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Personality Disorders

Characterizing the mental health concerns of significant others of those with borderline personality disorder (BPD) and the influence of BPD on them

(PS8-C63) Characterizing the Mental Health Concerns of Significant Others of Those with Borderline Personality Disorder (BPD) and the Influence of BPD on Them

Saturday, November 18, 2023
10:00 AM – 11:00 AM PST
Location: Regency Ballroom, Level 7
Borderline personality disorder (BPD) is a serious, debilitating psychiatric condition characterized by instability in emotions, interpersonal relationships, and behaviors. Significant others (SOs: family member, romantic partner, friend) of those with BPD also exhibit elevated mental health concerns, but the specific nature of these concerns and the factors that contribute to them have not been thoroughly investigated. These mental health concerns may be influenced by individuals with BPD’s symptom severity in general and/or with respect to specific BPD components (i.e., emotional, interpersonal, or behavioral symptom domains), but this has not been studied. Such information is essential to identify what SOs may require interventions for, and what targets in dyadic interventions for BPD that incorporate SOs may be necessary to improve SO mental health. This study therefore aims to: 1) characterize the mental health concerns (i.e., depression, anxiety, trauma exposure and Posttraumatic Stress Disorder [PTSD], objective and subjective burden, impulsive behaviors) that SOs of those with BPD experience; and 2) clarify whether and how overall BPD symptom severity, and specific BPD components (i.e., emotional, interpersonal, behavioral BPD symptom domains), associate with these SO mental health concerns. A sample of SOs of those with BPD (N=46) completed measures of their own depression, anxiety, trauma exposure, PTSD, objective and subjective burden, and impulsive behaviors at baseline, one-, and two-month follow-ups. SOs also completed informant-reports of their loved one with BPD’s overall BPD symptom severity and severity of emotional, interpersonal, and behavioral BPD symptom domains at the same timepoints. Results indicate that SOs exhibited low psychopathology across most mental health concerns, though exhibited moderate anxiety severity. General estimating equation (GEE) models indicated that higher informant-rated general BPD symptom severity in the person with BPD predicted higher levels of SO depression (B=1.57, SE=.45), χ2(1)=11.90, p=.000, anxiety (B=1.49, SE=.52), χ2(1)=8.18, p=.004, PTSD (B=2.94, SE=1.46), χ2(1)=4.05, p=.044, and objective (B=4.53, SE=.86), χ2(1)=27.89, p=.000 and subjective burden (B=4.38, SE=.81), χ2(1)=29.17, p=.000, but not impulsive behaviors. Informant-rated behavioral instability in those with BPD positively predicted all SO mental health outcomes: depression (B=.05, SE=.02), χ2(1)=4.68, p=.030, anxiety (B=.05, SE=.02), χ2(1)=6.49, p=.011, PTSD (B=.17, SE=.06), χ2(1)=8.02, p=.005, impulsive behaviors (B=.29, SE=.07), χ2(1)=17.31, p=.000, and objective (B=.09, SE=.04), χ2(1)=4.81, p=.028 and subjective burden (B=.09, SE=.04), χ2(1)=7.10, p=.008. Informant-rated emotional instability in those with BPD positively predicted objective (B=.36, SE=.12), χ2(1)=9.48, p=.002, and subjective burden (B=.48, SE=.10), χ2(1)=21.01, p=.000. Interpersonal instability in those with BPD did not predict SO mental health. Results highlight that behavioral and emotional BPD symptom domains may be particularly deleterious to SO mental health concerns, and BPD treatment providers may wish to consider referrals for SO mental healthcare in such instances.