Salivary testosterone is associated with feelings of senselessness and self-dislike in women with borderline personality disorder

Abstract

Background: Women with borderline personality disorder (BPD) show increased basal levels of testosterone. We investigated whether salivary testosterone levels in women with BPD were indicative of specific symptoms associated with BPD. Based on the assumed link between testosterone and interpersonal dominance, we hypothesized a positive association between testosterone and externalising, i.e. aggressive or impulsive behaviour, potentially contributing to higher burden of interpersonal reactivity and conflict.Methods: Saliva was collected from 98 women with BPD (average age in years: 28, range 18–46) between 1 and 2 pm. Self-rating scales were administered to assess severity of BPD (Borderline Symptom Checklist, BSL-23) and depressive symptoms (Beck’s Depression Inventory, BDI-II). Regression analyses targeted associations between individual testosterone levels and BSL-23 and BDI-II total and by-item scores.Results: Higher testosterone levels were associated with higher overall disease burden indicated by BSL-23 and BDI-II total scores. When analysed by item, higher testosterone levels were significantly associated with increased feelings of self-dislike, senselessness and pessimism, and the feeling of being a failure.Conclusion: Our findings show that in women with BPD testosterone levels are positively associated with increased borderline and depressive symptomatology. Contrary to our expectations, rather than predicting externalising symptoms, higher testosterone is associated with a well-defined cluster of internalising symptoms characterized by a pessimistic and derogatory view towards oneself.

Keywords

• Borderline personality disorder
• testosterone
• depression
• gonadal hormones
• internalising symptoms
• Testosterona