Childhood Disruptions in Caregiving, Adult Parental Attachment, and Borderline Features in Emerging Adulthood: Rejection Sensitivity as a Mechanism of Influence.

Borderline personality disorder (BPD) is a severe psychiatric disorder first diagnosed in adolescence or emerging adulthood, which develops in part in the context of early attachment relationships. We tested a cross-sectional model linking caregiver disruptions during childhood, current parental attachment, and rejection sensitivity, to borderline features in 2,546 emerging adult college students. A structural equation model revealed that childhood caregiver disruptions were associated with lower quality adult parental attachment. Moreover, rejection sensitivity mediated the relationship between adult parental attachment and borderline features. Results suggest a representational model of others as rejecting links early disruptions in caregiving relationships and attachment insecurity, to borderline features in emerging adulthood. Implications for practice are discussed, including for means of targeting cognitive schemas related to rejection sensitivity, which could lead to reductions in BPD symptoms.

Applying the DSM-5 Alternative Model of Personality Disorders and the Shedler-Westen Assessment Procedure to the Classic Case of "Madeline G.": Novice and Expert Rater Convergences and Divergence.

Prior research supports the learnability of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Alternative Model of Personality Disorders (AMPD). However, researchers have yet to compare novice ratings on the AMPD's Level of Personality Functioning Scale and the 25 pathological personality traits with expert ratings. Furthermore, the AMPD has yet to be examined with the idiographic Shedler-Westen Assessment Procedure (SWAP). We compared the aggregated AMPD clinical profile of a group of psychology doctoral students who learned the AMPD to high levels of reliability to that of an expert rater using the crucible of the classical case of "Madeline G." Examination of AMPD and SWAP ratings of "Madeline G." revealed excellent overall concordance but suggests that novice raters tend to perceive lower levels of personality impairment.