ABSTRACT

The current study examined the differentiation of borderline (BPD) and antisocial personality disorders (ASPD) in forensic settings, with particular emphasis on the utility of the MMPI-2-RF in differential diagnosis. This study examined these constructs across correctional and forensic psychiatric samples from the U.S. and the Netherlands using varying assessment/diagnosis modalities, including self-report, structured interview, and clinician-derived personality disorder (PD) diagnosis from both DSM-5 Section II and Section III perspectives. Our findings showed that internalizing psychopathology – and to a lesser extent interpersonal and thought dysfunction – differentiated BPD from ASPD; however, inconsistencies existed across samples. Higher levels of externalizing psychopathology were not found to differentiate ASPD across any of the samples or PD conceptualizations used in the current study. This suggests that diagnostic clarity may be particularly difficult in forensic settings and supports previous work that has shown problematic diagnostic overlap and a lack of differentiation between PD constructs. Nonetheless, as our current diagnostic system continues to rely on categorical determination of PDs, the current study suggests the MMPI-2-RF may enhance diagnostic differentiation.

摘要

目前的研究检查了法医环境中边缘性 (BPD) 和反社会人格障碍 (ASPD) 的区分，特别强调了 MM​​PI-2-RF 在鉴别诊断中的效用。本研究使用不同的评估/诊断方式检查了来自美国和荷兰的矫正和法医精神病学样本的这些结构，包括来自 DSM-5 第 II 节和第第三节观点。我们的研究结果表明，内在化的精神病理学——以及在较小程度上的人际关系和思维功能障碍——将 BPD 与 ASPD 区分开来。但是，样本之间存在不一致。没有发现更高水平的外化精神病理学可以在当前研究中使用的任何样本或 PD 概念化中区分 ASPD。这表明在法医环境中诊断明确性可能特别困难，并支持以前的工作，这些工作表明诊断重叠存在问题，并且缺乏区分 PD 结构。尽管如此，由于我们目前的诊断系统继续依赖于 PD 的分类确定，目前的研究表明 MMPI-2-RF 可能会增强诊断差异。