Borderline personality and depression: New findings show gender differences in adolescents

A recent study published in the Journal of Psychiatric Research has revealed a complex relationship between borderline personality traits and depressive symptoms in Chinese adolescents. The study, conducted over two years with middle school students, found that the presence of borderline personality traits can predict depressive symptoms and vice versa, buth with notable differences between boys and girls.

Adolescence is a period marked by significant changes—biological, emotional, cognitive, and social. This stage of development can increase vulnerability to mental health issues, particularly depression. Research indicates that around one-third of adolescents worldwide may experience depressive symptoms, with figures in China ranging from 17.9% to 25.8%. Amid various factors that contribute to adolescent depression, borderline personality disorder has often been overlooked.

Characterized by instability in emotions, identity, and relationships, borderline personality disorder can significantly impact mental health. Prior studies have shown a link between borderline personality traits and depressive symptoms, but whether this relationship is one-way or reciprocal remains unclear. This study aimed to clarify this relationship and explore whether gender influences these dynamics.

The researchers selected seventh-grade students from a middle school in Huaibei City, Anhui Province, China, for a longitudinal study. The first wave of the survey was conducted in September 2019, and the second wave followed in September 2021. Students completed self-report questionnaires that assessed their demographic information, depressive symptoms, and borderline personality traits. Only those who completed both surveys were included, resulting in a final sample of 1,608 students.

The questionnaires were administered by trained investigators without the presence of teachers to ensure confidentiality and independent responses. The Center for Childhood Epidemiology Research Depression Scale (CES-DC) was used to measure depressive symptoms, and the Chinese version of the Borderline Personality Profile Scale for Children (BPFS-C) assessed borderline personality traits. Both scales demonstrated high reliability, with Cronbach’s alpha coefficients indicating good internal consistency.

The study found intriguing patterns in the relationship between borderline personality traits and depressive symptoms. Overall, depressive symptoms and borderline personality traits decreased between the first and second survey waves. However, boys showed lower scores for both conditions compared to girls.

The analysis revealed a bidirectional relationship between borderline personality traits and depressive symptoms in boys: borderline traits predicted depressive symptoms two years later, and vice versa. For girls, the relationship was different; while borderline traits predicted future depressive symptoms, depressive symptoms did not predict future borderline traits.

Despite its significant findings, the study has several limitations. For instance, the sample was drawn from a single middle school, which may limit the generalizability of the results to other populations. In addition, the reliance on self-reported data introduces the possibility of response bias.

“Given the lack of research on bidirectional associations and gender differences between adolescent [borderline personality traits] and depressive symptoms, the specific reasons for these findings should be explored in more longitudinal studies in the future,” the researchers wrote.

The study, “Bidirectional relationship between borderline personality features and depressive symptoms in early adolescence: A school-based cohort study,” was authored by Shaojie Wang, Lulu Fang, Yuan Li, Leilei Cao, Gengfu Wang, Juan Chen, and Puyu Su.