Borderline personality disorder traits in adolescents with anorexia nervosa

Brain Behav. 2021 Dec;11(12):e2443. doi: 10.1002/brb3.2443. Epub 2021 Nov 22.


Objective: To examine the correlation between eating disorder (ED) symptoms and borderline personality disorder (BPD) traits in a sample of adolescents with eating disorders.

Method: There were 168 participants (Mage = 16.0 years; SD = 1.16) with a diagnosis of anorexia nervosa (AN) or Eating Disorder Not Otherwise Specified-AN type. Eating Disorder Examination (EDE) and the Borderline Personality Questionnaire (BPQ) were used to assess ED symptoms and BPD traits.

Results: A total of 10 participants (6.6%) scored above the clinical cut-off for a likely diagnosis of BPD. A positive correlation was observed between BPQ total score and EDE global (rs = 0.64, p < .001). There were also positive correlations between the BPQ self-image and emptiness subscales and all EDE subscales. Similarly, the EDE eating concern subscale was correlated with all BPQ subscales.

Discussion: Previous studies have demonstrated that some BPD traits (i.e., suicidality, impulsivity, anger) are co-morbid with ED but the link with other BPD traits has been poorly studied in adolescents and those with AN. These findings indicate that while the prevalence of BPD in adolescents with AN may be relatively low, ED symptom severity is closely related to severity of BPD traits, particularly identity disturbance and feelings of emptiness.

Keywords: adolescents; anorexia nervosa; borderline personality disorder; psychopathology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anorexia Nervosa* / diagnosis
  • Anorexia Nervosa* / epidemiology
  • Borderline Personality Disorder* / diagnosis
  • Borderline Personality Disorder* / epidemiology
  • Feeding and Eating Disorders* / diagnosis
  • Feeding and Eating Disorders* / epidemiology
  • Humans
  • Impulsive Behavior
  • Surveys and Questionnaires