Preliminary validation of the Interpersonal Dysphoria Model of Borderline Personality Disorder

Background: Borderline personality disorder (BPD) is one of the most puzzling psychiatric disorders. In order to improve its understanding and management, we have recently proposed an interpersonal dysphoria model that emphasizes the key role of the complex emotional state of dysphoria in BPD. The purpose of this study was to test the interpersonal dysphoria model using a structural equation modeling analysis. Sampling and Methods: The sample consisted of 105 patients with BPD and 105 healthy controls. A total of five self-report instruments and three semistructured interviews were administered to the participants. Results: The best-fitting structural model fit the data well in the BPD sample. Background dysphoria and negative interpersonal disposition were significant predictors of situational dysphoria, which in turn was a significant predictor of various symptoms of BPD. This model differs from the originally proposed one in terms of impaired empathy not being a component of negative interpersonal disposition and organizing and disorganizing BPD symptoms being replaced by interpersonal (abandonment fears, angry outbursts, and stormy relations) and affective (affective shifts and emptiness) symptoms. Conclusions: Although some revision was needed, the findings provide support to the proposed model, which needs to be further tested in a larger sample of individuals with BPD.