Johnson Dawn M, Shea M Tracie, Yen Shirley, Battle Cynthia L, Zlotnick Caron, Sanislow Charles A, Grilo Carlos M, Skodol Andrew E, Bender Donna S, McGlashan Thomas H, Gunderson John G, Zanarini Mary C
Summa Health System, St Thomas Hospital, Akron, OH 44310, USA.
Compr Psychiatry. 2003 Jul-Aug;44(4):284-92. doi: 10.1016/S0010-440X(03)00090-7.
A majority of the literature on borderline personality disorder (BPD) focuses on its occurrence in women or does not specifically assess for gender differences in clinical presentations. Some studies report that men with BPD may be more likely to be diagnosed with substance use disorders, as well as paranoid, passive-aggressive, narcissistic, sadistic, and antisocial personality disorders (PDs). Additionally, women with BPD appear to be more likely to report histories of adult physical and sexual abuse and to meet diagnostic criteria for post-traumatic stress disorder (PTSD) and eating disorders. The purpose of the present study was to further examine gender differences in BPD. Using baseline data from the Collaborative Longitudinal Personality Disorders Study (CLPS), men and women who met criteria for BPD were compared on current axis I and II disorders, BPD diagnostic criteria, childhood trauma histories, psychosocial functioning, temperament, and personality traits. Men with BPD were more likely to present with substance use disorders, and with schizotypal, narcissistic, and antisocial PDs, while women with BPD were more likely to present with PTSD, eating disorders, and the BPD criterion of identity disturbance. Generally speaking, women and men with BPD displayed more similarities than differences in clinical presentations. The differences that did emerge are consistent with those found in epidemiological studies of psychopathology and therefore do not appear unique to BPD. Additionally, many gender differences traditionally found in epidemiological samples did not emerge in BPD subjects. For example, no difference was found in rates of major depressive disorder, a condition that is more prevalent in females. Thus, BPD pathology may be a prevailing characterization that can attenuate usual gender-based distinctions.
大多数关于边缘型人格障碍（BPD）的文献聚焦于其在女性中的发生情况，或者没有专门评估临床表现中的性别差异。一些研究报告称，患有BPD的男性可能更易被诊断为物质使用障碍，以及偏执型、被动攻击型、自恋型、虐待狂型和反社会型人格障碍（PDs）。此外，患有BPD的女性似乎更有可能报告成年期身体虐待和性虐待史，并且更符合创伤后应激障碍（PTSD）和饮食失调的诊断标准。本研究的目的是进一步探究BPD中的性别差异。利用协作纵向人格障碍研究（CLPS）的基线数据，对符合BPD标准的男性和女性在当前的轴I和轴II障碍、BPD诊断标准、童年创伤史、心理社会功能、气质和人格特质方面进行了比较。患有BPD的男性更有可能出现物质使用障碍，以及分裂型、自恋型和反社会型PDs，而患有BPD的女性更有可能出现PTSD、饮食失调以及身份紊乱的BPD标准。一般来说，患有BPD的女性和男性在临床表现上的相似之处多于差异。确实出现的差异与在精神病理学流行病学研究中发现的差异一致，因此似乎并非BPD所特有。此外，在流行病学样本中传统上发现的许多性别差异在BPD受试者中并未出现。例如，在重度抑郁症的发病率上未发现差异，而重度抑郁症在女性中更为普遍。因此，BPD病理学可能是一种普遍的特征，它可以减弱通常基于性别的差异。
