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Can someone at least post the abstract since i cant view the full text

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Background

Research on the precursors of borderline personality disorder (BPD) reveals numerous child and adolescent risk factors, with impulsivity and trauma among the most salient. Yet few prospective longitudinal studies have examined pathways to BPD, particularly with inclusion of multiple risk domains.

Methods

We examined theory-informed predictors of young-adult BPD (a) diagnosis and (b) dimensional features from childhood and late adolescence via a diverse (47% non-white) sample of females with (n = 140) and without (n = 88) carefully diagnosed childhood attention-deficit hyperactivity disorder (ADHD).

Results

After adjustment for key covariates, low levels of objectively measured executive functioning in childhood predicted young adult BPD diagnostic status, as did a cumulative history of childhood adverse experiences/trauma. Additionally, both childhood hyperactivity/impulsivity and childhood adverse experiences/trauma predicted young adult BPD dimensional features. Regarding late-adolescent predictors, no significant predictors emerged regarding BPD diagnosis, but internalizing and externalizing symptoms were each significant predictors of BPD dimensional features. Exploratory moderator analyses revealed that predictions to BPD dimensional features from low executive functioning were heightened in the presence of low socioeconomic status.

Conclusions

Given our sample size, caution is needed when drawing implications. Possible future directions include focus on preventive interventions in populations with enhanced risk for BPD, particularly those focused on improving executive functioning skills and reducing risk for trauma (and its manifestations). Replication is required, as are sensitive measures of early emotional invalidation and extensions to male samples.

Did it factor in children with parents who have narcissistic personality disorder?

Hmm, I don't believe this study was conducted with a directed intent of including those born and raised by parents with the disorder,

"Borderline Personality Disorder Dimensional Features. Because both diagnostic interview and self-report measures may yield optimal assessment of BPD [81], we also included a dimensional measure of BPD in order to assess and validate the categorical measure of BPD.

For a large subset of the sample, a 15-item self-report scale was included, based on the BPD module of the Structured Clinical Interview for DSM-5 Axis II disorders (SCID-II) [82].

However, every participant did not complete this self-report measure, as it was added after data collection began. Additionally, some participants completed only interviews and did not return their packet of questionnaires including this measure.

Each item of the measure is rated dichotomously (0 = No, 1 = Yes), so that the total possible score ranged from 0–15, with higher scores indicating more features of BPD. For example, items included: “Have you often become frantic when you thought that someone you really cared about was going to leave you?” This scale is consistent with DSM-5 BPD criteria, and has been used in several other studies, with satisfactory internal reliability (α = 0.81) [83, 84]."

Aspects of it may have been included in the participents self report, however I believe that snippet will give you a better understanding of it than I can.

I think I can safely say that the scope of this study doesn't necessarily include that factor however I am far from the best that can interpret this study, I've only posted this since another commenter couldn't access the site.

To add on to u/Bierbart12 's question: Did they control for children with one or more parent with Borderline Personality Disorder?

From my own limited understanding, it seems to focus specifically on those diagnosed with it and a combination of diagnosable criteria and self reported measures.

If you want, I can provide you with specific extracts of it that you may think would best answer your question?

I've posted what you asked on here since you can't view it.

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Background Research on the precursors of borderline personality disorder (BPD) reveals numerous child and adolescent risk factors, with impulsivity and trauma among the most salient. Yet few prospective longitudinal studies have examined pathways to BPD, particularly with inclusion of multiple risk domains.

Methods We examined theory-informed predictors of young-adult BPD (a) diagnosis and (b) dimensional features from childhood and late adolescence via a diverse (47% non-white) sample of females with (n = 140) and without (n = 88) carefully diagnosed childhood attention-deficit hyperactivity disorder (ADHD).

Results After adjustment for key covariates, low levels of objectively measured executive functioning in childhood predicted young adult BPD diagnostic status, as did a cumulative history of childhood adverse experiences/trauma. Additionally, both childhood hyperactivity/impulsivity and childhood adverse experiences/trauma predicted young adult BPD dimensional features. Regarding late-adolescent predictors, no significant predictors emerged regarding BPD diagnosis, but internalizing and externalizing symptoms were each significant predictors of BPD dimensional features. Exploratory moderator analyses revealed that predictions to BPD dimensional features from low executive functioning were heightened in the presence of low socioeconomic status.

Conclusions Given our sample size, caution is needed when drawing implications. Possible future directions include focus on preventive interventions in populations with enhanced risk for BPD, particularly those focused on improving executive functioning skills and reducing risk for trauma (and its manifestations). Replication is required, as are sensitive measures of early emotional invalidation and extensions to male samples.

“First, findings highlight the longstanding effects of early experiences of adversity and trauma. Prevention of these childhood experiences, especially through public health initiatives, cannot be overemphasized. Second, our results reveal the importance including global executive function (EF) deficits in childhood as indicators of risk for BPD, in addition to the focus on childhood impulsivity. These findings have implications for guiding early clinical assessment and intervention (e.g., through early EF skills training) to prevent later BPD. In short, we highlight the need for interventions before the adolescent period, which appears to be an especially sensitive time of risk [11].”

I wish I could explain how hard BPD is to those that don’t suffer from it.

The best explanation I’ve seen is it’s like a 3rd burn of the emotions that’s constantly being poked.

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What's REALLY cool, is that intervention is so helpful, that researchers have actually considered if we can "treat" away this evolutionary adaptation. What would it be like without this particular generational traumatic feedback loop?

I have to wonder if kids with poor executive function and inattentiveness/hyperactivity are more likely to be abused (hence higher ACEs), resulting in elevated risk for BPD.

I also have to wonder if the poor executive function and inattentiveness/hyperactivity are temporally preceded by increased ACEs—in other words, I wonder if ACEs might cause some of the ADHD-like features.

It’s also possible that neither is true (in which case both are probably just risk factors), or that both are true (in which case they all interrelate).

I’m not a researcher in developmental psychology, so I…really don’t know enough to answer my own queries.

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how was the distinction made between the emotional disregulation present in ADHD and BPD - how was misdiagnosed BPD excluded?

Sorry to be pedantic but Actually a qualifying feature of 3rd degree burns is that they destroy the nerves and you CAN’T feel them.

I

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It looks like they relied on pre-existing information in the healthcare system when recruiting, which of course doesn't rule out misdiagnosed BPD(a disorder that is thought to be over-diagnosed in women). But it does give some rigor to their selection. Furthermore they seem to have done thorough assessment for ADHD:

>Following recruitment, all participants were screened for ADHD regardless of if they had already had a pre-established diagnosis. To establish a baseline diagnosis of ADHD, we used the parent-administered Diagnostic Interview Schedule for Children, 4th ed. (DISC-IV) [55] and SNAP rating scale [52], Hinshaw, [54] for the diagnostic algorithm). Comparison girls could not meet diagnostic criteria for ADHD on either measure. Some comparison girls met criteria for internalizing disorders (3.4%) or disruptive behavior disorders (6.8%) at baseline, yet our goal was not to match ADHD participants on comorbid conditions but instead to obtain a representative comparison group. Exclusion criteria included intellectual disability, pervasive developmental disorders, psychosis, overt neurological disorder, lack of English spoken at home, and medical problems preventing summer camp participation. The final sample included 228 girls with ADHD-Combined presentation (n = 93) and ADHD-Inattentive presentation (n = 47), plus an age- and ethnicity-matched comparison sample (n = 88). Participants were ethnically diverse (53% White, 27% African American, 11% Latina, 9% Asian American), reflecting the composition of the San Francisco Bay Area in the 1990’s. Family income was slightly higher than the median local household income in the mid-1990s, yet income and educational attainment of families were highly variable, ranging from professional families to those receiving public assistance. On average, parents reported being married and living together (65.8%) at the baseline assessment.

That said, they admit that the choice focus on psychometrics to utilize the entirity of the instrument they used to measure them, instead of sperating the predictor domains of hyperactivity vs. impulsivity is potentially limiting. Though they encourage more research into that:

> Fifth, we did not separate predictor symptom domains of hyperactivity vs. impulsivity, as psychometrics are superior when using the full 9-item Hyperactivity/Impulsivity scale. As well, this measure is more consistent with the DSM’s layout of symptoms. Although we support the separation of theses symptoms in future research—see the excellent national analysis by Tiger et al. [27]—we elected to include the full 9-item scale.

I find it really interesting that the results only work for the younger age group and not for the late adolescence age group, where a BPD diagnosis is usually becoming present.

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I hope someone does some follow-up studies, because that's really curious

Yeah, this team has definitely started to scratch at something interesting. It's a shame that funding to study personality disorders is like non-existent.