title: The construct of effortful control: an approach to borderline personality disorder heterogeneity.
abstract: BACKGROUND
  The present study investigated the heterogeneity of DSM-IV borderline personality disorder (BPD) diagnosis as a function of the construct of effortful control. We hypothesized 3 subgroups of BPD patients based on effortful control, that would also differ in other areas of functioning, such as symptoms, interpersonal relations and personality organization.
  
  
  METHODS
  Forty-seven clinically referred individuals were reliably diagnosed as meeting DSM-IV criteria for BPD using semistructured interviews. Effortful control, symptomatology, interpersonal functioning and personality organization were assessed using self-report questionnaires.
  
  
  RESULTS
  Cluster and profile analyses were performed and identified 3 subgroups. Subgroup 1, with high effortful control, exhibited the fewest problems in symptoms, interpersonal functioning and personality organization. Subgroup 3, with low ratings of effortful control, had the most problems in these areas, and subgroup 2, a group high in some aspects of effortful control but low in others, ranged midway between groups 1 and 3.
  
  
  CONCLUSIONS
  The findings indicate a relationship between attentional mechanisms and the clinical expression of borderline personality pathology. Effortful control is a valuable construct for identifying subgroups of BPD patients, thus helping to understand the heterogeneity in BPD. Limitations of the study include the exclusive use on self-report of effortful control, as well as the small sample size. Future research should further investigate the associations of neurocognition and borderline pathology, as well as different approaches to treatment of the different BPD subgroups.
authors.affiliation: Columbia University Medical Center, New York, NY 10032, USA. Simone.Hoermann@gte.net
authors.forename: Simone
authors.initials: S
authors.lastname: Hoermann
authors.forename: John F
authors.initials: JF
authors.lastname: Clarkin
authors.forename: James W
authors.initials: JW
authors.lastname: Hull
authors.forename: Kenneth N
authors.initials: KN
authors.lastname: Levy
mesh_terms: D000328:Adult; D001288:Attention; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D016000:Cluster Analysis; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008297:Male; D020377:Self Efficacy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires