Borderline Personality Disorder Symptoms in a Conflict-Affected Population: A Study Among University Students in a Low-Middle-Income Country

Background: Borderline Personality Disorder (BPD) is a severe mental health condition that is often intensified by trauma, instability, and sociocultural stressors. This study investigates the prevalence and psychological predictors of BPD symptoms among Palestinian university students in a politically unstable context. Methods: A cross-sectional study was conducted among 538 participants across the West Bank using validated Arabic versions of the McLean Screening Instrument and the Borderline Personality Questionnaire. Statistical analyses included Spearman’s correlation, Mann-Whitney, Kruskal-Wallis, linear regression, and path analysis. Results: Females reported significantly higher levels of affective instability, abandonment fears, and intense anger. Exposure to sociopolitical violence (e.g., living near settlements or being attacked) was associated with elevated BPD symptoms. Regression and path analysis identified disturbed self-image, abandonment, impulsivity, and quasi-psychotic symptoms as key predictors of self-harm. Unexpectedly, transportation methods and medication use were also associated with symptom severity. Conclusion: Sociopolitical adversity, gender, and psychological vulnerabilities significantly influence BPD symptom expression in Palestinian youth. These findings highlight the urgent need for culturally tailored, trauma-informed, and gender-sensitive mental health interventions in conflict zones. Future longitudinal studies are recommended to monitor symptom development and evaluate the effectiveness of targeted therapies.