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Sexual Orientation and Borderline Personality Traits
Abstract
Borderline Personality Disorder (BPD) is a psychiatric condition characterized by severe dysfunction across four psychiatric phenotypes: affect regulation, interpersonal difficulties, cognitive symptoms (e.g. perceptual disturbances) and behavioral difficulties (e.g. self-harm & impulsivity). Lifetime prevalence of BPD is low (approximately 5.9% in the U.S.); however, individuals that possess high borderline personality traits often experience dysfunction in various aspects of their lives, though they do not meet the threshold for diagnosis. Previous research has examined borderline personality traits in the general population. However, no studies to our knowledge have examined differences in borderline personality traits in adults that identify as a sexual minority. The current study examined borderline personality traits in LGBT+ individuals. Participants’ (N=268) scores on the Borderline Personality Questionnaire (BPQ) were compared to a previous study’s findings from a U.S. sample (Poreh et al., 2006; N=181). Participant responses were collected using online platforms such as Prolific and MTurk, as well as responses from SONA systems (i.e. college students), and participants recruited from LGBT+ events. An independent sample t-test was run to determine if there were differences in BPD traits as measured BPQ total scores between Poreh and colleagues (2006) study and the current sample. Those in the current sample (M = 35.26, SD = 16.92) were reporting significantly greater BPQ total scores than those in Poreh and collogues (2006) study (M = 21.06, SD = 12.91), t(447) = 9.565, p = 0.0001, d = .94. These findings suggest that LGBT+ individuals on average possess higher borderline personality traits than the general U.S. population. The disproportionate presentation of borderline personality traits in LGBT+ individuals may result from minority stress. Previous studies have implicated higher internalized transdiagnostic symptoms resulting from minority stress, and this may be the case with certain BPD features (e.g. emotion dysregulation, emptiness & abandonment). Future studies should examine underlying mechanisms of minority stress and unique moderators that place LGBT+ individuals at higher risk for developing pathological personality traits.
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Background: In recent years, there have been significant advancements in understanding the etiology,
assessment, and treatment of borderline personality disorder (BPD). However, the influence of culture has
not been carefully considered. The present review is an attempt to identify cultural factors that may
change the presentation, assessment, and response to treatment among adults and adolescents with BPD.
Discussion: We discuss the relevance of examining the BPD diagnosis across cultures, define culture, and
review studies on the prevalence of BPD across sociocultural groups. Conclusion: We provide a
comprehensive list of assessments developed to capture BPD and the cultural adaptations and validations
attempted thus far. We also summarize the evidence base for culturally sensitive treatments for BPD.
Finally, we present suggestions for future research and clinical implications for our findings.
Over the past several decades, research has focused increasingly on developmental precursors to psychological disorders that were previously assumed to emerge only in adulthood. This change in focus follows from the recognition that complex transactions between biological vulnerabilities and psychosocial risk factors shape emotional and behavioral development beginning at conception. To date, however, empirical research on the development of borderline personality is extremely limited. Indeed, in the decade since M. M. Linehan initially proposed a biosocial model of the development of borderline personality disorder, there have been few attempts to test the model among at-risk youth. In this review, diverse literatures are reviewed that can inform understanding of the ontogenesis of borderline pathology, and testable hypotheses are proposed to guide future research with at-risk children and adolescents. One probable pathway is identified that leads to borderline personality disorder; it begins with early vulnerability, expressed initially as impulsivity and followed by heightened emotional sensitivity. These vulnerabilities are potentiated across development by environmental risk factors that give rise to more extreme emotional, behavioral, and cognitive dysregulation. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
The purpose of this study was to assess the prevalence of homosexuality/ bisexuality and same-sex relationships in a sample of 362 hospitalized subjects, 290 with borderline personality disorder (BPD) and 72 comparison subjects with other personality disorders. At baseline and at five contiguous 2-year follow-up intervals, subjects meeting DIB-R and DSM-III-R criteria for BPD or at least one other personality disorder were interviewed using a semi-structured interview about their sexual orientation and the gender of intimate partners. Subjects with BPD were significantly more likely than comparison subjects to report homosexual or bisexual orientation and intimate same-sex relationships. There were no significant differences between male and female borderline subjects in prevalence of reported homosexual or bisexual orientation or in prevalence of reported same-sex relationships. Subjects with BPD were significantly more likely than comparison subjects to report changing the gender of intimate partners, but not sexual orientation, at some point during the follow-up period. A reported family history of homosexual or bisexual orientation was a significant predictor of an aggregate outcome variable assessing homosexual/bisexual orientation and/or same sex relationship in borderline subjects. Results of this study suggest that same-gender attraction and/or intimate relationship choice may be an important interpersonal issue for approximately one-third of both men and women with BPD.
Diagnostic accuracy of borderline personality disorder in the gay population: How gay cultural norms and clinician bias may impact diagnosis
- J Khachikian
Khachikian, J. (2013). Diagnostic accuracy of borderline personality
disorder in the gay population: How gay cultural norms and clinician bias
may impact diagnosis. Alliant International University.