Researchers have identified a subgroup of adolescents and young adults with elevated features of borderline personality disorder (BPD) and higher impulsive sexual behavior outside relationships. The findings, published in the journal Frontiers in Psychology, highlight the issues surrounding sexuality, fidelity, and love that are often faced by youth with BPD.
Adolescence is a period of life when an increase in risk-taking converges with the emergence of sexual behavior. While risky sexual behavior among youth is a public health concern, some studies suggest that only a subgroup of young people engage in such behavior. There is evidence to suggest that youth with BPD may be one such subgroup.
Borderline personality disorder is characterized by impulsivity, difficulty regulating one’s emotions, and issues maintaining lasting interpersonal relationships. In both adolescents and adults, BPD features have been tied to risky sexual behaviors like engaging with a higher number of sexual partners. However, the overall findings have been inconsistent, and the mechanism linking BPD to risky sexual behavior remains unclear.
Study author Michaël Bégin and his colleagues conducted a study to explore specific profiles of risky sexual behavior among youth and to determine whether any of the profiles would involve elevated features of BPD. Distinct from previous studies, the researchers used a statistical approach called latent profile analysis (LPA).
A group of Canadian students between the ages of 14 and 21 completed questionnaires as part of a wider project on personality disorders. The current study involved a final sample of 126 youth who indicated being sexually active within the last six months and were included in the analysis. The surveys included assessments of five aspects of sexual risk-taking (risky sexual acts, risk-taking with uncommitted partners, impulsive sexual behavior, risky anal sex, intent to engage in sexual behaviors), and four features of BPD (affective instability, identity problems, negative relationships, and self-harm).
The analysis revealed three distinct profiles concerning risky sexual behavior. The most popular profile was defined by little to no risky sexual behavior, and around 78% of the sexually active youth fell into this category. Since the majority of youth belonged to this category, this suggests that young people are generally capable of managing the health risks involved with sexual activity.
A second profile was characterized by unprotected sex within relationships and described about 10% of the sexually active students. This group did not demonstrate high levels of impulsive sex, suggesting that their risky sexual behavior was mainly confined to committed relationships. The authors say that some youth may be under the impression that the use of condoms is not necessary within romantic relationships so long as contraception is being used. However, unprotected sex leaves this group vulnerable to sexually transmitted infections.
The third profile was defined by impulsive sex outside relationships, and about 12% of youth fit into this category. Compared to the other two groups, these students had significantly higher levels of impulsive sexual behavior and sex with uncommitted partners. They also had elevated BPD features. This falls in line with previous findings suggesting that youth with BPD have more sexual partners and that adults with BPD engage in more impulsive sexual activity with uncommitted partners.
Bégin and his team say this impulsive sexual behavior may reflect the difficulty forming stable relationships that often characterizes BPD. “Youth who are unable to develop relationships with committed partners may resort to sex with multiple partners to satisfy needs for sex, intimacy, and connectedness,” the authors write, noting that this type of “hook-up” behavior can lead to psychological distress and increase depression.
Longitudinal studies are needed to illuminate how risky sexual behavior and BPD features unfold and interact over time. “Sexuality is often ignored in clinical work with adolescents,” the researchers emphasize. “However, being alert to risky sexual behavior in clinical work with adolescents and young adults with BPD and helping them overcome their difficulties in establishing sexual and attachment relationships may reduce the risk of resorting to impulsive sex with multiple partners.”
The study, “Risky Sexual Behavior Profiles in Youth: Associations With Borderline Personality Features”, was authored by Michaël Bégin, Karin Ensink, Katherine Bellavance, John F. Clarkin, and Lina Normandin.