Where Does Borderline Personality Disorder Come From?

A new study offers insight into the origins of Borderline Personality Disorder.

By Mark Travers, Ph.D. | August 18, 2021

A new study published in Frontiers in Psychology suggests that Borderline Personality Disorder — the most common personality disorder with an estimated prevalence of about 1.7% — has its roots in early childhood trauma more than genetic vulnerability.

"Borderline Personality Disorder (BPD) is a psychiatric disorder featured by intense fears of abandonment, difficulties in emotion regulation, feelings of emptiness, unstable interpersonal relationships, impulsivity, and heightened risk-taking behaviors, as well as high levels of interpersonal aggression," state the authors of the research, led by Benjamin Otto of Ruhr-University Bochum in Germany. "It seems that females are more frequently affected from BPD, at least in clinical settings, than males, with a ratio of about four to one."

To better understand the causes of Borderline Personality Disorder, the researchers recruited 95 adult women, 44 of whom were previously diagnosed with the disorder, to complete a series of psychological assessments including a life history questionnaire, a personality test, a questionnaire measuring aggressiveness, a childhood trauma questionnaire, and a chronic stress questionnaire. The researchers also recorded participants' Allostatic load, or wear and tear on the body occurring from exposure to chronic stress, by measuring bodily indicators of stress such as blood pressure, waist-to-hip ratio, and body mass index.

They found that participants with Borderline Personality Disorder scored significantly higher on the childhood trauma questionnaire than non-BPD participants. This finding corroborates other research that has found that up to 80% of people diagnosed with BPD experienced some form of emotional neglect and physical or sexual abuse during childhood.

The study goes further to identify the sequence of events that leads to the development of BPD. The authors contend that childhood trauma produces a "Pace-of-Life-Syndrome," whereby individuals grow faster, exhibit higher metabolism, and are more prone to early bodily decline and death. This results in higher Allostatic loads in adulthood.

"In line with expectations, BPD patients had significantly higher scores suggestive of a fast Pace-of-Life-Syndrome than controls, they were more aggressive, more burdened with chronic stress and were exposed to more severe childhood adversity," say the authors.

They also report robust personality differences between BPD and non-BPD individuals. For instance, the researchers found that BPD participants exhibited higher levels of neuroticism, lower levels of extraversion, lower levels of conscientiousness, and lower levels of agreeableness. They also found that BPD individuals were less open to new experiences.

They conclude, "To the best of our knowledge, this is the first study that has directly examined the question of whether the clinical condition labeled Borderline Personality Disorder bares features suggestive of a fast Pace-of-Life-Syndrome and consequences including poorer body maintenance and repair. The findings could therefore be of particular relevance for public health, particularly in terms of prevention and risk reduction for deleterious outcomes that are not only psychologically determined, but also by means of physical health."

The authors note that a fast Pace-of-Life-Syndrome is not specific to BPD; other psychiatric conditions, such as attention deficit/hyperactivity disorder, bipolar disorder, and addictive disorders also fall into this category.