Racial Differences Between African and White Americans in the Presentation of Borderline Personality Disorder

Race and Social Problems 06/2009; 1(2):87-96. DOI: 10.1007/s12552-009-9006-2


Borderline personality disorder (BPD) is commonly thought of as a disorder of White females. Despite evidence indicating similar
prevalence rates across races and genders, no study has examined the experience of BPD among ethnic minorities and how this
differs from Whites. The affective and behavioral symptoms of BPD were studied in 17 African Americans and 27 White Americans
with the disorder. Results indicated that African Americans experience greater affective intensity and emotional dysregulation,
fewer self-harming behaviors, and more thoughts of interpersonal aggression than Whites. Differences in affective symptoms
were accounted for by group differences in substance use and receipt of inpatient services, whereas differences in behavioral
symptomatology persisted after adjusting for potential confounders. These findings suggest that not only is BPD not a disorder
exclusive to White females, but that the experience of the disorder may differ substantially across races. Implications for
future research and directions for developing culturally relevant treatments are discussed.

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    ABSTRACT: In this paper, we offer guiding principles for assessing personality disorder (PD) in adolescents based on research on the development, manifestations, and impact of PD in youth. First and most important, remember to assess PD in youth, rather than assessing only non-PD conditions. Second, consider using the DSM-5 Alternative Dimensional Model of PDs. Third, assess acute symptoms and long-term underlying personality patterns and impairment. Fourth, evaluate past and present contextual factors (families, peers, schools and neighborhoods, SES, and culture). Fifth, gather information from both the adolescents themselves and knowledgeable informants. Sixth, focus assessment on problematic patterns of behavior, thinking, and feeling because those patterns will provide better targets for treatment than specific PD diagnoses. Seventh, highlight personality strengths and resources for change.
    Full-text · Article · Dec 2013 · Clinical Psychology Science and Practice