Borderline personality disorder traits associate with midlife cardiometabolic risk.

Abstract

There is growing interest in relationships between borderline personality disorder (BPD) pathology and physical health outcomes. Diagnostic BPD and BPD-related traits, for instance, have been shown to associate with self-reported cardiovascular disease and various cardiometabolic risk factors. However, potential confounding of these associations by comorbid depression, which itself contributes to risk for heart disease, remains unresolved, and previous research is limited by nearly uniform reliance on self-reported health status. In the present study, we examine the association of BPD traits and contemporaneously assessed depressive mood with instrumented measures of cardiometabolic risk in a midlife community sample (N = 1,295). BPD pathology was measured using dimensional, multi-informant trait measures; depressive symptomology was self-reported; and cardiometabolic risk was indexed via multiple indicators of insulin resistance, adiposity, dyslipidemia, and blood pressure. Structural equation modeling was used to estimate the effects of BPD traits and depressive symptoms on aggregated cardiometabolic risk, adjusting for their shared variance. Results showed both BPD features and depressive symptomatology related to the extent of cardiometabolic risk; when examined simultaneously, only BPD associated independently with risk indicators. In further supporting a link between BPD pathology and cardiovascular disease risk, these findings warrant future work to elucidate intervening behavioral and biological mechanisms.

Borderline Personality Disorder in a “Life History Theory” Perspective: Evidence for a Fast “Pace-of-Life-Syndrome”

“…This finding is consistent with the interpretation of a mediating effect of PoLS on the indirect relationship between early adversity and AL. Consistent with our findings, Barber et al (2020) have recently reported that people with BPD who are in their mid-40s have an elevated cardiometabolic risk mediated by insulin resistance, adiposity, dyslipidemia, and blood pressure, which seems to clearly reflect elevated AL in this clinical group. In our study, the AL score comprised only four measures (SBP, DBP, BMI, and WtH ratio), while it lacked additional serum markers examining chronic inflammation, dyslipidemia, or insulin resistance.…”

“…Aside from psychological signs and symptoms associated with BPD, there is evidence to suggest that individuals with BPD are also at heightened risk of developing cardiovascular disease and stroke; in fact, the risk for cardiovascular disease and stroke seems to be even specific for BPD in comparison with other personality disorders ( Moran et al, 2007 ), and largely independent of comorbid depression ( Barber et al, 2020 ). The risk for cardiovascular disease, in part, relates to elevated rates of overweight and obesity, as well as hypertension and diabetes mellitus among people diagnosed with BPD ( Powers and Oltmanns, 2012 ).…”

Altered Left Ventricular Myocardial Deformation in Young Women With Borderline Personality Disorder: An Echocardiographic Study

“…Consistent with this risk profile, Moran et al (12) reported that patients with BPD have a 7.2-fold elevated risk of coronary heart disease compared with the general population, as well as an 8.5-fold risk of stroke. More recent work has further corroborated these findings suggesting that the risk of CVD is specific for BPD when compared with other personality disorders, and also when controlling for comorbid depression (12,13). Notably, Barber et al (13) determined that each standard deviation (SD) increase in BPD traits in a general population equals the age effect of 9.2 years among people in their mid-40s, which is fully in line with the hypothesis of AL and the effects of chronic stress on premature aging (8).…”

Predictors of treatment response to serotonin and noradrenaline reuptake inhibitors in fibromyalgia

“…In order to test the relationships between the insulin resistance and a lack of response to treatment with SNRI we built a basal one-factor logistic regression model. We selected the other factors for the model based on existing literature reporting associations between insulin resistance and depression, personality disorders, as well as smoking [26][27][28][29][30]. The above mentioned factors were evaluated and the collinearity of logits was ruled out.…”