Borderline personality disorder (BPD) is more frequently diagnosed among sexual minority (SM) populations. SM populations also report higher levels of internalizing and externalizing psychopathology, two core domains of clinical problems that are highly comorbid with BPD. Contextual factors (e.g., group-specific norms) might affect endorsement of BPD items for reasons other than an underlying liability to experience BPD or internalizing and externalizing psychopathology. Therefore, BPD items may be "easier" to endorse (i.e., be associated with lower indicator thresholds) for SM populations relative to non-SM populations. We tested this hypothesis in a large, nationally representative sample of the U.S. population (N = 35,723, SM n = 1,150) using an item response theory approach. Several BPD indicators demonstrated differential item functioning of indicator thresholds, though these results varied based on impairment and sex. Endorsement of impulsive sex and chronic suicidality were consistently associated with lower indicator thresholds among SM groups; lower BPD, internalizing and externalizing factor levels were necessary for item endorsement for SM individuals. Chronic suicidality and impulsivity criteria may conflate BPD-related variance with SM-specific factors, such as potentially nonpathological SM group norms and minority stress processes. Implications for equitable diagnosis and future research on the BPD syndrome in SM populations are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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研究边缘型人格障碍诊断标准和基于性取向的内化/外化领域之间的差异项目功能。


边缘性人格障碍（BPD）在性少数（SM）人群中更常见。 SM 人群还报告了更高水平的内化和外化精神病理学，这是与 BPD 高度共存的临床问题的两个核心领域。背景因素（例如，特定群体的规范）可能会影响对 BPD 项目的认可，原因不仅仅是体验 BPD 或内化和外化精神病理学的潜在责任。因此，相对于非 SM 人群，SM 人群的 BPD 项目可能“更容易”认可（即，与较低的指标阈值相关）。我们使用项目反应理论方法在具有全国代表性的美国人口样本（N = 35,723，SM n = 1,150）中测试了这一假设。一些 BPD 指标显示了指标阈值的不同项目功能，尽管这些结果因损伤和性别而异。 SM 群体中对冲动性行为和慢性自杀倾向的认可始终与较低的指标阈值相关；较低的 BPD、内化和外化因素水平对于 SM 个体的项目认可是必要的。慢性自杀和冲动标准可能会将 BPD 相关差异与 SM 特定因素混为一谈，例如潜在的非病理性 SM 群体规范和少数群体压力过程。讨论了 SM 人群 BPD 综合征的公平诊断和未来研究的意义。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。