Gender Bias in the Diagnosis of Borderline Personality Disorder: The case of inappropriate anger as diagnostic criterion
On 28 April Astrid Fly Oredsson will give a GIR talk (Gendering in Research Network)
Although studies of general population samples have reported fairly equal rates of men and women amongst those who satisfy the criteria for borderline personality disorder (BPD), an estimated 70-75% of those clinically diagnosed with BPD are women. While it has been posited that this difference in rates between clinical and non-clinical samples can be explained by a higher propensity amongst women to seek medical assistance, I explore an alternative, yet not inconsistent, explanation: namely, that psychiatric taxonomy contributes to gender bias in the clinical application of BPD criteria, thus, leading to an overrepresentation of women amongst those with a formal diagnosis.
The focus of my talk is the “inappropriate anger” criterion which is vaguely defined rely-ing on unclear terminology such as having “temper”, “enduring bitterness,” and “verbal out-bursts” as illustrative examples. The vagueness of the criterion increases the risk of non-expert judgements and prejudices influencing clinical decision-making and diagnostic processes. And in the case of anger, this is likely to disproportionately affect women.