Rajat Rao
Janhwi Singh

The Relationship Between Childhood Adversity and The Development Of Borderline Personality Disorder-

Introduction-

Borderline personality disorder (BPD) is both a common and serious psychiatric disorder. Early theories of its etiology were derived from the writings of psychoanalytic thinkers. However, there have been three generations of research examining the etiology of this disorder. In general, it appears that borderline personality disorder is an admixture of childhood adversity, a vulnerable temperament, and a triggering event—which leads to a full-blown case of BPD.(Zanarini, M.C., Wedig, M.M. (2014). Childhood Adversity and the Development of Borderline Personality Disorder. In: Sharp, C., Tackett, J. (eds) Handbook of Borderline Personality Disorder in Children and Adolescents. Springer, New York, NY.)In psychoanalytic and psychotherapeutic efforts at definitive characterologic work with borderline patients,have observed a core experiential state of intensely painful loneliness. This feeling state often includes a sense of inner emptiness together with increasing panic and despair; over time these patients develop a concomitant desperate hopelessness that this feeling will ever be alleviated.(Adler, G., & Buie, D. H., Jr. (1979). Aloneness and borderline psychopathology: The possible relevance of child development issues. International Journal of Psychoanalysis, 60(1), 83–96.) Prominent substance abuse history, tempestuous biographies, and unstable early home environment were common to all diagnostic subgroups. In family history, borderlines were most like bipolar controls, and differed significantly from schizophrenic, unipolar, and personality controls.(Akiskal, H. S., Chen, S. E., Davis, G. C., Puzantian, V. R., Kashgarian, M., & Bolinger, J. M. (1985). Borderline: An adjective in searchofanoun.JournalofClinicalPsychiatry,46(2),41–48. )

Childhood trauma in borderline personality disorder-

 In the developmental formulation, disruptions in relations with primary caretakers are thought to be an important factor in the genesis of the disorder.  Parental neglect and un-protectiveness are although disruption of early attachments is frequently cited, the role of childhood trauma, including parental abuse, in the development of this disorder has received less systematic attention.  Walsh (17), Frank and Paris (18), Gunderson (6), and Feldman and Guttman . Early, prolonged separation from or permanent loss of primary caretaker ens is described anecdotally and demonstrated in a significant proportion of patients in retrospective studies.

Prevalence and severity of childhood adversity in adolescents with BPD-

 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.An experiment was conducted wherein the participants included 104 adolescent (aged 13–17 years) inpatients with BPD, 60 age-matched, psychiatrically healthy adolescents, and 290 adult inpatients with BPD. Its result was 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.[Christina M. Temes Ph.D., Laura R. Magni Ph.D., Garrett M. Fitzmaurice Sc.D., Blaise A. Aguirre M.D., Marianne Goodman M.D., Mary C. Zanarini Ed.D]

The Role of Trauma in Early Onset Borderline Personality Disorder-

• • Temperamental Factors- There is a general consensus that temperamental vulnerabilities combined with childhood adversities play a role in the development of BPD traits,researchers identified several temperamental traits in children or adolescents, including affective instability, negative affectivity, negative emotionality, inappropriate anger that could predispose to borderline personality disorder.(Model proposed by Cloninger for personality pathology underlines the role of temperamental characteristics in BPD development)

• Environmental Factors-  It has been supposed that the development of cognition and affectivity, the integration of thinking and emotions, and the ability to discern emotional states are disturbed by early trauma with consequent post-traumatic reactions.Children who suffer maltreatments may infer negative characteristics of themselves and others.This assumption may lead them to see themselves as “helpless, unlovable, or weak and to view other people as dangerous, rejecting, or unavailable”.

(Traumatic Experiences and Early Onset of BPD-The hypothesis that early traumatic life experiences foster the development of BPD received increasing scientific validation.)

• Bullying – Bullying is when someone uses their power to hurt others on purpose. It happens again and again and there’s an unfair balance of power between the bully and the victim.Several studies reported that being bullied during the period of primary school is a strong predictor of early BPD.(Wolke and colleagues (73) conducted one study in order to explore the association between peer victimization and BPD symptoms.)

• Genetic Influence – Studies show that serious life events such as physical abuse, rape, and childhood sexual abuse interact with polymorphisms of genetic structure, producing patterns characteristics in lines of BPD (Bozzatello P et. al 2021). All these slight modifications in the genetic structures combined with early adverse experience has a direct relation with development and severity of BPD symptoms in young individuals. Specific genetic polymorphisms such as those in serotonin transporter and catechol-O-methyltransferase, upon experiencing adverse life experiences, influence impulsivity and other behavioural patterns characteristics of BPD in affected individuals.

It is statistically proven that, Emotional abuse and neglect demonstrated the largest effects, with individuals with BPD being 38.11 and 17.73 times more likely to report these experiences compared to non-clinical controls, respectively. (C Porter et. Al 2019)

Conclusion-

Yes, Borderline Personality Disorder (BPD) is a serious mental health condition. It significantly impacts a person’s ability to manage emotions, maintain stable relationships, and develop a consistent sense of identity. It has been demonstrated that both adolescents and adults with BPD report higher rates of childhood adversity and traumas. People with an unpleasant experience like regular conflicts in house,physical/sexual abuse, bad child-parent relationship or any other experience face the issue of BPD.However, the psychological world is still looking for its proper cure,individuals with BPD are strongly recommended to seek therapy.