The predictive validity of the DSM‐5 alternative model for borderline personality disorder: Associations with coping strategies, general distress, rumination, and suicidal ideation across one year

Abstract The DSM‐5 Alternative Model for Personality Disorders (AMPD) characterizes borderline personality disorder (BPD) in part as a constellation of maladaptive personality trait facets including emotional lability, anxiousness, separation insecurity, depressivity, impulsivity, risk‐taking, and hostility. Previous studies have supported the construct validity of AMPD‐BPD; however, research examining its predictive validity in relation to theoretically and clinically relevant constructs remains needed. The present study investigates the longitudinal relationships between AMPD‐BPD and general distress, rumination, and suicidal ideation, as well as adaptive and maladaptive coping targeted in Dialectical Behavior Therapy (DBT) in a sample of participants with elevated BPD symptomology. We also examined if dysfunctional coping skill use at 9‐month follow‐up explained the relationship between baseline BPD traits and outcomes at 1‐year. There were significant correlations between baseline trait BPD with dysfunctional coping skill use at 9‐month follow‐up and psychological distress and rumination at 1‐year follow‐up. Dysfunctional skill use exhibited a significant indirect effect in the association between trait BPD and rumination after 1 year. The findings of this study support the construct validity of AMPD‐BPD that can inform treatment and research.