Developmental Pathways to Borderline Personality Disorder

Abstract

This paper reviews recent studies of biological and environmental risk and protective factors and patterns of continuity leading to borderline personality disorder (BPD). It focuses on prospective studies of children and adolescents and studies of young people with borderline pathology, reporting findings from genetics, neurobiology, experimental psychopathology, environmental risk, and precursor signs and symptoms. Studies of individuals earlier in the course of BPD demonstrate relatively consistent environmental risk factors, but neurobiological and experimental psychopathology findings are still inconsistent. Also, temperamental and mental state abnormalities that resemble aspects of the BPD phenotype emerge in childhood and adolescence and presage the BPD syndrome in adolescence or adulthood. Further work is required to better understand the roles that all these factors play in the developmental pathways to BPD and to increase their specificity for BPD in order to facilitate prevention and early intervention.

Early detection and intervention for borderline personality disorder in adolescence

“…The period of adolescence is seen as a particularly vulnerable phase for the development of BPD (17), and in recent years BPD has been described as a developmental disorder with onset in adolescence around age 13 (18,19 …”

Petrificación epistémica y la restauración de la confiabilidad epistémica: Una nueva conceptualización del trastorno límite de la personalidad y su tratamiento psicosocial

“…Esto no es específico para el TLP: nosotros sabemos que semejantes experiencias disminuyen la respuesta al tratamiento independientemente del diagnóstico primario (ej., Teicher & Samson, 2013). Entre los individuos con trastornos de la personalidad, los rangos de trauma infantil son altos (73% informan abusos, de los cuales el 34% es abuso sexual y 82% informaron de negligencia; Ball & Links, 2009;Chanen & Kaess, 2012). En los pacientes con TLP es cuatro veces más probable que en los controles normales que hayan sufrido un trauma temprano (Johnson, Cohen, Brown, Smailes, & Bernstein, 1999).…”

Neurobiological Findings in Youth with Borderline Personality Disorder

“…Studies of candidate genes in the serotonergic and dopaminergic systems have not yielded any convincing empirical or sufficiently reliable results (16). A single study of adolescents postulated that a specific gene polymorphism (i.e., the short allele of the serotonin transporter gene, 5-HTTLPR) was a risk factor for the development of BPD (17).…”

“…Structural brain differences have also been found to be associated with childhood maltreatment (33). Because a history of a broad range of adverse childhood experiences have been found in both adults (34) and youth with BPD (16), this raises the question of whether these early adverse life experiences may also be linked to the neuroanatomical changes seen in patients with BPD. So far, no imaging studies involving young patients with BPD have investigated the effect of prior exposure to early life stressors on brain anatomy.…”