Trait Approach to BPD: Clinical Application

The Five-Factor Model (FFM) is a questionnaire that divides personality into five traits or categories: open-mindedness, conscientiousness, extroversion, agreeableness and neuroticism (negative emotionality) (Cervone & Pervin, 2023; Trull & Brown, 2013; Amini et al., 2014). FFM has been found to be a strong predictor of a BPD diagnosis in a multitude of research studies (Trull & Brown, 2013). That is, researchers predicted higher scores in neuroticism, extroversion and open-mindedness and low scores in agreeableness and conscientiousness for those with a BPD diagnosis (Trull & Brown, 2013). Several researchers have conducted studies which have shown such results (Trull & Brown, 2013). Furthermore, studies which have examined BPD traits as they relate to the FFM, have shown a positive relationship between negative emotionality (neuroticism) and impulsivity, separation insecurity and depression and a significant relationship between open-mindedness and emotional liability and risk taking (Amini et al., 2014). 

While some clinicians argue against the use of the FFM as a diagnostic tool, others view the FFM as useful as it assesses traits that are core to the BPD diagnosis including emotional regulation, social and interpersonal domains, as well as impulsivity and disinhibition (Trull & Brown, 2013). In addition, proponents for use of the FFM for diagnosis of BPD argue the FFM measures traits which can provide information that foreshadows treatment behavior (Trull & Brown, 2013). In fact, a study conducted by Amini et al. (2014) found a positive significant relationship between the FFM and DSM personality traits with DSM-IV-TR BPD symptoms, suggesting there is a strong correlation between BPD diagnostic criteria and the FFM. Conversely, one of the core components to BPD criteria, affect instability, is not well measured by the FFM; while neuroticism and affect instability have some overlapping constructs, there are also unique aspects to each that do not overlap, thus it is important for clinicians to use other means such as therapeutic judgement to determine symptoms relevant to diagnosis and cannot rely solely on the FFM (Trull & Brown, 2013). 

References

Amini M, Pourshahbaz A, Mohammadkhani P, Khodaie Ardakani‌ M, Lotfi M. The Relationship between Five-Factor Model and DSM-5 Personality Traits on Patients with Borderline Personality Disorder. PCP 2014; 2 (1) :59-67
URL: http://jpcp.uswr.ac.ir/article-1-165-en.html

Trull, T. J., & Brown, W. C. (2013). Borderline personality disorder: A five-factor model perspective. In T. A. Widiger & P. T. Costa, Jr. (Eds.), Personality disorders and the five-factor model of personality (3rd ed., pp. 119–132). American Psychological Association. https://doi.org/10.1037/13939-008


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