The aetiological and psychopathological validity of borderline personality disorder in youth: A systematic review and meta-analysis

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

doi:10.1016/j.cpr.2015.12.001

Cited by 117 publications

(112 citation statements)

References 92 publications

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“…The relatively smaller body of literature on the childhood experiences of adolescents with BPD has largely mirrored the adult literature (see Winsper, Lereya, Marwaha, Thompson, Eyden, & Singh, 2016 for a review). In particular, studies have indicated that adolescents with BPD are more likely to report experiences of various forms of abuse and neglect when compared to adolescents from non-clinical and non-BPD clinical samples (Atlas, 1995; Horesh, Ratner, Laor, & Toren, 2008; Horesh, Sever, & Apter, 2003; Infurna et al, 2016; James, Berelowitz, & Vereker, 1996; Ludolph, Westen, Misle, Jackson, Wixom, & Wiss, 1990).…”

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confidence: 99%

“…Studies regarding the validity of BPD in adolescence have emphasized the importance of examining relevant clinical phenomena (e.g., comorbidity, risk factors) to assess the construct of BPD in adolescence in addition to symptoms alone (Sharp & Romero, 2007; Winsper et al, 2016). One way to assess validity is to examine a clinical correlate in adolescents believed to have BPD and in relevant comparison groups to determine the level of similarity between adult BPD vs. divergence from a normative adolescent trajectory.…”

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confidence: 99%

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Prevalence rates of childhood protective factors in adolescents with BPD, psychiatrically healthy adolescents and adults with BPD

Borkum

Temes

Magni³

et al. 2017

Personality & Mental Health

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Objective Existing research has demonstrated that both adolescents and adults with borderline personality disorder (BPD) report higher rates of childhood adversity than their same-age peers; no studies have examined if adolescents and adults with BPD differ based on the extent of these experiences. In the present study, we compared the prevalence rates and severity of multiple forms of abuse and neglect in adolescents and adults with BPD and in psychiatrically healthy adolescents. Methods Participants included 104 adolescent (aged 13-17 years) inpatients with BPD, 60 age-matched, psychiatrically healthy adolescents, and 290 adult inpatients with BPD. All participants completed an interview that assessed the presence and severity of multiple forms of childhood abuse and neglect. Results A significantly higher percentage of adolescents with BPD reported 5 of 12 pathological childhood experiences and described more severe abusive experiences than their psychiatrically healthy peers. In comparison to adolescents with BPD, a significantly higher percentage of adults with BPD reported nearly all forms of childhood adversity and rated these experiences as more severe. Conclusions Taken together, these results suggest that adults with BPD report more severe profiles of abuse and neglect than adolescents with the disorder, even though adolescents with BPD differ from healthy peers.

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confidence: 99%

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confidence: 99%

Prevalence rates of childhood protective factors in adolescents with BPD, psychiatrically healthy adolescents and adults with BPD

Borkum

Temes

Magni³

et al. 2017

Personality & Mental Health

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“…A growing body of studies have demonstrated the clinical utility, validity and reliability of the adolescent (Kaess, Brunner, & Chanen, 2014;Sharp & Fonagy, 2015;Winsper et al, 2016) and to a lesser extent child (Hawes, 2014;Winsper et al, 2016) BPD phenotype. 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).…”

Section: Introductionmentioning

confidence: 99%

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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“…The persistence of symptoms for meeting diagnostic threshold for BPD has been shown to be as stable in youth as in adult samples [1][2][3] and BPD in adolescents shares similar predictors and outcomes to the disorder in adults [2,4]. For important comorbidities such as attention deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD), evidence of discriminant validity has also been shown [5,6].…”

Section: Introductionmentioning

confidence: 98%

“…Insecure or disorganized caregiver attachment in early life may increase one's risk for BPD, with a history of hostile or neglectful parenting being a common risk factor [21]. Individuals with BPD often report increased fear of losing their primary attachment figure, making it difficult to ascertain whether attachment difficulties precede BPD or are a result of the disorder's emotional impact [70], A recent metaanalysis examining the strength of association between childhood abuse and BPD symptoms found that report of physical abuse OR parental hostility/verbal abuse OR parental neglect were each independently associated with a 3-fold increase in risk for BPD [2] compared to the outcome of no BPD in adulthood. Report of childhood sexual abuse was associated with a 5-fold increase in risk for BPD in the same study.…”

Section: Studies Comparing Bpd and Depressionmentioning

confidence: 99%

Borderline personality disorder in children and adolescents: discriminant validity in relation to major depressive disorder

Boylan¹,

Dyce²,

Semovski³

2017

J Psychol Psychiatry

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Clinical discernment of the diagnosis of borderline personality disorder (BPD) in adolescents is difficult, due in part to very high rates of comorbidity with major depressive disorder (MDD) or depressive symptoms. This paper reviews published research on studies about risk factors, neurobiological and neuropsychological correlates and treatment in both disorders for persons less than 25 years of age. The aim is to focus on differences identified between the disorders to substantiate their discriminative validity, although similarities are included. Very few studies were found which directly compared youth with both disorders -or both disorders -in the same sample. These studies found strong covariation between BPD and MDD symptoms across adolescence and conjoint response to dialectical behavioural therapy. Youth with BPD may have greater impairments in social processing than youth with MDD. Indirect comparisons supported poor evidence for discriminative validity and no findings were replicated. To date, the limited research base does not support that BPD and MDD are distinct disorders in adolescence, however the absence of observed differences is not the same as evidence of no difference. Given the importance of improving psychiatric and psychological care for youth, it is strongly recommended that studies about adolescent mood and mood disorder include concurrent and repeated measurement of BPD and MDD.

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The aetiological and psychopathological validity of borderline personality disorder in youth: A systematic review and meta-analysis

Cited by 117 publications

References 92 publications

Prevalence rates of childhood protective factors in adolescents with BPD, psychiatrically healthy adolescents and adults with BPD

Prevalence rates of childhood protective factors in adolescents with BPD, psychiatrically healthy adolescents and adults with BPD

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

Borderline personality disorder in children and adolescents: discriminant validity in relation to major depressive disorder

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