Self-reported mistrust in borderline personality disorder: A meta-analytic review.

Recent studies indicate that borderline personality disorder (BPD) is marked by chronic interpersonal dysfunction, particularly impairments in trust, which significantly hinder recovery. This review aims to examine the association between mistrust and BPD and explore the potential moderating effects of factors such as age, gender, education, type of measurement of mistrust and BPD, and study design and sample source. This review was pre-registered on PROSPERO. A comprehensive search was conducted across EMBASE, MEDLINE, PsycINFO, Scopus, and Web of Science, with the last search on May 6, 2025. The risk of bias in the included studies was assessed using the Joanna Briggs Institute (JBI) Checklist for Cross-Sectional Associational Studies and the JBI Checklist for Case-Control Studies. The inclusion criteria encompassed published analytical observational studies in English that utilized psychometrically valid self-report measures of mistrust and BPD, without restrictions on publication date. A three-level meta-analytical model was used to synthesize the extracted effect sizes from the studies. A total of 212 studies (reflecting 254 independent samples, 457 effect sizes, and 119,691 participants) were included. Results showed that the pooled correlation between mistrust and BPD was r = 0.45 (95 % CI [0.43, 0.46], p < .001), with demographic variables having no moderating effect. Despite some limitations with studies included in the meta-analysis, such as the failure to identify and handle confounding variables and the lack of standard criteria to assess BPD, the findings highlight the role of interpersonal mistrust in BPD and underscore the need for further research to clarify its clinical relevance.