Development Of Borderline Personality Disorder Research Articles

3.96 Identifying Preschool-Age Moderating Factors in the Development of Borderline Personality Disorder

Despite a growing literature on early childhood risk factors for borderline personality disorder (BPD), few studies have examined symptoms that may mitigate the effects of those risk factors. Here we examined whether 3 preschool-age characteristics—impulsivity, emotional lability, and initiative taking—moderated the relationship between known preschool-age risk factors and adolescent BPD symptoms.

The Pathogenesis of Borderline Personality Disorder: Evolution of Evidence and Treatment Implications for Two Prominent Models.

Since Stern first started his work in 1938, the field has recognized several empirically supported models of the etiology of borderline personality disorder (BPD). Two such models are the Tripartite Model of the Development of BPD and the Biosocial Development Model of BPD. The Tripartite Model of the Development of BPD suggests that it is a combination of a hyperbolic temperament, traumatic childhood experiences, and an event or series of events that trigger the onset of BPD. Whereas the Biosocial Development Model of BPD elaborates on the work of Linehan's Biosocial Theory. This model suggests a combination of an emotionally vulnerable temperament and an invalidating environment cause BPD. Over 70 years of research support these models. This article covers a detailed description of each of these models, the decades of research supporting these models, similarities, differences, treatment implications, the latest research, and future directions.

Identifying moderating factors during the preschool period in the development of borderline personality disorder: a prospective longitudinal analysis

BackgroundDespite a growing literature detailing early childhood risk factors for borderline personality disorder (BPD), few studies have examined moderating factors that might mitigate or exacerbate the effects of those risk factors. The current study examined whether three preschool-age characteristics—impulsivity, emotional lability, and initiative-taking—moderated the relationship between known preschool-age risk factors and adolescent BPD symptoms.MethodsWe performed multilevel modeling analyses in a sample (n = 151) from the Preschool Depression Study, a prospective longitudinal study with assessments from preschool through adolescence. Preschool risk factors included adverse childhood experiences, internalizing symptoms, and externalizing symptoms measured with parent clinical interviews. Preschool moderating factors were assessed via parent report and observational coding of temperament and behavior. The Borderline Personality Features Scale for Children measured BPD symptoms in adolescence.ResultsWe found that observed initiative-taking moderated the relationship between preschool internalizing symptoms and adolescent BPD symptoms (b = 0.57, p = .011) and moderated the relationship between preschool externalizing symptoms and adolescent BPD symptoms (b = 1.42, p = .013). Greater initiative-taking was associated with lower BPD risk for children with high internalizing or externalizing symptoms. Conversely, for children with low internalizing or externalizing symptoms, greater initiative-taking was associated with increased BPD risk.ConclusionsWe identify a potential moderating factor in BPD development, offer novel targets for screening and intervention, and provide a framework for using early childhood observational assessments in BPD research. Our findings suggest the need for future research on early moderating factors in BPD development, which could inform early childhood interventions targeting those factors to mitigate the effects of potentially less malleable risk factors.

Potential epigenetic mechanisms in psychotherapy: a pilot study on DNA methylation and mentalization change in borderline personality disorder.

Genetic and early environmental factors are interwoven in the etiology of Borderline Personality Disorder (BPD). Epigenetic mechanisms offer the molecular machinery to adapt to environmental conditions. There are gaps in the knowledge about how epigenetic mechanisms are involved in the effects of early affective environment, development of BPD, and psychotherapy response. We reviewed the available evidence of the effects of psychotherapy on changes in DNA methylation and conducted a pilot study in a sample of 11 female adolescents diagnosed with BPD, exploring for changes in peripheral DNA methylation of FKBP5 gene, which encodes for a stress response protein, in relation to psychotherapy, on symptomatology and underlying psychological processes. For this purpose, measures of early trauma, borderline and depressive symptoms, psychotherapy outcome, mentalization, and emotional regulation were studied. A reduction in the average FKBP5 methylation levels was observed over time. Additionally, the decrease in FKBP5 methylation observed occurred only in those individuals who had early trauma and responded to psychotherapy. The results suggest an effect of psychotherapy on epigenetic mechanisms associated with the stress response. The finding that epigenetic changes were only observed in patients with early trauma suggests a specific molecular mechanism of recovery. The results should be taken with caution given the small sample size. Also, further research is needed to adjust for confounding factors and include endocrinological markers and therapeutic process variables.

Adverse Childhood Experiences and Neurocognition in Borderline Personality Disorder: A Call-to-Action Perspective Review.

Adverse childhood experiences (ACEs) contribute to the development of personality traits leading to adult borderline personality disorder (BPD). Neurocognitive changes could partly mediate the association between ACEs and BPD. We discuss how exposure to ACEs could induce alterations in neurocognition, which, in turn, would contribute to the development of BPD. We conducted a review of MEDLINE articles through 2021, documenting a link between ACEs, neurocognitive impairments, and BPD, and also focusing on the pairwise associations. ACEs appear to have a strong impact on neurocognition and are a predictive factor for BPD. Maltreated, abused, and emotionally invalidated children are more likely to present BPD traits. Neurocognitive impairments in adults exposed to ACEs and in patients with BPD arise from similar brain alterations in the amygdala, hippocampus, and prefrontal cortex. These impairments seem to be linked with clinical dimensions of BPD: increased impulsivity to altered inhibitory control; dissociative experiences to nonspecific autobiographical memory; and emotionally biased facial recognition to unstable interpersonal relationships. This perspective review highlights the contributory role of neurocognition in the association between ACEs and BPD. Additional research is needed, however, on the interconnections among ACEs, neurocognition, and BPD. Future studies could also focus on developing tools to assess early adversity in BPD specifically and on psychotherapeutic approaches to promptly remedy neurocognitive impairments.

The relation between Complex PTSD and Borderline Personality Disorder – a review of the literature

IntroductionAdults diagnosed with Borderline Personality Disorder (BPD) likely have a history of psychological trauma. There has been research about the connection between Complex Post-Traumatic Stress Disorder (c-PTSD) and BPD.ObjectivesThis paper provides a review of the relationship between complex trauma and key features of BPD.MethodsReview of the literature from 2015 to present, using search engines such as Pubmed and Google Shoolar, using the following keywords: borderline personality disorder, complex post-traumatic stress disorder, traumaResultsTraumatic victimisation and compromised primary caregiving relationships have been hypothesized to be key aetiological factors in the subsequent development of BPD. c-PTSD was defined as a syndrome with symptoms of emotional dysregulation, dissociation somatisation and poor self-esteem, with distorted cognition about relationships, following traumatic interpersonal abuse. It was proposed as an alternative for understanding and treating people who had suffered prolonged and severe interpersonal trauma, many of whom were diagnosed with BPD. Although, the boundaries between c-PTSD and BPD remain vague. Currently, the main difference is the assumption that symptoms of c-PTSD are sequelae of exposure to traumatic stress, which is not inherent in the current DSM-5 definition of BPD. Furthermore, to date, the neurochemistry and neurostructural changes seen in c-PTSD, BPD and PTSD do not clearly differentiate the three conditions.ConclusionsBPD and PTSD are relatively distinct with regard to the precise qualitative definitions of their diagnostic features, but nevertheless have substantial potential overlap in their symptom criteria.DisclosureNo significant relationships.

Borderline personality disorder and the big five: molecular genetic analyses indicate shared genetic architecture with neuroticism and openness

Both environmental (e.g. interpersonal traumatization during childhood and adolescence) and genetic factors may contribute to the development of Borderline Personality Disorder (BPD). Twin studies assessing borderline personality symptoms/features in the general population indicate that genetic factors underlying these symptoms/features are shared in part with the personality traits of the Five Factor Model (FFM) of personality—the “Big Five”. In the present study, the genetic overlap of BPD with the Big Five -Openness to Experience, Conscientiousness, Extraversion, Agreeableness, and Neuroticism- was assessed. Linkage disequilibrium score regression was used to calculate genetic correlations between a genome-wide association study (GWAS) in central European populations on BPD (N = 2543) and GWAS on the Big Five (N = 76,551–122,886, Neuroticism N = 390,278). Polygenic scores (PGS) were calculated to test the association of the genetic disposition for the personality traits with BPD case-control status. Significant positive genetic correlations of BPD were found with Neuroticism (rg = 0.34, p = 6.3*10−5) and Openness (rg = 0.24, p = 0.036), but not with the other personality traits (all | rg | <0.14, all p > 0.30). A cluster and item-level analysis showed positive genetic correlations of BPD with the Neuroticism clusters “Depressed Affect” and “Worry”, and with a broad range of Neuroticism items (N = 348,219–376,352). PGS analyses confirmed the genetic correlations, and found an independent contribution of the personality traits to BPD risk. The observed associations indicate a partially shared genetic background of BPD and the personality traits Neuroticism and Openness. Larger GWAS of BPD and the “Big Five” are needed to further explore the role of personality traits in the etiology of BPD.

Difficulties in Emotion Regulation Mediated the Relationship Between Reflective Functioning and Borderline Personality Symptoms Among Non-Clinical Adolescents.

The literature has established the associations between reflective functioning (RF), affect regulation, and the development of borderline personality disorder (BPD) symptoms. We aimed to examine the mediator role of difficulties in emotion regulation on the relationship between RF and BPD symptoms in a non-clinical adolescent sample. The sample was composed of 546 Turkish adolescents with a mean age of 16.18 (SD = 1.67). Of the sample, 62.5% were adolescent girls and 37.5% of boys. In the present cross-sectional research, volunteer adolescents along with parental permission filled out Socio-Demographics Form, Reflective Functioning Questionnaire, Difficulties in Emotion Regulation Scale, and Borderline Personality Inventory on paper during counseling sessions at schools. Process macro was used to conduct mediation analyses. Compromised RF was related to an increase in adolescent borderline personality symptoms, both directly and indirectly via difficulties in emotion regulation. In this non-clinical adolescent sample, a lower degree of certainty, as well as a higher degree of uncertainty about the mental states, were related to a propensity to emotion dysregulation, specifically experiencing emotions less clearly, approaching emotions impulsively, and facing emotions without a modulation strategy. These associations were in turn related to an increase in borderline personality symptoms. The present research results suggest RF and emotion regulation problems as one field of early intervention for adolescents with BPD symptoms.

Comorbid borderline personality disorders in women with post-partum depression admitted to mother-baby units

Borderline personality disorder (BPD) is associated with perinatal depression and parenting difficulties. However, little is known about the characteristics and specific effects of BPD in women with postpartum depression. This study aimed to explore 1) the sociodemographic, mental health characteristics, and motherhood difficulties in women with a major depressive postpartum episode (MDPE) and a comorbid diagnosis of BPD, compared to those with other personality disorders (other PD) or no PD and 2) whether BPD itself may be an independent risk factor for infant neglect in women with a MDPE. 412 women admitted to a Mother and Baby Unit (2001–2010) with a MDPE were involved in this study. Our study showed that women with MDPE-BPD (n = 64) more frequently reported a history of childhood maltreatment, single status, low social support, a history of depression, smoking during pregnancy and suicide attempt during the perinatal period compared to women with other PDs (n = 88) or no PD (n = 260). Women with comorbid BPD had a greater length of stay. Regarding infant care, neglect, abuse, and separation at discharge were more frequent in women with comorbid BPD. Logistic regression was performed to specifically examine whether BPD in women with a MDPE was an independent risk factor for infant neglect during the postpartum period. Comorbid BPD was independently associated with infant neglect (OR = 2.21; CI95% [1.02–4.81]). Our results underline the importance of screening for BPD in women with perinatal depression. Further studies are needed to explore the links between MDPE, BPD, and infant development.

Understanding the Relationship Between Sleep Problems in Early Childhood and Borderline Personality Disorder: A Narrative Review.

ObjectiveRecent research indicates that sleep problems in childhood precede the development of borderline personality disorder (BPD) symptoms, but the mechanisms by which sleep problems associate with BPD are still unknown. This narrative review aims to provide some potential explanations for how early sleep problems might associate with BPD.MethodsWe used the biosocial developmental model of BPD as a framework to discuss how sleep problems may associate with BPD. Articles were identified via PubMed and Embase, and papers published between January 1991 and April 2021 were extracted. Authors made a series of literature searches using the following keywords: Sleep problems, Insomnia, Nightmares, Hypothalamic–Pituitary–Adrenal Axis (HPA), Prefrontal Cortex, Family Psychopathology, Disrupted Attachment, Child Maltreatment, Impulsivity, Emotion Regulation, Internalizing, Externalizing, Rumination, Childhood, Adolescence, Young people. The inclusion criteria were published in peer-reviewed journals; human studies or reviews; published in English. The exclusion criteria were commentaries; abstracts from conferences; studies with animal samples. A total of 96 articles were included for the purpose of this review.ResultsThe evidence from this review suggests that some biological factors and core features of BPD act as potential mechanisms mediating the associations between early sleep and subsequent BPD, while some family-related factors might constitute common risk factors for sleep problems and BPD.ConclusionThe biosocial developmental model of BPD provides a plausible characterization of how sleep disruption might lead to subsequent BPD. Further research on new developmental and early intervention approaches to understand how sleep in early stages associates with BPD could have significant clinical impact on these patients and could inform targeted therapeutic interventions.

An Overview on Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a psychiatric disease marked by unstable interpersonal relationships, fear of abandonment, difficulty regulating emotions, feelings of emptiness, persistent dysphoria or sadness, impulsivity, and increased risk-taking behaviors. The prevalence of borderline personality disorder has been reported at 11 percent in the psychiatric outpatient community and as high as 20% in the psychiatric inpatient population. Patients with BPD have a high rate of morbidity, which makes medical treatment more difficult. Although the role of genetics in BPD is unclear, inheritance of BPD appears to be considerable. Life events are also found to play a role in the development of BPD. The most important risk factor for the development of BP is childhood trauma. Symptoms that have been present since adolescence or early adulthood and manifest in a variety of settings are used to make the diagnosis. There are no lab or imaging tests available to aid in the diagnosis. Patients with borderline personality disorder benefit from three evidence-based treatments. Mentalizing-based therapy (MBT). Dialectical behavior therapy (DBT) and transference-focused psychotherapy (TFP). In this review we will be discussing epidemiology, etiology, clinical features diagnosis and treatment of BPD.

The Role of Trauma in Early Onset Borderline Personality Disorder: A Biopsychosocial Perspective

The role of childhood trauma in the development of borderline personality disorder (BPD) in young age has long been studied. The most accurate theoretical models are multifactorial, taking into account a range of factors, including early trauma, to explain evolutionary pathways of BPD. We reviewed studies published on PubMed in the last 20 years to evaluate whether different types of childhood trauma, like sexual and physical abuse and neglect, increase the risk and shape the clinical picture of BPD. BPD as a sequela of childhood traumas often occurs with multiple comorbidities (e.g. mood, anxiety, obsessive-compulsive, eating, dissociative, addictive, psychotic, and somatoform disorders). In such cases it tends to have a prolonged course, to be severe, and treatment-refractory. In comparison with subjects who suffer from other personality disorders, patients with BPD experience childhood abuse more frequently. Adverse childhood experiences affect different biological systems (HPA axis, neurotransmission mechanisms, endogenous opioid systems, gray matter volume, white matter connectivity), with changes persisting into adulthood. A growing body of evidence is emerging about interaction between genes (e.g. FKBP5 polymorphisms and CRHR2 variants) and environment (physical and sexual abuse, emotional neglect).

Attachment anxiety as mediator of the relationship between childhood trauma and personality dysfunction in borderline personality disorder.

Insecure attachment has been described as mediating the relationship between childhood trauma and dysfunctional personality traits in different mental disorders. Despite the role insecure attachment and childhood trauma have independently demonstrated to play as determinants of borderline personality disorder, less is known about the mediating mechanisms explaining these associations. For the first time, we assessed adult attachment, childhood trauma and dimensional personality pathology in a sample of outpatients with borderline personality disorder and tested whether the association between childhood trauma and personality dysfunction was at least partially attributable to insecure attachment. The results showed that attachment anxiety fully mediated the relationship between specific types of trauma (emotional abuse and physical neglect) and emotional dysregulation. Further, emotional abuse was both directly associated with dissocial behaviour and indirectly via attachment anxiety (partial mediation). Emotional abuse has been described as an essential environmental factor for the development of borderline personality disorder and emotional dysregulation, on its part, as the core feature of the condition. Our results indicate that attachment anxiety explains the link between these central aspects of borderline personality disorder. Our findings are consistent with previous research and current etiological understanding of the condition and provide support for recommending a careful assessment of childhood traumatic experiences and adult attachment style to gain a more comprehensive insight into the symptoms and its heterogeneity. As a secondary aim, we assessed the effect parental mental illness may have in these mediation models, but no significant influence on childhood trauma, attachment or personality was found.

Borderline Personality Traits: The Roles of Childhood Teasing and Traumatic Experiences

Background and Objective: The relationship of borderline personality traits with childhood teasing and traumatic experiences is a major risk factor in the development of borderline personality disorder (BPD) symptoms; nonetheless, this relationship is not fully understood. The present study aimed to provide further evidence on the role of childhood teasing, traumatic experiences, and other pathological personality traits, such as negative affectivity, antagonism, psychoticism, disinhibition, detachment, depression, anxiety, and stress symptom, in the development of borderline personality disorder, especially in Iranian non-clinical populations. Materials and Methods: A total of 385 college students were assessed by teasing questionnaire-revised (TQ-R), childhood trauma questionnaire (CTQ), Personality Inventory for DSM-5 Brief Form (PID-5-BF), the borderline personality scale (SIB), and the depression, anxiety, and stress scale (DASS-21). Results: Descriptive statistics, Pearson Correlations, and stepwise regression analysis statistics were conducted to examine the relationship of borderline personality traits with childhood teasing and traumatic experiences. The current study supported the significant positive correlation of borderline personality disorder with PID-5-BF, such as negative affectivity, antagonism, psychoticism, disinhibition, detachment, depression, anxiety, and stress symptoms, as well as teasing and traumatic experiences in non-clinical individuals. Conclusions: As evidenced by the results of this study, childhood traumatic experiences have a prominent role to play in the development of borderline personality psychopathology.

Interactive Effects of Parent Emotion Socialization and Child Physiological Reactivity in Predicting Adolescent Borderline Personality Disorder Features.

Theories suggest that a transaction between child biological vulnerability and parent emotion socialization underlies the development of borderline personality disorder (BPD) features. Yet, few studies have examined the interaction between these factors prospectively in at-risk samples. Consequently, this study tested whether parental reactions to children's negative emotions moderated the effect of the child's physiological reactivity to stress in predicting adolescent BPD features in a sample of youth with and without clinical elevations in attention deficit/hyperactivity disorder (ADHD). Participants were 61 children (52% female) and parents (90% mothers). When children were 9-13years old, their physiological reactivity to a social stressor was assessed based on respiratory sinus arrhythmia (RSA) and skin conductance level (SCL) reactivity; parents also reported on their supportive and non-supportive reactions to their child's negative emotions. Children were followed-up four to five years later at ages 14-18years old and their BPD features were assessed based on parent and adolescent report. Significant interactions between children's SCL reactivity and parental reactions to children's negative emotions were found in predicting adolescent BPD features. Children with low SCL reactivity to social stress and parents high in supportive/low in non-supportive reactions were lowest in adolescent BPD features. However, greater SCL reactivity predicted greater adolescent BPD features specifically when the parent was high in support or low in non-support. Childhood ADHD symptoms also significantly predicted greater adolescent BPD features. Findings suggest that children with different patterns of SCL reactivity may respond differently to parental reactions to their emotions.

A genome-wide methylation study reveals X chromosome and childhood trauma methylation alterations associated with borderline personality disorder

Borderline personality disorder (BPD) is a severe and highly prevalent psychiatric disorder, more common in females than in males and with notable differences in presentation between genders. Recent studies have shown that epigenetic modifications such as DNA methylation may modulate gene × environment interactions and impact on neurodevelopment. We conducted an epigenome wide study (Illumina Infinium HumanMethylation450k beadchip) in a group of BPD patients with (N = 49) and without (N = 47) childhood traumas and in a control group (N = 44). Results were confirmed in a replication cohort (N = 293 BPD patients and N = 114 controls) using EpiTYPER assays. Differentially methylated CpG sites were observed in several genes and intragenic regions in the X chromosome (PQBP1, ZNF41, RPL10, cg07810091 and cg24395855) and in chromosome 6 (TAP2). BPD patients showed significantly lower methylation levels in these CpG sites than healthy controls. These differences seemed to be increased by the existence of childhood trauma. Comparisons between BPD patients with childhood trauma and patients and controls without revealed significant differences in four genes (POU5F1, GGT6, TNFRSF13C and FAM113B), none of them in the X chromosome. Gene set enrichment analyses revealed that epigenetic alterations were more frequently found in genes controlling oestrogen regulation, neurogenesis and cell differentiation. These results suggest that epigenetic alterations in the X chromosome and oestrogen-regulation genes may contribute to the development of BPD and explain the differences in presentation between genders. Furthermore, childhood trauma events may modulate the magnitude of the epigenetic alterations contributing to BPD.

Presentation of Borderline Personality Disorder Symptoms in Adulthood: Development of Depression Mediates the Effect of Childhood and Adolescent Exposure to Violence.

Past research has linked the development of borderline personality disorder to earlier exposure to violence. However, the causal link by which this relationship exists has not yet been fully identified. The present study sought to examine how exposure to violence predicted heterogeneity in the development of depressive systems and results in the arousal of borderline personality disorder symptoms in adulthood. The Pathways to Desistance data were used in the analyses. This data set consisted of the responses of 1354 juvenile offenders followed across 7 years. Group-based trajectory modeling was used to identify latent trajectories of depressive symptoms. Ordinary least squares regression was used to model covariate effects on borderline personality disorder symptoms in adulthood. Results indicated that a three-group depression trajectory model best fit the data. Direct victimization early in life was associated with increased borderline personality disorder symptoms in adulthood. When trajectory group assignment was accounted for in the model, the relationship between direct victimization and borderline personality disorder symptoms was attenuated by around 30%. Implications are discussed.

Impaired set-shifting in drug-naïve patients with borderline personality disorder: an event-related potentials study

Background: Neurocognitive impairments might play a key role in the development of Borderline Personality Disorder (BPD), however, the pathophysiological mechanism underlying cognitive impairment of BPD is largely unknown. This study was aimed to examine the electrophysiological mechanism of deficits in set-shifting processing in patients with BPD.Methods: Twenty-seven drug-naïve patients with BPD and twenty-four healthy controls were recruited. Demographic variables and clinical characteristics of all subjects were collected. Behavioral data and event-related potentials (ERPs) were recorded when subjects were performing the task-switching paradigm, which was applied to investigate the set-shifting function. The P2, N2 and P3 components in the task-switching paradigm would be analyzed.Results: Patients with BPD had significantly higher level of impulsivity, depression and anxiety than healthy controls. When performing the switching task, the BPD group had lower P2 amplitude and higher N2 amplitude than the control group. In the BPD group, the P2 latency at Fz electrode in repeat task was correlated positively with the level of depression, and P2 latency at Pz electrode in repeat task and switch task both had significantly negative relationships with the the level of anxiety.Limitations: This cross-sectional designed study did not clarify the causal relationship of the electrophysiological characteristics and the development of BPD.Conclusions: Patients with BPD might have abnormal brain activities when overcoming the inhibition of current task and inhibiting the effects of prior task, and their top-down control function might be impaired. These findings provide some useful clues for the underlying pathophysiological mechanism of BPD.

Preliminary Investigation of the Psychometric Properties of the Parent Version of the Borderline Personality Features Scale for Children (BPFS-P)

There is growing evidence that features of borderline personality disorder (BPD) emerge in childhood and present long-term risk for the development of BPD. Thus, valid and reliable assessments of BPD features in childhood are needed. This study examined the psychometric properties of the parent version of the Borderline Personality Features Scale for Children (BPFS-P) in a large, representative sample (N = 1,050; 51.5% male; M age = 8.42, SD = 2.31; Agerange = 5 to 12 years). The factor structure of the BPFS-P was examined, and measurement invariance was tested across child age and sex as well as caregiver informant sex. Additionally, the unique contribution of the identified factors of the BPFS-P to overall impairment and need for treatment beyond co-occurring dimensions of additional psychopathology was examined. A one factor structure was identified, which demonstrated measurement invariance across child sex and age as well as caregiver informant sex. BPD features measured with the BPFS-P contributed unique variance to explaining overall impairment and need for treatment. These findings point to the potential of the BPFS-P to break new ground in identifying youth at risk for BPD.

From Child Abuse to Developing Borderline Personality Disorder Into Adulthood: Exploring the Neuromorphological and Epigenetic Pathway.

Borderline personality disorder (BPD) is one of the most common personality disorders seen in the general population. Among multiple identified risk factors, one of the most influential elements is exposure to an adverse childhood experience in terms of emotional, physical, or sexual abuse. A cascade of neuromorphological and epigenetic changes occurs in response to these childhood stressors, which may have a strong link to the development of BPD. PubMed and Google Scholar were searched for articles relevant to child abuse and the development of BPD. The search was not restricted to any time frame or geographic location. Significant epigenetic and neuromorphological changes are seen with child abuse, contributing to the development of BPD. Chronic stressors lead to hypothalamic-pituitary axis (HPA) activation, releasing cortisol that acts on the prefrontal cortex, amygdala, and hippocampus, producing the behavioral patterns seen in BPD. Overstimulation of gray matter leads to permanent neuromorphological changes, which can be visualized in functional MRI/brain scans. Hypermethylation of messenger ribonucleic acid in various sites suggests the impact of child abuse on the genetic level. Interestingly, the prevalence of BPD is seen equally in both genders but is diagnosed more frequently in females because they tend to be more likely to seek help. Understanding the impact of early age life stressors into adulthood calls for serious focus on early diagnosis and intervention. This implies the need for more studies in patients with BPD with or without any childhood traumatic experience and a better understanding of the changes that occur biopsychologically and genetically in response to trauma.