Differences in Personality and Defense Style According to the Levels of Borderline Personality Organization Model on the Network Perspective

This study aims to compare the network characteristics of personality traits and defense styles based on the personality organization model.We categorized the personality disorder (PD) group into two borderline personality organizations (BPO) according to Otto Kernberg's model.A total of 766 patients with PDs were enrolled based on the diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-text revision and DSM-5.The high BPO group included 448 patients diagnosed with avoidant, dependent, histrionic, and narcissistic PDs, while the low BPO group comprised 318 patients diagnosed with borderline, antisocial, paranoid, schizoid, and schizotypal PDs.We created a network using 12 PD characteristics from the Personality Disorder Questionnaire-4+ and 4 defense styles from the Defense Style Questionnaire, treating these as nodes within each BPO group.An extended Bayesian Information Criterion and graphical lasso model were employed to construct the network.To compare the networks, we analyzed global strength and individual edges using the Network Comparison Test (NCT).The results showed that the global strength of the low BPO group was higher than that of the high BPO group (high BPO: 7.63, low BPO: 9.35, p=0.029).The NCT confirmed a significant difference in network structure between the two groups (p=0.043), with variations at the individual edge level.This indicates that the low BPO group exhibits more severe personality pathology with a poorer prognosis than the high BPO group.