Problematic internet use and borderline personality features: A systematic review informed by the alternative model of personality disorders.

Abstract

Background and aims: Associations between problematic internet use (PIU) and borderline personality disorder (BPD) have been reported, but the literature is highly heterogeneous, with some studies assessing overall BPD severity and others examining individual traits (e.g., emotional lability, impulsivity, dissociation). This review synthesizes these approaches using the Alternative Model of Personality Disorders (AMPD), examining how BPD-relevant pathological personality traits (Criterion B) and impairments in self and interpersonal functioning (Criterion A) relate to PIU.

Methods: Following PRISMA 2020 guidelines, we searched PsycINFO, Web of Science, PubMed, Embase, and Scopus for studies examining associations between PIU (e.g., general use, social media, gaming, smartphone use) and personality traits or functioning in adults. Study quality was assessed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Results: Thirty studies (N = 21,358) met inclusion criteria. Emotional lability and impulsivity showed the most consistent associations with PIU across outcome types. Few studies examined impairments in personality functioning, but available evidence suggests that identity disturbance may predict PIU over time and that interpersonal dysfunction is associated with greater use of online environments for reassurance and emotion regulation. Associations involving dissociation and detachment were relatively weak and less consistent.

Discussion and conclusions: Studies varied widely in design, measures, and theoretical approach, limiting direct comparison across studies. Despite this heterogeneity, findings indicate that emotional lability, impulsivity, and identity disturbance appear to represent transdiagnostic vulnerabilities that increase risk for PIU and shape patterns of online engagement.