(PS8-D76) Recognizing Borderline Personality Disorder in Men: Gender Differences in Borderline Personality Disorder Symptom Presentation

TITLE: Recognizing Borderline Personality Disorder in Men: Gender Differences in Borderline Personality Disorder Symptom Presentation

AUTHORS:

Saivone Sanchious, B.A.

Shereen Khoo, Ph.D.

Mark Zimmerman, M.D.

ABSTRACT:

Borderline personality disorder (BPD) is diagnosed predominately in women (75%) (American Psychological Association, 2013). One possible reason for this gender disparity may be due to clinicians conceptualizing certain BPD symptoms such as suicidality, self-harm, and interpersonal problems as core to the disorder (e.g., Linehan, 1993; Markowitz et al., 2006; Biskin & Paris, 2012); these symptoms are typically endorsed at higher rates by women (Shields, 2002; Claes et al., 2007; Lutz et al., 2022). However, past research has shown that BPD patients not endorsing suicidality show similar rates of impairment as those who do (e.g., Zimmerman & Becker, 2022). Patients may also meet criteria for BPD without endorsing any symptoms related to interpersonal problems or suicidality. The current study aims to examine potential gender differences in BPD symptom presentation in order to better recognize BPD presentation in men and minimize gender stereotypes surrounding BPD.

Method. Partial hospital patients and outpatients seeking psychiatric treatment were evaluated using semi-structured diagnostic interviews, of whom 325 and 390 (respectively) met criteria for BPD. 

Results. A chi-square test of independence was performed to examine the relationship between gender and criterion presence. In the outpatient sample, men endorsed higher rates of chronic feelings of emptiness (χ2 (1, N = 390) = 4.82, p = .03) whereas women endorsed higher rates of identity disturbance (χ2 (1, N = 390) = 3.82, p = .05). In the partial hospital sample, women endorsed higher rates of relationship instability (χ2 (1, N = 325) = 9.03, p < .001) and fear of abandonment (χ2 (1, N = 325) = 4.97, p = .03).

Conclusions. Men and women with BPD present differently, which may have led to a lack of recognition of more masculine forms of BPD criterion. This is clinically important as information about symptom profiles may lead to better recognition of BPD in men in order to provide them with appropriate treatment.