According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Borderline Personality Disorder, otherwise known as Emotional Regulation Disorder, affects approximately 2% of the general population. Officially, the cause of BPD is unknown. However, studies have shown that particular environmental and genetic factors significantly increase the chances of developing BPD.
Childhood Trauma
Individuals with Borderline Personality Disorder frequently report that they experienced a significant amount of trauma in childhood. Three common forms of childhood trauma are physical abuse, sexual abuse and significant domestic abuse between parents.
A study done by Harvard Medical School showed that 71% of those in their study suffered from physical abuse, 68% suffered from sexual abuse and 52% witnessed significant domestic abuse in their household. While sexual abuse by family members is common, patients often report that they were sexually abused by a non-caregiver.
Effects of childhood abuse include, but are not limited to: depression, anxiety, sexual dysfunction, suicidal thoughts and insomnia as well as severe self-esteem issues.
Separation and Abandonment
Another commonly known cause of Borderline Personality Disorder is separation or abandonment in childhood. A significant number of patients have reported that they experienced the divorce or separation of their parents, the death of an immediate family member or other loss of familial support.
Exposure to an environment in which full, half, step or foster-siblings were brought in and out of the child’s life have also been noted to be potentially harmful to the psychological development of children, and could lead to Borderline Personality Disorder, amongst other conditions.
Inconsistent Parenting and Emotional Neglect
It has been noted that inconsistent parenting and/or emotional neglect could contribute to the development of Borderline Personality Disorder. Inconsistent parenting refers to the idea that parents alter their parenting style from one extreme to another, or that two parents have two separate styles of parenting consistently throughout the child’s upbringing.
For example, one parent may have been supportive and kind, while the other acted as the sole disciplinary. Another example would be a parent who switched consistently between an extreme display of emotional support and an extreme display of disappointment or blame.
Some patients also reported that parental figures were workaholics, or otherwise occupied with their own lives, leaving the patient isolated and without consistent interaction with their parents or siblings as a child.
Lack of Supportive Community
Some studies have shown that BPD patients indicated they were without a supportive community, either within their extended family or within their educational, religious or recreational environment. Patients were either completely isolated from social interaction, and therefore, without emotional support from figures other than their parents and siblings, or were without emotional support within their social interactions.
Patients who were bullied as a child may have an increased chance of developing BPD.
Biological Factors
Biological factors have been proven to assist in the development of Borderline Personality Disorder, but are significantly increased when accompanied by one or more of the above environmental factors.
Studies funded by NIMH have proven that patients who struggle with impulsive aggression have diluted regulation of neural circuits, causing a decreased ability to control their emotions. Chemicals within these circuits, such as serotonin, norepinephrine and acetylcholine are known to regulate emotions such as anger, sadness and anxiety.
This issue may be further enhanced when the individual is under the influence of substances such as alcohol and narcotics, as well as stress.
These biological concerns are likely to be passed on from previous familial generations, but can also be developed from exposure to environmental factors such as those above.
A Combination of Factors
It is important to keep in mind that while these are five of the most reported causes of Borderline Personality Disorder, that there is no confirmed cause. More often than not, individuals diagnosed with BPD have experienced more than one of the causes listed above.
Sources
Zanarini M.C. (2000) "Childhood experiences associated with the development of borderline personality disorder". Psychiatric Clinics of North America, 23 (1): 89-101.
Roosa M.W., Reinholtz C., Angelini P.J. (1999). "The relation of child sexual abuse and depression in young women: comparisons across four ethnic groups". Journal of Abnormal Child Psychology 27 (1): 65–76.
Herman J.L., Perry J.C. and Van der Kolk B.A. (1989) "Childhood trauma in borderline personality disorder". Department of Psychiatry, Harvard Medical School, Cambridge Hospital, Mass. 146: 490-495.
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