Neurobiological Findings in Youth with Borderline Personality Disorder

Abstract

This review summarizes recent neurobiological research into youth with borderline personality disorder (BPD) to better delineate the biological factors involved in the development of this disorder. Psychobiological studies when BPD first becomes manifest are of particular interest, because there are fewer confounding factors (e.g., duration of illness, drug abuse, medication, other therapeutic interventions) at this time. This article focuses on recent findings in the field of neuroimaging, neuropsychology, neuroendocrinology, genetics, and pain perception, and it aims to integrate these findings in a developmental psychopathology model of BPD. In studies of clinical samples of adults with BPD, structural imaging studies revealed abnormalities predominantly in the frontolimbic areas. Disturbances in emotional information processingparticularly involving negative stimuli-may mediate affective dysregulation as a core feature of BPD. Genetic studies could reveal that the stability of BPD traits in youth is largely influenced by a combination of genetic and non-shared environmental factors. Hyporesponsiveness to a laboratory stressor indicates an enduring alteration of the hypothalamicpituitary-adrenal axis. Findings of a higher pain threshold indicate that pain processing is already disturbed during the early stages of BPD, which could contribute to the initiation or maintenance of self-injurious behavior. All biological factors, together with environmental risk factors, may contribute to the core symptoms of BPD: severe emotional and behavioral dysregulation. Further research should investigate the development of BPD in youth by using longitudinal designs to determine whether the neurobiological factors are a cause, an effect, or an epiphenomenon of BPD.

Structural Features Related to Affective Instability Correctly Classify Patients With Borderline Personality Disorder. A Supervised Machine Learning Approach

“…Results indicate that the alterations in the triad involving putamen, amygdala, and OFC represent the specificity of this disorder ( 42 – 44 ). This circuit has been largely associated with affective instability and anger control as a consequence of dysfunctional emotion regulation (see Figure 3 ) ( 3 , 10 , 11 , 29 , 30 , 80 , 81 ).…”

A systematic review of the neurobiological underpinnings of borderline personality disorder (BPD) in childhood and adolescence

“…For the updated search we used the following search strings: (BPD OR "emotionally unstable personality" OR borderline*) AND (child* OR adolescen* OR youth* OR young* OR teen* OR lists of included studies were inspected for relevant titles. We also examined the reference lists of related narrative reviews as a cross check (Brunner, Henze, Richter, & Kaess, 2015;Chanen, Jovev, McCutcheon, Jackson, & McGorry, 2008;Goodman et al, 2013).…”

Personality Disorder in Childhood and Adolescence comes of Age: a Review of the Current Evidence and Prospects for Future Research

“…Furthermore, contrary to common expectations, research reveals that normal personality undergoes normative changes throughout the entire lifespan (93). Hence, some degree of development and change in personality is to be expected throughout the life course, as a result of the complex interactions between heritable dispositions and the environment (94)(95)(96)(97)(98)(99).…”