Sex Bias in Classifying Borderline and Narcissistic Personality Disorder

Wouter Braamhorst*, Jill Lobbestael, Wilco H. M. Emons, Arnoud Arntz, Cilia L. M. Witteman, Marrie H. J. Bekker

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


This study investigated sex bias in the classification of borderline and narcissistic personality disorders. A sample of psychologists in training for a post-master degree (N = 180) read brief case histories (male or female version) and made DSM classification. To differentiate sex bias due to sex stereotyping or to base rate variation, we used different case histories, respectively: (1) non-ambiguous case histories with enough criteria of either borderline or narcissistic personality disorder to meet the threshold for classification, and (2) an ambiguous case with subthreshold features of both borderline and narcissistic personality disorder. Results showed significant differences due to sex of the patient in the ambiguous condition. Thus, when the diagnosis is not straightforward, as in the case of mixed subthreshold features, sex bias is present and is influenced by base-rate variation. These findings emphasize the need for caution in classifying personality disorders, especially borderline or narcissistic traits.
Original languageEnglish
Pages (from-to)804-808
JournalJournal of Nervous and Mental Disease
Issue number10
Publication statusPublished - Oct 2015


  • Sex bias
  • borderline personality disorder
  • narcissistic personality disorder
  • gender roles


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