Borderline personality disorder (BPD), long seen as an unchanging and lifelong condition, may actually have both stable and variable elements according to new research.
The study found that about half of BPD features persist over time, while the other half fluctuate.
This suggests BPD has a more dynamic course than traditionally thought.
Key Takeaways:
- Around 45% of BPD characteristics represent an unchanging “core” of the disorder. This stable component is called “borderline proneness.”
- The remaining 55% of BPD features vary over time and situations. This dynamic element reflects episodic influences on symptoms.
- Both the stable and changeable aspects of BPD relate strongly to the Big Five personality traits, especially high neuroticism and low agreeableness.
- Borderline proneness associates specifically with childhood trauma and inborn temperament, while the variable component links more to day-to-day functioning.
- The findings indicate BPD has both enduring and transient features, which may help in understanding causes and customizing treatments.
Source: J Abnorm Psychol
The Enduring and Episodic Sides of BPD
Borderline personality disorder is a condition marked by unstable relationships, emotions, sense of self, and impulsive behavior.
BPD has had a reputation among mental health professionals as being very stubborn and long-lasting.
However, research in the last 15 years has challenged this notion, showing that most individuals with BPD improve significantly over a decade of follow-up.
A new study published in Journal of Abnormal Psychology used advanced statistical modeling to break down BPD into stable versus variable components over 10 years.
The study followed 668 patients, assessing BPD features 5 times over the decade.
The analysis showed that around 45% of BPD characteristics represent an unchanging “core” of the disorder that persists across time and situations.
The researchers called this stable component “borderline proneness.”
The remaining 55% of BPD features were found to vary over time and situations.
This dynamic element reflects episodic influences on symptoms that come and go.
For example, a stressful event like a relationship breakup might temporarily exacerbate BPD symptoms.
The findings indicate BPD has both enduring and transient sources, suggesting a more fluid course than traditionally thought.
Connecting BPD’s Stable and Variable Sides to Personality Traits
The study also looked at how the stable and variable components of BPD relate to basic personality traits.
The results showed that both the persistent and fluctuating parts of BPD correlate strongly with the Big Five traits, especially high neuroticism and low agreeableness.
Neuroticism, reflecting the tendency to experience negative emotions, had an especially robust link to the unchanging “borderline proneness” element of BPD.
This stable neurotic core explained why BPD symptoms persist over time for many individuals.
Meanwhile, the changeable facet of BPD aligned closely with fluctuations in the same Big Five traits over the study period.
For instance, temporary dips in agreeableness coincided with worsening BPD symptoms.
This personality trait connection supports the validity of partitioning BPD into stable and dynamic parts.
Personality Correlates of Enduring Versus Situational BPD Features
To further test whether the stable and episodic aspects of BPD have distinctive correlates, the researchers looked at links to childhood trauma, temperament, and day-to-day functioning.
The results showed that borderline proneness associates very strongly with a history of childhood maltreatment, including abuse, neglect, and witnessing violence.
Early trauma appears to instill an enduring susceptibility to BPD.
Proneness also connected preferentially to inborn temperament dimensions like high negative affect.
In contrast, the variable BPD component related more closely to fluctuations in psychosocial functioning over the study period as assessed by clinicians.
For example, times when symptoms were acutely elevated aligned with dips in ability to work and form relationships.
This pattern suggests environmental stressors play a bigger role in the changeable facet of BPD.
Implications for Treating and Studying Borderline Personality Disorder
The findings indicating BPD has both stable and transient underpinnings have important implications for mental health practice and research.
For clinicians, the results suggest that while core BPD features may endure, properly targeted psychotherapy can potentially deflect situational symptom flare-ups.
This highlights the value of distinguishing enduring versus acute BPD symptoms in order to maximize early treatment gains.
For researchers, the study implies that the causes and courses of the stable versus variable facets of BPD need to be investigated separately.
Genetics and childhood environment are likely most relevant to explaining the unchanging “borderline proneness” element.
In contrast, factors like life events and stress may account better for fluctuations in BPD symptoms over time.
Assessing these two BPD components individually will yield clearer insights into origins and treatments.
Overall, the findings open up an exciting new framework for dissecting the complex puzzle of borderline personality disorder.
This “hybrid model” recognizing persistent and episodic influences could lead to better customized interventions that improve the lives of those suffering from BPD.
With enhanced understanding of its dynamic nature, the borderline concept itself may evolve into something more scientifically sound and clinically useful.
References
- Study: Borderline personality disorder is equally trait-like and state-like over ten years in adult psychiatric patients
- Authors: Christopher C. Conway et al. (2018)
