Dissociation in patients with borderline personality disorder in acute inpatient care – A latent profile analysis

• Published in: Comprehensive psychiatry Vol. 78; pp. 67 - 75
• Main Authors: Jaeger, Susanne, Steinert, Tilman, Uhlmann, Carmen, Flammer, Erich, Bichescu-Burian, Dana, Tschöke, Stefan
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2017; Elsevier Limited
• Subjects: Adult; Borderline personality disorder; Borderline Personality Disorder - complications; Borderline Personality Disorder - psychology; Crisis intervention; Cross-Sectional Studies; Dissociative Disorders - complications; Dissociative Disorders - psychology; Female; Humans; Inpatient care; Inpatients - psychology; Male; Monte Carlo simulation; Patients; Personality disorders; Psychosis; Quantitative psychology; Researchers; Young Adult
• ISSN: 0010-440X; 1532-8384
• DOI: 10.1016/j.comppsych.2017.07.005

Dissociation is a common symptom in Borderline Personality disorder (BPD) and its consideration is important for the therapeutic outcome. The aim of this cross-sectional study was to scrutinize the co-occurrence of BPD symptoms and dissociative experiences. In particular, we were interested in the occurrence of specific symptom clusters characterizing qualitatively different patient groups in a clinical sample of BPD patients. We analyzed the data of 103 patients in a specialized acute inpatient care crisis intervention unit. Measures were the Borderline Symptom List (BSL-95), a German adaption of the Dissociative Experience Scale (FDS), and the Symptom Checklist SCL-90-R. We applied a Latent Profile Analysis (LPA) using the subscales of BSL-95 and FDS to investigate the existence of distinct latent classes of symptom profiles. Afterwards, we related the obtained profiles to other clinical and demographic characteristics. Dissociative experiences of moderate to severe intensity were common among patients with BPD. LPA revealed that a model of three classes fitted the data best: one class was characterized by co-occurrence of severe borderline symptoms and frequent dissociative experiences, one class showed low symptom burden in both measures, and one class showed considerable borderline symptoms but only moderate dissociative experiences. The classes were closely related to the severity of other self-rated psychological problems and showed significantly different occurrences of stress-related comorbid disorders. The results underline that dissociation is an important factor in many (but not all) BPD patients. This should be addressed by increased attention to dissociative symptoms in the diagnostic process and the adjustment of treatment plans.