Overview of Borderline Personality Disorder
Borderline personality disorder (BPD) is a mental disorder marked by a pattern of
ongoing instability in moods, behavior, self-image, and functioning (APA, 2013). These
experiences often result in impulsive actions and unstable relationships. A person with BPD may
experience intense episodes of anger, depression, and anxiety that may last from only a few
hours to days (NIMH, 2017). BPD has been a diagnosable disorder since 1980 when it was first
included in the third edition of the Diagnostic and Statistical Manual for Mental Disorders (APA,
1987). The U.S. National Institutes of Health (NIH) reports that approximately 5.9% of the U.S.
population has BPD (Grant et al. 2008). The American Psychiatric Association reports a broad
range of prevalence from 1.6% - 5.9% of the U.S. population (APA, 2013). It is most of often
noted that the prevalence rates of BPD in women are much higher than in men, at a ratio of 3:1
(APA, 2013). However, this glaring difference in diagnosis rates has brought about research into
why there appears to be a higher diagnosis rate in women versus men, and there have been
studies conducted in the last ten years that have suggested that the prevalence rates between men
and women are more comparable than often times reported (Grant et al., 2008).
It is important to consider the possible reasons behind the stark difference in rates of
diagnosis of BPD between men and women, as in order to properly and effectively address and
treat BPD as the complex and impactful mental illness it is, there must be a correct diagnosis,
void of bias, error and/or assumption. An exploration of the potential reasons for the differential
diagnosis rates of BPD leads us to examine the methods of sampling in research studies
exploring the demonstration of BPD symptoms, the utilization of treatment modalities, the
potential of clinician bias in assessing for BPD in patients or clients, as well as the potential
differences in how symptoms of BPD are demonstrated in women and men.
Finally, we must consider if there is any evidence of a biological indicator of BPD that
might offer insight into the popularly reported prevalence rates of BPD between men and
women. Could it be that BPD does in fact afflict more women than men, or could women's
socialization within the dominant US cultural framework predispose them to the development of
borderline personality disorder. As Dana Becker (1997) noted in her influential text on BPD and
gender, Through the Looking Glass: Women and Borderline Personality Disorder, gender
inequality between women and men in the United States impacts what is commonly considered
deviant behavior within the constructs of social norms and expectations, and that women, due to
their unequal status in patriarchal structures are vulnerable to being victims of the pathologizing
of otherwise normal expressions of affect .
Diagnosis and Prevalence Rates
It has been established that...