Affective and Sensation-Seeking Pathways Linking Borderline Personality Disorder Symptoms and Alcohol-Related Problems in Young Women.

Borderline personality disorder (BPD) and alcohol use disorder often cooccur, yet we know little about risk processes underlying this association. We tested two mechanistic pathways linking BPD symptoms and alcohol-related problems. In the "affective pathway," we hypothesized that BPD symptoms would be associated with alcohol-related problems through affective instability and drinking to cope. In the "sensation-seeking pathway," we proposed that BPD symptoms would be related to alcohol-related problems through sensation seeking and drinking to enhance positive experiences. We tested a multiple mediation model using age-18 cross-sectional data from the Pittsburgh Girls Study. Results supported both pathways: BPD symptoms had an indirect effect on alcohol-related problems by (1) affective instability and coping motives (β = .03, p < .05), and (2) sensation-seeking and enhancement motives (β = .02, p < .05). These results highlight coping and enhancement drinking motives as possible mechanisms that explain co-occurrence of BPD symptoms and alcohol-related problems in young females.