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Exploring Transdiagnostic Mechanisms Linking Borderline Personality Disorder and Disordered Eating

AI Summary
  • BPD severity predicts disordered eating, consistently across EDI-2 measures but less robustly for EDE-Q.
  • Transdiagnostic vulnerabilities emerge: person-related self-loathing strengthened the BSL-95 to EDE-Q association; agreeableness moderated BSL-95 to EDI-2.
  • Results highlight BPD-ED links but interaction findings are exploratory due to sample size; interpret moderations with caution and pursue replication.
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J Pers Disord. 2026 Oct;40(5):474-490. doi: 10.1521/pedi.2026.40.5.474.

ABSTRACT

Borderline personality disorder (BPD) frequently co-occurs with eating disorders (EDs). Disordered eating may serve as a coping strategy to regulate emotions/manage rejection sensitivity, abandonment fears, shame, and self-disgust. Research examining disordered eating in BPD remains limited. This study explored ED pathology/related psychological constructs in adults diagnosed with BPD. Eighty participants completed questionnaires assessing BPD symptom severity, ED pathology, childhood trauma, cognitive distortions, shame, self-disgust, coping, personality traits, and emotion regulation. Mean-centered linear regression models tested whether psychological constructs influenced the association between BPD severity (BSL-95) and disordered eating (EDI-2, EDE-Q). Given the sample size, moderation analyses were considered exploratory. BSL-95 was associated with disordered eating (p < .001), consistently across EDI-2 but less robustly for EDE-Q. Two exploratory interactions emerged: person-related self-loathing strengthened the BSL-95-EDE-Q link, and agreeableness was associated with variation in the BSL-95-EDI-2 association. Findings underscore BPD-ED associations/highlight transdiagnostic vulnerabilities; however, interaction findings should be interpreted with caution due to the study’s exploratory nature.

PMID:42863111 | DOI:10.1521/pedi.2026.40.5.474

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