The Relationship Between Child Abuse and BPD

Does child abuse cause borderline personality disorder (BPD)? There is no simple answer. In fact, we don't yet know exactly what causes BPD, though it is believed to be a mix of biological and environmental factors.

There is evidence that people with BPD are more likely to report a history of some type of child abuse or other distressing childhood experiences. Yet many people who have experienced child abuse do not have BPD and many people with BPD were not abused or maltreated as children.

What Is Child Abuse?

The term "child abuse" covers a wide range of mental and physical injuries done to a minor. Experts generally assign a set of experiences to this category:

• Emotional abuse: Undergoing emotional attacks, such as verbal abuse or degradation
• Physical abuse: Being physically hurt or injured, such as bruising or broken bones
• Sexual abuse: Being subjected to a sexual experience or exploited in a sexual manner by someone older

Forty to 76% of people with BPD report that they were sexually abused as children, and 25% to 73% report that they were physically abused. So, while there is a good deal of research that links childhood abuse to BPD, there is also evidence that about a third of people with BPD report no abuse.

Other forms of abuse can be more passive, such as in the case of physical neglect where the child is denied basic necessities, like food or water. There is also emotional neglect, where a child's emotional needs are ignored.

No form of abuse is necessarily considered more severe than another; all forms of abuse can have long-lasting implications for the person and can shape their mental state. Both child abuse and neglect can be related to the development of psychological disorders. Sometimes the term "child maltreatment" is used to describe both abuse and neglect of children.

Child Abuse and BPD

Research does indicate that there is a relationship between child abuse and borderline personality disorder (BPD). People with BPD report high rates of childhood sexual abuse, emotional abuse, and/or physical abuse.

There is also evidence to link BPD to other forms of child maltreatment, such as emotional and physical neglect. In fact, some research suggests that emotional and physical neglect may be even more closely related to the development of BPD than physical or sexual abuse. However, this is difficult to determine, since children who experience abuse also often experience some form of neglect.

How Abuse Might Lead to BPD

If childhood abuse is a risk factor for BPD, what are the ways in which these childhood experiences lead to the development of BPD? 

Other studies have likewise investigated the role of emotional abuse in subsequent BPD diagnosis. While these studies are important in looking for causes that may be preventable, they are also helpful in determining how treatment may help people currently coping with the disorder, in particular, how approaches involving emotion regulation may especially be of benefit.

In addition to emotional abuse, emotional invalidation has also been tied to BPD, though it could be argued that an invalidating environment is a form of emotional abuse.

BPD and Those Who Experience Abuse

When comparing the symptoms of BPD in those who were abused as children and those who were not, it's been found that sexual abuse in childhood specifically appears to be linked to an increased risk of suicidal attempts in people with BPD.

What the Research Says

Research has fairly conclusively demonstrated a relationship between BPD and childhood maltreatment. That said, there is no clear evidence that maltreatment causes BPD.

Research that demonstrates an association between two things doesn't necessarily prove that there is a cause between them. Clearly, with child abuse statistics indicating that abuse is much more common than we would think, it is important to determine whether or not it is one of the causes of borderline personality disorder.

More research is needed to evaluate the precise relationships between childhood abuse and BPD, and if abuse is a cause, what types of child maltreatment are most closely associated with the development of BPD. 

A Word From Verywell

BPD is a highly misunderstood disease. If you are living with BPD or know someone living with the disorder, take the time to learn what you can. Contrary to popular opinion, BPD is treatable, and those living with it can live meaningful lives.

While the experience of BPD is often marked by significant problems with interpersonal relationships, this aspect of the disorder can be improved greatly with understanding on the part of both the person living with the disorder and those who care about them.