Borderline personality disorder has strongest link to childhood trauma

People with borderline personality disorder are 13 times more likely to report childhood trauma than people without any mental health problems, according to University of Manchester research.

The analysis of data from 42 international studies of over 5,000 people showed that 71.1 percent of people who were diagnosed with the serious health condition reported at least one traumatic childhood experience.

The study was carried out by researchers at the University of Manchester in collaboration with Greater Manchester Mental Health NHS Foundation Trust and the Spectrum Centre for Mental Health Research, Lancaster University. It is published in the journal Acta Psychiatrica Scandinavia.

In the latest of a series of meta-analyses by the team on the effects of childhood trauma on adult mental health, they show it is much more likely to be associated with BPD than mood disorders, psychosis and other personality disorders.

The most common form of adverse experience reported by people with BPD was physical neglect at 48.9 percent, followed by emotional abuse at 42.5 percent, physical abuse at 36.4 percent, sexual abuse at 32.1 percent and emotional neglect at 25.3 percent.

BPD is often a debilitating mental health problem that makes it hard for someone to control their emotions and impulses.

The disorder, often linked to self-harm and substance abuse, is hard to treat and associated with significant costs to sufferers and society as a whole.

Some of the characteristics of this condition, such as experiencing extreme, overwhelming emotions over what might be seen to others as a minor issue, are common, but become chronic and exaggerated after childhood trauma.

Dr. Filippo Varese from the University of Manchester, said, "During childhood and adolescence, our brain is still undergoing considerable development and we are also refining strategies to deal with the challenges of everyday life, and the negative feelings that come with them.

"In some people who have experienced chronic, overwhelming stress in childhood, it is likely that these responses do not develop in the same way. People can become more sensitive to 'normal' stress. They are sometimes unable to deal with intense negative thoughts and feelings, and they might resort to dangerous or unhelpful measures to feel better, such as taking drugs or self-harming. This can lead to various mental health difficulties, including the problems commonly seen in people who receive a diagnosis of BPD.

"We found a strong link between childhood trauma and BPD, which is particularly large when emotional abuse and neglect was involved."

He added: "Borderline is a slightly misleading term—as it implies that this condition only has a mild impact. Far from that, BPD can be very distressing and difficult to treat.

"The term BPD was originally used to indicate mental health problems that were not a psychosis nor an anxiety or depressive disorder—but something in the middle. Another term used in modern times is 'emotionally unstable personality disorder,' which perhaps gives a clearer picture of the kind of problems typically described by these people.

"We hope these findings underline the importance of trauma informed care for people accessing mental health services, where prevalence rates of BPD are high.

"But further research is needed to explore the complex factors also likely to be involved such as biology, experiences in later life, and psychological processes."