From Child Abuse to Developing Borderline Personality Disorder Into Adulthood: Exploring the Neuromorphological and Epigenetic Pathway

Abstract

Borderline personality disorder (BPD) is one of the most common personality disorders seen in the general population. Among multiple identified risk factors, one of the most influential elements is exposure to an adverse childhood experience in terms of emotional, physical, or sexual abuse. A cascade of neuromorphological and epigenetic changes occurs in response to these childhood stressors, which may have a strong link to the development of BPD. PubMed and Google Scholar were searched for articles relevant to child abuse and the development of BPD. The search was not restricted to any time frame or geographic location. Significant epigenetic and neuromorphological changes are seen with child abuse, contributing to the development of BPD. Chronic stressors lead to hypothalamic-pituitary axis (HPA) activation, releasing cortisol that acts on the prefrontal cortex, amygdala, and hippocampus, producing the behavioral patterns seen in BPD. Overstimulation of gray matter leads to permanent neuromorphological changes, which can be visualized in functional MRI/brain scans. Hypermethylation of messenger ribonucleic acid in various sites suggests the impact of child abuse on the genetic level. Interestingly, the prevalence of BPD is seen equally in both genders but is diagnosed more frequently in females because they tend to be more likely to seek help. Understanding the impact of early age life stressors into adulthood calls for serious focus on early diagnosis and intervention. This implies the need for more studies in patients with BPD with or without any childhood traumatic experience and a better understanding of the changes that occur biopsychologically and genetically in response to trauma.

The Role of Trauma in Early Onset Borderline Personality Disorder: A Biopsychosocial Perspective

“…Intense emotional responses to small stress with a greater latency for returning to baseline conditions are common in young BPD patients. Moreover, over-functioning of the prefrontal cortex generates loss of rationality, reasoning, and decision- making capacity in BPD patients ( 20 , 81 ).…”

“…Several investigators found an increase of cortisol levels (urinary, salivary, and blood) in patients with BPD, hallmarking HPA activation (78)(79)(80). The cortisol hyper-stimulation of the hippocampus can generate a distorted interpretation of signals from the environment as constant menaces, therefore sending this danger signals to amygdala, that modulates fear and aggression (20). Intense emotional responses to small stress with a greater latency for returning to baseline conditions are common in young BPD patients.…”

“…These traumatic experiences could be also associated to neuromorphological abnormalities and to neuroendocrine changes (i.e. hypothalamic-pituitary axis (HPA) activation) that are observed in patients with early BPD and abuse/neglect history ( 20 ).…”

The Mediating Role of Forgiveness and Self-Efficacy in the Relationship Between Childhood Maltreatment and Treatment Motivation Among Malaysian Male Drug Addicts

“…Exposure to maltreatment during childhood has long been associated with an increased risk of subsequent psychological and behavioral problems across the human lifespan including mood disorders ( Norman et al, 2012 ; Lippard and Nemeroff, 2020 ), depression ( Dhamayanti et al, 2020 ), post-traumatic stress disorder ( McLaughlin et al, 2017 ; Schuck and Widom, 2019 ), borderline personality disorder ( Mainali et al, 2020 ), adult criminality ( Minh et al, 2013 ; Kim et al, 2016 ), and drug and substance abuse ( Elwyn and Smith, 2013 ; Mandavia et al, 2016 ). Studies have demonstrated that maltreatment histories are relatively common among individuals receiving treatment for substance and drug abuse ( Funk et al, 2003 ; Banducci et al, 2014 ; Loy et al, 2020a ).…”

A Review of Stressors as Inducer for Personality Disorders and Anxiety Disorders

“…Negative childhood experiences, causing dysfunction of the HPA axis [8], can lead to some kind of PD in adults [9]. Early life stress can also induce ADs in later life through changing the status of the HPA axis.…”