The Relationship Between Child Abuse and BPD

The Link Between Abuse and Borderline Personality Disorder (BPD)

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What is the link between childhood abuse and borderline personality disorder?. James Darrel/The Image Bank/Getty Images

Does child abuse cause borderline personality disorder (BPD)? There is no simple answer; we don't yet know exactly what causes BPD, though it is believed to be a mix of biological and environmental factors. There is evidence that people with BPD are more likely to report a history of some type of child abuse or other distressing childhood experiences. Yet many people who have experienced child abuse do not have BPD and many people with BPD were not abused or maltreated as children.

What Is Child Abuse?

The term "child abuse" covers a wide range of mental and physical injuries done to a minor. Experts generally assign a set of experiences to this category:

  • Physical abuse: Physically hurt or injured, such as bruising or broken bones
  • Sexual Abuse: Being subjected to a sexual experience or exploited in a sexual manner by someone older
  • Emotional abuse: Undergoing emotional attacks, such as verbal abuse or degradation

Other forms of abuse can be more passive, such as in the case of physical neglect where the child is denied basic necessities, like food or water. There is also emotional neglect, where a child's emotional needs are ignored. No form of abuse is considered more severe than another; all forms of abuse can have long-lasting implications for the person and can shape their mental state.

Both child abuse and neglect can be related to the development of psychological disorders.

Sometimes the term "child maltreatment" is used to describe both abuse and neglect of children.

Research on Child Abuse and Borderline Personality Disorder (BPD)

Research does indicate that there is a relationship between child abuse and borderline personality disorder (BPD). People with BPD report high rates of childhood sexual abuse, emotional abuse, and/or physical abuse.

Forty to 76 percent of people with BPD report that they were sexually abused as children, and 25 to 73 percent report that they were physically abused. So, while there is a good deal of research that links childhood abuse to BPD, there is also evidence that about a third of people with BPD report no abuse.

There is also evidence to link BPD to other forms of child maltreatment, such as emotional and physical neglect. In fact, some research suggests that emotional and physical neglect may be even more closely related to the development of BPD than physical or sexual abuse. However, this is difficult to determine, since children who experience abuse also often experience some form of neglect.

How Childhood Abuse Might Lead to Borderline Personality Disorder

If childhood abuse is a risk factor for BPD, what are the way in which these childhood experiences lead to the development of BPD? A 2016 study found that emotional abuse was the most significant type of abuse in later BPD and that preoccupied adult attachment may be a mediator between the abuse and BPD. Other studies have likewise investigated the role of emotional abuse in later BPD. While these studies are important in looking for causes that may be preventable, they are also helpful in determining how treatment may help people currently coping with the disease, in particular, appproaches involving emotion regulation.

In addition to emotional abuse, emotional invalidation has also been tied to BPD, though it could be argued that an invalidating environment is a form of emotional abuse.

Is BPD Different in Those Who Suffered Childhood Abuse?

When comparing the symptoms of BPD in those who were abused as children and those who were not, it's been found that sexual abuse in childhood specifically appears to be linked to an increased risk of suicidal attempts in people with BPD.

The Bottom Line on Child Abuse and BPD

Research has fairly conclusively demonstrated a relationship between BPD and child maltreatment. That said, there is no clear evidence that maltreatment causes BPD.

Research that demonstrates an association between two things doesn't necessarily prove that there is a cause between them. Clearly, with child abuse statistics indicating that abuse is much more common than we would think, it is important to determine whether or not it is one of the causes of borderline personality disorder.

More research is needed to evaluate the precise relationships between childhood abuse and BPD, and if abuse is a cause, what types of child maltreatment are most closely associated with the development of BPD.  It's likely that BPD is related to the combination of a number of different factors, including genetic factors, temperament, biology, and other environmental considerations.

BPD is a highly misunderstood disease. If you are living with BPD or know someone living with the disorder, take the time to learn what you can. Contrary to popular opinion, BPD is treatable, and those living with the disease can live meaningful lives. While there can be significant problems with interpersonal relationships, this aspect as well can be improved greatly with understanding on the part of both the person living with the disorder and those who care about him or her.

Sources:

Bornovalova, M., Gratz, K., Delany-Brumsey, A., Paulson, A., and  Lejuez. Temperamental and.Environmental Risk Factors for Borderline Personality Disorder Among Inner-City Substance Users in Residential Treatment. Journal of Personality Disorders. 2006. 20(3):218-31.

Frias, A., Palma, C., Farriols, N., Gonzalez, L., and A. Horta. Anxious Adult Attachment May Mediate the Relationship Between Childhood Emotional Abuse and Borderline Personality Disorder. Personality and Mental Health. 2016. 10(4):274-284.

Kuo, J., Khoury, J., Metcalfe, R., Fitzpatrick, S., and A. Goodwill. An Examination of the Relationship Between Childhood Emotional Abuse and Borderline Personality Disorder Features: The Role of Difficulties with Emotion Regulation. Child Abuse and Neglect. 2015. 39:147-55.

Soloff, P., Feske, U., and A. Fabio. Mediators of the Relationship Between Childhood Sexual Abuse and Suicidal Behavior in Borderline Personality Disorder. Journal of Personality Disorders. 2008. 22(3):221-32.

Westbrook, J., and H. Berenbaum. Emotional Awareness Moderates the Relationship Between Childhood Abuse and Borderline Personality Disorder Symptom Factors. Journal of Clinical Psychology. 2016 Oct 4. (Epub ahead of print).

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