Determining the key childhood and adolescent risk factors for future BPD symptoms using regularized regression: comparison to depression and conduct disorder.
Risk factors
borderline personality disorder
comorbidity
longitudinal studies
machine learning
Journal
Journal of child psychology and psychiatry, and allied disciplines
ISSN: 1469-7610
Titre abrégé: J Child Psychol Psychiatry
Pays: England
ID NLM: 0375361
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
accepted:
23
04
2020
pubmed:
26
5
2020
medline:
16
10
2021
entrez:
26
5
2020
Statut:
ppublish
Résumé
Research has yielded factors considered critical to risk for borderline personality disorder (BPD). Yet, these factors overlap and are relevant to other disorders, like depression and conduct disorder (CD). Regularized regression, a machine learning approach, was developed to allow identification of the most important variables in large datasets with correlated predictors. We aimed to identify critical predictors of BPD symptoms in late adolescence (ages 16-18) and determine the specificity of factors to BPD versus disorders with putatively similar etiology. We used a prospective longitudinal dataset (n = 2,450) of adolescent girls assessed on a range of clinical, psychosocial, and demographic factors, highlighted by previous research on BPD. Predictors were grouped by developmental periods: late childhood (8-10) and early (11-13) and mid-adolescence (14-15), yielding 128 variables from 41 constructs. The same variables were used in models predicting depression and CD symptoms. The best-fitting model for BPD symptoms included 19 predictors and explained 33.2% of the variance. Five constructs - depressive and anxiety symptoms, self-control, harsh punishment, and poor social and school functioning - accounted for most of the variance explained. BPD was differentiated from CD by greater problems with mood and anxiety in BPD and differences in parenting risk factors. Whereas the biggest parenting risk for BPD was a punitive style of parenting, CD was predicted by both punitive and disengaged styles. BPD was differentiated from MDD by greater social problems and poor behavioral control in BPD. The best predictors of BPD symptoms in adolescence are features suggesting complex comorbidity, affective activation, and problems with self-control. Though some risk factors were non-specific (e.g., inattention), the disorders were distinguished in clinically significant ways.
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
223-231Subventions
Organisme : NIMH NIH HHS
ID : K01 MH109859
Pays : United States
Informations de copyright
© 2020 Association for Child and Adolescent Mental Health.
Références
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Association.
Black, D.W., Blum, N., Pfohl, B., & Hale, N. (2004). Suicidal behavior in borderline personality disorder: Prevalence, risk factors, prediction, and prevention. Journal of Personality Disorders, 18, 226-239.
Caspi, A., Houts, R.M., Belsky, D.W., Goldman-Mellor, S.J., Harrington, H.L., Israel, S., … & Moffitt, T. E. (2013). The p Factor. Clinical Psychological Science, 2(2), 119-137.
Choi-Kain, L.W., Zanarini, M.C., Frankenburg, F.R., Fitzmaurice, G.M., & Reich, D.B. (2010). A longitudinal study of the 10-year course of interpersonal features in borderline personality disorder. Journal of Personality Disorders, 24, 365-376.
Conway, C.C., Hipwell, A.E., & Stepp, S.D. (2017). Seven-year course of borderline personality disorder features: Borderline pathology is as unstable as depression during adolescence. Clinical Psychological Science, 5, 742-749.
Friedman, J., Hastie, T., & Tibshirani, R. (2010). Regularization paths for generalized linear models via coordinate descent. Journal of Statistical Software, 33, 1-22.
Hastie, T., Tibshirani, R., & Friedman, J. (2009). The elements of statistical learning, data mining, inference, and prediction. New York, NY: Springer Science & Business Media.
Hipwell, A.E., Loeber, R., Stouthamer-Loeber, M., Keenan, K., White, H.R., & Kroneman, L. (2002). Characteristics of girls with early onset disruptive and antisocial behaviour. Criminal Behaviour and Mental Health, 12, 99-118.
Keenan, K., Hipwell, A., Chung, T., Stepp, S., Stouthamer-Loeber, M., Loeber, R., & McTigue, K. (2010). The Pittsburgh Girls Study: Overview and initial findings. Journal of Clinical Child and Adolescent Psychology, 39, 506-521.
Kuhn, M. (2008). Building predictive models in R using the caret package. Journal of Statistical Software, 28, 1-26.
Lenzenweger, M.F., Loranger, A.W., Korfine, L., & Neff, C. (1997). Detecting personality disorders in a nonclinical population: Application of a 2-stage procedure for case identification. Archives of General Psychiatry, 54, 345-351.
Ollendick, T.H., Seligman, L.D., Butcher, A.T., & Div, M. (1999). Does anxiety mitigate the behavioral expression of severe conduct disorder in delinquent youths? Journal of Anxiety Disorders, 13, 565-574.
Stepp, S.D. (2012). Development of borderline personality disorder in adolescence and young adulthood: Introduction to the special section. Journal of Abnormal Child Psychology, 40, 1-5.
Stepp, S.D., Lazarus, S.A., & Byrd, A.L. (2016). A systematic review of risk factors prospectively associated with borderline personality disorder: Taking stock and moving forward. Personality Disorders: Theory, Research, and Treatment, 7, 316-323.
Stepp, S.D., Scott, L.N., Jones, N.P., Whalen, D.J., & Hipwell, A.E. (2016). Negative emotional reactivity as a marker of vulnerability in the development of borderline personality disorder symptoms. Development and Psychopathology, 28, 213-224.
van Asselt, A.D.I., Dirksen, C.D., Arntz, A., & Severens, J.L. (2007). The cost of borderline personality disorder: Societal cost of illness in BPD-patients. European Psychiatry, 22, 354-361.
Winsper, C., Marwaha, S., Lereya, S.T., Thompson, A., Eyden, J., & Singh, S.P. (2015). Clinical and psychosocial outcomes of borderline personality disorder in childhood and adolescence: A systematic review. Psychological Medicine, 45, 2237-2251.
Winsper, C., Zanarini, M., & Wolke, D. (2012). Prospective study of family adversity and maladaptive parenting in childhood and borderline personality disorder symptoms in a non-clinical population at 11 years. Psychological Medicine, 42, 2405-2420.
Yuan, G.-X., Ho, C.-H., & Lin, C.-J. (2011) An improved GLMNET for l1-regularized logistic regression. Journal of Machine Learning Research, 13, 1999-2030.
Zanarini, M.C., Frankenburg, F.R., Dubo, E.D., Sickel, A.E., Trikha, A., Levin, A., & Reynolds, V. (1998). Axis II comorbidity of borderline personality disorder. Comprehensive Psychiatry, 39, 296-302.