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

• Author: Thomas Wojciechowski
• DOI: http://doi.org/10.1177/07340168221105000
• Published date: 01 June 2023
• Date: 01 June 2023
• Subject Matter: Articles

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 identif‌ied 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 specif‌ically is deviant peer association. This

dearth of research persists despite the fact that deviant peer association has been identif‌ied 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 amplif‌ication 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 identif‌ied 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 identif‌ied 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 specif‌ically 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 identif‌ied, 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 f‌ield 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 def‌initions 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 def‌initions), social learning theory also indicates the relevance

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