Adverse childhood experiences (ACE) have long been correlated with mental health struggles like addiction, depression and anxiety in adulthood. But a new analysis, conducted by researchers at the University of Manchester, found that borderline personality disorder (BPD) was actually the mental illness most strongly associated with childhood trauma.
BPD is a mental illness characterized by nine classic symptoms, some of which include unstable interpersonal relationships, impulsivity, difficulty regulating emotions and suicidality. BPD is the mental illness with the highest suicide rate and affects approximately 1.7 percent of the general population.
In the new study, researchers analyzed data from 97 studies to compare adverse childhood experiences of people diagnosed with BPD to people with other psychiatric diagnoses and people with no history of mental health issues. They found that people with BPD were approximately three times more likely to report childhood adversity than people with other mental health conditions and 13 times more likely than people without any mental health problems.
The most common childhood adverse experiences reported by people with BPD were physical neglect (48.9%), emotional abuse (42.5%), physical abuse (36.4%) sexual abuse (32.1%) and emotional neglect (25.3%).
Experiencing childhood abuse or adverse experiences can disrupt a child’s development, which may explain why many people with BPD can act out in painful ways that hurt people in their lives (or themselves).
“During childhood and adolescence, our brain is still undergoing considerable development and we are also refining strategies to deal with the challenges of everyday life, and the negative feelings that come with them,” Filippo Varese, Ph.D., one of the study authors, said in a press release, adding:
In some people who have experienced chronic, overwhelming stress in childhood, it is likely that these responses do not develop in the same way. People can become more sensitive to ‘normal’ stress. They are sometimes unable to deal with intense negative thoughts and feelings, and they might resort to dangerous or unhelpful measures to feel better, such as taking drugs or self-harming. This can lead to various mental health difficulties, including the problems commonly seen in people who receive a diagnosis of BPD.
Mighty contributor Oriana Allen knows what it’s like to struggle with unhelpful coping mechanisms due to BPD and childhood trauma. In her piece, “How Childhood Trauma Affected My Borderline Personality Disorder,” she described how “splitting” (a classic BPD symptom also known as black-and-white thinking) affected her choices when trying to regulate her intense internal experiences:
For a long time, my sense of identity became split into two separate versions: a bad self and good self. For most of my childhood and early adolescence, I viewed myself as bad. So, like a self-fulfilling prophecy, I became bad.
By age 11, I had lost my childlike innocence and replaced it with anger. I began binge-drinking, stealing and experimenting with substances. This version of self helped me escape the painful emotions and thoughts about myself and my traumatic experiences. It gave me a sense of freedom and power until the consequences of my actions caught up with me. Then, I became even more enslaved and powerless.
Though it’s true BPD can be difficult to live with, contrary to what you might read online, it is treatable. With ongoing support and effective skills-based therapy — especially dialectical behavior therapy (DBT) — recovery from BPD is extremely likely.
Dr. Varese said he hopes the findings from the study encourage the importance of trauma-informed care for people with BPD, though he recognizes more research needs to be done on the condition in general.
“Further research is needed to explore the complex factors also likely to be involved such as biology, experiences in later life and psychological processes,” he explained.