Clinical and psychosocial outcomes of borderline personality disorder in childhood and adolescence: a systematic review

Winsper, Catherine; Marwaha, Steven; Lereya, Suzet Tanya; Thompson, Andrew; Eyden, Julie; Singh, Swaran P.

doi:10.1017/s0033291715000318

Cited by 80 publications

(71 citation statements)

References 64 publications

(218 reference statements)

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“…Third (and related to the previous point), although there is growing evidence for the validity of BPD in adolescence Kaess et al, 2014;Winsper, Marwaha, et al, 2015), it is recognised that a proportion of youths demonstrating the BPD phenotype will not be diagnosed with BPD in adulthood. Thus, findings from the cross-sectional literature (although suggestive) will require further elaboration from longitudinal studies to identify the neurobiological underpinnings of chronic BPD symptom trajectories.…”

Section: Discussionmentioning

confidence: 93%

“…Recent systematic evidence indicates that the diagnostic stability of BPD in adolescence is largely comparable (though slightly attenuated) to that in adulthood, and that a considerable proportion of adolescents continue to manifest BPD symptoms up to 20 years later (Winsper, Marwaha, et al, 2015). Reflecting these findings, national treatment guidelines and classification systems have recently confirmed the legitimacy of the BPD diagnosis in adolescence (American Psychiatric Association, 2013;NICE, 2009;Tyrer, Crawford, & Mulder, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…Contemporary theories for the aetiology of BPD take a lifespan approach, proposing that an inborn tendency towards emotionality is potentiated across early development by environmental risk factors . Within this context, BPD is unlikely to appear de novo in early adulthood (Paris, 2013), but may be considered as the continuation of a collection of BPD precursor symptoms that first emerge during childhood or early adolescence Winsper, Marwaha, et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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

Winsper

Marwaha

Lereya

et al. 2016

Reviews in the Neurosciences

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AbstractContemporary theories for the aetiology of borderline personality disorder (BPD) take a lifespan approach asserting that inborn biological predisposition is potentiated across development by environmental risk factors. In this review, we present and critically evaluate evidence on the neurobiology of BPD in childhood and adolescence, compare this evidence to the adult literature, and contextualise within a neurodevelopmental framework. A systematic review was conducted to identify studies examining the neurobiological (i.e. genetic, structural neuroimaging, neurophysiological, and neuropsychological) correlates of BPD symptoms in children and adolescents aged 19 years or under. We identified, quality assessed, and narratively summarised 34 studies published between 1980 and June 2016. Similar to findings in adult populations, twin studies indicated moderate to high levels of heritability of BPD, and there was some evidence for gene-environment interactions. Also consistent with adult reports is that some adolescents with BPD demonstrated structural (grey and white matter) alterations in frontolimbic regions and neuropsychological abnormalities (i.e. reduced executive function and disturbances in social cognition). These findings suggest that neurobiological abnormalities observed in adult BPD may not solely be the consequence of chronic morbidity or prolonged medication use. They also provide tentative support for neurodevelopmental theories of BPD by demonstrating that neurobiological markers may be observed from childhood onwards and interact with environmental factors to increase risk of BPD in young populations. Prospective studies with a range of repeated measures are now required to elucidate the temporal unfurling of neurobiological features and further delineate the complex pathways to BPD.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Winsper

Marwaha

Lereya

et al. 2016

Reviews in the Neurosciences

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“…Recently, researchers have focused on the developmental precursors of BPD in recognition of the fact that personality disorders do not appear de novo in adulthood. Rather, they have an identifiable phenotype emergent in childhood or early adolescence (Crowell et al 2009; Geiger and Crick 2010), which indicates a heightened risk of personality disorder in adulthood (Lahey et al 2005; Winsper et al 2016; 2015). …”

mentioning

confidence: 99%

Sleep Problems in Childhood and Borderline Personality Disorder Symptoms in Early Adolescence

Lereya

Winsper

Tang

et al. 2016

J Abnorm Child Psychol

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Sleep disorders, such as insomnia and nightmares, are commonly associated with Borderline Personality Disorder (BPD) in adulthood. Whether nightmares and sleep-onset and maintenance problems predate BPD symptoms earlier in development is unknown. We addressed this gap in the literature using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants included 6050 adolescents (51.4 % female) who completed the UK Childhood Interview for DSM-IV BPD at 11 to 12 years of age. Nightmares and sleep onset and maintenance problems were prospectively assessed via mother report when children were 2.5, 3.5, 4.8 and 6.8 years of age. Psychopathological (i.e., emotional temperament; psychiatric diagnoses; and emotional and behavioural problems) and psychosocial (i.e., abuse, maladaptive parenting, and family adversity) confounders were assessed via mother report. In logistic regressions, persistent nightmares (i.e., regular nightmares at 3 or more time-points) were significantly associated with BPD symptoms following adjustment for sleep onset and maintenance problems and all confounders (Adjusted Odds Ratio = 1.62; 95 % Confidence Interval = 1.12 to 2.32). Persistent sleep onset and maintenance problems were not significantly associated with BPD symptoms. In path analysis controlling for all associations between confounders, persistent nightmares independently predicted BPD symptoms (Probit co-efficient [β] = 0.08, p = 0.013). Emotional and behavioural problems significantly mediated the association between nightmares and BPD (β =0.016, p < 0.001), while nightmares significantly mediated associations between emotional temperament (β = 0.001, p = 0.018), abuse (β = 0.015, p = 0.018), maladaptive parenting (β = 0.002, p = 0.021) and subsequent BPD. These findings tentatively support that childhood nightmares may potentially increase the risk of BPD symptoms in early adolescence via a number of aetiological pathways. If replicated, the current findings could have important implications for early intervention, and assist clinicians in the identification of children at risk of developing BPD.Electronic supplementary materialThe online version of this article (doi:10.1007/s10802-016-0158-4) contains supplementary material, which is available to authorized users.

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“…The issue of personality disorder assessment prior to adulthood (Fonagy et al, 2015;Newton-Howes, Clark, & Channen, 2015;Winsper, Marwaha, Lereva, & Thompson, 2015) and in aging adults (Kandler, Kornadt, Hagemeyer, & Neyer, 2015;Cooper, Balsis, & Oltmanns, 2014;Wagner, Ram, Smith, & Gerstorf, 2016) have received significant attention in recent research. This is a trend that should continue to establish a better understanding of personality stability and change across the life course.…”

Section: Directions For Further Researchmentioning

confidence: 99%

Stability and change in personality and personality disorders

Hopwood

Bleidorn

2018

Current Opinion in Psychology

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In this paper we review recent findings related to stability and change in personality and personality disorder. Estimates of stability vary depending on a number of methodological and substantive factors.These factors include the type of stability being examined, the type of construct being assessed, the method being used to assess personality, how participants are sampled, and developmental trends in personality stability and change. We describe current evidence about personality stability with respect to each of these factors. We conclude that current gaps in the literature can be filled by more carefully attending to factors that impact estimates of stability and change, and provide recommendations about how future research can fill those gaps.

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Clinical and psychosocial outcomes of borderline personality disorder in childhood and adolescence: a systematic review

Cited by 80 publications

References 64 publications

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

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

Sleep Problems in Childhood and Borderline Personality Disorder Symptoms in Early Adolescence

Stability and change in personality and personality disorders

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