Madden, Gregory A. Ordway, Michael W. Otto, Ghanshyam N. Pandey, Giampaolo Perna, Jane Pirkis, Kelly Posner, Anne Rohs, Pedro Ruiz, Molly Ryan, Alan F. Schatzberg, S. Charles Schulz, M. Katherine Shear, Morton M. Silverman, April R. Smith, Marcus Sokolowski, Barbara Stanley, Zachary N. Stowe, Sarah A. Struthers, Leonardo Tondo, Gustavo Turecki, Robert J. Ursano, Kimberly Van Orden, Anne C. Ward, Danuta Wasserman, Jerzy Wasserman, Melinda K. Westlund, Tracy K. Witte, Kseniya Yershova, Alexandra Zagoloff, Sidney Zisook
- Edited by Stephen H. Koslow, University of Miami, Pedro Ruiz, University of Miami, Charles B. Nemeroff, University of Miami
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- Book:
- A Concise Guide to Understanding Suicide
- Published online:
- 05 October 2014
- Print publication:
- 18 September 2014, pp vii-x
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18 - Bridging the gap between landscape ecology and natural resource management
- Edited by Jianguo Liu, Michigan State University, William W. Taylor, Michigan State University
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- Book:
- Integrating Landscape Ecology into Natural Resource Management
- Published online:
- 14 January 2010
- Print publication:
- 01 August 2002, pp 433-460
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Summary
Introduction
In every respect, the valley rules the stream.
Noel Hynes (1975)The challenges facing natural resource managers occur over entire landscapes and involve landscape components at many scales. Many resource managers are shifting their approach from managing resources such as fish, wildlife, and water separately to managing for the integrity of entire ecosystems (Christensen et al., 1996). Indeed, nearly all resource management agencies in the USA have recognized that informed management decisions cannot be made exclusively at the level of habitat units or local sites. It is generally accepted that ecological patterns and processes must be considered over large areas when biodiversity and ecological function must be maintained while the goods and services desired by the public are provided. For example, forest managers must determine the patterns and timing of tree harvesting while maintaining an amount and arrangement of habitats that will sustain many species. Managers of parks and nature reserves must be attentive to actions occurring on surrounding lands outside their jurisdiction. Aquatic resource managers must broaden their perspective to encompass the terrestrial and human landscape to manage stream and lake resources effectively (Hynes, 1975, widely regarded as the father of modern stream ecology and quoted above; Naiman et al., 1995). Landscape ecology also is implicit in the paradigm of ecosystem management (Grumbine,1994; Christensen et al., 1996).
Despite the acknowledged importance of a landscape perspective by both scientists and resource managers, determining how to implement management at broader scales is very much a work in progress.
Chiding the Plays: Then till Now
- Edited by Allardyce Nicoll
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- Book:
- Shakespeare Survey
- Published online:
- 28 March 2007
- Print publication:
- 02 January 1965, pp 1-10
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Summary
'Shakespeare is a dead issue.' Thus T. J. B. Spencer concludes his 1959 British Academy lecture. 'The resistance to his magnificent tyranny is over....' And Spencer would seem to be right on the grounds of his argument. Whether Shakespeare's work, taken as a whole, is worth the attention it has come to compel, the influence it has exerted is not now a matter for much disagreement. Even the long-fought war on Shakespeare's language, so tellingly reviewed by Spencer, has ended in something like our surrender. We hear, now, much about what Shakespeare's words are doing, little about their 'conceited' badness. Utter detraction on these and on the other classic grounds has gone, detraction, that is, of Shakespeare. But not of Shakespeare's plays.
The distinction is a just one. Issues of judgment on particular Shakespeare plays are not dead. Critics do not ordinarily go to 'Shakespeare'. They go to Troilus and Cressida or Othello or The Winter's Tale, and they still find fault. Often they find fault with interpretations of other critics, not the play. When they do, they may exhibit the 'shadow-boxing of rival bardolaters', as Spencer says. But where they make judgments against the play, or something in the play, the boxing is real. They do make such judgments, and not only against the earliest plays. There are the standard issues still active: the rejection of Falstaff, the death of Cordelia, the moral ambiguities of Antony and Cleopatra. Such matters are widely defended, subtly interpreted, and yet not settled. Shakespeare's handling of them, and not merely some critic's interpretation of it, is still questioned.