Table 1.
Studies on precocious environmental factors.
| Family-related factors | ||||
|---|---|---|---|---|
| Study | Study Design | Sample | Trial Duration | Outcomes |
| Cohen et al., 2008 [40] | Longitudinal study; community population | A random residence-based cohort of children and young adults between ages 10 and 36 | 26 years | Low family socioeconomic status → STPD and BPD in offspring |
| Crawford et al., 2009 [41] | Longitudinal study; community population | 766 youths aged 13 to 33 | 21 years | Extended maternal separations before age 5 → offspring BPD symptoms |
| Carlson et al., 2009 [56] | Longitudinal study; community population | A sample of young mothers and their first-born children (N = 162; 82 males, 80 females) | 28 years | BPD symptoms in adulthood related to endogenous and environmental history in early childhood |
| Winsper et al., 2012 [59] | Cohort study; community population | 6050 mothers and their children (age range 10.4–13.6 years, mean age 11.7 years) | 11 years | Family adversity → BPD symptoms of offspring |
| Stepp et al., 2013 [52] | Longitudinal cohort study; community population | 1709 students 14–18 years old (360 with a history of a depressive disorder and 284 with a history of mood disorders) vs. 457 HC | 16 years | Maternal-child discord, maternal BPD, paternal SUD + proband depression, SUD and suicidality associated with later BPD symptoms |
| Reinelt et al., 2013 [62] | Longitudinal cohort study; community population | 295 children (15–20 years old) and their biological mothers drawn from the population-based Greifswald Family Study | 5 years | Maladaptive mother-child interactions → longitudinal transmission of borderline symptoms from mother to child |
| Barnow et al., 2013 [63] | Longitudinal cohort study; community population | 323 offspring (15–20 years old) and their mothers from the community-based Greifswald Family Study | 5 years | Maternal BPD symptoms and depression → BPD and general psychopathology in offspring |
| Stepp, Whalen et al., 2014 [43] | Longitudinal cohort study; community population | 2451 girls aged 14–17 drawn from the Pittsburgh Girls Study | 3 years | Only-child characteristics, and not caregiver psychopathology, predicted BPD symptoms |
| Stepp et al., 2015 [37] | Longitudinal study; community population | 113 at-risk adolescent girls aged 16–18 | 3 years | Family adversity → ↑ BPD symptoms during late adolescence in offspring |
| Lyons-Ruth et al., 2015 [54] | Cross-sectional study; community population | 120 young adults | - | BPD traits → more role for confusion and more disoriented behavior in the interaction with the parent |
| Hammen et al., 2015 [58] | Longitudinal study; community population | 385 youths (235 females, 150 males, offspring of mothers with a probable history of depression) | 20 years | OXTR rs53576 moderates the link between early family quality and later BPD symptoms |
| Conway et al., 2015 [66] | Longitudinal study; community population | 700 at-risk youths (15–20 years old) | 5 years | Maternal externalizing disorder history, offspring internalizing disorder history, family stressors and school-related stressors → ↑ BPD risk |
| Winsper et al., 2015 [22] | Longitudinal study; community population | 6050 mothers and their children (11–12-year-olds) | 12 years | Prenatal anxiety and depression → BPD in offspring |
| Infurna et al., 2016 [55] | Cross-sectional study; clinical inpatient population | 91 female adolescent psychiatric inpatients (Mage = 15.57 years), along with 87 mothers and 59 fathers | - | Low maternal care and paternal psychiatric symptoms → adolescent BPD in offspring |
| Vanwoerden et al., 2017 [53] | Cross-sectional study; clinical inpatient population | 301 adolescent (65.1% female; ages 12–17) inpatients | - | Parental guilt induction and psychological control → children’s BPD features |
| Mahan et al., 2018 [64] | Cross-sectional study; clinical outpatients and community population | 28 mothers with a diagnosis of BPD and 28 HC with male and female adolescents aged 14–18 | - | Mothers with BPD use more total psychological control with their children → adolescent affective instability |
| Steele et al., 2020 [65] | Cross-sectional study; community population | 284 parents (94.72% female, Mage = 37.37), of which 69 (24.30%) met BPD criteria | - | Individuals high in BPD features → ↑ stress and ↓ competence in their parenting role |
| Trauma-related factors | ||||
| Study | Study Design | Sample | Trial Duration | Outcomes |
| Johnson et al., 2000 [86] | Longitudinal study; community population | 738 youths and their mothers | 18 years | Childhood emotional, physical and supervision neglect → ↑ risk for PDs + ↑ PD symptom levels during adolescence and early adulthood |
| Johnson et al., 2001 [85] | Longitudinal study; community population | 793 mothers and their offspring assessed in four waves (at ages 5, 14, 16 and 22 years) | 18 years | Maternal verbal abuse during childhood → BPD, NPD, OCPD and PPD during adolescence or early adulthood |
| Rogosch et al., 2004 [70] | Longitudinal study; community population | 211 six-year-old children (135 maltreated and 76 non-maltreated) | 3 years | Six-year-old maltreated children → ↓ agreeableness, conscientiousness and openness to experience + ↑ neuroticism, maintained at age 9 |
| Horesh et al., 2008 [78] | Cross-sectional study; community and clinical population | 19 adolescents with MDD, 20 with BPD and 20 matched controls | - | The BPD group reported more sexual abuse LE than the control and MDD groups |
| Horesh et al., 2009 [79] | Retrospective study; community and clinical population | 40 suicidal adolescents and young adults with MDD (22) or BPD (18), 40 non-suicidal adolescents and young adults with MDD (20) and BPD (20), 40 HC | - | Suicidal BPD participants reported more lifetime sex-abuse-related LE compared with non-suicidal BPD participants |
| Biskin et al., 2011 [71] | Longitudinal study; community and clinical population | 47 adolescent girls (31 with BPD, 16 HC) | 10 years | Unremitting BPD associated with a current episode of MDD, lifetime SUD and self-reported childhood sexual abuse |
| Staebler et al., 2011 [88] | Cross-sectional study; community and clinical population | 35 patients with BPD and 33 HC | - | A negative bias for perceived social participation and ambiguous facial emotional expressions → disturbed relatedness in patients with BPD |
| Venta et al., 2012 [74] | Cross-sectional study; clinical inpatient population | 147 adolescent BPD inpatients | - | Adolescents with BPD more likely to have a history of sexual trauma and to report sexual concerns |
| Belsky et al., 2012 [83] | Longitudinal cohort study; community population | 1116 pairs of same-sex twins | 12 years | Exposure to harsh treatment in the family environment through age 10 → BPD-related characteristics at age 12 |
| Wolke et al., 2012 [89] | Longitudinal study; community population | 6050 mothers and their children drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC) | 11 years | Victims of peer bullying and of chronic victimization → ↑ risk of BPD symptoms |
| Jovev et al., 2013 [84] | Longitudinal study; community population | 245 children (aged 11–13) | 2 years | Childhood neglect → ↑ BPD symptoms; childhood abuse → ↑ ASPD symptoms |
| Lyons-Ruth et al., 2013 [87] | Longitudinal study; community population | Adolescents (Mage 19.9 years) from 56 families participating in a longitudinal study since infancy | 18 years | Maternal withdrawal in infancy → BPD symptoms + suicidality/self-injury in late adolescence |
| Lereya et al., 2013 [90] | Longitudinal study; community population | 4810 children and adolescents drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort assessed for bullying exposure (7–10 years old) and self-harm (16–17 years old) | 10 years | Being bullied → ↑ risk of self-harm, directly and indirectly, via depression symptoms in early adolescence |
| Bornovalova et al., 2013 [94] | Longitudinal study; community population (twins) | Over 1300 pairs of twins (11 to 24 years old) | 13 years | Common genetic influences that also overlap with internalizing and externalizing disorders → association between childhood abuse and BPD traits |
| Hecht et al., 2014 [82] | Cross-sectional study; community population | 314 maltreated and 285 non-maltreated children (Mage = 11.30) from comparable low socioeconomic backgrounds | - | Maltreated children had more severe BPD features, according to chronicity, patterns of onset and recency of maltreatment |
| Cicchetti et al., 2014 [95] | Cross-sectional study; community population | 1051 maltreated and non-maltreated low-income children | - | Different pattern of gene-environment interaction according to gender |
| Stepp et al., 2015 [42] | Longitudinal study; community population | 113 at-risk adolescent girls aged 16–18 | 3 years | Exposure to adversity → ↑association between negative emotional reactivity and BPD symptoms |
| Infurna et al., 2016 [75] | Cross-sectional study; clinical population | 44 female adolescent inpatients with BPD and 47 CC with mixed psychiatric diagnoses | - | Sexual abuse, general family functioning and low maternal care → adolescent BPD |
| Kaplan et al., 2016 [76] | Longitudinal study; clinical population | 58 female youths with BPD aged 13–21 years with (n = 29) and without (n = 29) a history of child abuse | 2 months | Child abuse (particularly co-occurring physical and sexual abuse) → ↑ risk for NSSI + suicidality among BPD youths. |
| Haltigan et al., 2016 [92] | Longitudinal study; community population | 566 Canadian children assessed yearly from ages 8 to 16 | 8 years | Parent- and child-reported mental health symptoms + peer relations risk factors + intra-individual risk factors: significant predictors of personality psychopathology |
| Winsper et al., 2017 [91] | Retrospective study; community population | 7159 children drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC), assessed from birth to 14 years | 14 years | Bully victimization associated with BPD symptoms |
| Antila et al., 2017 [93] | Longitudinal study; clinical inpatient population | 508 adolescent inpatients (300 girls, 208 boys) | 12 years | Female victims of bullying (but not boys) → ↑ likelihood of developing a PD later in life, especially BPD |
| Sengutta et al., 2019 [80] | Cross-sectional study; clinical inpatient population | 200 inpatients aged 16–21 years with non-psychotic disorders | - | Childhood trauma (emotional neglect and sexual abuse) → psychotic-like experiences, with the mediation of BPD features |
| Turniansky et al., 2019 [81] | Retrospective study; clinical inpatient population | 78 female adolescent inpatients with BPD with (n = 38) and without (n = 40) a history of prolonged childhood sexual abuse (CSA) | 8 years | Prolonged CSA → ↑ duration and ↑ number of psychiatric hospitalizations + ↑ rate of NSSI and suicidal attempts, smoking, alcohol use and sexual impulsivity. |
| Bozzatello et al., 2020 [69] | Cross-sectional study; clinical outpatient population | 68 BPD outpatients | - | Earlier onset of BPD mainly associated with traumatic events (abuse, neglect, dysfunction in household environment and bullying) |
| Rajan et al., 2020 [77] | Longitudinal cohort study; community population | 519 girls aged 12–17 with registration of CSA experience in their medical record and 4920 age-matched HC | 7 years | CSA → ↑ risk for suicide attempts, stress disorders, psychosis and alcohol abuse + ↑ healthcare consumption patterns and drug prescriptions |
| Geselowitz et al., 2021 [71] | Longitudinal cohort study; community population | 170 children drawn from a prospective longitudinal study of early childhood depression, assessed at ages 3, 6, 14 and 19 | 16 years | Preschool ACEs, internalizing symptoms and low maternal support → BPD symptoms + preschool and school-age suicidality |
BPD, borderline personality disorder; ASPD, antisocial personality disorder; DSM, Diagnostic and Statistical Manual of Mental Disorders.