Differentiating BPD in adolescents with NSSI disorder: the role of adverse childhood experiences and current social relationships

Abstract

BackgroundAs borderline personality disorder (BPD) is increasingly considered a lifespan developmental disorder, we need to focus on risk factors and precursors in the developmental pathways to BPD, in order to enable early detection and intervention. Within this developmental pathway, adolescence is a crucial phase in the light of the manifestation of the disorder. Relational factors such as adverse childhood experiences and current relational problems can be considered important in adolescents who are at-risk for BPD. Nonsuicidal self-injury (NSSI) is a key precursor for adolescent BPD and one of the most promising targets for early detection and intervention of BPD.MethodsIn a clinical sample of 152 adolescents engaging in nonsuicidal self-injury (NSSI) disorder referred to mental healthcare in Germany, this study investigated whether we can differentiate who has BPD from 1) adverse childhood experiences; and 2) the quality of current relationships, both with parents and peers. BPD was assessed both categorically as a dichotomized score and dimensionally as a continuous score.ResultsMore adverse childhood experiences, but not low quality of current social relationships, were related to more BPD symptoms and an increased risk for meeting full criteria for BPD. In the dimensional model, current social relationship quality with parents and peers did not show a moderating (protecting or aggravating) effect on the association between adverse childhood experiences and BPD. Using a categorical approach, however, the association between childhood adversity and meeting full criteria for BPD was higher in individuals reporting higher quality of current parent-child relationship.ConclusionsThese results highlight adverse childhood experiences as risk factors of BPD, while the role of current social relationships seems more complex.

Borderline Personality Disorder in Young People: Associations with Support and Negative Interactions in Relationships with Mothers and a Best Friend

“…Close friendships appear to place special burdens during early adolescence, and the expectations for exclusivity of best friendship in particular may be a marker of BPD [30]. Although different ndings in associations between parental and best-friend relationship quality and BPD were reported [11,31,28], research is needed to consider the dynamics of exclusive "best-friend" roles in relation to BPD [28]. The literature paints a developmental pictures on how friendship relationships may be seen as an extension of the attachment relationship developed in parent-child relationship in childhood.…”

Non-Suicidal Self-Injury and Its Relationship with Family Psychological Function and Perceived Social Support among Iranian High School Students

“…A family has psychological functions that provide a safe and secure environment to meet the psychological needs of its members 6 . Family conflicts as well as poor family bond are associated with numerous destructive behaviors of adolescents such as NSSI 7 .…”

Comorbidity Between Non-suicidal Self-Injury Disorder and Borderline Personality Disorder in Adolescents: A Graphical Network Approach

“…Around 61% of adolescents with BPD pathology have engaged in NSSI at least once, making "recurrent NSSI and suicidal behavior" the most commonly met diagnostic criterion for BPD in adolescence (34,37). In this young at-risk age group, the comorbidity between BPD and NSSI is complex (38). For instance, displaying BPD symptoms indicates greater severity of NSSI based on several parameters (36) such as a younger age of NSSI onset (37,39), more frequent NSSI episodes (40), and a higher likelihood of repetitive NSSI (41).…”