Longitudinal associations between non-suicidal self-injury and borderline personality disorder in adolescents: a literature review

Abstract Background Borderline personality disorder (BPD) in adolescent samples is similar to BPD in adults concerning clinical characteristics. A notable difference is that adolescents with BPD – and adolescents in general – are more likely than adults to present with acute symptoms such as non-sui...

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Main Authors: Victoria E. Stead, Khrista Boylan, Louis A. Schmidt
Format: Article
Language:English
Published: BMC 2019-02-01
Series:Borderline Personality Disorder and Emotion Dysregulation
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40479-019-0100-9
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author Victoria E. Stead
Khrista Boylan
Louis A. Schmidt
author_facet Victoria E. Stead
Khrista Boylan
Louis A. Schmidt
author_sort Victoria E. Stead
collection DOAJ
description Abstract Background Borderline personality disorder (BPD) in adolescent samples is similar to BPD in adults concerning clinical characteristics. A notable difference is that adolescents with BPD – and adolescents in general – are more likely than adults to present with acute symptoms such as non-suicidal self-injury (NSSI) and suicidal behaviours. BPD is the only disorder in the Diagnostic and Statistical Manual- 5th Edition that includes a criterion of NSSI. Additionally, NSSI is purported to be a developmental precursor of BPD under the biosocial developmental model. Though much cross-sectional data have illustrated the robust association of adolescent NSSI and BPD, no review to date has summarized the longitudinal associations between these phenomena. The aim of this literature review was to summarize what is known about the longitudinal associations between adolescent NSSI and BPD symptoms. Information on the developmental course of NSSI in relation to BPD would be helpful to clinicians, as the rate of NSSI is high in adolescent populations, and research indicates early, possibly BPD-specific interventions are imperative. Methods A literature search was conducted using Embase, MEDLINE, and PsycINFO databases and cited reference searches. Criteria included studies of adolescents (age ≤ 18 at baseline) from either epidemiological or clinical samples, incorporating a longitudinal design, with predictors and outcomes of interest, including both NSSI and BPD diagnosis/symptoms/traits. Results Six independent samples were identified that matched our search criteria. The articles were grouped and reported on separately by population type (epidemiological vs. clinical), and directionality of relations. We identified two epidemiological and four clinical samples. Five samples examined the longitudinal associations of NSSI preceding BPD, three samples measured BPD in adolescence (baseline age ≤ 18), and two of those samples measured BPD at baseline. Both epidemiological studies revealed significant longitudinal associations between NSSI and later BPD/BPD symptoms; however, they differed notably in their methodologies hindering data synthesis across studies. In the clinical studies, findings of the association or predictive relations were not consistent. This is potentially due to differing methodologies, or differences in treatment effectiveness and responsiveness across the samples. Conclusions This review highlights the paucity of data that are available examining the longitudinal association between NSSI and BPD within adolescent samples. Thus, it is not possible to reliably comment on how NSSI and BPD are related over time. Future studies will benefit from the measurement of BPD symptoms in very early adolescence, and concurrent measurement of NSSI as well as other forms of suicidal behaviours across adolescence.
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spelling doaj.art-f6c570d7007b41a2806885c573b34f402022-12-21T18:40:37ZengBMCBorderline Personality Disorder and Emotion Dysregulation2051-66732019-02-016111210.1186/s40479-019-0100-9Longitudinal associations between non-suicidal self-injury and borderline personality disorder in adolescents: a literature reviewVictoria E. Stead0Khrista Boylan1Louis A. Schmidt2Department of Psychology, Neuroscience & Behaviour, McMaster UniversityDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph’s Healthcare HamiltonDepartment of Psychology, Neuroscience & Behaviour, McMaster UniversityAbstract Background Borderline personality disorder (BPD) in adolescent samples is similar to BPD in adults concerning clinical characteristics. A notable difference is that adolescents with BPD – and adolescents in general – are more likely than adults to present with acute symptoms such as non-suicidal self-injury (NSSI) and suicidal behaviours. BPD is the only disorder in the Diagnostic and Statistical Manual- 5th Edition that includes a criterion of NSSI. Additionally, NSSI is purported to be a developmental precursor of BPD under the biosocial developmental model. Though much cross-sectional data have illustrated the robust association of adolescent NSSI and BPD, no review to date has summarized the longitudinal associations between these phenomena. The aim of this literature review was to summarize what is known about the longitudinal associations between adolescent NSSI and BPD symptoms. Information on the developmental course of NSSI in relation to BPD would be helpful to clinicians, as the rate of NSSI is high in adolescent populations, and research indicates early, possibly BPD-specific interventions are imperative. Methods A literature search was conducted using Embase, MEDLINE, and PsycINFO databases and cited reference searches. Criteria included studies of adolescents (age ≤ 18 at baseline) from either epidemiological or clinical samples, incorporating a longitudinal design, with predictors and outcomes of interest, including both NSSI and BPD diagnosis/symptoms/traits. Results Six independent samples were identified that matched our search criteria. The articles were grouped and reported on separately by population type (epidemiological vs. clinical), and directionality of relations. We identified two epidemiological and four clinical samples. Five samples examined the longitudinal associations of NSSI preceding BPD, three samples measured BPD in adolescence (baseline age ≤ 18), and two of those samples measured BPD at baseline. Both epidemiological studies revealed significant longitudinal associations between NSSI and later BPD/BPD symptoms; however, they differed notably in their methodologies hindering data synthesis across studies. In the clinical studies, findings of the association or predictive relations were not consistent. This is potentially due to differing methodologies, or differences in treatment effectiveness and responsiveness across the samples. Conclusions This review highlights the paucity of data that are available examining the longitudinal association between NSSI and BPD within adolescent samples. Thus, it is not possible to reliably comment on how NSSI and BPD are related over time. Future studies will benefit from the measurement of BPD symptoms in very early adolescence, and concurrent measurement of NSSI as well as other forms of suicidal behaviours across adolescence.http://link.springer.com/article/10.1186/s40479-019-0100-9Borderline personality disorderNon-suicidal self-injuryLongitudinalAdolescents
spellingShingle Victoria E. Stead
Khrista Boylan
Louis A. Schmidt
Longitudinal associations between non-suicidal self-injury and borderline personality disorder in adolescents: a literature review
Borderline Personality Disorder and Emotion Dysregulation
Borderline personality disorder
Non-suicidal self-injury
Longitudinal
Adolescents
title Longitudinal associations between non-suicidal self-injury and borderline personality disorder in adolescents: a literature review
title_full Longitudinal associations between non-suicidal self-injury and borderline personality disorder in adolescents: a literature review
title_fullStr Longitudinal associations between non-suicidal self-injury and borderline personality disorder in adolescents: a literature review
title_full_unstemmed Longitudinal associations between non-suicidal self-injury and borderline personality disorder in adolescents: a literature review
title_short Longitudinal associations between non-suicidal self-injury and borderline personality disorder in adolescents: a literature review
title_sort longitudinal associations between non suicidal self injury and borderline personality disorder in adolescents a literature review
topic Borderline personality disorder
Non-suicidal self-injury
Longitudinal
Adolescents
url http://link.springer.com/article/10.1186/s40479-019-0100-9
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AT louisaschmidt longitudinalassociationsbetweennonsuicidalselfinjuryandborderlinepersonalitydisorderinadolescentsaliteraturereview