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)
Abstract:
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.