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Childhood adversity and borderline personality disorder: a meta-analysis.
Acta Psychiatr Scand 2020; 141(1):6-20AP

Abstract

OBJECTIVE

The aim of this meta-analysis was to better understand the magnitude and consistency of the association between childhood adversity and borderline personality disorder (BPD) across case-control, epidemiological and prospective cohort studies.

METHOD

Following the review protocol (reference: CRD42017075179), search terms pertaining to adversity and BPD were entered into three search engines. Random-effects meta-analysis synthesised the size and consistency of the effects.

RESULTS

A total of 97 studies compared BPD to non-clinical (k = 40) and clinical (k = 70) controls. Meta-analysis of case-control studies indicated that individuals with BPD are 13.91 (95% CI 11.11-17.43) times more likely to report childhood adversity than non-clinical controls. This effect was smaller when considering retrospective cohort (OR: 2.59; 95% CI 0.93-7.30) and epidemiological (OR: 2.56, 95% CI 1.24-5.30) studies. Findings were significant across adversity subtypes with emotional abuse (OR: 38.11, 95% CI: 25.99-55.88) and neglect (OR: 17.73, 95% CI = 13.01-24.17) demonstrating the largest effects. Individuals with BPD were 3.15 (95% CI 2.62-3.79) times more likely to report childhood adversity than other psychiatric groups.

CONCLUSIONS

This meta-analysis corroborates theoretical proposals that exposure to adverse life experiences is associated with BPD. It highlights the importance of considering childhood adversity when treating people diagnosed with BPD.

Authors+Show Affiliations

Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK. Lancashire Care NHS Foundation Trust, Lancashire, UK.Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK. Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31630389

Citation

Porter, C, et al. "Childhood Adversity and Borderline Personality Disorder: a Meta-analysis." Acta Psychiatrica Scandinavica, vol. 141, no. 1, 2020, pp. 6-20.
Porter C, Palmier-Claus J, Branitsky A, et al. Childhood adversity and borderline personality disorder: a meta-analysis. Acta Psychiatr Scand. 2020;141(1):6-20.
Porter, C., Palmier-Claus, J., Branitsky, A., Mansell, W., Warwick, H., & Varese, F. (2020). Childhood adversity and borderline personality disorder: a meta-analysis. Acta Psychiatrica Scandinavica, 141(1), pp. 6-20. doi:10.1111/acps.13118.
Porter C, et al. Childhood Adversity and Borderline Personality Disorder: a Meta-analysis. Acta Psychiatr Scand. 2020;141(1):6-20. PubMed PMID: 31630389.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Childhood adversity and borderline personality disorder: a meta-analysis. AU - Porter,C, AU - Palmier-Claus,J, AU - Branitsky,A, AU - Mansell,W, AU - Warwick,H, AU - Varese,F, Y1 - 2019/11/18/ PY - 2019/10/15/accepted PY - 2019/10/21/pubmed PY - 2019/10/21/medline PY - 2019/10/21/entrez KW - adversity KW - borderline personality disorder KW - meta-analysis KW - trauma SP - 6 EP - 20 JF - Acta psychiatrica Scandinavica JO - Acta Psychiatr Scand VL - 141 IS - 1 N2 - OBJECTIVE: The aim of this meta-analysis was to better understand the magnitude and consistency of the association between childhood adversity and borderline personality disorder (BPD) across case-control, epidemiological and prospective cohort studies. METHOD: Following the review protocol (reference: CRD42017075179), search terms pertaining to adversity and BPD were entered into three search engines. Random-effects meta-analysis synthesised the size and consistency of the effects. RESULTS: A total of 97 studies compared BPD to non-clinical (k = 40) and clinical (k = 70) controls. Meta-analysis of case-control studies indicated that individuals with BPD are 13.91 (95% CI 11.11-17.43) times more likely to report childhood adversity than non-clinical controls. This effect was smaller when considering retrospective cohort (OR: 2.59; 95% CI 0.93-7.30) and epidemiological (OR: 2.56, 95% CI 1.24-5.30) studies. Findings were significant across adversity subtypes with emotional abuse (OR: 38.11, 95% CI: 25.99-55.88) and neglect (OR: 17.73, 95% CI = 13.01-24.17) demonstrating the largest effects. Individuals with BPD were 3.15 (95% CI 2.62-3.79) times more likely to report childhood adversity than other psychiatric groups. CONCLUSIONS: This meta-analysis corroborates theoretical proposals that exposure to adverse life experiences is associated with BPD. It highlights the importance of considering childhood adversity when treating people diagnosed with BPD. SN - 1600-0447 UR - https://www.unboundmedicine.com/medline/citation/31630389/full_citation L2 - https://doi.org/10.1111/acps.13118 DB - PRIME DP - Unbound Medicine ER -