A study of women with borderline personality disorder in Germany found that they experience heightened dissociative symptoms in sexual situations. Compared to healthy women, this increase was most pronounced in symptoms of depersonalization and derealization. The findings were published in the journal Borderline Personality Disorder and Emotion Dysregulation.
Borderline personality disorder is a mental health condition characterized by intense emotional instability and difficulty in maintaining relationships. Individuals with this disorder frequently experience rapid mood swings, feelings of emptiness, and an intense fear of abandonment. They are also prone to impulsive behaviors, such as reckless spending or self-harm, as a way to cope with their emotional turmoil.
Romantic relationships for individuals with borderline personality disorder tend to be tumultuous, as they often swing between idealizing and devaluing their partners. Additionally, there is evidence that these individuals tend to experience dissociative symptoms in sexual situations. Dissociative symptoms involve a disconnection or disruption in a person’s thoughts, memory, identity, or sense of reality.
Common dissociative symptoms include feeling detached from oneself (depersonalization), experiencing the world as unreal or distorted (derealization), having significant memory gaps (dissociative amnesia), or expressing psychological distress through physical symptoms such as paralysis, blindness, or other neurological defects without a medical cause (conversion).
Study author Rose Gholami Mazinan and her colleagues sought to explore the severity of dissociative symptoms experienced by individuals with borderline personality disorder during sexual situations and their association with previous sexual abuse experiences and post-traumatic stress disorder symptoms.
They conducted two studies. In the first study, the researchers investigated a group of 114 women with borderline personality disorder recruited from the University Medical Center Hamburg-Eppendorf (UKE) and outpatient clinics in Hamburg and Munich, Germany. These participants were between 18 and 45 years old. The study also included a matched group of 114 healthy participants recruited through advertisements.
Study participants completed assessments of dissociative symptoms in sexual situations using an adapted version of the Dissociative Experiences Scale. They also completed measures of proneness to risky sexual behaviors (the Sexual Risk Survey), borderline personality disorder symptoms (the Borderline Symptom List), sexual abuse experiences in adulthood (the Adult Sexual Abuse Questionnaire), post-traumatic stress disorder symptoms (the International Trauma Questionnaire), and recalled childhood trauma experiences (the Childhood Trauma Questionnaire).
For the second study, 41 women with borderline personality disorder and 41 healthy women from the first study participated. In this study, participants listened to an audio clip through headphones designed to create sexual arousal. The audio clip featured a female narrator describing a female-initiated sexual interaction with a man from her perspective. After listening to the clip, participants completed an assessment of current dissociation symptoms using the Dissociation Tension Scale Acute.
Results showed that women with borderline personality disorder reported more dissociative symptoms than the healthy women. This difference was most pronounced in the severity of depersonalization symptoms. In the second study, women with borderline personality disorder also showed higher levels of dissociation symptoms after listening to the sexually arousing audio compared to healthy women. Again, the difference was most pronounced in the severity of depersonalization symptoms, followed by derealization.
A higher intensity of recalled childhood trauma experiences was associated with more depersonalization symptoms, while more reported sexual abuse experiences in adulthood were weakly associated with higher overall dissociation symptoms. Women with borderline personality disorder were also more prone to impulsive and uncommitted sexual behaviors.
“Increased level of depersonalization and conversion in sexual situations were best explained by BPD [borderline personality disorder] symptoms while derealization seemed to be mainly influenced by PTSD-symptoms [posttraumatic stress disorder symptoms] in patients with BPD. Meanwhile, higher impulsive and uncommitted sexual behavior in BPD were best explained by intensity of derealization during sexual situations, while conversion might somehow function as protective factor,” the study authors concluded.
The study sheds light on the specificities of sexual experiences of women with borderline personality disorder. However, the design of the study does not allow for any cause-and-effect inferences to be drawn from the data. Additionally, the study included only women, so the results may not be applicable to men.
The paper, “Borderline personality disorder and sexuality: causes and consequences of dissociative symptoms,” was authored by Rose Gholami Mazinan, Christina Dudek, Hannah Warkentin, Maja Finkenstaedt, Johanna Schröder, Richard Musil, Leonhard Kratzer, Johannes Fuss, and Sarah V. Biedermann.