Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia.
Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
Early Interv Psychiatry. 2019 Jun;13(3):502-508. doi: 10.1111/eip.12510. Epub 2017 Oct 27.
Borderline personality disorder (BPD) is a severe mental disorder that is characterized by unstable relationships, impulsive behaviours and identity disturbance. BPD usually has its onset between puberty and young adulthood and presents disproportionately among females in clinical settings. Taken together, this makes young women with BPD a particularly vulnerable group with regard to healthy psychosexual development. It was hypothesized that female youth with BPD pathology would be more likely to score worse on measures of sexual health and safety, and to show greater uncertainty in sexual identity formation.
Fifty 15 to 24 yr-old females with 3 or more Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) BPD criteria were compared with 204 females from a nationally representative sample. Both groups were interviewed using a comprehensive interview for sexual health and relationships. The patient group completed a structured diagnostic interview.
Young women with borderline personality pathology engaged in sexual relationships at a younger age, with more sexual partners in the previous year, in more casual relationships. They were more likely to practice unsafe sex for their first sexual experience, to be coerced into unwanted sexual activity, to be unclear about their sexual identity or their sexual attraction, and to report worse overall health status.
BPD pathology in youth is associated with poor sexual health and safety, and uncertainty in sexual identity formation. These findings support the need for assessment of the sexuality and sexual health of youth with BPD, along with the need for routine screening in sexual health services for BPD features among high-risk youth.
边缘型人格障碍（BPD）是一种严重的精神障碍，其特征为人际关系不稳定、冲动行为和身份紊乱。BPD 通常在青春期到成年早期之间发病，在临床环境中女性患者比例过高。综上所述，这使得患有 BPD 的年轻女性在健康的性心理发展方面成为一个特别脆弱的群体。据推测，患有 BPD 病理的年轻女性在性健康和安全性方面的得分更差，并且在性身份形成方面表现出更大的不确定性。
将 50 名年龄在 15 至 24 岁之间、符合《精神障碍诊断与统计手册》第五版（DSM-V）3 项以上 BPD 标准的女性与来自全国代表性样本的 204 名女性进行比较。两组均使用全面的性健康和关系访谈进行访谈。患者组完成了结构化的诊断访谈。
具有边缘型人格病理的年轻女性更早开始性行为，在过去一年中有更多的性伴侣，并且处于更随意的关系中。她们更有可能在第一次性行为时进行不安全的性行为，被强迫进行非自愿的性活动，对自己的性身份或性吸引力感到不确定，并且总体健康状况更差。
青年时期的 BPD 病理与性健康和安全性差以及性身份形成的不确定性有关。这些发现支持对患有 BPD 的青年进行性行为和性健康评估的必要性，以及在性健康服务中对高危青年的 BPD 特征进行常规筛查的必要性。
