Empirical evidence documents disparities in the diagnosis of severe forms of psychopathology among racial/ethnic minority persons. However, research on diagnostic differences in personality disorders is equivocal: Some suggest higher prevalence of personality disorders among racial/ethnic minority persons, whereas other results suggest the opposite. The goal of the current study was to investigate (a) differences in the diagnosis of borderline personality disorder (BPD) in a mostly cisgender, heterosexual sample among racial/ethnic minority patients compared with non-Hispanic White patients and (b) whether any observed differences were attributable to differences in underlying maladaptive personality domains. Using data from partial hospital patients (N = 2,657), we found few differences in the diagnosis of BPD based on racial/ethnic group membership. We also conducted measurement invariance analyses of the Personality Inventory for DSM-5-Brief Form (PID-5-BF), finding evidence of invariance across White and non-White participants in these data. Any instances of diagnostic disparity were explained by group differences in maladaptive personality domains. These results provide context to the extant literature documenting mixed results about racial/ethnic differences in prevalence of personality disorders. In addition, they suggest relative specificity in BPD diagnostic bias related to sexual minority populations.

The Personality Inventory for DSM-5 Brief Form (PID-5-BF) was developed with an assumption of invariance across sexual and gender minority individuals (SGM). This assumption has yet to be tested empirically. Using multigroup confirmatory factor analysis, we examined measurement invariance in the PID-5-BF across SGM status in clinical (N=1174; n=254 SGM) and non-clinical (N=1456; n=151 SGM) samples. Measurement invariance was supported for the PID-5-BF structure, item thresholds, and factor loadings, but not at the item intercept level. SGM individuals endorsed higher Negative Affectivity, Antagonism, Disinhibition, and Psychoticism domains in both samples. In the clinical sample, adjusting for partial invariance decreased Detachment and Antagonism levels for SGM persons. In the non-clinical sample, adjusting for partial invariance reduced Antagonism disparities in the SGM group, even rendering original group differences null. Our results support the use of the PID-5-BF in SGM populations but indicate that some measurement bias may drive observed disparities in maladaptive trait domains, and in-turn, personality disorder diagnosis.

The Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Brief Form (PID-5-BF) was developed with an assumption of invariance across sexual and gender minority (SGM) individuals. This assumption has yet to be tested empirically. Using multigroup confirmatory factor analysis, we examined measurement invariance in the PID-5-BF across the SGM status in clinical ( N = 1,174; n = 254 SGM) and nonclinical ( N = 1,456; n = 151 SGM) samples. Measurement invariance was supported for the PID-5-BF structure, item thresholds, and factor loadings, but not at the item intercept level. SGM individuals endorsed higher negative affectivity, antagonism, disinhibition, and psychoticism domains in both samples. In the clinical sample, adjusting for partial invariance decreased detachment and antagonism levels for SGM persons. In the nonclinical sample, adjusting for partial invariance reduced antagonism disparities in the SGM group, even rendering original group differences null. Our results support the use of the PID-5-BF in SGM populations but indicate that some measurement bias may drive observed disparities in maladaptive trait domains and, in turn, personality disorder diagnosis.