There are biological and environmental factors that increase the risk of someone developing borderline disorder. These have shown significant abnormalities in specific pathways in the brains of people with borderline disorder compared to people in the general population.
Neglectful parenting, and repeated physical, emotional and sexual abuse, and abandonment in childhood are very common environmental risk factors that contribute to the severity of borderline disorder in those individuals who possess genetic risk factors. It is common, but not essential, that genetic and environmental factors interact to increase the severity of the disorder. The reverse has not been shown to occur.
Effective treatments are now available for people who suffer from borderline disorder. The main treatments utilized are medications in combination with borderline disorder-specific individual and group psychotherapies.
It is now increasingly well recognized that structured family involvement in the treatment process substantially improves the results and shortens the duration of intensive treatment. Borderline personality disorder. National Institute of Mental Health. Skodol A. Borderline personality disorder: Epidemiology, clinical features, course, assessment, and diagnosis.
Treatment of borderline personality disorder. Newlin E, et al. Personality disorders. Continuum: Lifelong Learning in Neurology. National Alliance on Mental Illness. Starcevic V, et al. Pharmacotherapy of borderline personality disorder: Replacing confusion with prudent pragmatism.
Current Opinion in Psychiatry. A few studies indicated that studies of neuroimaging can contribute to identify which brain structures are altered in subjects with risk factors for early onset BPD.
For example, structural abnormalities of fronto-limbic areas have been related to impulsive and emotional dysregulation. If these changes of brain structures are specific enough, they will contribute to identify biological markers or neural signatures, a primary goal in psychiatric and brain imaging research.
Of course, it must be noticed that we present here only a hypothetical model with the main purpose to stimulate the interest of researchers and the debate among experts. The indicators of a high-risk condition for early onset of BPD, and particularly the effects of their coexistence and interaction in the proposed model, must be furtherly investigated and confirmed in specific studies.
One of the more challenging issues at the present state of our knowledge is to make clear which of the factors proposed in this model have a primary role in the pathogenesis of BPD and which intervene only at a later time to augment and trigger the effects of primary factors. An important contribution to understand the complex effects of temperamental traits, traumatic experiences, and environmental dysfunctions on the neurobiology of young BPD patients could derive from studies of functional changes in brain areas during administration of specific stimuli For example, studies of autobiographical memories in such populations could be of great value to investigate the effects of life events and traumatic experiences on the function of fronto-limbic brain structures involved in the construction of identity.
PB and SB equally contributed to summarizing the literature data and writing the review. MB collected literature data and organized the tables. PR contributed to writing and supervising the review. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. National Center for Biotechnology Information , U. Journal List Front Psychiatry v. Front Psychiatry.
Published online Oct 9. Author information Article notes Copyright and License information Disclaimer. This article was submitted to Psychopathology, a section of the journal Frontiers in Psychiatry. Received Jan 7; Accepted Sep 4. The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
This article has been cited by other articles in PMC. Abstract Borderline personality disorder BPD is a severe and heterogeneous mental disorder that is known to have the onset in young age, often in adolescence.
Keywords: borderline personality disorder, prodromal factors, early symptoms, childhood, adolescence, outcome. Introduction Borderline personality disorder BPD is a severe and heterogeneous mental disturbance connoted by a pattern of identity diffusion, interpersonal disturbances, and chronic instability, with episodes of severe affective and impulsive dyscontrol 1.
Results The search described in the previous section provided 2, records, and among them 1, overlapping studies were excluded. Open in a separate window.
Figure 1. Discussion Precocious Environmental Factors Several studies have identified a broad range of environmental factors that are related to subsequent risk for BPD, including socio-economic status, family psychopathology, parent-child relationship, and maltreatments or other traumatic events.
Family-Related Factors and Early BPD Only two longitudinal studies specifically investigated the association between socioeconomic status low income, low educational level, and low status occupation and early onset of BPD.
Table 1 Summary of studies on precocious environmental factors. Reinelt et al. Mother-child discord predicted BPD symptoms Mahan et al.
Bornovalova et al. Child and Adolescent Temperament and Personality Factors The investigation of intrapsychic factors, including temperamental characteristics and personality trait profiles in childhood and adolescence, is fundamental to recognize predictors of BPD at an early phase. Early Psychopathological Features and Diagnosis Available evidences highlighted that internalizing and externalizing psychopathology is often present before the onset of BPD in adolescents.
Table 2 Summary of studies on child and adolescent temperament and personality factors and early psychopathological features. Table 3 Summary of studies on neuroimaging and effect of early detection on course and outcome of BPD. Competence in both childhood and adulthood was the best predictor of attaining an excellent recovery. Effect of Early Detection on Course and Outcome of BPD Detecting personality abnormalities in childhood and adolescence is a challenge for clinicians and is crucial to increase our knowledge of personality psychopathology in adulthood.
Conclusions On the basis of the results discussed in the previous paragraphs, adolescence represents a sensitive and vulnerable phase for the development of BPD A Preliminary Model of Risk Factors in BPD We tried to support the work of clinicians in this field by providing a synthetic summary of findings collected in the different clusters of risk factors.
Author Contributions PB and SB equally contributed to summarizing the literature data and writing the review. Conflict of Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Borderline personality disorder in adolescence: an expert research review with implications for clinical practice. Eur Child Adolesc Psychiatry 24 — Treatment histories of borderline inpatients. Compr Psychiatry 42 2 — J Pers Disord 18 1 — The cross-informant concordance and concurrent validity of the Borderline Personality Features Scale for Children in a community sample of boys.
Clin Child Psychol Psychiatry 16 3 — The criterion validity of the Borderline Personality Features Scale for Children in an adolescent inpatient setting. J Pers Disord 25 4 — Socioeconomic background and the developmental course of schizotypal and borderline personality disorder symptoms.
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Psychol Med 42 11 — The impact of childhood temperament on the development of borderline personality disorder symptoms over the course of adolescence. Borderline Pers Disord Emot Dysregul Reciprocal effects of parenting and borderline personality disorder symptoms in adolescent girls. Dev Psychopathol Negative emotional reactivity as a marker of vulnerability in the development of borderline personality disorder symptoms.
Dev Psychopathol 28 1 — Lenzenweger MF, Cicchetti D. Toward a developmental psychopathology approach to borderline personality disorder. Dev Psychopathol 7 4 —8. Macfie J. Development in children and adolescents whose mothers have borderline personality disorder. Child Dev Perspect 3 1 Maternal transmission of borderline personality disorder symptoms in the community-based Greifswald Family Study.
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Psychiatr Res — Correlates, stability and predictors of borderline personality disorder among previously suicidal youth. Eur Child Adolesc Psychiatry 24 4 — The effect of childhood physical and sexual abuse on adolescent weapon carrying. J Adolesc Health 40 6 —8. Emotion dysregulation and negative affect: association with psychiatric symptoms. J Clin Psychiatry 72 5 — Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study.
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Aetiological pathways to Borderline Personality Disorder symptoms in early adolescence: childhood dysregulated behaviour, maladaptive parenting and bully victimisation. Borderline Pers Disord Emot Dysregul 3 ; 4 Haltigan JD, Vaillancourt T. You could join a support group. A support group is where people come together to share information, experiences and give each other support.
You might be able to find a local group by searching online. Rethink Mental Illness have support groups in some areas. You can find out what is available in your area if you follow this link: www.
Recovery colleges are part of the NHS. They offer free courses about mental health to help you manage your symptoms. They can help you to take control of your life and become an expert in your own wellbeing and recovery. You can usually self-refer to a recovery college. But the college may inform your care team. Unfortunately, recovery colleges are not available in all areas. To see if there is a recovery college in your area you can use a search engine such as Google. As a carer, friend or family member of someone living with borderline personality disorder BPD , you might find that you need support.
How do I get support from my peers? You can get peer support through carer support services or carers groups. You can search for local groups in your area by using a search engine such as Google. How can learning about BPD help? Learning about BPD can help you to:. Learning about BPD was the most important thing I did to help understand the pain that my partner was going through. I learned how to best help her in moments of extreme emotional pain.
I am now able to de-escalate situations quicker, leaving my partner comforted instead of feeling distant. It has improved our relationship a great deal and brought us closer. What is a care plan? The care plan is a written document that says what care your relative or friend will get and who is responsible for it.
A care plan should always include a crisis plan. A crisis plan will have information about who to contact if they become unwell. You can use this information to support and encourage them to stay well and get help if needed.
Can I be involved in care planning? As a carer you can be involved in decisions about care planning. Your relative or friend needs to give permission for the NHS to share information about them and their care. These techniques can help you when you feel anxious. Website : www. They have some useful information sheets and a workbook for people who are experiencing problems with coping with their feelings.
And for people experiencing distress. BPD World Provides information and support to people affected by personality disorders. It has an online support forum. Samaritans Can be contacted by telephone, letter, e-mail and mini-com. There's also a face-to-face service, available at their local branches. They are open 24 hours a day, every day of the year. Telephone : Email : jo samaritans.
Telephone : Website : www. Sane Line Work with anyone affected by mental illness, including families, friends and carers. Their helpline is open between pm and They also provide a free text-based support service called Textcare and an online supportive forum community where anyone can share their experiences of mental health. Telephone : pm — pm every evening Textcare : www. Support Line They offer confidential emotional support to children, young adults and adults by telephone, email and post.
They work with callers to develop healthy, positive coping strategies, an inner feeling of strength and increased self-esteem to encourage healing, recovery and moving forward with life. Their opening hours vary so you need to ring them for details.
Telephone : E-mail : info supportline. They offer accredited confidential, anonymous and free support, information and signposting to people anywhere in the UK through their helpline and webchat service. Their helpline is open between 5pm and midnight every day of the year.
Telephone : 58 58 58 Webchat : through the website Website : www. My Black Dog Provides peer support webchat with volunteers who have experienced mental illness. Available evenings and weekends. Check the website for opening times. Websit e: www. Papyrus UK Work with people under 35 who are having suicidal feelings. And with people who are worried about someone under Their helpline is open 9am — 10pm in the week. And between 2pm and 10pm at weekends and bank holidays. Telephone : 41 41 Email : pat papyrus-uk.
Shout can help with urgent issues such as suicidal thoughts, abuse or assault, self-harm, bullying and relationship challenges. Text : Text Shout to Website : www. Donate Search Menu. About us About us. See our contacts page Looking to contact us?
Covid support. Supporting yourself Read more Supporting yourself. Covid information hub See all pages Covid information hub. Help in your area. Find peer support online Visit the Clic website Find peer support online. Advice and information. Contact our advice service today Need more information? Get involved. Become a campaigner Sign up today Become a campaigner. Get help now. Advice and information About mental illness Learn more about conditions Borderline personality disorder.
Borderline personality disorder This section has information on borderline personality disorder BPD , including symptoms, causes and treatments. If you would like more advice or information you can contact our Advice and Information Service by clicking here. Download Borderline personality disorder factsheet. Share: Contact us:. Overview BPD means that you feel strong emotions that you struggle to cope with.
You may feel upset or angry a lot of the time. Around 1 in people live with BPD. There are different reasons why people get BPD. A lot of people who live with a diagnosis of BPD have had traumatic experiences in their childhood. If you are someone living with a diagnosis of BPD, it is more likely that you will self-harm. And have challenges with relationships, alcohol or drugs. There is help available.
There are different ways to treat BPD. The NHS should normally offer you therapy. Need more advice? If you need more advice or information you can contact our Advice and Information Service.
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