Degree Date


Document Type

Dissertation - Public Access

Degree Name

Psy.D. Doctor of Clinical Psychology

Academic Discipline

Clinical Psychology

First Advisor

Dr. Susan Zoline

Second Advisor

Dr. Christopher Rector

Third Advisor

Dr. Jenine Chiles


Bipolar disorder and borderline personality disorder are two diagnoses that are often difficult to differentiate. Current literature supports this challenge and reveals a high rate of misdiagnosis between the two, as well as a high prevalence of borderline personality disorder diagnoses in women. Diagnostic accuracy remains a vital skill for clinicians to effectively address the needs of clients, and diagnostic assessment tools are often used to aid in this endeavor. The focus in this study was to explore gender discrepancies in responses across the main features of borderline personality disorder (i.e., affective instability, identity problems, negative relationships, and self-harm) and the main features of bipolar disorder (i.e., activity level, grandiosity, and irritability), each corresponding with the specific Personality Assessment Inventory Borderline and Mania subscales. This study used archival data from 102 outpatient individuals who completed the PAI at intake. Results showed men scored significantly higher on the Mania Grandiosity subscale and scored within the high elevation range of the Mania scale at a rate of 3.70 times that of women. No statistical differences were found in the remaining subscale mean scores or in the elevations in the three Mania subscales across gender. Further, no significant results were found in comparing the mean scores or elevations of the Borderline scale or its four subscales. The results of the current study may support the use of the PAI in differentiating between bipolar disorder and borderline personality disorder, as well as objectively assessing for borderline personality disorder criteria after controlling for gender bias.


Table of Contents

Abstract 1

Chapter One: Introduction 2

Chapter Two: Literature Review 3

Diagnostic Overlap Between Bipolar Disorder and Borderline Personality Disorder 3

Gender Differences in Diagnosing Borderline Personality Disorder 10

The Personality Assessment Inventory (PAI) 13

Rationale for Present Study 22

Aims and Hypotheses 25

Chapter Three: Methodology 27

Participants 27

Measures 27

Procedure 28

Data Analysis 28

Ethical Safeguards 29

Chapter Four: Results 30

Demographic Data 30

Hypothesis 1 33

Hypothesis 2 37

Chapter Five: Discussion 42

Hypothesis 1 43

Hypothesis 2 45

Limitations 46

Chapter Six: Conclusions and Suggestions for Future Research 48

References 50

Appendix A: Regression Tables 56

Appendix B: SPSS Ordinal Regression Syntax 59