Longitudinal dynamics between the central nodes in the symptoms network of borderline personality disorder: An intraindividual network analysis

Background: Borderline Personality Disorder (BPD) is a severe and heterogeneous psychiatric condition. Current research has some limitations: (1) findings from group (i.e., interindividual) analyses are often incorrectly generalized to individuals (i.e., intraindividual); and (2) research tends to emphasize common causes of symptomatology rather than exploring the interrelationships between symptoms.

Method: The current study aimed to analyze the intraindividual dynamics of central BPD symptoms using a temporal network analysis. Longitudinal measurement data collected over two years at regular six-month intervals in 212 patients diagnosed with BPD were used.

Results: The network analysis extracted temporal and contemporaneous intraindividual relationships, the former were directional relationships between previous emptiness and subsequent identity instability, as well as identity instability and anger dysregulation. Also, previous anger dysregulation predicted identity instability and subsequent emptiness. In the same time window, the contemporaneous network and its topology underscored the relevance of anger dysregulation for its relation to most BPD symptoms, including identity instability and suicidal intent.

Limitation: Measurements with widely spaced intervals do not capture symptom dynamics in a recording window similar to real-time.

Conclusion: Exploring the dynamic between anger dysregulation and identity instability may be crucial for understanding the severity of BPD at the individual level and could potentially inform treatment.