Exploratory factor analysis of borderline personality disorder criteria in hospitalized adolescents.
OBJECTIVE
The authors examined the factor structure of borderline personality disorder (BPD) in hospitalized adolescents and also sought to add to the theoretical and clinical understanding of any homogeneous components by determining whether they may be related to specific forms of Axis I pathology.


METHODS
Subjects were 123 adolescent inpatients, who were reliably assessed with structured diagnostic interviews for Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition Axes I and II disorders. Exploratory factor analysis identified BPD components, and logistic regression analyses tested whether these components were predictive of specific Axis I disorders.


RESULTS
Factor analysis revealed a 4-factor solution that accounted for 67.0% of the variance. Factor 1 ("suicidal threats or gestures" and "emptiness or boredom") predicted depressive disorders and alcohol use disorders. Factor 2 ("affective instability," "uncontrolled anger," and "identity disturbance") predicted anxiety disorders and oppositional defiant disorder. Factor 3 ("unstable relationships" and "abandonment fears") predicted only anxiety disorders. Factor 4 ("impulsiveness" and "identity disturbance") predicted conduct disorder and substance use disorders.


CONCLUSIONS
Exploratory factor analysis of BPD criteria in adolescent inpatients revealed 4 BPD factors that appear to differ from those reported for similar studies of adults. The factors represent components of self-negation, irritability, poorly modulated relationships, and impulsivity--each of which is associated with characteristic Axis I pathology. These findings shed light on the nature of BPD in adolescents and may also have implications for treatment.
Department of Psychiatry, University of California, San Francisco, CA 94143, USA. beckerd@sutterhealth.org
Daniel F
DF
Becker
Thomas H
TH
McGlashan
Carlos M
CM
Grilo
D000293:Adolescent; D000298:Adolescent, Hospitalized; D001008:Anxiety Disorders / Q000523:psychology; D001883:Borderline Personality Disorder / Q000523:psychology*; D003134:Commitment of Persons with Psychiatric Disorders; D019955:Conduct Disorder / Q000523:psychology; D003865:Major Depressive Disorder / Q000523:psychology; D019263:Dysthymic Disorder / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D019966:Substance-Related Disorders / Q000523:psychology