Clinical Brown Bag: Applying a HiTOP(ian) approach to understanding clinical bias: Borderline personality disorder diagnosis among (SGM) Sexual and Gender Minority populations.

Abstract:
Borderline personality disorder (BPD) is considered a severe form of psychopathology associated with a host of negative outcomes. Empirical evidence suggests high prevalence of BPD diagnosis among sexual and gender minority samples. Non-cisgender identity has been historically equated with BPD diagnosis, the improper diagnosis of which imposes potential barriers to accessing appropriate gender affirming care. In addition, sexual and gender minority populations contend with greater psychosocial stress and exhibit higher rates of common forms of psychopathology than their heterosexual cisgender peers. Limited evidence suggests that higher prevalence of BPD diagnosis among sexual and gender minority individuals might not accurately index underlying BPD-pathology levels among these populations. Further, current conceptualization and treatment recommendations for BPD diagnosis diverge in subtle, yet potentially detrimental, ways from evidence-based treatment principles for sexual and gender minority individuals. In the current talk, I will present the results from 3 studies incorporating a transdiagnostic factors approach—consistent with the Hierarchical Taxonomy of Psychopathology (HiTOP) model—to examining bias in the diagnosis of BPD among sexual and gender minority individuals.