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TitleBorderline personality disorder in adolescence
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LanguageEnglish
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Borderline Personality Disorder in adolescence: exploring gender differences and

effectiveness of Dialectical Behaviour Therapy





Amanda Leather

















A thesis submitted for the degree of

Doctorate in Forensic Psychology Practice (ForenPsyD)



Centre for Forensic and Criminological Psychology

University of Birmingham



2014

Page 2

University of Birmingham Research Archive


e-theses repository


This unpublished thesis/dissertation is copyright of the author and/or third
parties. The intellectual property rights of the author or third parties in respect
of this work are as defined by The Copyright Designs and Patents Act 1988 or
as modified by any successor legislation.

Any use made of information contained in this thesis/dissertation must be in
accordance with that legislation and must be properly acknowledged. Further
distribution or reproduction in any format is prohibited without the permission
of the copyright holder.

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(such as, peer insecurity or being introverted). Despite criticism about not exploring non

problem areas such as positive self-esteem, the focus of the MACI is to explore concerning

behaviour, therefore it does not claim to explore non problem issues (McCann, 2008).

The MACI is a self-report, true-false measure, comprising of 160 items over thirty-one

scales, within three domains. Personality Pattern includes twelve personality scales,

Expressed Concerns include eight scales and Clinical Syndromes include seven scales. In

addition, the MACI has three modifying scales; disclosure, desirability and debasement,

which explore adolescent responses and allows for scoring adjustments to be made or for a

test to be considered invalid, due to response style. Finally, there is a validity scale (two

items). This scale was included to ensure adolescents are focused on the task and enables the

test to be invalidated should these items be endorsed.

Grossman Facet Scales

More recently, the MACI has undergone further development, and the most recent manual

includes Grossman Facet Scales (Millon et al., 2006). The development of these scales

originated using earlier research by Davis (1994) who explored the personality scales using

factorial analysis and identified a number of domains for each scale. Millon et al. (2006)

using this origin -

structural domains identified how the personality pattern is expressed; functional domains

which explore regulatory behaviours include - expressive behaviour, interpersonal conduct,

cognitive style/content and regulatory mechanisms. The other four domains labelled

structural, include; self-image, object representations, morphologic organization and

mood/temperament. The four latter domains typically require clinical involvement (Millon et

al., 2006). Within the Grossman facet scores the three most salient domains are identified for

each personality pattern, this helps assist interpretation as it offers clarity on processes

regarding specific personality patterns. McCann (1999) argues that this adaptation provide

more elaborate interpretation of the personality scales and scale validity.

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Table 12: Description of MACI and Grossman Facet scales

Scale Construct being assessed

Scale X: Disclosure (160

items)

Explores the openness of the adolescent during the test

Scale Y: Desirability (17

items)

Explores whether answers given are desirable

Scale Z: Debasement (16

items)

Explores if the focus is on negative characteristics

Scale VV (2 items) Monitors for random responses as an indication of not

paying attention to the task

Scale 1. Introversive (44

items) DSM IV Scale -

Schizoid Personality

Facet scales:

1.1 expressively impassive
1.2 temperamentally apathetic
1.3 interpersonally unengaged

Measures the ability to experience pleasure or pain and

emotional detachment and the avoidance of interactions

with others, through feeling apathetic about social

interactions.

Explores pleasure or pain experiences

Measures the ability to form peer relationship

self-perception and level of maturity

Scale 2A. Inhibited (37

items) DSM IV Scale -

Avoidant Personality

Facet Scales:

2.1a expressively fretful

2.2a Interpersonally aversive

2.3a alienated self-image

Measures how uncomfortable the adolescent feels around

others, despite their desire for relationships.





Measures expression of distress or concern

Explores relationships with others and degree of isolation

Assesses perception of self

Scale 2B. Doleful (24 items)

DSM IV Scale – Depressive

Personality



Facet Scales:



2.1b Temperamentally Woeful

2.2b Cognitively Pessimistic

2.3bExpressively Disconsolate

essimistic view of life and their

future outlook. Often following a loss the adolescent has

lost hope about happiness in the future.





Explores level of pessimistic attitude

Measures feelings of hopelessness and negativity

Measures lack of positive outlook and hopelessness about

life

Scale 3. Submissive (48

items) DSM IV Scale -

Dependent Personality

Facet Scales:

3.1 Interpersonally Docile



Measures attachment and their degree of dependency on

others to manage their anxiety.





Explores perception that others need to provide nurturance

and security.

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Appendix 15

Table 15: Alpha coefficient for each scale and facet scale

Name of Scale Number of

items

within

scale

Internal

consistency

Cross

validation

sample

Test re-

test

Modifying Indices

X. Disclosure

Y. Desirability

Z. Debasement



-

17

16



-

0.73

0.87



-

0.75

0.85



0.86

0.71

0.84

Personality Patterns

1. Introversive
i. Expressively Impassive

ii. Temperamentally Apathetic
iii. Interpersonally Unengaged



44

7

7

7



0.83

0.76

0.50

0.77



0.82

-

-

-



0.63

-

-

-

2a. Inhibited

i. Expressively fretful
ii. Interpersonally Aversive

iii. Alienated self-image

37

9

12

9

0.86

0.77

0.80

0.83

0.86 0.70

2b. Doleful

i. Temperamentally Woeful
ii. Expressively Disconsolate

iii. Cognitively Pessimistic

24

8

8

8

0.86

0.79

0.71

0.67

0.85 0.83

3. Submissive
i. Interpersonally Docile

ii. Temperamentally Pacific
iii. Expressively Incompetent

48

7

10

8

0.74

0.44

0.71

0.53

0.73 0.88

4. Dramatising
i. Interpersonally Attention

seeking

ii. Gregarious Self Image
iii. Cognitive Flighty

41

9



12

6

0.82

0.59



0.63

0.58

0.84 0.70

5. Egotistic
i. Admirable self

image

ii. Cognitively
Expansive

iii. Interpersonally
Exploitive

39

10

7

8

0.80

0.79

0.63

0.58

0.82 0.82

6A. Unruly

i. Expressively Impulsive
ii. Acting Out Mechanism

iii. Interpersonally
Irresponsible

39

8

9

11

0.84

0.77

0.78

0.69

0.83 0.79

6b. Forceful

i. Interpersonally Abrasive
ii. Expressively Precipitate

22

7

7

0.83

0.80

0.80

0.81 0.85

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iii. Isolation Mechanism 7 0.55
7. Conforming

i. Expressively Disciplined
ii. Interpersonally Respectful
iii. Conscientious Self-image

39
8
10
8

0.86
0.71
0.65
0.64

0.86 0.91

8a. Oppositional
i. Discontented self image

ii. Expressively Resentful
iii. Interpersonally Contrary

43
9
9
12

0.85
0.74
0.72
0.76

0.82 0.76

8b. Self demeaning
i. Cognitively Diffident

ii. Undeserving Self Image
iii. Temperamentally

Dysphoric

44
9
9
7

0.90
0.78
0.72
0.73

0.89 0.88

9.Borderline Tendency
i. Temperamentally Labile

ii. Cognitively Capricious
iii. Uncertain Self Image

21
10
11
8

0.86
0.74
0.76
0.75

0.86 0.92

Expressed concerns:
A. Identity Diffusion


32


0.79


0.76


0.77

B. Self Devaluation 38 0.91 0.90 0.85
C. Body Disapproval 17 0.85 0.84 0.89
D. Sexual Discomfort 37 0.73 0.69 0.74
E. Peer Insecurity 19 0.75 0.77 0.57
F. Social Insensitivity 39 0.79 0.79 0.83
G. Family Discord 28 0.79 0.76 0.89
H. Childhood Abuse 24 0.83 0.81 0.81
Clinical Syndromes
AA. Eating Dysfunctions


20


0.86


0.85


0.78

BB. Substances Abuse Proneness 35 0.89 0.88 0.90
CC. Delinquent Predisposition 34 0.77 0.76 0.80
DD. Impulsive Propensity 24 0.79 0.75 0.78
EE. Anxious Feelings 42 0.75 0.75 0.85
FF. Depressive Affect 33 0.89 0.88 0.81
GG. Suicidal Tendency 25 0.87 0.87 0.91

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