Gender bias of antisocial and borderline personality disorders among psychiatrists

Antisocial Personality Disorder (ASPD) and Borderline Personality Disorder (BPD) challenge mental health professionals with similar maladaptive behaviors. However, these two disorders differ regarding available evidence-based treatments. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been criticized as being gender-biased diagnostic construct. The present study aimed to determine the gender bias of ASPD and BPD among Turkish psychiatrists.

Three case vignettes were randomly presented as male or female to the psychiatrists online. The first case was a patient with schizophrenia case to confirm the participant's ability to diagnose. The second case was a patient with ASPD, and the third one was a patient with BPD.

Two hundred fifty participants diagnosed the first case correctly (n = 250). The results with statistical significance demonstrated that a female case with ASPD was 5.1 times more likely to get misdiagnosed than a male case with ASPD (p˂0.0001).

Categorical classification of personality disorders in DSM leads to gender bias in in the diagnosis of ASPD and BPD. The present study shows that female cases with ASPD are misdiagnosed as BPD which may result in treatment attempts without evidence.