Differentiating BPD in adolescents with NSSI disorder: the role of adverse childhood experiences and current social relationships

Background: As borderline personality disorder (BPD) is increasingly considered a lifespan developmental disorder, we need to focus on risk factors and precursors in the developmental pathways to BPD, in order to enable early detection and intervention. Within this developmental pathway, adolescence is a crucial phase in the light of the manifestation of the disorder. Relational factors such as adverse childhood experiences and current relational problems can be considered important in adolescents who are at-risk for BPD. Nonsuicidal self-injury (NSSI) is a key precursor for adolescent BPD and one of the most promising targets for early detection and intervention of BPD. Methods: In a clinical sample of 152 adolescents engaging in nonsuicidal self-injury (NSSI) disorder referred to mental healthcare in Germany, this study investigated whether we can differentiate who has BPD from 1) adverse childhood experiences; and 2) the quality of current relationships, both with parents and peers. BPD was assessed both categorically as a dichotomized score and dimensionally as a continuous score. Results: More adverse childhood experiences, but not low quality of current social relationships, were related to more BPD symptoms and an increased risk for meeting full criteria for BPD. In the dimensional model, current social relationship quality with parents and peers did not show a moderating (protecting or aggravating) effect on the association between adverse childhood experiences and BPD. Using a categorical approach, however, the association between childhood adversity and meeting full criteria for BPD was higher in individuals reporting higher quality of current parent-child relationship. Conclusions: These results highlight adverse childhood experiences as risk factors of BPD, while the role of current social relationships seems more complex

Borderline personality disorder in young people: associations with support and negative interactions in relationships with mothers and a best friend

BACKGROUND: Impaired interpersonal functioning has been highlighted as a core feature of borderline personality disorder (BPD). Adolescence and young adulthood form important developmental stages within both the emergence of BPD and the development of interpersonal functioning, which takes place mostly in relationships with parents and friends. This study aimed to: (i) investigate relations between BPD symptoms and both supportive and negative interactions with mothers and best friends; (ii) investigate whether the relations were moderated by age; (iii) test the robustness of our findings by comparing the results based on self-reports with results from a subsample in which supportive and negative interactions with mothers were rated by the mother. METHODS: 312 young people referred to mental healthcare completed self-report measures on BPD and supportive and negative interactions. Multiple regression analyses were conducted to examine the relations between BPD features and perceived supportive and negative interactions with mothers and a best friend, and to investigate whether these relations were moderated by age. Robustness of our findings was studied in a subsample (n = 104), by using a multi-informant design in maternal report on supportive and negative interactions with mothers. RESULTS: Multiple regression analyses demonstrated that negative interactions with mothers as well as with a best friend were related to more BPD symptoms in young people. Supportive interactions were not related to BPD symptoms. Both BPD and quality of relations were not related to age. In a subsample in which supportive and negative interactions with mothers were rated by the mother, the maternal report showed slightly different results. In this model, both supportive and negative interactions with a best friend were positively related, whereas interactions with mothers were not related to BPD symptoms in young people. CONCLUSIONS: Results highlight the importance of relationships with mothers and a best friend during adolescence and young adulthood. Given that BPD often emerges during this developmental phase, future research is needed to clarify how quality of relationships could alter pathways toward BPD in young people. TRIAL REGISTRATION: Not applicable

Problemen in het begrijpen van en omgaan met anderen: relaties tussen borderlinepersoonlijkheidsproblemen en psychosociaal functioneren bij adolescenten

BACKGROUND For a long time there was controversy and reservations with regards to diagnosing borderline personality disorder (bpd) under the age of eighteen. Progress in scientific knowledge has shown that adolescence is a key phase in the understanding of the development of the disorder. AIM To contribute to the understanding of the developmental trajectory of bpd by studying associations between bpd and the interpersonal functioning in adolescence. METHOD To study associations between personality, cluster B personality pathology and bpd and associations between bpd and interpersonal functioning, specified in social information processing and relationship quality with parents and peers. RESULTS Personality dimensions and social information processing, both independently and together, are related to cluster B personality pathology and bpd. Furthermore, the importance of quality of relationships with parents in relation to bpd is confirmed.. CONCLUSION The role of social environment is complex in the development of bpd. The results underpin the interpersonal nature of bpd in adolescence as a crucial phase within the psychosocial development

Borderline personality pathology in young people: Complexities in understanding of and relating to others

BACKGROUND For a long time there was controversy and reservations with regards to diagnosing borderline personality disorder (bpd) under the age of eighteen. Progress in scientific knowledge has shown that adolescence is a key phase in the understanding of the development of the disorder. AIM To contribute to the understanding of the developmental trajectory of bpd by studying associations between bpd and the interpersonal functioning in adolescence. METHOD To study associations between personality, cluster B personality pathology and bpd and associations between bpd and interpersonal functioning, specified in social information processing and relationship quality with parents and peers. RESULTS Personality dimensions and social information processing, both independently and together, are related to cluster B personality pathology and bpd. Furthermore, the importance of quality of relationships with parents in relation to bpd is confirmed.. CONCLUSION The role of social environment is complex in the development of bpd. The results underpin the interpersonal nature of bpd in adolescence as a crucial phase within the psychosocial development

Borderline Personality Disorder and Antisocial Behaviors in Adolescence: The Role of Impulsivity

A considerable amount of research shows that antisocial behaviors, most notably problems with alcohol, problems with drugs, and conduct problems, is common during adolescence (e.g., Moffitt, 1993). In the past few decades, the presence of Borderline Personality Disorder (BPD) in adolescents also became increasingly acknowledged. Research has suggested that BPD traits are related to more antisocial behavior (e.g., Beauchaine, Klein, Crowell, Derbidge, & Gatzke-Kopp, 2009; Trull et al., 2018; Wilson, Fertuck, Kwitel, Stanley, & Stanley, 2006). However, it remains unclear how this relationship works. Of all personality traits, particularly impulsivity seems to be related to both BPD traits and antisocial behaviors. Impulsivity is therefore a promising construct in explaining the relationship between both constructs. BPD traits and antisocial behaviors might have shared variance that can be explained by impulsivity. However, various conceptions of impulsivity are present in the literature, all relating to different aspects of personality. Whiteside and Lynam (2001) suggested that there are five facets of impulsivity: (lack of) premeditation, positive urgency, negative urgency, sensation seeking, and (lack of) perseverance. This facet level may be particularly important to understand the link between BPD traits and antisocial behaviors, because some facets of impulsivity might be specifically related to BPD traits and some facets of impulsivity might be specifically related to antisocial behaviors. By investigating these facets of impulsivity together in one model, we can examine which facets are (most) important in the constructs BPD and antisocial behaviors, and in the relationship between the two. We expect that there will be one or more facet(s) that are related to both, and that the presence of these facets of impulsivity partly explain the concurrent link between BPD traits and antisocial behaviors

Relationships : empirical contribution. Understanding personality pathology in adolescents: the five factor model of personality and social information processing.

This study seeks to integrate two research traditions that lie at the base of the understanding of personality pathology in adolescents. The first research tradition refers to normal personality according to the Five Factor Model (FFM). The second tradition specifies the key feature of personality disorder as the capacity to mentalize, which can be reflected in Social Information Processing (SIP). In a clinical sample of 96 adolescents, the authors investigated response generation, coping strategy, and memories of past frustrating experiences as part of SIP, as mediator in the relationship between personality and personality pathology, and a possible moderating role of personality on the relationship between SIP and personality pathology. The hypothesized mediation, by which the effects of personality dimensions on personality pathology was expected to be mediated by SIP variables, was found only for the effect of Neuroticism, most specifically on BPD, which appeared to be mediated by memories the patients had about past frustrating conflict situations with peers. Some moderating effects of personality on the relationship between SIP variables and personality pathology were found, suggesting that high Agreeableness and sometimes low Neuroticism can buffer this relationship. These results suggest that personality dimensions and social cognitions both independently and together play a role in adolescents' personality pathology

Social Information Processing and Cluster B Personality Pathology among Clinic-Referred Adolescents

BACKGROUND: This study investigated relations between personality pathology and mentalizing capacities reflected in social information processing (SIP) of adolescents. SAMPLING AND METHODS: 96 adolescent outpatients completed a structured interview regarding SIP. Their clinicians completed a checklist based on DSM-IV, assessing severity of personality pathology. RESULTS: Significant relations were found between the severity of personality pathology and SIP: the more severe the personality pathology, the higher the intensity of reported emotions, the more likely adolescents were to choose inadequate coping strategies and aggressive reactions in social situations, and the more positively they evaluated aggressive reactions. Severity of traits of antisocial (ASPD) and borderline personality disorder (BPD) had unique associations with distinctive SIP variables: ASPD being more related to inadequate coping strategies, less reflection on other's motives and aggressive responses, and BPD being more related to avoidant or prosocial responses and in particular to memories of frustrating events. CONCLUSIONS: This study provides evidence for difficulties in SIP among adolescents with more severe personality pathology, suggesting that the steps in the SIP model can be used to operationalize mentalizing problems. The results seem to paint a picture of ASPD and BPD having a shared background, but their own specific problems concerning SIP

Associations Between Borderline Personality Disorder Symptoms and Online Self-Disclosure in Clinically Referred Youth

Communicating online via social media has proven to facilitate disclosure of intimate topics and can therefore be helpful in the development of intimate relationships. However, for youth with borderline personality disorder (BPD) symptoms, it may be more difficult to know when, what, and to whom to disclose (i.e., effective disclosure) in online contacts. The authors examine associations between BPD symptoms, online self-disclosure, and ineffective online self-disclosure (e.g., regretting sharing something online). The sample consisted of 235 clinically referred youth (66.4% female), aged 12-25 years (M = 17.82, SD = 2.96). Structural equation modeling revealed that BPD symptoms were related to higher levels of same- and cross-sex online self-disclosure as well as to more ineffective online self-disclosure. There was no moderation by sex or age. This study suggests that youth with BPD symptoms are at risk for oversharing personal information, which could affect forming and maintaining intimate relationships and increases online risks