1 - (Sym 73) The Significance of Borderline Personality Features to Impairment in School-age Youth

Hypothesis/Objective: Borderline personality features (BPF) emerge in childhood and are associated with widespread impairment. However, BPF are often present alongside other mental health problems, including attention-deficit/hyperactivity (ADHD), oppositional defiant disorder (ODD), depression, and anxiety, and it is unclear to what extent BPF uniquely influence youth impairment. This study examines the unique contribution of BPF to functional impairment among school-aged youth. It is hypothesized that BPF will contribute unique variance to functional outcomes.

Methods: Data were collected via internet from standing panels of respondents maintained by a survey company in order to obtain a study sample representative of the United States population based on gender, race, income, and geography. A total of 962 parents completed ratings of psychopathology, including ADHD, ODD, depression, anxiety, and BPD, and impairment about their child (50.1% male; M_age = 8.42, SD =2.31). Separate stepwise binary logistic regression analyses were conducted. Hosmer and Lemeshow tests were used to determine the best fitting models. Analyses included all psychopathology measures, as well as child age and sex to explore effects of BPF and other psychopathology variables on peer, parent, family, academic, classroom behavior, self-esteem, and overall impairment as well as need for treatment.

Results: For peer impairment, including only BPF (OR=1.09, 95% CI 1.08-1.10) produced the best fitting model. For family impairment, including BPF (OR=1.06, 95% CI 1.04-1.08) and ODD (OR=2.69, 95% CI 1.90-3.82) produced the best fitting model, and a similar pattern emerged for parent impairment, showing BPF (OR=1.06, 95% CI 1.04-1.08) and ODD (OR=2.65, 95% CI 1.88-3.73) produced the best model fit. ADHD alone produced the best fitting model for academic progress (OR=4.42, 95% CI 3.52-5.54) and classroom behavior (OR=5.96 95% CI 4.65-7.67). The best fitting model was produced by including ADHD (OR=2.13, 95% CI 1.56-2.91) and BPF (OR=1.07, 95% CI 1.05-1.08) for overall impairment, and a similar pattern showing effects of ADHD (OR=3.89, 95% CI 2.79-5.43) and BPF (OR=1.06, 95% CI 1.046-1.08) on need for treatment.

Conclusions: BPF is associated with widespread impairment in youth even when accounting for co-occurring psychopathology. Efforts to develop targeted interventions to improve clinical outcomes for youth with BPF are needed.