Childhood Adversity and Borderline Personality Disorder: A Meta-Analysis

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Carly Porter
  • Jasper Palmier-Claus
  • Alison Branitsky
  • Helen Warwick


Objective: The aim of this meta-analysis was to better understand the magnitude and consistency of the association between childhood adversity and borderline personality disorder (BPD) across case-control, epidemiological and prospective cohort studies.

Method: Following the review protocol (reference: CRD42017075179), search terms pertaining to adversity and BPD, were entered into three search engines. Random effects meta-analysis synthesised the size and consistency of the effects.

Results: 97 studies compared BPD to non-clinical (k = 40) and clinical (k = 70) controls. Meta-analysis of case control studies indicated that individuals with BPD are 13.91 (95% CI 11.11-17.43) times more likely to report childhood adversity than non-clinical controls. This effect was smaller when considering retrospective cohort (OR: 2.59; 95% CI .93-7.30) and epidemiological (OR: 2.56, 95% CI 1.24-5.30) studies. Findings were significant across adversity subtypes with emotional abuse (OR: 38.11, 95% CI: 25.99-55.88) and neglect (OR: 17.73, 95% CI=13.01-24.17) demonstrating the largest effects. Individuals with BPD were 3.15 (95% CI 2.62-3.79) times more likely to report childhood adversity than other psychiatric groups.

Conclusions: This meta-analysis corroborates theoretical proposals that exposure to adverse life experiences is associated with BPD. It highlights the importance of considering childhood adversity when treating people diagnosed with BPD.

Bibliographical metadata

Original languageEnglish
Pages (from-to)6-20
JournalActa Psychiatrica Scandinavica
Issue number1
Early online date19 Oct 2019
Publication statusPublished - 1 Jan 2020