Borderline Personality Disorder in males: A study of sex differences and implications for improving treatment outcomes

Despite decades of research conducted on Borderline Personality Disorder (BPD), the majority of studies have been conducted with female-only or female-dominated samples, leaving the field unclear about potential gender differences. This is despite the prevalence of BPD being equal between females and males. This thesis applies a series of differential research methods to better understand BPD in males. Study 1 was a scoping review to synthesise key findings and identify if there are any sex-specific trends in the BPD literature. Results from study 1 found sex differences in symptomatic manifestation and a general lack of literature regarding males with BPD. Study 2 was a comprehensive and systematic analysis of 12-month longitudinal quantitative data (n = 96) conducted to compare the outcome differences or similarities in current psychotherapy treatments of males and females. Results found females to benefit more from existing treatment than males. This suggests that current treatment for BPD may be more suitable for females than males. Study 3 then involved a more in-depth qualitative exploration of the experiences of males (n = 14) in treatment for BPD. Study 3 synthesised and elaborated the findings of this thesis, with a view to improve treatment adherence and outcomes for males. These studies found BPD to manifest differently between the sexes. Current treatments are not as effective for males, and modifications to available therapy and improving staff attitude and reducing stigma are required to improve access and effectiveness for males with BPD.