(PS6-37) Personality Functioning and Identity: The Relationship between Acceptance, Community, and BPD Traits

Abstract Text: Sexual minority (SM) individuals exhibit disproportionately high borderline personality disorder (BPD) prevalence rates (Reuter et al., 2016). The Alternative Model for Personality Disorders (AMPD; APA, 2022) proposes a dimensional approach to personality disorders with two criteria: Criterion A (functional impairment) and Criterion B (maladaptive personality traits). One theory explaining the elevated rates of BPD in SM individuals is that social context and minority stress may increase the likelihood of meeting BPD criteria or elevating measures of Criterion A and B (Rodriguez-Seijas et al., 2022; Asadi et al., 2024). Internalized homonegativity, rejection sensitivity, and feeling disconnected may contribute to the higher levels of personality impairment among SMs. We hypothesized that lower Criterion A-related functioning (The Level of Personality Functioning Scale-Brief Form 2.0; Hutsebaut et al., 2016), nonacceptance of one’s sexual orientation (The Self-Acceptance of Sexuality Inventory; Camp et al., 2022) and lacking a sense of pride, clarity about one’s sexual orientation, or connection with the SM community (Lesbian, Gay, and Bisexual Group Identity Measure; Sarno & Mohr, 2016) would predict requiring further evaluation for BPD (McLean Screening Instrument for BPD; Zanarini et al., 200). Additionally, we hypothesized that the sexual orientation-specific variables would add incremental validity when combined with Criterion A.

A sample of 344 cisgender gay men, lesbian women, bisexual men, and bisexual women (Mage = 37.93, SD = 13.44) living in the United States were recruited via Prolific, an online survey participant recruitment website. The hypotheses were partially supported. Hierarchical binary logistic regressions found that accepting and not resisting one’s sexual orientation and not engaging in the LGB community better predicted meeting the BPD cut-off than did Criterion A sub-scales alone, χ2(5, N = 344) = 29.55, p < .001. It explained between 30.50% (Cox & Snell R2) and 41.50% (Nagelkerke R2) of the variance and correctly classified 76.50% of the participants. Identity (OR = 3.09, 95% CI [1.96, 4.89] and interpersonal (OR = 2.37, 95% CI = 1.41, 3.99]) impairment still increase the odds to a greater extent than the sociocultural components. The results suggest that lower self-acceptance of one’s sexuality and increased involvement in the SM community may increase the likelihood of meeting BPD criteria on screeners for SM people, but it does not fully explain personality functioning deficits.