Gender differences in borderline personality disorder: findings from the collaborative longitudinal personality disorders study

Abstract

A majority of the literature on borderline personality disorder (BPD) focuses on its occurrence in women or does not specifically assess for gender differences in clinical presentations. Some studies report that men with BPD may be more likely to be diagnosed with substance use disorders, as well as paranoid, passiveaggressive, narcissistic, sadistic, and antisocial personality disorders (PDs). Additionally, women with BPD appear to be more likely to report histories of adult physical and sexual abuse and to meet diagnostic criteria for post-traumatic stress disorder (PTSD) and eating disorders. The purpose of the present study was to further examine gender differences in BPD. Using baseline data from the Collaborative Longitudinal Personality Disorders Study (CLPS), men and women who met criteria for BPD were compared on current axis I and II disorders, BPD diagnostic criteria, childhood trauma histories, psychosocial functioning, temperament, and personality traits. Men with BPD were more likely to present with substance use disorders, and with schizotypal, narcissistic, and antisocial PDs, while women with BPD were more likely to present with PTSD, eating disorders, and the BPD criterion of identity disturbance. Generally speaking, women and men with BPD displayed more similarities than differences in clinical presentations. The differences that did emerge are consistent with those found in epidemiological studies of psychopathology and therefore do not appear unique to BPD. Additionally, many gender differences traditionally found in epidemiological samples did not emerge in BPD subjects. For example, no difference was found in rates of major depressive disorder, a condition that is more prevalent in females. Thus, BPD pathology may be a prevailing characterization that can attenuate usual gender-based distinctions. © 2003 Elsevier Inc. All rights reserved. B ORDERLINE personality disorder (BPD) isassociated with significant morbidity and frequent use of mental health resources. 1-3 Studies cite BPD rates of approximately 0.4% to 1.8% among community samples, 4-7 and 10% to 25% among clinical samples. 8,9 BPD is more often diagnosed in women, with estimates that approximately two thirds to three quarters of those diagnosed with BPD are women. 6,9-12 Consequently, a majority of the literature on BPD focuses on its occurrence in women 13 or does not incorporate gender as a separate variable, therefore not addressing possible gender differences in clinical presentations. 14,15 Thus, little is known regarding potential gender differences in persons with BPD that may impact the manifestation, course, and treatment of BPD in both men and women.Although BPD is believed to occur more frequently in women, research findings on the prevalence of BPD in men and women are inconsistent. In some studies, when significant differences in rates of personality disorders (PD) are found, rates are usually higher among men. [16][17][18][19] One of the more methodologically sound community studies 7 found that men had higher rates...

Comorbidity between Post-Traumatic Stress Disorder and Borderline Personality Disorder: A Review

“…As for epidemiological studies, the main methodological flaw was the use of samples with mainly female subjects with BPD. In this respect, future epidemiological research should control the potentially modulating variable of gender, particularly as different research studies have found that there is a greater probability of PTSD for females with BPD [82]. Further epidemiological studies among subjects with a primary diagnosis of PTSD should also be encouraged in order to accurately assess the comorbidity between both disorders.…”

Comparação entre solicitações psiquiátricas de dois hospitais gerais universitários brasileiros: uso do protocolo de registro de interconsulta em saúde mental

“…Estudos acerca da relação entre gênero e transtornos de personalidade consideraram que alguns tipos de transtornos (por exemplo, borderline em mulheres 29 , e anti-social e narcisista em homens 30 ) podem estar relacionados ao sexo, porém, devido a possíveis limitações metodológicas, esses aspectos necessitariam de maiores investigações.…”

Combined Treatment of Major Depression in Patients with Borderline Personality Disorder: A Comparison with Pharmacotherapy

“…Further, Cyranowski and others treated patients suffering from depression with IPT and found that subjects meeting criteria for a personality disorder more frequently needed adjunctive SSRI treatment to achieve remission of depressive episodes (16). Although this comorbidity is very common (53% to 85% in BPD samples) (27)(28)(29)(30)(31) and exerts significant effects on severity of depression and social impairment (27,32,33), there are currently no studies that focus on combined treatment of major depression that affects patients with BPD. The use of psychotherapy in treating these patients is central to the investigation of this topic.…”