Development Of Borderline Personality Disorder Research Articles

Interpersonal trauma Dissociates borderline from other personality disorders in social orienting

Patients with Borderline Personality Disorder (BPD), particularly with comorbid trauma-disorders, show an attentional bias towards angry facial expressions. This is often interpreted to reflect increased anxiety and sensitivity to social threats. Given BPDs severe problems in reacting to and interpreting social communication, we investigated whether this threat bias extends to social orienting. Using a gaze-cueing task, we assessed whether centrally presented dynamic fearful and happy gaze stimuli promote the detection of peripherally presented targets. Groups with BPD (N = 50) and other personality disorders (OPD, N = 51) were compared to healthy controls (HC, N = 46), and evaluated on the independent influence of traumatic experience, trait anxiety and trait anger. Across groups we find reliable gaze-cueing. In line with earlier evidence, trait anxiety predicts faster detection of targets signaled by a fearful gaze in HCs. This threat bias is however not present in BPDs and OPDs, thus the threat bias in BPD does not extend to social orienting. Instead, self-experienced trauma predicts amplified gaze-cueing in BPDs, but reduced gaze-cueing in OPDs. This not only emphasizes the importance of evaluating trauma exposure in personality disorders, but also suggests that the childhood adversity typically associated with the development of BPD promotes increased social orienting.

Differential methylation of OPRK1 in borderline personality disorder is associated with childhood trauma.

According to a growing body of neurobiological evidence, the core symptoms of borderline personality disorder (BPD) may be linked to an opioidergic imbalance between the hedonic and stimulatory activity of mu opioid receptors (MOR) and the reward system inhibiting effects of kappa opioid receptors (KOR). Childhood trauma (CT), which is etiologically relevant to BPD, is also likely to lead to epigenetic and neurobiological adaptations by extensive activation of the stress and endogenous opioid systems. In this study, we investigated the methylation differences in the promoter of the KOR gene (OPRK1) in subjects with BPD (N = 47) and healthy controls (N = 48). Comparing the average methylation rates of regulatorily relevant subregions (specified regions CGI-1, CGI-2, EH1), we found no differences between BPD and HC. Analyzing individual CG nucleotides (N = 175), we found eight differentially methylated CG sites, all of which were less methylated in BPD, with five showing highly interrelated methylation rates. This differentially methylated region (DMR) was found on the falling slope (5') of the promoter methylation gap, whose effect is enhanced by the DMR hypomethylation in BPD. A dimensional assessment of the correlation between disease severity and DMR methylation rate revealed DMR hypomethylation to be negatively associated with BPD symptom severity (measured by BSL-23). Finally, analyzing the influence of CT on DMR methylation, we found DMR hypomethylation to correlate with physical and emotional neglect in childhood (quantified by CTQ). Thus, the newly identified DMR may be a biomarker of the risks caused by CT, which likely epigenetically contribute to the development of BPD.

The Illness Trajectory in Marilyn Monroe's Psychological Autopsy: From Autism Spectrum Disorder to Borderline Personality Disorder and Bipolar Disorder with Catatonia.

A mounting body of literature is showing that, in the clinical and general population, autism spectrum disorder (ASD) or autistic traits (ATs) would appear to be spread along a continuum, reaching the highest levels among individuals affected by other mental disorders, such as borderline personality disorder (BPD) and bipolar disorder (BD). Furthermore, individuals with ASD or ATs appear to be more vulnerable to psychological traumas, with greater likelihood of developing post-traumatic stress disorder (PTSD) and BD. Marilyn Monroe was a famous actress, singer and model, as well as one of the most admired stars of American cinema and a timeless icon. The present report debates the possibility to explore Marilyn Monroe's case under a neurodevelopmental perspective according to which a ASD favored, on one hand, her worldwide success and, on the other, her mental illness trajectory. The analysis is based on the review of her four biographies written by psychiatrists and clinical psychologists, her complete filmography, interviews, filmed material and personal scripts. The present work reconstructed a hypothetical illness trajectory originating from a ASD and culminating in a BD with unspecified catatonia, followed by premature death whose cause has never been clarified. The description of this illness trajectory also confirms the strong impact of psychological traumas on the substrate of ASD vulnerability and its correlation with the development of BPD and BD. This paper suggests Marilyn Monroe as a possible prototypical case of BPD under a neurodevelopmental perspective that accounts the ASD, as reported in DSM-5-TR (2022), in verbal adult without intellectual impairment, high-functioning autism (HFA), as vulnerability background predisposing to the progression to BPD and BD with unspecified catatonia, triggered by multiple traumas.

The relationship between childhood emotional abuse and borderline personality disorder: the mediating role of difficulties in emotion regulation among Lebanese adults

ObjectiveThe present study investigates the mediating effect of difficulties in emotion regulation in the association between childhood emotional abuse and Borderline Personality Disorder (BPD) among Lebanese adults.MethodThis cross-sectional study, involving 411 participants, was conducted between March and August 2022. Lebanese individuals from all governorates of the country were recruited using the Snowball Sampling technique. Three self-report scales were utilized to complete this research; the ‘Difficulties in Emotion Regulation Scale—Brief Version (DERS-16)’ which evaluates the difficulties in emotion regulation of individuals, the ‘Childhood Trauma Questionnaire—Short Form (CTQ-SF)’ which grants a subjective evaluation of the general childhood environment of the participants, as well as the ‘Borderline Personality Questionnaire (BPQ)’ which measures Borderline Personality Disorder traits, that demonstrate significant convergence with the disorder.ResultsThe results indicate that DERS-16 played an indirect effect role between childhood emotional abuse scores and Borderline Personality Disorder. Higher emotional abuse scores were significantly associated with higher DERS-16 scores, which in turn was significantly associated with higher BPQ scores. Moreover, childhood emotional abuse was directly associated with higher BPQ scores.ConclusionThis work suggests that, among the different forms of childhood abuse, emotional abuse may have a role in the development of Borderline Personality Disorder. Training on emotion regulation strategies would potentially benefit individuals in preventing BPD development and facilitating therapeutic processes.

Psychometric properties of the Hungarian childhood trauma questionnaire short form and its validity in patients with adult attention-deficit hyperactivity disorder or borderline personality disorder

BackgroundCompelling evidence supports the role of childhood traumatization in the etiology of psychiatric disorders, including adult attention-deficit hyperactivity disorder (aADHD) and borderline personality disorder (BPD). The aim of this study was to examine the psychometric properties of the Hungarian version of the Childhood Trauma Questionnaire Short Form (H-CTQ-SF) and to investigate the differences between patients diagnosed with aADHD and BPD in terms of early traumatization.MethodsAltogether 765 (mean age = 32.8 years, 67.7% women) patients and control subjects were enrolled from different areas of Hungary. Principal component analysis and confirmatory factor analysis were carried out to explore the factor structure of H-CTQ-SF and test the validity of the five-factor structure. Discriminative validity was assessed by comparing clinical and non-clinical samples. Subsequently, aADHD and BPD subgroups were compared with healthy controls to test for the role of early trauma in aADHD without comorbid BPD. Convergent validity was explored by measuring correlations with subscales of the Personality Inventory for DSM-5 (PID-5).ResultsThe five scales of the H-CTQ-SF demonstrated adequate internal consistency and reliability values. The five-factor model fitted the Hungarian version well after exclusion of one item from the physical neglect scale because of its cross-loading onto the emotional neglect subscale. The H-CTQ-SF effectively differentiated between the clinical and non-clinical samples. The BPD, but not the aADHD group showed significant differences in each CTQ domain compared with the healthy control group. All CTQ domains, except for physical abuse, demonstrated medium to high correlations with PID-5 emotional lability, anxiousness, separation insecurity, withdrawal, intimacy avoidance, anhedonia, depressivity, suspiciousness, and hostility subscales.ConclusionsOur study confirmed the psychometric properties of the H-CTQ-SF, an easy-to-administer, non-invasive, ethically sound questionnaire. In aADHD patients without comorbid BPD, low levels of traumatization in every CTQ domain were comparable to those of healthy control individuals. Thus, the increased level of traumatization found in previous studies of aADHD might be associated with the presence of comorbid BPD. Our findings also support the role of emotional neglect, emotional abuse and sexual abuse in the development of BPD.

BPD and epigenetics: No medications, but psychotherapy helps in early trauma

Epigenetics refers to the modification of gene expression rather than alteration of the genetic code itself. The DNA doesn't change. But to use a common example, mice raised by stressed mothers are more likely to be stressed themselves even if not exposed to a stressful environment. A recent study found that both genetic and early environmental factors affect the development of borderline personality disorder (BPD), a condition for which this is no evidence‐based pharmacological treatment at this point.

Is Child Maltreatment a Risk Factor for Borderline Personality Disorder? A Systematic Review of Prospective Longitudinal Studies

Background:Borderline personality disorder (BPD) is a clinical condition associated with numerous individual and collective negative consequences. According to several etiological theories and retrospective research, child maltreatment (CM) may be considered a central factor explaining BPD development.Objectives:In order to verify this hypothesis, a systematic review of prospective longitudinal studies was conducted.Methods:Following searches in five electronic databases, 19 articles that examined the relationship between CM (i.e., physical, sexual and emotional abuse; physical and emotional neglect) and BPD (i.e., diagnosis or severity score) were selected.Results:Overall, the results only partly confirm the hypothesis that CM is a risk factor for BPD. Evidence for a prospective relationship between CM and later BPD is stronger in studies using a symptom count compared to a categorical diagnosis. However, the small number of studies precludes assessing the differential impacts between CM types and BPD.Conclusion:Available prospective longitudinal studies do not unequivocally support the idea that CM is a robust risk factor for BPD. Future research needs are discussed.

Understanding the Development of Borderline Personality Disorder from an Evolutionary Perspective

Patients with borderline personality disorder (BPD), a type of personality disorder, typically experience extreme mood swings, leading to unstable personal relationships, severe morbidity, and high social costs. Given that natural selection is known to optimize survival gains, how are there still individuals whose ability to manage social relationships is broken, maintain personal relationships, and sustain survival? The current study proposes two possible hypotheses to answer this question. Hypothesis A predicts that mental disorders are caused by an inevitable genetic mutation that affects human behaviors. In this case, there were no adaptive designs of BPD. Hypothesis B suggests that BPD may be once helpful to ones survival in some environments, leading to its gene adaptation. If this hypothesis holds, BPD can be found in certain circumstances more commonly than others. The study concluded that the BPD prevalence rates found between different ethnic groups (Asian, Hispanic, and Caucasian) are inconsistent, suggesting that there was an adaptive purpose for developing BPD. It also implied that the aspects attributed to the variety of BPD prevalence rates among societies might be found based on different social values. Further investigations are needed to investigate the adaptive mechanisms of BPD to help with BPD diagnoses and treatments for BPD patients in various cultural settings.

MALADAPTIVE PARENTING AND PEER GROUP BULLYING AS PATHOLOGICAL PATHWAYS TO BORDERLINE PERSONALITY DISORDER SYMPTOMS IN EARLY ADULT: CASE REPORT

Introduction – Maladaptive experiences during adolescene have been consistently linked with borderline personality disorder. BPD is a serious mental illness characterized by pervasive pattern of instability in affect regulation, impulse control, interpersonal relationships, and self-image. Tthere was an interrelated relationship between parenting experiences and the development of BPD symptoms. Children who reported chronic bullying had a fivefold increase in the likelihood of developing BPD symptoms. Methods – Presented the case of patient, 20 years old young male with symptoms of borderline personality disorder turned out to have maladaptive parenting and history of became victim by peer group bullying since childhood. Data were taken from interviews and mental status examinations in psychiatric clinics, then a literature review was carried out. Results – The development of borderline personality disorder in adult linked with report of low care parenting, involves coldness, indifference, and rejection. BPD is also inevitable from hereditary risk factors. Discuss – There is a direct significant association between being victim of bullying and development of BPD. Empathy is one important aspect of social behavior that may not function in BPD. Atypical depressed patients with affective dysregulation first diagnosed with borderline personality disorder if do not meet the diagnostic criteria for bipolar disorder. Conclusion – Borderline personality disorder (BPD) is very prone to occur in young adults. Starting from affect dysregulation, inability to impulse control, unstable interpersonal relationships, and unstable self-image that begin to develop in children and adolescents when exposed to environmental risk factors. Risk factors that are very often influencing are family and peer group relationships. BPD is also an entry point for developing into bipolar disorder. Therefore, effective interventions should be targeted, early preventing the development of affect dysregulation in the development of the borderline personality disorder by reducing exposure to environmental risk factors. Keywords: borderline personality disorder, maladaptive parenting, bullying.

The meaning of lithium and naltrexone pharmacotherapy in the treatment of borderline personality disorder – a narrative review

Introduction: Borderline personality disorder (BPD) affects approximately 1%-3% of the population. As the most common personality disorder, BPD features behavioural, emotional and social dysfunctions. It often co-occurs with self-harm, suicidal tendencies and substance abuse. To date, pharmacological treatment does not provide sufficient therapeutic effects. The aim of our study is to analyse the neurobiological, genetic and environmental components in the aetiopathogenesis of BPD and to collect data on the innovative use of lithium and naltrexone in the therapy of BPD. Methods: Basing on PubMed and Google Scholar databases using the following keywords: borderline, lithium, naltrexone for papers published from 1979 to 2022. Results: Difficult childhood, and emotional, sexual and physical abuse are the strongest predictors of BPD development. The core symptoms of BPD may be related to dysfunction of the serotonin, dopaminergic, endogenous system and opioid systems. Variation in 5-HTT, COMT, FKBP5 and oxytocin receptor genes may influence the course of BPD. Imaging studies have shown structural and functional abnormalities in the prefrontal cortex, amygdala and hippocampus. Lithium reduces impulsivity, aggression, suicidal tendencies and self-harm in BPD. Naltrexone may effectively reduce self-harm without suicidal tendencies, impulsivity, substance abuse and suicidality. Conclusions: No unified model has been developed to account for environmental, genetic and neurobiological components in the pathogenesis of BPD. Understanding the mechanisms is a crucial step towards personalising treatment. The use of lithium and naltrexone may have positive therapeutic effects. Randomised clinical trials are required to establish the efficacy and safety of both drugs in long-term treatment. Keywords: borderline, lithium, naltrexone

Genetic Influences on Outcomes of Psychotherapy in Borderline Personality Disorder: A Narrative Review of Implications for Personalized Treatment.

Borderline personality disorder (BPD) manifests as instability in mood, relationships, self-image, and behavior, representing a challenging mental health issue. This review scrutinizes genetic factors influencing BPD and the corresponding treatment outcomes. The primary objective of this narrative review is to illuminate the association between genetic factors and BPD treatment outcomes, discussing the potential of genetic testing for personalized therapy. The review is derived from observational and experimental studies on BPD, genetic factors, and psychotherapy from 2000 to 2023, sourced primarily through PubMed. Reviews and meta-analyses were excluded. Our review suggests that genetic factors account for 40-60% of BPD variation, with significant roles played by epigenetic alterations like DNA methylation and microRNAs, particularly in the context of childhood trauma. Gene-environment interactions are also vital for BPD's development. Treatments such as dialectical behavior therapy, mentalization-based therapy, and schema therapyhave shown efficacy, with success variability possibly linked to genetic factors. However, existing research is constrained by recall bias, diverse methodologies, and limited sample sizes. Future research necessitates long-term follow-up, diverse populations, and controlled variables to enhance our comprehension of BPD treatment outcomes' genetic foundations. The review underlines the promise of personalized medicine in BPD treatment, driven by genetic insights.

Integrating Psychosocial Risks With Emerging Evidence for Borderline Personality Disorders in Adolescence: An Update for Clinicians.

Borderline personality disorder (BPD) has seen significant advances in the knowledge of its developmental phenomenology during late childhood and adolescence. Various genetic, neurobiological, psychological, and social factors are implicated in the etiology of BPD. With emerging evidence on BPD development in adolescence, the review focused on recent literature to understand the role of psychosocial risk factors. The effects of adverse familial environment, physical, emotional, verbal, and sexual abuse, intergenerational transmission of psychopathological traits, maternal neglect and rejection, low socioeconomic status, bullying victimization, and dating violence were reviewed to understand their role in the development of BPD. BPD is a highly complex, serious, and enduring mental illness that has now been widely accepted to have symptoms that onset in early adolescence and could be diagnosed as early as age 12. BPD symptoms are stable, phenomenologically distinct from externalizing and internalizing disorders, and often present with co-occurring disorders, which during assessment could not explain impairments associated with BPD. New measures like the Difficulties in Emotion Regulation Scale (DERS), detailed developmental histories, understanding of psychosocial risks, shared decision-making, and psychoeducation could assist in early diagnosis and improvement of long-term outcomes. The implementation of evidence-based treatments is a challenge given higher costs and access to services; therefore, modifications in the treatment based on the core principles of these strategies should be considered. It is imperative to screen for psychosocial factors early in higher-risk groups. The assessment of familial factors, parental histories of psychopathologies, and histories of childhood abuse is important in context with impairing symptoms of clinical presentation and dimensional aspects of self-functioning. The role of family therapies, parental psychoeducation, and the integration of trauma-informed care approaches are important for clinical outcomes. Also, coordinated efforts with multiple stakeholders like school awareness programs, anti-bullying policies, legislation, and enforcement of existing laws might be instrumental in addressing issues related to victimization by peers.

Dialectical Behavioral Skills Group Therapy for Parents of Adolescents With Borderline Personality Disorder: A Pilot Study.

Research has indicated the effectiveness of Dialectical behavior therapy in adolescents (DBT-A) with severe emotion dysregulation and other symptoms of Borderline Personality Disorder (BPD). The objective was to determine if DBT skills group with caregivers only could influence in potential mediators of DBT outcomes including rearing styles, emotion regulation and mindfulness skills, evaluated in both parents and adolescents. We implemented a 12-week group intervention based on DBT-A addressed to seven parents of adolescents with features of BPD. We tested differences after treatment using the non-parametric Wilcoxon test and calculated effect sizes. To understand individual changes, we reported clinical reliable change (CRC). The intervention was effective for improving rearing styles, emotion regulation and mindfulness skills in adolescents. Changes were stable after 6months. The intervention showed good levels of satisfaction reported by parents. A short DBT group-only intervention with caregivers could modify relevant processes related with features of BPD in adolescents. Early interventions with adolescents with symptoms of BPD could prevent the development of BPD influencing in potential mediation mechanisms.

The role of youths' cardiac autonomic balance and parental responses to youth emotion in vulnerability to borderline personality disorder development.

Developmental models of borderline personality disorder (BPD) emphasize the effects of youths' biological vulnerabilities and their experiences of parental responses to emotion, as well as the interaction between these two elements. The current study evaluated the independent and interactive effects of two indices of autonomic nervous system response and parental responses to youth negative emotions on severity and exacerbation of youths' BPD features during the transition to adolescence. The sample consisted of 162 psychiatric youth (10-14 years; 47.2% female) and their parents. At baseline, youth and their parents completed a lab-based conflict discussion during which parasympathetic and sympathetic nervous system response were measured and indices of sympathetic-parasympathetic balance and coactivation/coinhibition were calculated. Youth also reported on supportive and non-supportive parental responses. At baseline and after 9 months, youth self-reported on their BPD features. Results demonstrated that shifting toward sympathetic dominance independently predicted exacerbation of BPD across 9 months. Additionally, fewer experiences of supportive parental responses and more non-supportive parental responses were associated with greater severity of BPD features in youth. This study highlights the role of autonomic response to parent-child conflict as well as the significance of parental responses to youth emotion for the development of BPD during this developmental window.

Neighbourhood characteristics and the treated incidence rate of borderline personality pathology among young people.

The impact of the wider social environment, such as neighbourhood characteristics, has not been examined in the development of borderline personality disorder. This study aimed to determine whether the treated incidence rate of full-threshold borderline personality disorder and sub-threshold borderline personality disorder, collectively termed borderline personality pathology, was associated with the specific neighbourhood characteristics of social deprivation and social fragmentation. This study included young people, aged 15-24 years, who attended Orygen's Helping Young People Early programme, a specialist early intervention service for young people with borderline personality pathology, from 1 August 2000-1 February 2008. Diagnoses were confirmed using the Structured Clinical Interview for DSM-IV Personality Disorders, and census data from 2006 were used to determine the at-risk population and to obtain measures of social deprivation and fragmentation. The study included 282 young people, of these 78.0% (n = 220) were female and the mean age was 18.3 years (SD = ±2.7). A total of 42.9% (n = 121) met criteria for full-threshold borderline personality disorder, and 57.1% (n = 161) had sub-threshold borderline personality disorder, defined as having three or four of the nine Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) borderline personality disorder criteria. There was more than a sixfold increase in the treated incidence rate of borderline personality pathology in the neighbourhoods of above average deprivation (Quartile 3) (incidence rate ratio = 6.45, 95% confidence interval: [4.62, 8.98], p < 0.001), and this was consistent in the borderline personality disorder sub-groups. This association was also present in the most socially deprived neighbourhood (Quartile 4) (incidence rate ratio = 1.63, 95% confidence interval: [1.10, 2.44]), however, only for those with sub-threshold borderline personality disorder. The treated incidence of borderline personality pathology increased incrementally with the level of social fragmentation (Quartile 3: incidence rate ratio = 1.93, 95% confidence interval: [1.37, 2.72], Quartile 4: incidence rate ratio = 2.38, 95% confidence interval: [1.77, 3.21]). Borderline personality pathology has a higher treated incidence in the more socially deprived and fragmented neighbourhoods. These findings have implications for funding and location of clinical services for young people with borderline personality pathology. Prospective, longitudinal studies should examine neighbourhood characteristics as potential aetiological factors for borderline personality pathology.

The Impact of Childhood Maltreatment on Risk of Borderline Personality Disorder

Borderline personality disorder (BPD) is a personality disorder characterized by emotional over-sensitivity. People with BPD show symptoms of erratic behavior, having a fear of abandonment, and experiencing unstable social relationships. The factors and elements that influence the development of BPD are uncertain and varied, but there is a correlation between the development of BPD and the person's experience of abuse and other adverse factors. The aim of this review is to understand the factors and elements in BPD development. According to previous studies, emotional and sexual abuse experienced in childhood is a very important cause of the development of BPD. Low levels of caregiver warmth and neglect are associated with the development of BPD symptoms but are not determinative. At the same time, personality traits play an essential role in the resilience of BPD. In addition, BPD often coexists with other psychological disorders. Neuroticism as a personality trait is significantly associated with BPD. Brain differences between BPD and typical controls may lead to differences in their emotions and their ability to regulate emotions, which is related to their ability to control their emotional impulses. This paper illustrates the impact of adverse childhood experiences and negative parenting styles on the risk of BPD. One limitations of previous studies is that most of the studies were conducted on women, and gender differences may lead to a certain degree of bias in the exploration of influencing factors. Future studies should invetigate this topic in larger and diverse samples. This study can contribute to the design of relevant prevention and parent education programs in school.

Co-Occurring Autism Spectrum and Borderline Personality Disorder: An Emerging Clinical Challenge Seeking Informed Interventions.

Co-Occurring Autism Spectrum and Borderline Personality Disorder: An Emerging Clinical Challenge Seeking Informed Interventions.

Borderline personality disorder: Gender bias and diagnostic disparities

Borderline Personality Disorder (BPD) is a DSM-5 Cluster B mental health condition. One of the lesser understood mental health conditions, BPD is marked by a multi-symptom profile such as high levels of emotional dysregulation, distorted self-image, volatile and unstable relationships, emotional instability, and higher levels of suicidality. Symptoms are often intense and enduring, causing significant chaos and stress in an individual’s life as well as those closest to them. Because there is a significant overlap of symptomology and diagnosis with other psychiatric disorders, BPD was at one time a contested diagnosis, thus research and treatment options remained limited. Currently, BPD is one of the more widely researched conditions, which has informed evidenced-based treatment, however, individuals carrying the diagnosis report difficulty accessing treatment and difficulty feeling understood by mental healthcare providers. The development of BPD remains unclear, although consistent with other mental health conditions there is a genetic constituent, and with BPD in particular a history of trauma. This research manual will explore current evidence-based practices and assessment methods to inform best practices when working with BPD.

Etiopathogenesis in the Development of Borderline Personality Characteristics in Children and Adolescents.

The validity and clinical significance of the characteristics of borderline personality disorder (BPD) in adolescents are increasingly being recognized. The persistence of BPD characteristics in adolescence is high and is associated with negative interpersonal, academic, professional, and financial outcomes. In the literature, BPD characteristics observed in children and adolescents are explained with psychodynamic theories, developmental models, and evolutionary approaches. Emotional dysregulation, interpersonal dysfunction, impulsivity, and self-harming behavior, negative life events, temperament characteristics, neuropsychological dysfunctions, neuroanatomical, genetic, hormonal, and immunological factors may play a role in BPD etiopathogenesis. This review aims to address different approaches and relevant factors for the development of BPD. The articles published between 1968-2021 in the PubMed database were reviewed, and prominent studies were selected for evaluation. The importance of invalidating environment, epistemic freezing and hypermentalization, complex or attachment trauma is emphasized in psychodynamic and developmental literature. In the evolutionary approach, on the other hand, romantic relationships and the onset of reproduction are emphasized as the reason for the emergence of symptoms during adolescence, and it is argued that BPD is related to the rapid life history strategy. It is stated that a decrease in volume in the orbitofrontal cortex and anterior cingulate cortex, which are involved in top-down emotional processing, and an increase in the activity of thalamus and hippocampus regions, which are involved in bottom-up emotional processing are observed in adolescents with BPD characteristics when compared to healthy controls. It is thought that the increase in activation in the superior temporal gyrus and precuneus observed in adolescents with BPD features is a neural indicator of hypermentalization, and the increase in activation in the insula is a neural indicator of social pain. It has been reported that the decrease in resting heart rate and the increase in heart rate variability observed in adolescents with BPD symptoms are associated with the activation of the parasympathetic system. BPD in adolescents is a disorder that challenges clinicians in terms of diagnosis, differential diagnosis, and treatment. It is crucial to evaluate the factors related to etiopathogenesis in BPD in a multifaceted and detailed manner. Keywords: Borderline Personality Disorder, Difficulty in Emotion Regulation, Mentalization, Trauma, Self-harming Behavior, Temperamental Characteristics.

Parental invalidation and its associations with borderline personality disorder symptoms: A multivariate meta-analysis.

Childhood invalidation has been postulated to be implicated in the development of borderline personality disorder (BPD), according to the biosocial model. Despite its significance, most systematic reviews and meta-analyses have focused on examining the associations between extreme forms of invalidation, such as sexual abuse, and BPD. Nonetheless, individuals could experience mild-to-severe levels of parental invalidation, with or without abuse. This study examined the relationship between parental invalidation as an overall construct and BPD symptoms, synthesized across 21 studies (total N = 7,198). As most reviewed studies utilized retrospective self-report measures, the effect sizes derived pertained largely to the association between reported childhood parental invalidation and BPD symptoms. We conducted a multivariate meta-analysis to account for the dependence of multiple effect sizes obtained from a single study and to maintain precision in obtained effect sizes. Maternal, paternal, and overall parental invalidation were positively associated with BPD symptoms, with small-to-moderate effect sizes of .26, .23, and .25, respectively. The mean effect size of maternal invalidation was greater than that of paternal invalidation. We also investigated if the parental invalidation-BPD associations were moderated by child gender, age, and culture (degree of individualism). Only overall parental invalidation and BPD symptoms association was moderated by child's gender, with larger effect sizes found for samples with a greater proportion of males. Age and culture did not moderate the parental invalidation-BPD association. Risk of publication bias was low. Our findings provide support for the invalidating childhood environment component of the biosocial model. (PsycInfo Database Record (c) 2022 APA, all rights reserved).