Three studies of Borderline Personality Disorder (BPD)

Fleck, et al. (2022) published “Child Versus Adolescent Borderline Personality Disorder Traits: Frequency, psychosocial correlates, and observed mother–child interactions” in Personality Disorders: Theory, Research, and Treatment. This study is helpful in examining child behavior. Here’s the abstract: 

Research has established the diagnostic validity of borderline personality disorder (BPD) in adolescence. The roots of BPD often lie in childhood; however, significantly less is known about the presence and correlates of BPD traits in school-age children and whether these are comparable with those observed in adolescents. Trained psychologists administered the Childhood Interview for Borderline Personality Disorder in a cohort of 14-year-old adolescents (n = 76) and a cohort of 9-year-old children (n = 70). We compared the prevalence of BPD traits in both cohorts and investigated common psychosocial correlates (comorbidity, impaired quality of life, emotional/behavioral problems, maternal distress, and observed mother–child interaction). Children and adolescents showed no significant differences regarding the type and frequency of BPD traits. In both cohorts, BPD traits were associated with comorbidity, emotional and behavioral problems, and lower quality of life. In contrast to adolescents, children’s BPD traits were not significantly related to maternal distress and showed less relations to interaction patterns. Negative maternal and dyadic behavior were associated with more BPD traits in adolescents during a conflict discussion but not during fun day planning. Our study suggests that BPD traits in children are similarly frequent as in adolescents and accompanied by psychosocial impairment. However, age-related differences were revealed, mostly indicating weaker associations with the mother–child relationship. Mother–child interaction patterns in youth seem to be especially relevant during conflict discussion and provide a target for intervention. Our study provides preliminary support for potential early detection of BPD pathology among children and encourages further study of its life span perspective. 

In the second study, Geluk Rouwhorst, ten Have, de Graaf, & Batelaan (2022) published “The Impact of Borderline Personality Disorder Symptoms on Onset and Course of Anxiety Disorders: Results of a general population study” in Personality Disorders: Theory, Research, and Treatment. Here’s there abstract:

Borderline personality disorder (BPD) has a negative impact on the onset and course of anxiety disorders. However, even though many people with anxiety disorders only have some BPD symptoms, little is known about the impact of BPD symptoms on anxiety disorders. This study examines the impact of BPD symptoms on the onset and persistence of anxiety disorders over a 3-year follow-up in the general population. Longitudinal data from the Netherlands Mental Health Survey and Incidence study were used (N = 4,618). BPD symptoms were assessed using the International Personality Examination, and anxiety disorders and other mental disorders were assessed with the Composite International Diagnostic Interview. Logistic regression analyses were performed, adjusting for a wide range of potential confounders such as childhood abuse and mood disorders. In all, 72.1% of the participants reported no BPD symptoms, 24.0% reported one to two symptoms, 3.1% reported three to four symptoms, and 0.8% reported ≥ 5 symptoms. There was a clear dose–response relation, with more BPD symptoms being associated with a higher risk for onset and persistence of anxiety disorders (both p for trend < .001). Even one to two BPD symptoms significantly impacted the onset (odds ratio = 3.32, 95% confidence interval [1.68, 6.54]) and persistence (odds ratio = 3.12, 95% confidence interval [1.01, 9.64]). Results appeared to be independent of multiple potential confounders. Even a low number of BPD symptoms impact the onset and persistence of anxiety disorders. Targeting these symptoms may improve the outcome of anxiety disorders. Future research should study the effect of various interventions for people with anxiety disorders and BPD symptoms. 

In the third study, Jańczak, Soroko, & Górska (2022) published “Metacognition and Defensive Activity in Response to Relational–Emotional Stimuli in Borderline Personality Organization” in Journal of Psychotherapy Integration. Here’s their abstract:

The aim of this study is to supplement the description of the functioning of individuals with borderline personality organization (BPO) in terms of metacognition by additionally describing the phenomenon of defense against emotional–relational experiences, as a possible factor contributing to observed levels of metacognition. The participants were divided into borderline (N = 69) and nonborderline groups (N = 71). After a procedure aimed at activating the attachment system, they were asked to tell a relational story, which was used to code a metacognition rate (using the Metacognition Assessment Scale–Revised, MAS-R) and a defensive activity (Defensive Activity Coding System, DACS). Both groups registered low levels of metacognition; no significant differences were found primarily, although ANCOVA reveals that, once the defense effect has been removed, BPO individuals present a lower level of metacognition than those in the control group. Furthermore, the causal mediation analysis confirmed the mediative role of defensiveness in the relation between metacognition and BPO. Defensive activity proved to interfere in the assessment of metacognition in individuals with BPO. 

Taken together, these studies may be helpful to clinicians who work with clients with BPO, especially given their higher levels of anxiety and defensiveness regarding attachment.