{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T08:15:06Z","timestamp":1778314506198,"version":"3.51.4"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T00:00:00Z","timestamp":1689552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008810","name":"NSW Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008810","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Borderline Personality Disorder (BPD) is a chronic, debilitating, and difficult to treat condition. BPD has recently been linked to steroid hormone dysregulation and medical conditions characterized by disturbed androgen metabolism. This study aimed to investigate cortisol and testosterone levels in BPD, and changes in hormones following psychological treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants with BPD (<jats:italic>n<\/jats:italic> = 33) completed a 12-week Dialectical Behavior Therapy group program. Pre and post salivary testosterone and cortisol were analyzed. Baseline hormones in the BPD group were compared to age-and-sex matched controls (<jats:italic>n<\/jats:italic> = 33). Non-parametric tests were utilized to investigate group differences, pre-post treatment hormone and symptom changes, and associations between symptoms and hormone levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants with BPD had significantly higher testosterone levels than controls. Mean testosterone levels in females with BPD were double that of female controls. Testosterone and cortisol levels were related, and some BPD symptoms were associated with with hormone levels. BPD symptoms reduced significantly with treatment, however pre to post hormone levels did not change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study supports an association between BPD symptoms and neuroendocrine dysfunction at baseline, however we found no reduction in hormone dysfunction post treatment. Further research into relationships between stress signaling and neuroendocrine disturbances in BPD may inform aetiological and treatment models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p>Australian New Zealand Clinical Trials Registry ACTRN12618000477224. Registered on 3 April 2018.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyg.2023.1195187","type":"journal-article","created":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T00:55:05Z","timestamp":1689641705000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Salivary testosterone and cortisol levels in borderline personality disorder before and after a 12-week group dialectical behavior therapy intervention"],"prefix":"10.3389","volume":"14","author":[{"given":"Tori","family":"Dyson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan J.","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle L.","family":"Townsend","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Finch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"South","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Barkus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Walter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carley","family":"Mendonca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brin F. S.","family":"Grenyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judy A.","family":"Pickard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,7,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e12590","DOI":"10.1111\/jne.12590","article-title":"Emerging insights into hypothalamic-pituitary-gonadal axis regulation and interaction with stress signalling","volume":"30","author":"Acevedo-Rodriguez","year":"2018","journal-title":"JNE"},{"key":"B2","volume-title":"Diagnostic and Statistical Manual of Mental Disorders - DSM-5","year":"2013"},{"key":"B3","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1080\/0167482X.2017.1311319","article-title":"Psychological distress, anger and quality of life in polycystic ovary syndrome: associations with biochemical, phenotypical andsocio-demographic factors","volume":"28","author":"Borghi","year":"2018","journal-title":"J. Psych."},{"key":"B4","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1001\/jamapsychiatry.2016.4287","article-title":"Efficacy of psychotherapies for borderline personality disorder: a systematic review and meta-analysis","volume":"74","author":"Cristea","year":"2017","journal-title":"JAMA psychiatry"},{"key":"B5","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1037\/a0015616","article-title":"A biosocial developmental model of borderline personality: elaborating and extending linehan's theory","volume":"135","author":"Crowell","year":"2009","journal-title":"Psychol. Bull"},{"key":"B6","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/j.psyneuen.2015.07.608","article-title":"Neuroticism and cortisol: the importance of checking for sex differences","volume":"62","author":"DeSoto","year":"2015","journal-title":"Psychoneuroendocrinology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/j.psyneuen.2016.05.026","article-title":"Increased hair testosterone but unaltered hair cortisol in female patients with borderline personality disorder","volume":"71","author":"Dettenborn","year":"2016","journal-title":"Psychoneuroendocrinology"},{"key":"B8","doi-asserted-by":"publisher","first-page":"360","DOI":"10.2174\/1570159X18666200429234430","article-title":"Targeting the endocannabinoid system in borderline personality disorder: corticolimbic and hypothalamic perspectives","volume":"19","author":"Ferber","year":"2021","journal-title":"Curr. Neuropharmacol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1023\/B:JOBA.0000007455.08539.94","article-title":"Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale","volume":"26","author":"Gratz","year":"2004","journal-title":"J. Psychopathol. Behav. Assess"},{"key":"B10","doi-asserted-by":"publisher","first-page":"539","DOI":"10.3389\/fpsyg.2018.00539","article-title":"Psychometric properties of the difficulties in emotion regulation scale (ders) and its short forms in adults with emotional disorders","volume":"9","author":"Hallion","year":"2018","journal-title":"Front. Psychol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1016\/j.jpsychires.2006.07.019","article-title":"Basal cortisol and DHEA levels in women with borderline personality disorder","volume":"41","author":"Jogems-Kosterman","year":"2007","journal-title":"J. Psychiatr. Res"},{"key":"B12","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/s12888-022-04483-0","article-title":"Effectiveness of outpatient and community treatments for people with a diagnosis of \u2018personality disorder': systematic review and meta-analysis","volume":"23","author":"Katakis","year":"2023","journal-title":"BMC Psychiatry"},{"key":"B13","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s10862-008-9107-z","article-title":"Assessing the functions of non-suicidal self-injury: psychometric properties of the inventory of statements about self-injury (ISAS)","volume":"31","author":"Klonsky","year":"2009","journal-title":"J. Psychopathol. Behav. Assess"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40479-016-0043-3","article-title":"Predicting dropout in outpatient dialectical behavior therapy with patients with borderline personality disorder receiving psychiatric disability","volume":"3","author":"Landes","year":"2016","journal-title":"Borderline Pers. Disord. Emot. Dysreg."},{"key":"B15","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1016\/j.jpsychires.2004.04.002","article-title":"Increased diurnal salivary cortisol in women with borderline personality disorder","volume":"38","author":"Lieb","year":"2004","journal-title":"J. Psychiatr. Res"},{"key":"B16","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.physbeh.2009.10.001","article-title":"Salivary testosterone, cortisol, and progesterone: two-week stability, interhormone correlations, and effects of time of day, menstrual cycle, and oral contraceptive use on steroid hormone levels","volume":"99","author":"Liening","year":"2010","journal-title":"Physiol. Behav"},{"key":"B17","first-page":"261","article-title":"Dialectical behavior therapy for borderline personality disorder: theory and method","volume":"51","author":"Linehan","year":"1987","journal-title":"Bull. Menninger Clin"},{"key":"B18","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.psyneuen.2015.02.023","article-title":"Testosterone and cortisol jointly modulate risk-taking","volume":"56","author":"Mehta","year":"2015","journal-title":"Psychoneuroendocrinology"},{"key":"B19","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1002\/pmh.1432","article-title":"A 1-year follow-up study of capacity to love and work: what components of borderline personality disorder most impair interpersonal and vocational functioning?","volume":"12","author":"Miller","year":"2018","journal-title":"Pers. Mental Health"},{"key":"B20","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/s11031-011-9264-3","article-title":"Testosterone, cortisol, and serotonin as key regulators of social aggression: a review and theoretical perspective","volume":"36","author":"Montoya","year":"2012","journal-title":"Motiv. Emot"},{"key":"B21","volume-title":"Borderline Personality Disorder: Treatment and Management","year":"2009"},{"key":"B22","unstructured":"Common Mental Health Problems: Identification and Pathways to Care (CG123)2011"},{"key":"B23","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/j.psyneuen.2007.04.001","article-title":"Changes in cortisol and DHEA plasma levels after psychotherapy for PTSD","volume":"32","author":"Olff","year":"2007","journal-title":"Psychoneuroendocrinology"},{"key":"B24","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1007\/s10862-017-9586-x","article-title":"Factor structure of the difficulties in emotion regulation scale (DERS) in adult outpatients receiving dialectical behavior therapy (DBT)","volume":"39","author":"Osborne","year":"2017","journal-title":"J. Psychopathol. Behav. Assess"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13063-021-05327-0","article-title":"Assessing the efficacy of a stepped-care group treatment programme for borderline personality disorder: study protocol for a pragmatic trial","volume":"22","author":"Pickard","year":"2021","journal-title":"Trials"},{"key":"B26","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.psyneuen.2015.02.002","article-title":"Increased testosterone levels and cortisol awakening responses in patients with borderline personality disorder: gender and trait aggressiveness matter","volume":"55","author":"Rausch","year":"2015","journal-title":"Psychoneuroendocrinology"},{"key":"B27","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1038\/sj.npp.1300003","article-title":"Fluvoxamine reduces responsiveness of HPA axis in adult female BPD patients with a history of sustained childhood abuse","volume":"28","author":"Rinne","year":"2003","journal-title":"Neuropsychopharmacology"},{"key":"B28","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1016\/j.jpsychires.2010.01.007","article-title":"Incidence of polycystic ovaries and androgen serum levels in women with borderline personality disorder","volume":"44","author":"Roepke","year":"2010","journal-title":"J. Psychiatr. Res"},{"key":"B29","first-page":"16","article-title":"Gender patterns in borderline personality disorder","volume":"8","author":"Sansone","year":"2011","journal-title":"Innov. Clin. Neurosci"},{"key":"B30","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1515\/ijamh-2013-0060","article-title":"Low testosterone levels may be associated with suicidal behavior in older men while high testosterone levels may be related to suicidal behavior in adolescents and young adults: a hypothesis","volume":"25","author":"Sher","year":"2013","journal-title":"Int. J. Adol. Med. Health"},{"key":"B31","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s40479-021-00151-z","article-title":"A systematic review of the factors associated with the course of borderline personality disorder symptoms in adolescence","volume":"8","author":"Skabeikyte","year":"2021","journal-title":"Borderline Pers. Disorder Emot. Dysreg."},{"key":"B32","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1037\/per0000186","article-title":"A systematic review of risk factors prospectively associated with borderline personality disorder: taking stock and moving forward","volume":"7","author":"Stepp","year":"2016","journal-title":"Personal. Disord. Theory Res. Treat"},{"key":"B33","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1038\/s41398-022-01912-2","article-title":"Borderline personality disorder and the big five: molecular genetic analyses indicate shared genetic architecture with neuroticism and openness","volume":"12","author":"Streit","year":"2022","journal-title":"Transl. Psychiatry"},{"key":"B34","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1177\/0004867417730650","article-title":"Borderline personality disorder and polycystic ovary syndrome: a review of the literature","volume":"52","author":"Tan","year":"2018","journal-title":"Aust. New Zeal. J. Psychiatry"},{"key":"B35","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.psyneuen.2018.12.009","article-title":"Systematic review and meta-analysis of basal cortisol levels in borderline personality disorder compared to non-psychiatric controls","volume":"102","author":"Thomas","year":"2019","journal-title":"Psychoneuroendocrinology"},{"key":"B36","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1177\/0004867415615950","article-title":"Borderline personality disorder and polycystic ovary syndrome","volume":"50","author":"Trisno","year":"2016","journal-title":"Aust. Psychiatry"},{"key":"B37","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.copsyc.2017.10.005","article-title":"The aetiology of borderline personality disorder (BPD): contemporary theories and putative mechanisms","volume":"21","author":"Winsper","year":"2018","journal-title":"Curr. Opin. Psychol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1192\/bjp.2019.166","article-title":"The prevalence of personality disorders in the community: a global systematic review and meta-analysis","volume":"216","author":"Winsper","year":"2020","journal-title":"Br. J. Psychiatr."},{"key":"B39","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1515\/revneuro-2016-0026","article-title":"A systematic review of the neurobiological underpinnings of borderline personality disorder (BPD) in childhood and adolescence","volume":"27","author":"Winsper","year":"2016","journal-title":"Rev. Neurosci"},{"key":"B40","doi-asserted-by":"publisher","first-page":"e0255055","DOI":"10.1371\/journal.pone.0255055","article-title":"Searching in the dark: Shining a light on some predictors of non-response to psychotherapy for borderline personality disorder","volume":"16","author":"Woodbridge","year":"2021","journal-title":"PLoS ONE"},{"key":"B41","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1521\/pedi.17.6.568.25355","article-title":"A screening measure for BPD: the McLean screening instrument for borderline personality disorder (MSI-BPD)","volume":"17","author":"Zanarini","year":"2003","journal-title":"J. Pers. Disord"},{"key":"B42","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1007\/s40750-014-0017-x","article-title":"Testosterone, cortisol and empathy: evidence for the dual-hormone hypothesis","volume":"1","author":"Zilioli","year":"2015","journal-title":"Adapt. Hum. Behav. Physiol"}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2023.1195187\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T00:55:10Z","timestamp":1689641710000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2023.1195187\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,17]]},"references-count":42,"alternative-id":["10.3389\/fpsyg.2023.1195187"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2023.1195187","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,17]]},"article-number":"1195187"}}