Development Of Borderline Personality Disorder Research Articles

Mind the Fathers: Associations of Parental Childhood Adversities With Borderline Personality Disorder Pathology in Female Adolescents.

Previous research revealed significant relations between the experience of childhood adversity (CA) and the development of borderline personality disorder (BPD) in adulthood. However, it is still uncertain whether parental CA could have a transgenerational association with adolescent BPD. We investigated associations between parents' CA (antipathy, neglect, physical abuse) and BPD traits within a clinical adolescent sample and tested for mediating variables. The sample consists of 91 female inpatients, along with 84 mothers and 59 fathers. Adolescent BPD traits were assessed using the BPD module of the Structured Clinical Interview for DSM-IV Disorders (SCID-II). Adolescent and parental CA and parental subclinical BPD traits were measured using validated self-report questionnaires (CECA.Q; PSSI). The findings revealed significant associations between parental CA and adolescent BPD traits, which were partially mediated by parental subclinical BPD traits and by paternal but not maternal CA. The results underline that early intervention of BPD must target the family environment, including fathers.

Five-year prospective investigation of self-harm/suicide-related behaviors in the development of borderline personality disorder.

Although borderline personality disorder (BPD) is frequently characterized by nonsuicidal self-injurious behavior (NSSI), suicide attempts (SA), suicidal ideation (SI), and/or suicide threats (ST), it is unclear whether these behaviors are precursors of BPD in adolescence. This study examined self-harm/suicide-related behaviors in the development of BPD from adolescence to adulthood in psychiatrically hospitalized adolescents. Participants were 116 adolescents consecutively admitted for a psychiatric hospitalization for self-harm/suicide-related behaviors. Adolescents completed self-report questionnaires assessing self-harm/suicide-related behaviors, maladaptive familial behavior, and peer victimization upon admission. Admission diagnoses and history of sexual/physical abuse were abstracted from medical/psychiatric records. Five years after index hospitalization, medical/psychiatric records were systematically reviewed and information on diagnoses was collected. Using multivariable logistic regression analyses, ST predicted BPD above and beyond NSSI, SA, and SI 5 years later (odds ratio = 1.31, 95% confidence interval [1.06, 1.62], p > .01). Traditional risk factors of BPD were not predictive of BPD at 5-year follow-up. Suicidal threats are an important risk factor in adolescents who engage in self-harm/suicide-related behaviors that may differentiate those adolescents who go on to develop BPD as adults. Implications for research and treatment are discussed. (PsycINFO Database Record

Attention deficit hyperactivity disorder (ADHD) and borderline personality disorder (BPD) – intersections systematic review

Given the well-known overlap of symptoms and diagnosis criteria between attention deficit and hyperactivity disorder (ADHD) and borderline personality disorder (BPD), recent studies have been made in this mental health research field. It is frequently observed that adults with a BPD diagnosis show a history of childhood ADHD symptoms, as well as a diagnosis for both diseases as adults. Even though many hypotheses have been presented, the nature of the relation between these two conditions is yet to be established. Thus, the authors consider the revision of the existing studies concerning how ADHD and BPD are related to be pertinent.PUBMED was used as a research source, with the search terms attention deficit and hyperactivity disorder and borderline personality disorder. Thirteen studies showing different possibilities and association mechanisms between ADHD and BPD were eligible for revision. All the studies have shown a statistical association between both diseases.The data mostly support the hypotheses that the two perturbations correspond to the same disease in different stages of evolution; that both are different diseases sharing a common etymological basis; that both perturbations are synergic, mutually powering each other while in comorbidity or that childhood ADHD may be a precursor to BPD during adolescence/adulthood.The necessity for more studies becomes evident, namely about the influence of the precocious treatment for ADHD and the development of BPD in the future and other potential factors that may be involved in this association.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Pupillary and affective responses to maternal feedback and the development of borderline personality disorder symptoms.

Etiological models propose that a biological vulnerability to emotional reactivity plays an important role in the development of borderline personality disorder (BPD). However, the physiological and phenomenological components of emotional reactivity that predict the course of BPD symptoms in adolescence are poorly understood. This prospective study examines pupillary and affective responses to maternal feedback as predictors of BPD symptom development in adolescent girls over 18 months. Fifty-seven 16-year-old girls completed a laboratory task in which they heard recorded clips of their own mothers making critical or praising statements about them, as well as neutral statements that did not pertain to them. Changes in girls' pupil dilation and subjective affect were assessed throughout the task. The results demonstrated that greater pupillary response to maternal criticism predicted increases in BPD symptoms over time. In addition, greater pupillary and positive affective responses to maternal praise were associated with higher BPD symptoms at age 16 and faster decreases in BPD symptoms over time, but only among girls who heard clips that were rated by independent observers as less praising. The results suggest that emotional reactivity can serve as either a risk or a protective factor depending on context, with differential effects of reactivity to criticism versus praise.

Parents' childhood experiences of bonding and parental psychopathology predict borderline personality disorder during adolescence in offspring.

Previous studies on borderline personality disorder (BPD) development suggest a transgenerational transmission of parent-child relationship quality, which may also be influenced by parents' mental health status. The aim of this study was twofold. First, we aimed to investigate the transgenerational effect of parental bonding experiences on the development of BPD in their offspring. Second, we examined the association between parents' mental health status and BPD in offspring. Ninety-one female adolescent psychiatric inpatients along with 87 mothers and 59 fathers were enrolled in the study. Adolescent BPD was assessed with the Structured Clinical Interview for DSM-IV-II, parental bonding with the Parental Bonding Instrument, and parents´ psychiatric symptoms with the Patient Health Questionnaire. We found that low parental care produced a transgenerational effect from mother to BPD in offspring. Further, significant associations were found between paternal psychiatric symptoms and adolescent BPD. High paternal stress levels mediated the association between maternal affect reported by fathers and BPD in daughters. There is evidence of a transgenerational effect of parental bonding specifically for female adolescents with BPD, compared with other clinical control subjects. Our findings highlight the importance of including both parents in future research and in early clinical treatment in adolescents with BPD.

The developmental trajectory of Borderline personality disorder and peer victimisation: Australian family carers’ perspectives

ABSTRACTVictimisation is a traumatic experience linked to development of Borderline personality disorder (BPD). However, there is limited research investigating the developmental journey prior to BPD diagnosis. School environments offer an opportunity for BPD prevention and early intervention. A survey with 19 Australian family carers of people with BPD asked what they noticed during the person’s infancy, childhood and adolescence, and their experiences of seeking help during that time. Sensitivity was most noticeable during infancy; difficulty making friends, school refusal/truancy and being bullied were prominent concerns once the child was at school; and concerns about anger, moodiness and impulsivity were the strongest prompts to seek help during adolescence, though doctor or teacher recommendation to do so was uncommon. BPD family carers’ experiences suggest that improved focus on addressing bullying and communication is needed.

The role of emotion dysregulation in the presence, associated difficulties, and treatment of borderline personality disorder.

Theory and research identify emotion dysregulation as one of the primary mechanisms underlying borderline personality disorder (BPD) and related pathology. Yet, despite the extensive research documenting an association between emotion dysregulation and BPD, many questions regarding the precise role of emotion dysregulation in the development and treatment of BPD and its associated difficulties remain unanswered. This paper reviews the extant literature on the role of emotion dysregulation in BPD and its associated difficulties, as well as the treatment of BPD-related pathology, and identifies important next steps for future research in this area. In particular, this review highlights the need for further research examining: (a) the dimensions of emotion dysregulation that are unique to BPD, (b) the role and nature of interpersonal (vs. intrapersonal) emotion regulation in BPD, (c) the role of emotion dysregulation in the physical (vs. mental) health problems associated with BPD, and (d) the role of emotion regulation in efficacious treatments for BPD. Such research has the potential to elucidate the precise emotion regulation deficits that are most relevant (and central) to BPD, the active ingredients and mechanisms of change in current efficacious treatments for BPD, and the most effective and efficient targets for integrative treatments for this population. (PsycINFO Database Record

Borderline personality disorder and the emerging field of developmental neuroscience.

Over the past 2 decades there has been a dramatic shift in understanding of personality disorders, such as borderline personality disorder (BPD). What was historically viewed as an entrenched pattern of antagonistic, interpersonally dependent, and uncorrectable conduct is now seen as the outcome of complex-yet modifiable-developmental processes. The borderline label, which once inspired such harsh opprobrium in clinical communities that early diagnosis was considered taboo, is now increasingly applied to adolescents who are receiving effective treatment and desisting from a borderline trajectory. Research examining the developmental origins and early manifestations of BPD is increasing rapidly, making it an appropriate time to take stock of current developmental research and articulate an agenda for the future. We identify 4 challenges that continue to impede innovative research on borderline personality development: (a) inadequate attention to continuity and discontinuity across development, (b) medical and diagnostic systems that localize personality pathology within the individual, (c) the lingering belief that biological research is antithetical to contextual/interpersonal understandings of psychopathology (and vice versa), and (d) reluctance to reach across disciplinary and developmental boundaries to identify creative paradigms and foster innovative discovery. In order to overcome these challenges, we propose an approach to future research on adolescent borderline pathology that integrates developmental psychopathology, social and affective neuroscience, and personality theory perspectives. This intersection-the developmental neuroscience of personality pathology-offers theoretical and methodological advantages over disciplinary isolation and is fertile ground for generating novel hypotheses on the development and prevention of BPD. (PsycINFO Database Record

A Neurobiological Model of Borderline Personality Disorder: Systematic and Integrative Review

Borderline personality disorder (BPD) is a severe mental disorder with a multifactorial etiology. The development and maintenance of BPD is sustained by diverse neurobiological factors that contribute to the disorder's complex clinical phenotype. These factors may be identified using a range of techniques to probe alterations in brain systems that underlie BPD. We systematically searched the scientific literature for empirical studies on the neurobiology of BPD, identifying 146 articles in three broad research areas: neuroendocrinology and biological specimens; structural neuroimaging; and functional neuroimaging. We consolidate the results of these studies and provide an integrative model that attempts to incorporate the heterogeneous findings. The model specifies interactions among endogenous stress hormones, neurometabolism, and brain structures and circuits involved in emotion and cognition. The role of the amygdala in BPD is expanded to consider its functions in coordinating the brain's dynamic evaluation of the relevance of emotional stimuli in the context of an individual's goals and motivations. Future directions for neurobiological research on BPD are discussed, including implications for the Research Domain Criteria framework, accelerating genetics research by incorporating endophenotypes and gene × environment interactions, and exploring novel applications of neuroscience findings to treatment research.

Child-Parent Attachment Styles and Borderline Personality Disorder Relationship

Many studies have focused on the attachment styles and their impact on human functioning and relationships (Bretherton, 1992). Some attachment styles have been associated with pathological way of human overall functioning, and it has already been observed that insecure attachment style in childhood may be associated with personality dysfunction (Brennan & Shaver, 1998). The purpose of this study is to investigate how people diagnosed with borderline personality disorder (BPD) describe their attachment style to the primary caregivers from their memories from childhood. This study was conducted in Germany in an inpatient psychiatric clinic. Fifteen participants represented a convenience sample, of patients already diagnosed with BPD. For this study Adult Attachment Interview (AAI) was used. The AAI is a semi-structured interview focusing on the early attachment experiences and their effects based on Attachment Theory.The results indicated that people diagnosed with BPD showed both preoccupied and dismissing child-parent attachment style,however it was the dismissing attachment style that dominated in our sample. The findings supported the hypothesis that participants who showed dismissing attachment style also used positive adjectives to describe the relationship with their primary caregiver, and those with the preoccupied attachment style used negative adjectives to describe the relationship with their primary caregiver. Even though, study was conducted with small number of participants, the study did provide evidence that there is a relationship between BPD and attachment styles in childhood. Threfore, the study offered contribution to the already existing knowledge and research findings regarding the influence of attachment style on BPD development. Keywords: Attachment, Personality disorder, Borderline Personality Disorder (BPD), child, childhood

Neuroimagerie fonctionnelle chez l’adolescent avec un trouble de personnalité limite

Borderline personality disorder (BPD) is being increasingly recognized by clinicians working with adolescents, and the reliability and validity of the diagnosis have been established in the adolescent population. Adolescence is known to be a period of high risk for BPD development as most patients identify the onset of their symptoms to be in the adolescent period. As with other mental health disorders, personality disorder, are thought to result from the interaction between biological and environmental factors. Functional neuroimaging studies are reporting an increasing amount of data on abnormal neuronal functions in BPD adult patients. However, no functional neuroimaging studies have been conducted in adolescents with BPD.Objectives This pilot project aims to evaluate the feasibility of a functional magnetic resonance imaging (fMRI) study coupled with clinical and psychological measures in adolescent girls with a diagnosis of BPD. It also aims to identify neuronal regions of interest (ROI) for the study of BPD in adolescent girls.MethodSix female adolescents meeting DSM-IV criteria for BPD and 6 female adolescents without psychiatric disorder were recruited. Both groups were evaluated for BPD symptoms, depressive symptoms, impulsivity, affective lability, and other potential psychiatric comorbidities. We used fMRI to compare patterns of regional brain activation between these two groups as they viewed 20 positive, 20 negative and 20 neutral emotion-inducing pictures, which were presented in random order.Results Participants were recruited over a period of 22 months. The protocol was well tolerated by participants. Mean age of the BPD group and control group was 15.8 ±0.9 years-old and 15.5 ±1.2 years-old respectively. Psychiatric comorbidity and use of medication was common among participants in the BPD group. This group showed higher impulsivity and affective lability scores. For the fMRI task, BPD patients demonstrated greater differences in activation than controls, when viewing negative pictures compared with neutral pictures, in limbic regions (amygdala and right hippocampus and parahippocampal areas) as well as in the superior frontal gyrus, right precentral gyrus and cerebellum, while control group showed greater activation in left precentral gyrus and right orbitofrontal area. Viewing positive pictures compared with neutral pictures led to increased activation of the left hippocampus and both parahippocampal regions, as well as middle cingulate cortex, superior temporal gyrus and cerebellum in the BPD group. In the control group, positive-scene viewing led to increased activity in the left superior parietal gyrus and right middle/superior temporal gyrus.Conclusion Limbic regions and areas from the prefrontal and orbitofrontal cortex are potential ROI for the study of the neurophysiology of BPD in female adolescents. The larger studies are needed to better understand the neural features found in these young patients.

Borderline personality disorder in adolescence. Prevention and early intervention from a cognitive analytic approach

IntroductionBorderline personality disorder begins in adolescence, however, its diagnosis is subject to some controversy and tends to be underdiagnosed. Stigma associated with its diagnosis, comorbidity with other axis I disorders or the changeable sense of identity during adolescence are some of the elements that obscure the diagnosis. Increasingly, recent studies have shown the utility of prevention programs as well as instituting early intervention in adolescents, with very hopeful outcomes.ObjectivesThe aim of this study is to review the benefits derived from early prevention and intervention programs in adolescents with borderline symptoms from a cognitive analytic approach.MethodsA systematic review for scientific articles extracted from research databases including Dialnet, EBSCO, Pubmed, Unika and Scholar Google was conducted. Other high-impact studies in the field were also included.ResultsEvidence reported by reviewed articles supports Cognitive analytical therapy as one of the most successful approaches, the same as Mentalization based therapy, in the treatment of Borderline personality disorder. From this approach, prevention and early intervention have shown their effectiveness in reducing borderline symptoms and risk factors besides they contribute to interpersonal functioning improvement.ConclusionsPrevention and early intervention constitute the main pillars to prevent the potential development of Borderline personality disorder or its evolution in more complex and irreversible forms. But this intervention must be carried not only in young already diagnosed, but also in those who are on the diagnostic threshold, presenting risk factors for further development.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Current trends in BPD research as indicative of a broader sea-change in psychiatric nosology.

The aim of the Special Section that this paper contributes to is to review current trends in borderline personality disorder (BPD) research. Three major trends were identified. First, there has been a marked increase in studies that attempt to locate BPD in the dimensional latent structure of psychopathology. Second, identifying the endophenotypic markers associated with BPD has become a focus of interest. Here, we focus on one endophenotype in the form of impaired self-other processing. Third, there has been an explosion of research into the developmental aspects of BPD specifically focused on uncovering complex Biology × Environment interactions in the development of BPD. This paper discusses how these trends (Dimensions, Biology, and Development) are challenging the nature and form of BPD as we know it, and may be indicative of a broader sea-change in psychiatric nosology. (PsycINFO Database Record

Effects of the interaction of childhood trauma and polymorphism of 5-HTT transporter on the development of borderline personality disorder

Effects of the interaction of childhood trauma and polymorphism of 5-HTT transporter on the development of borderline personality disorder

Borderline personality disorder and neuropsychological measures of executive function: A systematic review.

The notion that neurocognitive deficits may be core to the development of borderline personality disorder (BPD) has received considerable attention in recent years, with growing evidence pointing to cognitive deficits in executive function (EF). A relationship between EF and BPD has long been suggested by evidence of high comorbidity between BPD and disorders characterized by poor EF (e.g. attention-deficit/hyperactivity disorder); however, despite a marked increase in studies of EF and BPD in recent years, the precise nature of this relationship remains unclear. We provide a systematic review of this emerging evidence base, with respect to (1) studies of participants diagnosed with BPD in which EF has been indexed in isolation from broader cognitive processes; (2) the specific domains of EF that have been most robustly associated with BPD; and (3) whether deficits in EF are uniquely associated with BPD, independent of comorbid psychopathology. Key directions for future research are discussed with respect to strategies for measuring EF and the need for research designs that control for phenotypic overlap between BPD and related forms of psychopathology.

First empirical evaluation of the link between attachment, social cognition and borderline features in adolescents

ObjectiveSeveral developmental models of borderline personality disorder (BPD) emphasize the role of disrupted interpersonal relationships or insecure attachment. As yet, attachment quality and the mechanisms by which insecure attachment relates to borderline features in adolescents have not been investigated. In this study, we used a multiple mediational approach to examine the cross-sectional interplay between attachment, social cognition (in particular hypermentalizing), emotion dysregulation, and borderline features in adolescence, controlling for internalizing and externalizing symptoms. MethodsThe sample included 259 consecutive admissions to an adolescent inpatient unit (Mage=15.42, SD=1.43; 63.1% female). The Child Attachment Interview (CAI) was used to obtain a dimensional index of overall coherence of the attachment narrative. An experimental task was used to assess hypermentalizing, alongside self-report measures of emotion dyregulation and BPD. ResultsOur findings suggested that, in a multiple mediation model, hypermentalizing and emotion dysregulation together mediated the relation between attachment coherence and borderline features, but that this effect was driven by hypermentalizing; that is, emotion dysregulation failed to mediate the link between attachment coherence and borderline features while hypermentalizing demonstrated mediational effects. ConclusionsThe study provides the first empirical evidence of well-established theoretical approaches to the development of BPD.

The Main and Interactive Effects of Maternal Interpersonal Emotion Regulation and Negative Affect on Adolescent Girls’ Borderline Personality Disorder Symptoms

The transaction of adolescent's expressed negative affect and parental interpersonal emotion regulation are theoretically implicated in the development of borderline personality disorder (BPD). Although problem solving and support/validation are interpersonal strategies that foster emotion regulation, little is known about whether these strategies are associated with less BPD severity among adolescents. Adolescent girls (age 16; N = 74) and their mothers completed a conflict discussion task, and maternal problem solving, support/validation, and girls' negative affect were coded. Girls' BPD symptoms were assessed at four time points. A 3-way interaction of girls' negative affect, problem solving, and support/validation indicated that girls' negative affect was only associated with BPD severity in the context of low maternal support/validation and high maternal problem solving. These variables did not predict changes in BPD symptoms over time. Although high negative affect is a risk for BPD severity in adolescent girls, maternal interpersonal emotion regulation strategies moderate this link. Whereas maternal problem solving coupled with low support/validation is associated with a stronger negative affect-BPD relation, maternal problem solving paired with high support/validation is associated with an attenuated relationship.

Developmental Trajectories of Borderline Personality Disorder Symptoms and Psychosocial Functioning in Adolescence.

In recent years, major gains toward understanding the emergence of borderline personality disorder (BPD) pathology, which is typically first noted during adolescence, have been made. Simultaneously, a profound shift has occurred in the adult personality pathology literature, in which empirical evidence rebuts the idea that personality disorders (PDs) are intractable disorders that do not develop or otherwise change over time, and therefore cannot be treated. The present study addresses a gap in our understanding of within-person change in BPD symptoms across adolescence and contributes to the limited literature on outcomes associated with adolescent BPD. Using an at-risk community sample of girls (N = 2,450), the authors used bivariate latent growth curve models to analyze the codevelopment of BPD symptoms with eight domains of psychosocial functioning (e.g., academic achievement, social skills, sexual behavior) across ages 14-17. Findings revealed moderate to strong effect sizes for the associations between BPD symptoms and every domain of psychosocial functioning, suggesting that the development of BPD was coupled with poorer outcomes across development. Controlling for depression and conduct disorder features revealed unique associations between BPD and self-perception, social skills, and sexual behavior. These results highlight the increased need for extending advancements in the adult PD literature to research on PDs in adolescence, and for greater recognition of adolescent BPD in clinical settings.

The role of childhood traumatization in the development of borderline personality disorder in Hungary

The role of childhood traumatization in the development of borderline personality disorder in Hungary

Borderline personality disorder: Disorder of trauma or personality, a review of the empirical literature.

This goal of this review was to explore empirical research examining the question of whether borderline personality disorder (BPD) is a disorder of “personality” or a disorder arising out of experiences of childhood trauma. The review highlighted the complexities in the relationship between childhood disorder (CT) and BPD and identified important implications for research and practice. Although relationships between specific trauma types and outcomes in adulthood are inconsistent, overall associations between CT and the development of BPD are strong and consistently identified. Research exploring the specific mechanisms through which CT may be related to the development of BPD in adulthood is beginning to untangle the complex web of interrelated factors such as heritable personality traits, affect regulation and dissociation, and trauma symptoms as mediators in the relationship between CT and BPD. Our strongest recommendation is for future researchers to further explore transdiagnostic factors such as the self capacity of affect regulation to further disentangle the complex pathways between CT, inherited personality traits, and the development of all forms of traumatogenic psychopathologies in adulthood.