Borderline personality disorder and regularly drinking alcohol before sex

Drug Alcohol Rev. 2017 Jul;36(4):540-545. doi: 10.1111/dar.12476. Epub 2017 Mar 20.

Abstract

Introduction and aims: Drinking alcohol before sex increases the likelihood of engaging in unprotected intercourse, having multiple sexual partners and becoming infected with sexually transmitted infections. Borderline personality disorder (BPD), a complex psychiatric disorder characterised by pervasive instability in emotional regulation, self-image, interpersonal relationships and impulse control, is associated with substance use disorders and sexual risk behaviours. However, no study has examined the relationship between BPD and drinking alcohol before sex in the USA. This study examined the association between BPD and regularly drinking before sex in a nationally representative adult sample.

Design and methods: Participants were 17 491 sexually active drinkers from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression models estimated effects of BPD diagnosis, specific borderline diagnostic criteria and BPD criterion count on the likelihood of regularly (mostly or always) drinking alcohol before sex, adjusted for controls.

Results: Borderline personality disorder diagnosis doubled the odds of regularly drinking before sex [adjusted odds ratio (AOR) = 2.26; confidence interval (CI) = 1.63, 3.14]. Of nine diagnostic criteria, impulsivity in areas that are self-damaging remained a significant predictor of regularly drinking before sex (AOR = 1.82; CI = 1.42, 2.35). The odds of regularly drinking before sex increased by 20% for each endorsed criterion (AOR = 1.20; CI = 1.14, 1.27) DISCUSSION AND CONCLUSIONS: This is the first study to examine the relationship between BPD and regularly drinking alcohol before sex in the USA. Substance misuse treatment should assess regularly drinking before sex, particularly among patients with BPD, and BPD treatment should assess risk at the intersection of impulsivity, sexual behaviour and substance use. [Thompson Jr RG, Eaton NR, Hu M-C, Hasin DS Borderline personality disorder and regularly drinking alcohol before sex Drug Alcohol Rev 2017;36:540-545].

Keywords: NESARC; borderline personality disorder; drinking alcohol before sex; sexual risk behaviour.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology*
  • Alcohol Drinking / psychology*
  • Borderline Personality Disorder / diagnosis
  • Borderline Personality Disorder / epidemiology*
  • Borderline Personality Disorder / psychology*
  • Female
  • Humans
  • Impulsive Behavior
  • Male
  • Middle Aged
  • Sexual Behavior / psychology*
  • Sexual Partners / psychology
  • Sexually Transmitted Diseases / diagnosis
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / psychology
  • Surveys and Questionnaires*
  • Unsafe Sex / psychology
  • Young Adult