Borderline personality disorder has long since been linked to risky sexual behavior and somatic issues, but the reasons underlying why have been under researched. A study published in JAMA Psychiatry explores factors that contribute to borderline personality disorder, such as early life adversity and reproductive strategies, that may help to explain these links.
Borderline personality disorder is a mental illness that is associated with unstable interpersonal relationships, fear of abandonment, emotional dysregulation, and more. These symptoms can lead to self-destructive behaviors, such as substance use, sexual risk-taking, suicide, and self-harm.
Understanding the developmental paths of BPD has been a major research interest in recent years in order to aid in prevention. An evolutionary psychological theory posits the idea that individuals with borderline personality disorder may prioritize reproductive goals in the short-term over long-term health as a response to early life adversity. This study seeks to test this theory.
For their study, Axel Baptista and colleagues utilized cross-sectional data from the National Epidemiologic Survey on Alcohol and Related Conditions. They utilized data from 30,149 adults in the United States who participated in wave 2 of this research. Of the entire sample, 892 participants had a diagnosis of borderline personality disorder, while the rest did not.
In this study, researchers examined measures of early life adversity, borderline personality disorder symptomology, and reproduction/maintenance trade-off. They looked at seven different factors that are commonly studied in life history research to capture this trade-off.
For the reproductive side, they considered the number of children and marriages, the age at which individuals first had sexual intercourse, and whether they had a history of sexually transmitted diseases. For the somatic maintenance side, they looked at the individual’s body mass index (a measure of weight and height), their self-assessment of their physical health, and their metabolic health.
Sex, age, and race were used as control variables.
Results showed that early life adversity, metabolic disorder score, and body mass index were all significantly higher for individuals with borderline personality. Additionally, people with borderline personality disorder had significant more children than those without borderline personality disorder when adjusting for age.
Consistent with previous research, experiencing more early life adversity increased the likelihood of being diagnosed with BPD later in life. The risk was increased by 56.5% for individuals who prioritized short-term reproductive goals over somatic health. These results were consistent across genders. These results suggest that experiencing early life adversity is associated with increased short-term reproductive priorities, and both factors increase the risk of being diagnosed with BPD in adulthood.
The results support the idea that BPD can be seen as a coping strategy where individuals compensate for the challenges posed by adverse conditions by prioritizing immediate reproductive benefits at the expense of long-term health, the researchers said. Impulsivity and risk-taking in particular may enhance an individual’s desirability as a partner.
This study took important steps in testing a theory of how BPD is linked to risky sexual behavior and somatic health concerns. Despite this, there are limitations to note. One such limitation is that the proportion of BPD individuals in the sample was low, with less than 3% being diagnosed with BPD. Additionally, proximity to reproductive maturity (age of puberty, age of menopause) was not measured, which is important for reproductive decision making.
“Together, this work opens up promising avenues for improving the prevention and the management of this disorder,” the researchers concluded. “First, it highlights the importance of taking somatic and reproductive traits into account in clinical management. In practical terms, informing patients with BPD about the consequences of short-term reproductive behaviors could prevent them from falling into many psychosocial pitfalls, e.g., unwanted parenthood, unstable interpersonal relationships, and sexual trauma.”
“Furthermore, if an investment in immediate reproduction leads to less investment in somatic maintenance and thus to health problems later in life, it is all the more important to seek reducing reproductive impulsivity. These observations underscore the importance of coordinating mental health services with reproductive and general health services.”
The study, “Associations Between Early Life Adversity, Reproduction-Oriented Life Strategy, and Borderline Personality Disorder“, was authored by Axel Baptista, Valérian Chambon, Nicolas Hoertel, Mark Olfson, Carlos Blanco, David Cohen,and Pierre O. Jacquet.