Childhood Adversity and Borderline Personality Disorder : A Meta-Analysis

Porter, Carly and Palmier-Claus, Jasper and Branitsky, Alison and Mansell, Warren and Warwick, Helen and Varese, Filippo (2020) Childhood Adversity and Borderline Personality Disorder : A Meta-Analysis. Acta Psychiatrica Scandinavica, 141 (1). pp. 6-20. ISSN 0001-690X

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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: 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 .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.