Exploring Gender Differences Between Bipolar Disorder and Borderline Personality Disorder in Responses on the Personality Assessment Inventory (PAI)

Bipolar disorder and borderline personality disorder are two diagnoses that are often difficult to differentiate. Current literature supports this challenge and reveals a high rate of misdiagnosis between the two, as well as a high prevalence of borderline personality disorder diagnoses in women. Diagnostic accuracy remains a vital skill for clinicians to effectively address the needs of clients, and diagnostic assessment tools are often used to aid in this endeavor. The focus in this study was to explore gender discrepancies in responses across the main features of borderline personality disorder (i.e., affective instability, identity problems, negative relationships, and self-harm) and the main features of bipolar disorder (i.e., activity level, grandiosity, and irritability), each corresponding with the specific Personality Assessment Inventory Borderline and Mania subscales. This study used archival data from 102 outpatient individuals who completed the PAI at intake. Results showed men scored significantly higher on the Mania Grandiosity subscale and scored within the high elevation range of the Mania scale at a rate of 3.70 times that of women. No statistical differences were found in the remaining subscale mean scores or in the elevations in the three Mania subscales across gender. Further, no significant results were found in comparing the mean scores or elevations of the Borderline scale or its four subscales. The results of the current study may support the use of the PAI in differentiating between bipolar disorder and borderline personality disorder, as well as objectively assessing for borderline personality disorder criteria after controlling for gender bias