(PS4-62) Psychopathology and impairment in Black and White Americans

Abstract Text: Research indicates that the presentation of psychopathology may vary depending on racial, ethnic, or cultural group (Bauer et al., 2012). This may be particularly true for borderline personality disorder (BPD), which is characterized by emotion dysregulation, interpersonal difficulties, identity disturbance, and impulsive behaviors (Chapman et al., 2024). Newhill et al. (2009) found that Black participants with BPD experienced more emotion dysregulation and fewer self-harm behaviors than White participants with BPD.

Beyond the presentation of specific symptoms, some researchers suggest that the degree of impairment from mental health conditions may vary across groups as well. Harmon & Cheavens (in preparation) reported that although Black participants endorsed higher BPD symptoms than White participants, the relationship between BPD symptoms and negative affect was weaker for Black participants. In the present study, we completed t-test and linear regression analyses to investigate relationships between psychopathology and impairment among a sample of Black and White American participants.

Data were collected from a community sample of 1,562 participants who identified as either Black (n = 585; 37.5%) or White (n = 977; 62.5%) American adults (Mage = 34.81, SD = 10.83). The sample was mostly female (n = 849; 54.4%) and most participants completed at least some college (n = 1,148; 73.5%). Participants completed self-report measures including demographics, the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q; Endicott et al., 1993), and the Perceived Stress Scale (PSS; Cohen et al., 1983). Finally, study assessors measured participants’ BPD symptoms through a semistructured clinical interview.

Black participants (M = 11.20, SD = 12.63) endorsed significantly higher rates of BPD symptoms than White participants (M = 8.10, SD = 10.80; t(1091.81) = -6.67, p < .001). However, there was a significant race by quality-of-life interaction (b = .08, t(1095) = 3.09, p = .002) such that the relationship between BPD symptoms and quality of life was weaker for Black participants (b = -.24, t(1095) = -12.14, p < .001) than White participants (b = -.32, t(1095) = -20.80, p < .001). This indicates that Black Americans may experience more BPD symptoms, but less functional impairment than White Americans. This finding has important implications for diagnosis and treatment of BPD. Researchers and clinicians need to understand how psychopathology presents and impacts functioning across all groups, in order to effectively diagnose and provide treatment. Future researchers should identify causal mechanisms for these relationships to understand whether these results reflect true differences in symptoms or differences in diagnostic measurement tools.