Phenomenology of borderline personality disorder: the role of race and socioeconomic status

J Nerv Ment Dis. 2013 Dec;201(12):1027-34. doi: 10.1097/NMD.0000000000000053.


Little is known about racial differences in borderline personality disorder (BPD) that may influence etiology, phenomenology, and treatment of women with BPD. A total of 83 women with BPD participated in this cross-sectional study: n = 41 white and n = 42 African-American women. Structured interviews were used to assess Axis I and II disorders, and a series of interviews and questionnaires captured internalizing and externalizing symptoms. The white women with BPD reported more severe internalizing symptoms, whereas the African-American women reported more severe externalizing symptoms. Except for the association between race and number of suicide attempts, the relationship between race and internalizing/externalizing symptoms was mediated by socioeconomic status. In conclusion, African-American women with BPD may present with more severe symptoms of lack of anger control and fewer suicidal behaviors than those of white women with BPD, raising the possibility that they are misdiagnosed and receive treatments that are not optimal for BPD.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aggression / psychology
  • Black People / psychology
  • Black People / statistics & numerical data
  • Black or African American
  • Borderline Personality Disorder / diagnosis
  • Borderline Personality Disorder / epidemiology*
  • Borderline Personality Disorder / psychology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Interview, Psychological
  • Psychiatric Status Rating Scales
  • Racial Groups / psychology*
  • Racial Groups / statistics & numerical data
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • White People / psychology
  • White People / statistics & numerical data