Borderline Personality Disorder and Online Behaviors: New Information Presented at APA Annual Meeting

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CONFERENCE REPORTER
According to poster presentations at the 2025 American Psychiatric Association Annual Meeting, unhealthy internet use is more severe and common among individuals with borderline personality disorder (BPD), and those with BPD are more likely to report impulsivity and compulsivity. Presenters from the department Laurie Avila, BA; Sophie Boutouis, BS; Megha Neelapu, BA; and Jon E. Grant, JD, MD, MPH, shared their findings.¹

Adults with BPD often have comorbid substance use disorders, with approximately 78% of adults with BPD developing a substance-related disorder or addiction at some point in their lives.² But research on comorbid behavioral addictions is limited. Investigators sought to understand the relationship between BPD and problematic internet use by conducting an online survey titled, "Personality, Mental Health, and Well-Being." A nonclinical sample of 346 adults (aged 18-75) took the survey. Probable BPD was identified using the McLean Screening Instrument for BPD (MSI-BPD). Problematic internet use was measured using a variety of tools, including the Internet Severity and Activities Addiction Questionnaire (ISAAQ-10), dating app use, and the Problematic Tinder Use Scale. Analyses were conducted via independent sample t-tests, 1-way analyses of covariance, and chi-square tests to evaluate the effects of probable BPD on clinical variables while controlling for confounding demographic variables.

Of the 289 participants who completed the MSI-BPD (mean age 37.48, 54.4% female), 13.1% (n=38) screened positively for BPD, and those with BPD scored significantly higher on the ISAAQ-10 (P<.001) and were more likely to have problematic internet use (P<.001).

Participants with BPD were also more likely to report consuming pornography "frequently," "very often," or "all the time," when compared with those without BPD (P=.032), and used dating apps more often (P=.020). Younger participants with BPD also reported more internet surfing (P=.002), streaming (P=.001), and online gaming (P=.039).

The presenters believe more research is needed to determine whether problematic internet use is exacerbated by BPD or contributes to BPD symptoms.

Additionally, investigators used this same sample and online survey “Personality, Mental Health, and Well-Being” to assess rates of impulse control disorders, impulsivity, and compulsivity in participants with probable BPD. While impulsive behaviors are a hallmark of BPD, the rates of comorbid impulse control disorders are unclear.

Participants were assessed using the Minnesota Impulse Control Disorders Interview (MIDI), the Barratt Impulsiveness Scale, and Cambridge-Chicago Compulsivity Trait Scale. They found that participants with BPD were more likely to screen positively for compulsive sexual behavior disorder (CSBD; P<.001). However, rates of CSBD did not significantly differ between men and women with BPD. Additionally, there were no significant differences in the rates of other impulse disorders, including compulsive buying disorder, trichotillomania, and gambling disorder. The investigators believe this suggests distinct mechanisms underlie different impulsive and compulsive disorders.

References

1. Grant J, Boutouis S, Neelapu M, Avila L. Online behaviors in people with borderline personality disorder from a self-report survey. Poster presented at: 2025 American Psychiatric Association Annual Meeting; May 17-22, 2025; Los Angeles, California.

2. Kienast T, Stoffers J, Bermpohl F, Lieb K. Borderline personality disorder and comorbid addiction. Dtsch Arztebl Int. 2014;111(16):280-286.

3. Grant J, Boutouis S, Neelapu M, Avila L. Rates of impulse control disorders in people with borderline personality disorder from an online self-report survey. Poster presented at: 2025 American Psychiatric Association Annual Meeting; May 17-22, 2025; Los Angeles, California.