Examining the Convergence of Clinicians’ Ratings of Maladaptive Personality Traits and Categorical Diagnostic Criteria of Borderline Personality Disorder

Maladaptive personality trait domains of negative affectivity, antagonism, and disinhibition undergird the borderline personality disorder (BPD) diagnosis according to the Alternative Model for Personality Disorders (AMPD). The current study compared the associations among clinicians' ratings of maladaptive personality traits, categorical BPD diagnostic criteria, and the global BPD diagnosis in response to a clinical vignette using a large, diverse sample (<i>N</i> = 426) of licensed mental health care practitioners in the United States and Canada. Negative affectivity emerged as the most consistent predictor of BPD criteria and the global diagnosis. At the trait facet level, emotional lability was the most consistent independent predictor of BPD criteria and diagnosis. These findings suggest that clinicians' agreement with BPD diagnostic criteria corresponds with their perceptions of the patients as experiencing problems related to instability of emotional experiences, feelings of nervousness and frequent worry, and a tendency to engage in dangerous and risky behaviors.