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An empirical comparison of three different borderline concepts.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
1987 (English)In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 76, no 3, 246-55 p.Article in journal (Refereed) Published
Abstract [en]

Forty-six inpatients were independently diagnosed according to the DSM-III concept of borderline personality disorder, the diagnostic interview for borderlines (DIB) and the concept of borderline personality organization, which is linked to Kernbergs structural interview. The interviews were videotaped. Satisfactory inter-rater reliability was demonstrated for the DIB, which furthermore showed high sensitivity and specificity in identifying patients with a clinical DSM-III diagnosis of borderline personality disorder from patients with a other personality disorders or schizophrenic disorders. Discriminant features, demographic profile and earlier treatment history for the patients with a borderline personality disorder are described and discussed. The structural interviews were scored according to a specified format. Inter-rater reliability was satisfactory but not too impressive. Borderline personality organization turned out to be a very broad concept and only half of the patients within this concept received a syndrome diagnosis of borderline personality disorder. A general conclusion was that borderline personality organization should not be considered as a diagnostic entity but rather as a different diagnostic dimension representing an intermediate level of personality structure.

Place, publisher, year, edition, pages
1987. Vol. 76, no 3, 246-55 p.
URN: urn:nbn:se:umu:diva-36469PubMedID: 3673651OAI: diva2:354242
Available from: 2010-09-30 Created: 2010-09-30 Last updated: 2015-03-16
In thesis
1. Clinical studies on the borderline concept with special reference to suicidal behavior
Open this publication in new window or tab >>Clinical studies on the borderline concept with special reference to suicidal behavior
1987 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The diagnostic concept of borderline personality has had various meanings throughout the last decades. From current clinical practice and research two principally different concepts have emerged: The syndrome concept of borderline personality disorder ( BPD ) as identified by the DSM-III or the Diagnostic Interview for Borderline (DIB) and the psychodynamic concept of borderline personality organization (BPO) as defined from the structural Interview (SI) by Otto Kernberg.

In the first part of the present study, the DIB, the SI and a percept-genetic test called Defense Mechanism test (DMT) have been utilized in a clinical study on psychiatric inpatients. In the second part completed suicides are studied among patients with borderline personality disorder.

Inter-rater reliability was satisfactory for the DIB both when utilized as a clinical interview and as a chart scoring instrument. Previous research findings concerning descriptive validity of the BPD concept were further supported. Fairly reliable scorings of personality organization could be made from the SI. BPO turned out to be a very inclusive concept and a subgroup (46%) also met criteria for BPD. By means of the DMT specific psychodynamic features were identified among patients with BPD which discriminated them from patients with other personality disorders or schizophrenic disorder. It is concluded, that there is empirical support to consider BPD a valid diagnostic entity. BPO should be conceptualized as a level of personality functioning rather than a diagnostic category and its validity remains to be proven.

Patients with BPD were not seriously overrepresented in a material of 145 psychiatric patients, suicided during inpatient care or shortly after discharge 1961 to 1980. The number and proportion of borderline patients, however, increased for every five- years-period. In an analysis of cases suicided during inpatient treatment, repressive/rejective behavior from staff was frequently observed. Risk factors were identified in comparative studies. Male sex, extensive earlier hospitalization, repressive/rejective staff behavior and frequent previous suicide attempts were associated with completed suicides. A specific pattern of psychological variables was identified among suicided borderline patients including antisocial traits, drug abuse and a less intense interpersonal attachment.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 1987. 51 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 204
National Category
urn:nbn:se:umu:diva-100571 (URN)
Public defence
1987-12-18, Psykiatriska klinikens föreläsningssal, KV, Regionsjukhuset i Umeå, Umeå universitet, Umeå, 09:15

Diss. (sammanfattning) Umeå : Umeå universitet, 1987, härtill 7 uppsatser.

Available from: 2015-03-16 Created: 2015-03-04 Last updated: 2015-04-09Bibliographically approved

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