A systematic review of the neurobiological underpinnings of borderline personality disorder (BPD) in childhood and adolescence
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Catherine Winsper
, Steven Marwaha
Abstract
Contemporary theories for the aetiology of borderline personality disorder (BPD) take a lifespan approach asserting that inborn biological predisposition is potentiated across development by environmental risk factors. In this review, we present and critically evaluate evidence on the neurobiology of BPD in childhood and adolescence, compare this evidence to the adult literature, and contextualise within a neurodevelopmental framework. A systematic review was conducted to identify studies examining the neurobiological (i.e. genetic, structural neuroimaging, neurophysiological, and neuropsychological) correlates of BPD symptoms in children and adolescents aged 19 years or under. We identified, quality assessed, and narratively summarised 34 studies published between 1980 and June 2016. Similar to findings in adult populations, twin studies indicated moderate to high levels of heritability of BPD, and there was some evidence for gene-environment interactions. Also consistent with adult reports is that some adolescents with BPD demonstrated structural (grey and white matter) alterations in frontolimbic regions and neuropsychological abnormalities (i.e. reduced executive function and disturbances in social cognition). These findings suggest that neurobiological abnormalities observed in adult BPD may not solely be the consequence of chronic morbidity or prolonged medication use. They also provide tentative support for neurodevelopmental theories of BPD by demonstrating that neurobiological markers may be observed from childhood onwards and interact with environmental factors to increase risk of BPD in young populations. Prospective studies with a range of repeated measures are now required to elucidate the temporal unfurling of neurobiological features and further delineate the complex pathways to BPD.
Funding: Prof. Singh receives funding from the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care West Midlands (CLAHRC-WM) initiative. The views expressed are those of the authors and not necessarily those of the CLAHRC-WM collaborative organisations, the NIHR, or the Department of Health.
Conflict of interest declaration: The authors report no conflict of interest.
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Articles in the same Issue
- Frontmatter
- The cholinergic system in the cerebellum: from structure to function
- Tanshinones and mental diseases: from chemistry to medicine
- Brain-derived neurotrophic factor: a mediator of inflammation-associated neurogenesis in Alzheimer’s disease
- SIRT1 as a therapeutic target for Alzheimer’s disease
- A systematic review of the neurobiological underpinnings of borderline personality disorder (BPD) in childhood and adolescence
- Neuroprotective properties of mitochondria-targeted antioxidants of the SkQ-type
- Imaging and machine learning techniques for diagnosis of Alzheimer’s disease
- Resting state functional magnetic resonance imaging processing techniques in stroke studies
Articles in the same Issue
- Frontmatter
- The cholinergic system in the cerebellum: from structure to function
- Tanshinones and mental diseases: from chemistry to medicine
- Brain-derived neurotrophic factor: a mediator of inflammation-associated neurogenesis in Alzheimer’s disease
- SIRT1 as a therapeutic target for Alzheimer’s disease
- A systematic review of the neurobiological underpinnings of borderline personality disorder (BPD) in childhood and adolescence
- Neuroprotective properties of mitochondria-targeted antioxidants of the SkQ-type
- Imaging and machine learning techniques for diagnosis of Alzheimer’s disease
- Resting state functional magnetic resonance imaging processing techniques in stroke studies