Examining Deviant Peer Association as a Moderator of the Relationship Between Borderline Personality Disorder Symptoms and Substance Use

AuthorThomas Wojciechowski
DOIhttp://doi.org/10.1177/07340168221105000
Published date01 June 2023
Date01 June 2023
Subject MatterArticles
Examining Deviant Peer
Association as a Moderator of
the Relationship Between
Borderline Personality Disorder
Symptoms and Substance Use
Thomas Wojciechowski
Abstract
Borderline personality disorder has been identied as a robust risk factor predicting substance use.
There is a dearth of research examining how peer ties may condition this relationship. This study
hypothesized that deviant peer association would amplify the relationship between Borderline per-
sonality disorder (BPD) symptoms and substance use. The Pathways to Desistance data were ana-
lyzed. Ordered logistic regression was used to analyze data. Results indicated that elevated levels of
BPD symptoms predicted increased substance use frequency. Deviant peer association moderated
the effects of BPD symptoms on marijuana use frequency and daily cigarette use. This moderation
effect was in the opposite direction hypothesized, indicating that greater levels of deviant peer asso-
ciation dulled the effect on BPD symptoms on substance use. The unexpected effect indicated that
youth reporting symptoms may be buffered against the impact of strain by having any peer relation-
ships, even deviant ones.
Keywords
borderline personality disorder, deviant peer association, substance use
Introduction
Borderline personality disorder (BPD) is a mental disorder characterized by instability in interper-
sonal relationships and identity, extreme emotionality accompanying black/white thinking, and
impulsivity (American Psychiatric Association, 2013). Individuals with BPD are at elevated risk
for engagement in numerous behaviors, including substance abuse (Lane et al., 2016; Scalzo
et al., 2018; Trull et al., 2018). Given the myriad of unhealthy outcomes that may stem from sub-
stance abuse (Baghaie et al., 2017; Fox et al., 2013; Kevil et al., 2019), identifying mechanisms
by which risk may be elevated among individual diagnosed with BPD is a paramount concern.
School of Criminal Justice, Michigan State University, East Lansing, MI, USA
Corresponding Author:
Thomas Wojciechowski, School of Criminal Justice, Michigan State University, 655 Auditorium Road, East Lansing, MI, USA.
Email: wojcie42@msu.edu
Article
Criminal Justice Review
2023, Vol. 48(2) 232-248
© 2022 Georgia State University
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/07340168221105000
journals.sagepub.com/home/cjr
One concept that remains understudied in this context specically is deviant peer association. This
dearth of research persists despite the fact that deviant peer association has been identied as a
robust risk factor for substance abuse also (Lee et al., 2017; Van Ryzin et al., 2012;
Wojciechowski, 2020a). Given mechanisms outlined in Akers(1973) social learning theory,
there is reason to believe that deviant peer association may moderate the relationship between
BPD and substance use, resulting in an amplication of the effects of BPD when exposure to
deviant peers is high. The present study sought to better understand these processes by examining
BPD symptoms as a predictor of substance use and the relevance of deviant peer association as a
moderator of this relationship.
Borderline Personality Disorder as a Predictor of Substance Use
BPD has been identied by past research as a robust predictor of substance use (Heath et al., 2018;
Helle et al., 2019; Scamaldo et al., 2020). There are numerous mechanisms by which the disorder
may increase risk for substance use behaviors. First, low impulse control is characteristic of the
disorder (Bach & Farrell, 2018; Linhartová et al., 2019). Individuals low in impulse control
have diminished capacity to stop and consider potential consequences of engagement in risky,
unhealthy, and in some cases illegal behavior like substance use. As such, it is unsurprising that
low impulse control has also been identied as a risk factor predicting substance use (Hentges
et al., 2018; Kozak et al., 2019; Oshri et al., 2018). This, however, is not the only mechanism
by which BPD symptoms may be associated with substance use. BPD is also characterized by
intense emotionality and poor emotion regulation (American Psychiatric Association, 2013;
Bertsch et al., 2018; Grzegorzewski & Kucharska, 2018). When faced with such intense emotions,
individuals may then cope using drugs and alcohol as a means of mitigating these negative affec-
tive states. This mechanism is consistent with theories like the self-medication hypothesis and
general strain theory and research has indicated support for these frameworks (Agnew, 1992;
Ertl et al., 2016; Khantzian, 1985; Zweig et al., 2015). Further, past research has specically indi-
cated the relevance of these mechanisms for understanding substance use in this population (Barral
& Casas, 2016; Donald et al., 2019; Scamaldo et al., 2020). With these mechanisms identied, it is
clear why individuals with BPD symptoms may be at increased risk for substance use. However,
this focus on the psychological aspects of BPD for understanding these behaviors ignores the
potential social factors that may contribute to this risk also. Deviant peer association is one
social factor that may be relevant for understanding substance use risk among individuals with
BPD symptoms.
Deviant Peer Association as a Moderator of the Relationship Between Borderline
Personality Disorder and Substance Use
Deviant peer association has been one of the more important concepts in the eld of criminology
since Akers discussed the concept with social learning theory (Akers, 1973). Social learning
theory posits that criminal and/or deviant behavior is learned just like any other behavior.
Individuals are exposed to others who provide denitions favorable or unfavorable to these behaviors
and individuals learn the motivations, rationalizations, and techniques for engagement in deviant
behaviors through these interactions. Social learning theory posits that deviant behavior generally
results when individuals are exposed to attitudes that are favorable toward offending at high fre-
quency, duration, and intensity and are provided by sources with higher priority (Akers, 1973).
For example, substance use risk would be much higher for a teenager raised in a home with
parents with substance use disorder compared to a teenager raised in a home of devout teetotalers.
Beyond attitudes like these (termed denitions), social learning theory also indicates the relevance
Wojciechowski 233

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