A Scoping Review of the Multiple Levels of Oppression Faced by Individuals Diagnosed with Borderline Personality Disorder

Background: Borderline personality disorder (BPD) has been characterized as one of the most stigmatized mental health conditions. Historically, research on prejudice and discrimination faced by individuals with mental health conditions has been within the “stigma model,” focused solely on individual-level processes. More recent research has expanded its scope to mezzo and macro-level processes. Objectives: This scoping review expands on this recent work by applying a critical anti-oppression paradigm to the literature on the prejudice and discrimination faced by individuals labeled with BPD. This paradigm shifts away from the traditional “stigma model” and categorizes oppression as occurring at individual, cultural, and institutional levels. This review seeks to “scope” the literature to determine whether there is a gap in research at any of those levels of oppression. Methods: Studies were included in this scoping review if they were peer-reviewed, published in English between 2018 and 2024, and investigated the diagnosis of BPD leading to some form of oppression. A four-phase search of CINAHL, Cochrane Library, APA PsycINFO, PsycNET, PubMed, Social Services Abstracts, SocINDEX, Google, and Google Scholar was conducted to identify relevant studies. Data from these studies were extracted and organized in Google Sheets. Integrative synthesis was performed. This study was guided and reported per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) checklist. Results: Twenty-six studies met the inclusion criteria. These included studies primarily focused on individual-level processes of the stigmatization of BPD. However, some studies investigated cultural and institutional levels of oppression as well. Interestingly, qualitative studies in which individuals with BPD were the participants universally revealed multiple levels of oppression, yet when the participants were the “oppressors,” such as mental health workers, findings less frequently identified oppression beyond the individual level. Conclusions: This researcher suggests increased research into the cultural and institutional oppression of individuals with BPD. Further qualitative and mixed-methods research should be pursued. Additionally, participatory research methods seem particularly suited to this topic, as this review suggests that individuals with BPD are already reporting components of their oppression that are being overlooked by researchers.