A systematic review of the factors associated with the course of borderline personality disorder symptoms in adolescence

Abstract

Background Research on personality pathology in adolescence has accelerated during the last decade. Among all of the personality disorders, there is strong support for the validity of borderline personality disorder (BPD) diagnosis in adolescence with comparable stability as seen in adulthood. Researchers have put much effort in the analysis of the developmental pathways and etiology of the disorder and currently are relocating their attention to the identification of the possible risk factors associated with the course of BPD symptoms during adolescence. The risk profile provided in previous systematic reviews did not address the possible development and course of BPD features across time. Having this in mind, the purpose of this systematic review is to identify the factors that are associated with the course of BPD symptoms during adolescence. Methods Electronic databases were systematically searched for prospective longitudinal studies with at least two assessments of BPD as an outcome of the examined risk factors. A total number of 14 articles from the period of almost 40 years were identified as fitting the eligibility criteria. Conclusions Factors associated with the course of BPD symptoms include childhood temperament, comorbid psychopathology, and current interpersonal experiences. The current review adds up to the knowledge base about factors that are associated with the persistence or worsening of BPD symptoms in adolescence, describing the factors congruent to different developmental periods.

Personality pathology in adolescence: relationship quality with parents and peers as predictors of the level of personality functioning

“…Unexpected results were also found -specifically, that discord in peer relationships was not related to the level of personality functioning. Previous studies have provided much evidence supporting the opposite and showing that negative experiences with peers are very important for the development and course of a personality disorder [24,31,52,53]. One of our explanations would be that the negative interactions that we were investigating were not at that extreme level, as victimization (studied in previous samples) would be.…”

Criteria A and B of the Alternative DSM-5 Model for Personality Disorders (AMPD) Capture Borderline Personality Features Among Adolescents

“…This briefly mentioned empirical evidence maps a trajectory of maladaptive traits (Criterion B) starting in childhood and continuing into adolescence ( 20 ). Taken together, while the studies of Criterion A and B suggest both being evident in adolescent personality pathology, their unique role is yet to be singled out, especially that of Criterion A. Beside this, a context of mental disorders should be considered as psychopathological symptoms have been established to be a risk factor for personality pathology ( 23 ), its severity ( 24 ), and course over adolescence ( 25 ).…”

Individualized Psychotherapy Treatment of Young People With Mental Disorders

“…Interpersonal, societal, and environmental factors include school achievements or career developments, finding a partner and raising a family, and financial concerns. A recent systematic review found that individual factors (e.g., childhood temperament and comorbid psychopathology) and current relational experiences (e.g., being exposed to peerrelated violence in friendships and in romantic relationships) were predictive of worse outcomes, namely, stability or increase in the levels of BPD symptoms (Skabeikyte and Barkauskiene, 2021). Accordingly, when treating young adults there is a special need to address these age-specific, individual and relational risk factors and challenges.…”