Differential impairment as an indicator of sex bias in the DSM-IV diagnostic criteria of four personality disorders

Abstract

The aim of the study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant and obsessive-compulsive personality disorders. A clinical sample of 668 individuals were evaluated for personality disorder criteria using a semi-structured interview, the DIPD-IV. Functional impairment was also assessed across four domains of functioning using both a semi-structured interview and self-report inventory. Using a regression model of bias based on theory of educational test bias, this study investigated differences in regression lines of men and women in the relationship between presence of a diagnostic criterion and level of impairment. We found relatively little evidence of sex bias in the DSM-IV criteria for these four personality disorders. However, eight of nine borderline personality disorder criteria did display a functional disparity between men and women on a measure of global functioning. Perhaps these borderline criteria are functioning differently for men than women and should be the focus of future research.