ORCID

https://orcid.org/0000-0003-4745-5523

Date of Award

2026

Document Type

Dissertation

Degree Name

Psychology (Ph.D.)

Department

Psychology

First Advisor

Wilson H McDermut

Second Advisor

Raymond A DiGiuseppe

Third Advisor

William F Chaplin

Abstract

Borderline personality disorder (BPD) is a severe personality disorder frequently seen in clinical settings due to high service utilization. It is characterized by emotion dysregulation, identity disturbance, suicidal behavior, fear of abandonment, and impulsive or risky behavior. BPD is categorized as a Cluster B personality disorder, alongside narcissistic personality disorder (NPD), which is defined by grandiosity, attention-seeking, and a lack of empathy. NPD can be further conceptualized across two subtypes: grandiose narcissism and vulnerable narcissism (VN). Unlike grandiose narcissism, VN has been largely neglected in research – despite overlapping features with personality and mood disorders, especially BPD. These shared features include emotion dysregulation, rejection sensitivity, and unstable identity, yet little work has explored how these conditions may interact. This dissertation aims to address this gap by examining comorbid BPD and VN in a small clinical sample to better understand whether these co-occurring traits mutually exacerbate symptom severity. The study included 97 adults hospitalized in a psychiatric inpatient unit in New York. Statistical analyses included latent profile analysis, ANOVAs, and multiple comparisons. Four distinct profiles emerged: BPD-VN, BPD, Subclinical, and Normative. The BPD-VN group reported significantly greater levels of emotion dysregulation, identity disturbance, and rejection sensitivity compared to the other groups. They also endorsed more lifetime suicide attempts and trauma exposure. The BPD group, though less severe in these key symptom domains, was the most frequently readmitted and had the longest hospital stays. This study builds on existing theory and research by clarifying how BPD and VN intersect and supports a more dimensional understanding of this comorbidity. Findings highlight the importance of identifying this population early in treatment settings to inform targeted interventions and implement safeguards both during and after hospitalization. Implications for risk assessment and treatment planning are discussed.

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