The Role of Gender in Borderline Personality Disorder

Role of Gender in BPD

Categories and themes derived from Grounded Theory qualitative content analysis of semi-structured interviews with individuals diagnosed with BPD, capturing experiences of gender in relation to self and interpersonal relationships including structural power dynamics

SC-IAT score

D-score derived from SC-IAT reaction times (ratio of mean reaction times between experimental blocks), reflecting the strength of implicit associations.

SC-IAT Stimulus Accuracy

Proportion of correct responses per stimulus and proportion of correct responses across all trials.

SC-IAT Internal Consistency

Internal consistency of each SC-IAT, assessed via split-half reliability or comparable coefficient.

Correlations Between Qualitative Category Frequencies and Psychosocial Construct Scores

Descriptive Pearson or Spearman correlation coefficients between frequencies of qualitative content analysis categories and mean scores of the following self-report measures: Mentalizing Gender Experience Questionnaire (MGEQ), Certainty of Mental States Questionnaire (CAMSQ), Internalized Stigma of Mental Illness Scale 10-item Version (ISMI-10), Borderline Symptom List Short Version (BSL-23), Positive Mental Health Scale (PMH), European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-5L), Level of Personality Functioning Scale-Brief Form (LPFS-BF 2.0), Depression Anxiety Stress Scale-21 (DASS-21), Rosenberg Self-Esteem Scale Revised Version (RSE), Family Patriarchy Questionnaire (FPQ), and Epistemic Trust Mistrust and Credulity Questionnaire (ETMCQ).

SC-IAT Administration Duration

Time required to complete each SC-IAT, recorded in minutes and seconds.

SC-IAT Convergent Validity

Exploratory Pearson or Spearman correlation coefficients between SC-IAT D-scores and scores of MGEQ and ISMI.

SC-IAT Participant Acceptance

Qualitative feedback from participants regarding perceived feasibility, comprehensibility, and acceptability of the SC-IAT procedure.

Mentalization Questionnaire

Mentalization Questionnaire (MZQ; Hausberg et al., 2012): The MZQ is a validated questionnaire designed to assess mentalization deficits. It consists of a total of 15 items across four scales associated with mentalization: emotional awareness, affect regulation, psychological equivalence mode, and negative self-reflection. The items (e.g., "I often have no idea what is going on inside me") are rated on a 5-point scale ranging from (1) "strongly disagree" to (5) "strongly agree." A high total score indicates low mentalizing ability.

Mentalizing Gender Experience Questionnaire

Mentalizing Gender Experience Questionnaire (Hauschild et al., in prep): The MGEQ was developed based on the Mentalizing Emotions Questionnaire (Kasper et al., 2024) and is currently being evaluated in a validation study (Hauschild et al., in prep.). The questions relate to the experiences of individuals with a specific gender identity (including agender) and encompass thoughts, feelings, and beliefs as well as (physical) sensations that individuals associate with their gender. In total, the MGEQ comprises 8 items (e.g., "I find it helpful to reflect on the reasons why others experience themselves as a woman/man/non-binary person/self-designation.") on the Self and Others subscales, and are rated on a 7-point Likert scale ranging from (1) "never" to (7) "always." Higher scores indicate a better understanding of aspects of gender identity in oneself and others, as well as the ability to communicate these aspects.

Certainty of Mental States Questionnaire

Certainty of Mental States Questionnaire (CAMSQ; Müller et al., 2023): The CAMSQ is a self-assessment tool in which participants evaluate their own mental states and those of others. The questionnaire consists of a total of 20 items (e.g., "I am aware of my deepest desires and longings."), which are answered on a 7-point scale ranging from (1) "never" to (7) "always" to measure participants' understanding of their own feelings and their perception of others. The results are divided into two main categories: self-confidence and confidence in others.

Internalized Stigma of Mental Illness Scale 10-item Version

Internalized Stigma of Mental Illness Scale 10-item Version (ISMI-10; Boyd et al., 2014): The ISMI measures experiences of stigma related to mental disorders. In the present study, the ISMI was specifically adapted to assess experiences of stigma associated with borderline personality disorder. The short scale comprises a total of 10 items (e.g., "I cannot contribute anything to society because I have borderline personality disorder") and is rated on a 4-point Likert scale ranging from (1) "strongly disagree" to (4) "strongly agree."