There is a profound link between Borderline Personality Disorder (BPD) and childhood trauma.
Researchers and psychologists have noted strong correlations between specific personality disorders and adverse childhood experiences, such as childhood abuse and severe emotional neglect.
This article will explore Borderline Personality Disorder in detail, its origins in childhood trauma, and how those with BPD symptoms can receive adequate help and support.
A large body of literature demonstrates that people who have suffered emotional neglect and childhood trauma are more likely to develop Borderline Personality Disorder as adults than those who had a stable upbringing.
Risk factors and statistics
Statistics illustrate several factors for BPD sufferers that separate the disorder from other personality disorders and mental health conditions.
- One of the main symptoms of Borderline Personality Disorder is Dissociation (being disconnected from other people and surroundings)
- Around three-quarters of Borderline Personality Disorder sufferers have engaged in self-harming behaviours at some stage.
- Around fifty -sixty percent of BPD patients have a history of being sexually abused.
- People with Borderline Personality Disorder are more likely to have concurrent mental health issues or ‘co-occurring’ mental health problems such as anxiety, depression, and bipolar disorder.
- Around ten percent of BPD patients will eventually commit suicide.
- Fortunately, the majority of Borderline Personality sufferers will improve with time (the prevalence rate for long-term remission is around seventy percent)
What is Borderline Personality Disorder?
Sometimes referred to as ’emotionally unstable personality disorder’ (EUAP), Borderline Personality Disorder is characterized by a distorted sense of self, chronic patterns of unstable relationships, and intense emotional responses.
People with Borderline Personality Disorder often engage in self-harm and other risky behaviours such as substance abuse.
BPD sufferers often find it challenging to return to their emotional baseline and may struggle with:
- Fear of abandonment
- Detachment from reality
- Feelings of emptiness
- Emotion regulation
Concurrent mental health conditions
Borderline Personality Disorder symptoms
According to research, symptoms of Borderline Personality Disorder may get triggered by events considered normal by others. Symptoms include:
- Unstable self-image or self-concept
- Extreme mood swings
- Intense anger
- Volatile and intense relationships
- Fear of abandonment and rejection followed by manic efforts to maintain relationships
- Persistent feelings of emptiness followed by intense longings to fill the ‘void’ (such as through drug abuse, alcoholism, and over-eating)
- Dissociation (feeling as though you are ‘detached’ from reality)
Borderline Personality Disorder BPD
A Psychology Today article written by Mark Travers, Ph.D., entitled ‘Why Childhood Trauma Can Lead to Borderline Personality Disorder,’ estimated that around 1.7 percent of Borderline Personality Disorder has roots in early childhood trauma.
The above prevalence rates are higher than those found in genetic vulnerability.
All this suggests that while genetic factors may play a role in developing Borderline Personality Disorder, child abuse, emotional and physical neglect, and overall childhood maltreatment are critical factors in developing Borderline Personality Disorder.
According to Mark Travers’s (Ph.D.) research, studies were conducted to understand more about Borderline Personality Disorder and the root cause (s).
The participants in the study included ninety-five adult women with a BPD diagnosis.
Those who took part in the study got asked to complete a sequence of psychological questionnaires; these included questionnaires measuring aggression, personality tests, chronic stress questionnaires, life history, and childhood trauma questionnaires.
According to Travers, researchers noted the ‘wear and tear’ or the ‘allostatic load’ of participants’ by analyzing bodily indicators of stress such as blood pressure, body mass index, and hip- to- waist ratio.
The research concluded that participants with Borderline Personality Disorder had profoundly higher scores on the childhood trauma questionnaire than non-BPD controls.
Furthermore, the above research is indicative of other studies that reported around eighty percent of patients diagnosed with Borderline Personality Disorder had experienced some form of child abuse and early stressful events, such as physical and sexual abuse.
Physical and mental health outcomes
The above study also identified several events that may lead to the development of Borderline Personality Disorder.
The researchers stated that childhood trauma and physical and emotional neglect produce a ‘pace-of-life syndrome,’ wherein people develop faster, demonstrate higher metabolic rates, and are more likely to experience premature physical decline and death than most.
Researchers also found significant personality differences between BPD sufferers and control groups.
For example, Borderline Personality Disorder sufferers tend to demonstrate increased levels of aggression and neuroticism.
On the other hand, BPD sufferers exhibited lower extraversion, conscientiousness, and agreeableness.
Other psychiatric disorders also get associated with poor physical and mental health outcomes (or pace-of-life syndrome), such as bipolar disorder, substance use disorders, and attention-deficit hyperactivity disorder (ADHD).
Biological and psychosocial factors
Other researchers believe that Borderline Personality Disorder involves genetic, environmental, neurological, and social factors.
Some literature states that genetic predispositions are essential factors in developing BPD symptoms and a Borderline Personality Disorder diagnosis.
For example, one study reported that those with close relatives with Borderline Personality Disorder are up to five times more likely to have the disorder themselves.
Affected biological systems
Biological factors are also integral to the development of Borderline Personality Disorder.
For instance, researchers found areas of dysfunction in the frontolimbic neuron in the brain in those with Borderline Personality Disorder, which produces intense responses to emotional stimuli that are exaggerated in the amygdala and are impaired in the anterior cingulate cortex (Michael J. Minzenberg et al., July 2008).
The above study correlates with some of the classic BPD symptoms wherein BPD sufferers tend to have intense emotional reactions that seem disproportionate to an event or external stimuli.
Although some researchers lean heavily towards biological and environmental factors, most researchers agree that childhood adversity and traumatic experiences in childhood are also significant factors in developing Borderline Personality Disorder.
Diagnostic and statistical manual
Borderline Personality Disorder has gotten recognized in the diagnostic and statistical manual (DSM-5) as a personality disorder.
Statistics show that Borderline Personality Disorder tends to affect women more than men, with females up to three times more likely to receive a BPD diagnosis.
Additionally, Borderline Personality Disorder is not as common in older people. Furthermore, up to half of the population diagnosed with BPD experience drastic improvement in their BPD symptoms within ten years.
Treatment for Borderline Personality Disorder typically involves psychotherapy, dialectical behaviour therapy (DBT), and cognitive-behavioural therapy (CBT).
An article written by Lois W. Choi – Kain and colleagues reported that dialectical behaviour therapy is one of the most effective treatments for Borderline Personality Disorder.
According to Kain’s report, DBT is a well-known, well-researched, evidence-based treatment for BPD.
Dialectical behaviour therapy helps BPD sufferers manage their interactions and sensitivities more effectively by acquiring skills such as enhanced mindfulness, which enable people to tolerate distress, regulate their emotions, and manage interpersonal relationships (Lois W. Choi – Kain et al.).
According to Kain, ‘one of the major mechanisms of change behind dialectical behaviour therapy occurs via acquisition and generalization of skills to be more emotionally regulated, mindful, and effective in the face of individual sensitivities’ (Lois W. Choi – Kain, et al.).
Other effective treatments for Borderline Personality Disorder include:
- Transference-focused therapy (TFP)
- Mentalization-based treatment (MBT)
- Schema-focused therapy (SFT)
People living with Borderline Personality Disorder tend to experience intense emotions, often oscillating between a polarity of emotional extremes.
For example, an individual with BPD may express profound gratitude towards another person’s perceived act of kindness.
However, shortly afterwards, they may feel incredible disappointment and sadness at a perceived abandonment or criticism (idealization and devaluation).
Extreme emotional lability
One of the core characteristics of BPD is affective instability, which manifests as unusually intense emotional responses to outward stimuli, accompanied by a slower return to emotional baseline.
The literature posits that people with Borderline Personality Disorder tend to experience profound interchangeable emotional shifts in mood and behaviour, often referred to as emotional lability.
Individuals with BPD tend to be joyful, enthusiastic, idealistic, and loving people but often experience a range of emotions that fluctuate between positive and negative states.
Furthermore, BPD sufferers tend to experience longer and more profound states of emotional pain compared to people with other personality disorder types.
Before discovering healthy coping mechanisms, BPD sufferers often engage in self-destructive behaviours to escape their emotional pain. Such behaviours may involve emotional isolation, substance abuse, self-harm, or suicidal behaviour.
In summary, most of the literature indicates that developmental factors play a significant role in developing Borderline Personality Disorder.
People with a history of child abuse, such as childhood sexual abuse, physical neglect, early life stress (such as traumatic events in childhood), and child maltreatment are significantly more likely to develop BPD.
Individuals with a diagnosis of BPD are more likely to report distressing childhood experiences such as emotional neglect and sexual, physical, and verbal abuse by caregivers of either sex.
In addition, Borderline Personality sufferers also reported that the validity of their emotions and feelings also got unacknowledged by one or both caregivers.
Caregivers also failed to protect their children in times of danger and significant distress and often neglected their physical and emotional needs.
Other studies show that caregivers demonstrated inconsistent care towards children, and parents of both sexes often withdrew emotionally from their children.
The research concluded that children with a history of child maltreatment, physical abuse, emotional abuse, and attachment difficulties are more likely to develop Borderline Personality Disorder.
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