A Comparison of Borderline Personality Features and Level of Personality Functioning in Explaining Mentalizing Capacity

Background Numerous studies have demonstrated that the Alternative Model for Personality Disorders (AMPD) outperforms traditional categorical nosology (i.e., Section II) in predicting an array of salient clinical outcomes. However, despite the centrality of social-cognitive impairments in personality disorder, few studies have examined the superiority of the AMPD over Section II in predicting social-cognitive deficits. The current study addresses this gap by evaluating the incremental validity of AMPD-defined level of personality functioning (LPF) versus borderline personality features in predicting mentalizing – a social-cognitive construct proposed to underlie the development of personality disorder. Method Participants included 267 university students ( M _age = 20.49, SD = 1.74) who completed self-report measures of LPF, borderline personality features, and two measures of mentalizing: the Reflective Functioning Questionnaire (RFQ) and the Mentalization Scale (MentS). Results Hierarchical regressions revealed that LPF explained additional variance in the RFQ beyond borderline features and internalizing psychopathology. Although borderline features also incremented LPF in predicting the RFQ, additional variance explained was less than half that contributed by the LPF over borderline features. LPF also incremented the variance explained in the MentS total score and subscales over and above borderline features and internalizing symptoms, whereas borderline features did not increment LPF in predicting any of the MentS variables. Conclusions These results strengthen the evidence base for the superiority of the AMPD over Section II and suggest that mentalizing deficits are best captured by a general indicator of personality impairment (i.e., LPF). Findings support the extension of mentalization-based treatment to AMPD-defined personality disorder, which should be explored in future research.