The Relationship Between Borderline Personality Features and Depressive and Generalized Anxiety Symptoms in a Sample of Treatment-Seeking Perinatal Women

Abstract

Introduction: Borderline personality disorder (BPD) is a severe psychiatric disorder characterized by emotion dysregulation, interpersonal dysfunction, and poor impulse control. Little research has investigated BPD in the context of major life events. The perinatal period (pregnancy until 12 months postpartum) is an important milestone that involves major role transitions and novel challenges. This thesis examined the associations between borderline personality features (BPF) and depressive and generalized anxiety symptoms in a sample of treatment-seeking perinatal women.

Methods: 74 perinatal women were recruited from the Women’s Health Concerns Clinic (WHCC) at St. Joseph’s Healthcare Hamilton, Canada, and enrolled in the WHCC Registry study. Participants were sent online intake questionnaires to collect data about demographic, personality, and other psychosocial variables. They also completed three self-report mental health measures: the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), the Edinburgh Postnatal Depression Scale (EPDS), and the Generalized Anxiety Disorder Scale (GAD-7). Logistic regression was used to determine whether a positive MSI-BPD screen (score ≥ 7) was associated with a higher likelihood of screening positive on the EPDS or GAD-7 (score ≥ 13).

Results: A positive screen on the MSI-BPD was significantly associated with an almost eighteen-fold increase in the odds of screening positive on the EPDS in our treatment-seeking perinatal sample (OR 17.84, 95% CI[2.11, 218.80], p<0.05). A positive screen on the MSI-BPD was not associated with higher odds of screening positive on the GAD-7, rather only childhood trauma and a positive screen on the EPDS emerged as significant predictor variables. Our findings may reflect the greater symptomatic overlap observed between BPD and perinatal depression as well as the comparatively lower comorbidity observed between GAD and BPD in non-perinatal research.

Conclusions and Future Directions: The use of self-report measures, low statistical power, and a treatment-seeking sample are limitations to consider when interpreting our findings. To our knowledge, this research study offers one of the first explorations into the relationship between BPD and generalized anxiety symptoms during the perinatal period. Future research should aim to better characterize perinatal BPD and investigate its relationship with other mental health conditions.