Psychopathy scores reveal heterogeneity among patients with borderline personality disorder

The treatment and management of individuals with borderline personality disorder (BPD) in psychiatric and forensic settings can be exceptionally challenging because such individuals usually evidence serious emotional and behavioral difficulties, including self-harm, impulsivity, affect dysregulation, and aggression. Utilizing a sample of 221 psychiatric patients meeting criteria for BPD, the current study systematically examines the underlying heterogeneity in BPD vis-a-vis psychopathy in an attempt to identify meaningful subgroups. We used latent profile analysis, bootstrapping techniques and analysis of variance to items in a scale assessing psychopathy to identify four subtypes of BPD which differed significantly by gender, level of psychopathy, criminal history and other salient characteristics. Findings hold significant implications for treatment and for guiding the refinement of existing evidence-based interventions and community management strategies.