The Cognitive, Ecological, and Developmental Origins of Self-Disturbance in Borderline Personality Disorder.

Axel Baptista,David Cohen,Pierre Olivier Jacquet,Valérian Chambon

doi:10.3389/fpsyt.2021.707091

Abstract

Self-disturbance is recognized as a key symptom of Borderline Personality Disorder (BPD). Although it is the source of significant distress and significant costs to society, it is still poorly specified. In addition, current research and models on the etiology of BPD do not provide sufficient evidence or predictions about who is at risk of developing BPD and self-disturbance, and why. The aim of this review is to lay the foundations of a new model inspired by recent developments at the intersection of social cognition, behavioral ecology, and developmental biology. We argue that the sense of agency is an important dimension to consider when characterizing self-disturbances in BPD. Second, we address the poorly characterized relation between self-disturbances and adverse life conditions encountered early in life. We highlight the potential relevance of Life-History Theory—a major framework in evolutionary developmental biology—to make sense of this association. We put forward the idea that the effect of early life adversity on BPD symptomatology depends on the way individuals trade their limited resources between competing biological functions during development.

Highlights

Clinical observations and experimental data, as well as a number of theoretical developments and international classifications, support the proposition that disturbances in self- and interpersonal functioning are fundamental to the psychopathology of Borderline Personality Disorder (BPD) [1,2,3]
Preliminary Conclusion To overcome the above limitations, future research in BPD should focus on better characterizing the relationship between bodily experiences and interpersonal difficulties, and on the role of affective experiences
The challenge for future research would be to unravel the interplay of emotional instability, bodily experiences and impaired interpersonal functioning in BPD

Summary

INTRODUCTION

Clinical observations and experimental data, as well as a number of theoretical developments and international classifications, support the proposition that disturbances in self- and interpersonal functioning are fundamental to the psychopathology of Borderline Personality Disorder (BPD) [1,2,3]. Such a blurring of self-other distinction could trigger occasional misattributions of agency in BPD patients It may explain altered bodily experiences, such as depersonalization, as SoA have been shown to be a key contributor to the sense of body ownership. Family instability, and physical insecurity can impact developmental trajectories primarily during early and late childhood [114, 115], low or unpredictable energy provisioning could have a disproportionate impact on developmental programming during the prenatal and postnatal periods where such a provisioning—and survival—is exclusively conditional on parental care [152] From this perspective, investing a large amount of metabolic resources in brain development is risky if food availability varies unpredictably, and slowing down neuromaturation to store more fat makes sense: it compensates for a potential lack of parental energy provisioning by relying on endogenous energy stores, even if it comes with costs to physical and mental health later in life, such as overweight, insulin resistance, reduced brain volume, cognitive impairment, or mental disorders such as ADHD [153,154,155,156,157]. This new developmental approach offers some preliminary insights into the developmental pathway by which early experiences lead to alterations in SoA and, more broadly, to BPD symptoms

CONCLUSION

Findings

DATA AVAILABILITY STATEMENT