Gender Patterns in BPD

While there may not be gender differences in BPD with regard to prevalence, some specific self-harm behaviors (e.g., self-cutting), and presenting levels of overall psychological distress, there appear to be notable gender differences with regard to personality traits, Axis I and II comorbidity, and treatment utilization histories. With regard to these differences, men with BPD are more likely to demonstrate explosive temperaments coupled with high levels of novelty seeking. Men with BPD are also more likely to evidence substance abuse whereas women with BPD are more likely to evidence eating, mood, anxiety, and posttraumatic stress disorders. With regard to Axis II comorbidity, men with BPD are more likely than women to have antisocial personality characteristics. Finally, men with BPD are more likely to have treatment histories for substance abuse whereas women with BPD are likely to have utilized more pharmacotherapy and psychotherapy services. Thus, given the similarities in men and women with BPD, there are also clear gender differences in BPD as well. These differences, reported in a number of different studies, may explain why women with BPD are more likely to be over-represented in mental health services and men with BPD are more likely to be over-represented in substance-abuse treatment programs and/or jails. An awareness of these clinical differences is particularly important in evaluating patients in psychiatric or primary care settings, as men and women with BPD appear to have slightly different clinical presentations and treatment histories.


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