Borderline personality disorder (or BPD) is a cluster-B personality disorder which is associated with impulse and emotional control, and difficulties with interpersonal relationships and self-imagine. Generally, the disorder is diagnosed in adolescence or early adulthood, but there are associated symptoms which are present in younger children or even babies (Burke & Stepp, 2012). The two major elements of BPD which have been identified in the literature as troublesome for the individual and those around them are a fear of abandonment and intense anger or emotional instability (Burke & Stepp, 2012), which can have severe effects on the individual and their personal relationships. As is common with mental disorders in general, there are many debates about the causes of BPD, although there is a general consensus that it is related to post-traumatic stress disorder (Burke & Stepp, 2012). There is also a suggestion that it may be genetic, with up to 65% of the variability in symptoms between individuals are due to genetic differences. It can be difficult to diagnose BPD in children because the symptoms may be different. Belsky et al (2012) examined a cohort of 12 year old children who had BPD-related characteristics, which included poor cognitive function, impulsivity and more difficulty in behavioral and emotional measures. Children who exhibited these characteristics as children were found to be more likely to develop adult BPD later in life, which suggests that measuring for these characteristics in children may be helpful in allowing early treatment.
One of the major reasons for the development of BPD in children and adults seems to be an early traumatic experience, including sexual and physical abuse (Burke & Stepp, 2012). For this reason, twin studies find it hard to estimate the impact that genetics has on developing BPD because there is often a shared environment, which means that both twins will generally be exposed to the same childhood trauma and therefore be more likely to develop problems in later life (Burke & Stepp, 2012). Goldman, D’Angelo, DeMaso & Mezzacappa (1992) found, in a study of 44 children with BPD and 100 other children visiting a psychiatric clinic, children with BPD were far more likely to have experienced physical or combined physical and sexual abuse (Burke & Stepp, 2012). Herman, Perry & Van der Kolk (1989) interviewed 21 individuals with BPD, 11 with BPD traits and 23 control individuals and again found that there was a strong link between BPD and major childhood trauma, particularly abuse. Bezirganian, Cohen & Brook (1993) found that in children and adolescents diagnosed with BPD or BPD-related traits, the vast majority had much lower scores on mother-child and father-child interaction measures than those without BPD, suggesting that the attachment issues that are evident in BPD individuals may be linked to earlier fears about abandonment that stem from childhood.
Similarly, children of mothers with BPD were found to be more likely to develop BPD, not necessarily because of the genetic component but because of the “wide array of poor psychosocial outcomes” that come from living in one of these families (Stepp et al, 2012, p76). When examining these types of family, it was found that the mother often oscillated between hostile control of the child and a form of passive aloofness that was associated with the development of BPD symptoms such as childhood aggression and fear of abandonment (Stepp et al, 2012). Burke & Stepp (2012) also found that a harsh physical environment combined with the presence of childhood oppositional defiant disorder (ODD) or attention-deficit hyperactivity disorder (ADHD) were also good predictors of adolescent and adult BPD. This suggests that, whilst BPD is not generally diagnosed in children, there are early indicators that can be used to predict its development later in life, and many childhood disorders can manifest as BPD later in life.
- Belsky, D. W., Caspi, A., Arseneault, L., Bleidorn, W., Fonagy, P., Goodman, M., … Moffitt, T. E. (2012). Etiological features of borderline personality related characteristics in a birth cohort of 12-year-old children. Development and Psychopathology, 24(01), 251–265. doi:10.1017/S0954579411000812
- Bezirganian, S., Cohen, P., & Brook, J. S. (1993). The impact of mother-child interaction on the development of borderline personality disorder. The American Journal of Psychiatry, 150(12), 1836–1842.
- Burke, J. D., & Stepp, S. D. (2012). Adolescent Disruptive Behavior and Borderline Personality Disorder Symptoms in Young Adult Men. Journal of Abnormal Child Psychology, 40(1), 35–44. doi:10.1007/s10802-011-9558-7
- Goldman, S. J., D’Angelo, E. J., DeMaso, D. R., & Mezzacappa, E. (1992). Physical and sexual abuse histories among children with borderline personality disorder. The American Journal of Psychiatry, 149(12), 1723–1726.
- Herman, J. L., Christopher, J., & Van der Kolk, B. A. (1989). Childhood trauma in borderline personality disorder. The American Journal of Psychiatry, 146(4), 490–495.
- Stepp, S. D., Whalen, D. J., Pilkonis, P. A., Hipwell, A. E., & Levine, M. D. (2012). Children of mothers with borderline personality disorder: Identifying parenting behaviors as potential targets for intervention. Personality Disorders: Theory, Research, and Treatment, 3(1), 76–91. doi:10.1037/a0023081