Associations between reproduction-focused life strategy, sex and Borderline Personality Disorder symptom expression: Evidence from the NESARC national study.

IntroductionBorderline personality disorder (BPD) features span internalizing and externalizing dimensions of psychopathology, and their expression varies across biological sexes. Despite substantial research efforts, major gaps remain in our understanding of this heterogeneity, particularly regarding its developmental underpinnings. Life history theory, a leading framework in evolutionary developmental biology, can help make sense of this heterogeneity. MethodsIn a large nationally representative prospective survey (n = 34 653), the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we used Multi-group MIMIC models to investigate whether and how the degree to which individuals trade off somatic maintenance against short-term reproductive goals relates to severity of BPD at a general and a single symptom level, and whether these associations differ between men and women in the general adult population. ResultsMen and women prioritizing short-term reproductive goals over somatic maintenance were more likely to endorse each of the 9 DSM-IV BPD symptoms through higher BPD severity, and were more likely to express impulsivity (b=0.11; SE, 0.018; p<.001) and suicidal/self-mutilation behavior (b =0.24; SE, 0.026; p< .001) and less likely to endorse stress-related paranoid ideation (b=-0.066; SE, 0.023; p=.004). Finally, females with a reproduction-oriented life history strategy were more likely to endorse affective instability than males (Females: b=0.12; SE, 0.025; p<.001; Males: b=-0.015; SE, 0.044; p=0.73). ConclusionsAn evolutionary-developmental framework, rooted in human life history theory can help make sense of the heterogeneous manifestations of BPD. Our work also opens the door for future research on the interplay of the reproduction/maintenance trade-off with other genetic and environmental factors and developmental processes in explaining the occurrence of BPD symptoms.