Borderline Personality Disorder And Childhood Trauma: Can Trauma Lead To BPD?

According to data from the National Comorbidity Study Replication (NCS-R), the prevalence of borderline personality disorder (BPD) is approximately 1.4% among those 18 and older in the U.S. In order to help these individuals, it can be helpful to learn more about BPD’s contributing factors. 

Research indicates that traumatic events during childhood can contribute to the development of BPD. Other risk factors may include neurotransmitter dysfunction, differences in brain development, and genetics. Borderline personality disorder can be treated with various forms of therapy, but dialectical behavior therapy tends to be the most recommended option.

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What is borderline personality disorder?

Borderline personality disorder (BPD) is a mental health condition that can have a significant impact on an individual's emotions, perceptions, and interpersonal relationships. Those experiencing BPD may struggle with a variety of symptoms, such as the following:

• Intense and rapid changes in mood
• Fear of abandonment, as well as behaviors that intended to avoid potential abandonment
• A sense of emptiness and dissociation
• Self-harming behavior and suicidal thoughts or threats
• Impulsivity and reckless behavior
• Substance misuse
• Unstable sense of self

While everyone’s situation is unique, those with BPD can experience significant challenges in relationships. For example, in a romantic relationship, a person with BPD may initially idealize their partner and believe they are their perfect match. 

Over time, this dynamic can change, and a person with BPD may begin to devalue their partner. This may be triggered by their fear of abandonment, as small mistakes (such as a missed phone call or a comment taken the wrong way) could be interpreted as signs that their partner intends to leave them. As a result, a person with BPD may start to pull away from their partner or separate entirely. 

To understand the symptoms and potential impacts of BPD, individuals may want to learn about the factors that could lead to its development. Several factors appear to put individuals at risk of developing BPD. 

What causes borderline personality disorder? 

According to the UK National Health Service (NHS), there may not be a single cause of BPD, but rather a variety of contributing factors. 

• Neurotransmitters: Neurotransmitters like dopamine and serotonin are typically involved in several functions that are vital to the body and brain, including coordination, movement, pleasure, reward, and mood regulation. Those with BPD can experience dopamine or serotonin dysfunction, producing altered levels of these chemicals that could increase impulsivity, aggression, and symptoms of depression. 
• Brain development: Magnetic resonance imaging (MRI) research suggests that multiple areas of the brains of individuals with BPD appear unusual, or, in some cases, smaller than those without BPD. Affected brain regions may include the following:
  
  • The orbitofrontal cortex, a region that usually plays a significant role in decision-making, emotions, and planning
  • The hippocampus, an area of the brain that generally helps to control memory, behavior, self-control, and learning
  • The amygdala, which can be important for the regulation of certain emotions, such as fear, anxiety, and aggression
• Genetics and environmental factors: Those with a family history of BPD or other mental illnesses may inherit genes from their parents that could increase their vulnerability to developing the disorder. Parents with serious mental health conditions or other significant challenges can also create an environment that could lead to the development of BPD. This includes environments involving neglect, substance misuse, and physical, sexual, or emotional abuse. 

These environments and other situations involving childhood trauma may be particularly influential in whether an individual develops BPD later in life. 

Can childhood trauma cause BPD? 

Research suggests that childhood trauma may play a significant role in the development of BPD. In a 2021 scientific article, researchers reviewed 20 years' worth of studies concerning various types of childhood trauma and their impacts on the development of BPD. They found that a variety of environmental, genetic, and temperamental factors can combine with traumatic experiences in childhood and promote the onset of BPD earlier in life. Additionally, the data collected by these researchers suggested that several situations could put someone at a higher risk for BPD development:

• Bullying, neglect, and abuse experienced in childhood
• Aggressive and negative temperament combined with familial dysfunction
• Abnormalities in certain areas of the brain (such as the front-limbic areas of the brain)

Furthermore, these researchers concluded that the effects of traumatic experiences may be enhanced by dysfunction in the family environment, as this environment may produce traumas that interact with a child’s specific genetic polymorphism or innate temperamental traits. 

Research also indicates that childhood trauma can impact the way that individuals with BPD behave. A 2023 study sought to examine whether traumatic childhood experiences are a factor in the adolescent incidence rate of high-risk behaviors. Of the 120 participants, data from the study indicated that all individuals with BPD experienced traumatic events in childhood. 

Overall, the study’s findings may reinforce the idea that childhood trauma plays a significant role in the formation of adolescent BPD symptoms. Researchers believe that due to these findings, detection of the early risk factors of childhood trauma may help to establish specific targets for early intervention. In addition to early intervention, treatments for older individuals with BPD are available and can be effective. 

Borderline personality disorder treatment options

While everyone may respond differently to various treatment approaches, the NHS recommends several forms of psychotherapy for individuals with BPD. 

• Mentalization-based therapy (MBT): MBT is a form of therapy that can help individuals who struggle to form mental images or ideas of others, a challenge that could make it difficult to understand the behavior of loved ones. With the assistance of an MBT provider, those with BPD can develop the skills necessary to sympathize with the perspectives of others and realize that their interpretations may not always be correct. 
• Therapeutic communities: Therapeutic communities can involve a variety of environments, sometimes taking the form of a residential home where individuals with BPD may live with others experiencing similar mental health situations. These communities typically provide a combination of group and individual therapy, as well as activities that can benefit a person’s confidence and social skills. 
• Art therapies: Multiple types of art therapy, such as drama therapy, music therapy, and dance movement therapy, can help those with BPD express their experiences and emotions. This may allow them to process the challenges of their disorder, either individually with a therapist or through group sessions. 

Are you experiencing symptoms of borderline personality disorder?

Find online mental health support here

Dialectical behavior therapy 

The most effective form of BPD treatment may be dialectical behavior therapy (DBT). DBT is a therapeutic approach that is specifically designed to treat those experiencing BPD, particularly emotional dysregulation symptoms. 

In general, DBT is built upon the principle that those with BPD have a distinct emotional vulnerability, often stemming from a childhood where parents or parental figures dismissed their thoughts and emotions. The combination of being emotionally vulnerable and experiencing childhood neglect can lead those with BPD to struggle with a cycle of feeling intense emotions but being unable to avoid an unnecessary sense of guilt over having them.

A DBT therapist may teach individuals to view their emotions not with guilt or shame, but as real and valid. In addition, DBT can increase a person’s mindfulness and ability to view situations without falling into dichotomous or “black-and-white” thinking, which can separate situations into extremes. These changes may help individuals engage in more positive behavior and stop thought patterns that could lead to negative consequences, such as self-harm. 

However, in-person forms of DBT and other types of therapy may be inconvenient or difficult to access for some individuals. For those who can’t drive or lack reliable transportation, commuting to a therapist's office can be difficult. Others may not have medical insurance, which could make it more challenging to find a therapist or afford therapy. In addition, some might be uncomfortable discussing their experiences face-to-face, instead preferring to talk through phone calls, online chat, or video conferences. In these situations, it may be beneficial to use alternative therapeutic formats, such as online therapy.

Although not much research currently exists evaluating the efficacy of online therapy for borderline personality disorder, a 2022 study suggested that online therapy could effectively reduce BPD symptoms.