Research Update - Borderline Personality Disorder

Written By NAMI Montana

July 7, 2023

NAMI Montana is committed to raising awareness and providing reliable information on mental health topics to support individuals and their loved ones. In this week’s research update, we highlight three peer-reviewed articles that explore different aspects of Borderline Personality Disorder (BPD).

These articles are shared for informational purposes only and should not replace professional medical advice. Individuals are encouraged to work closely with their clinicians and healthcare providers to determine the most appropriate care and treatment options for their unique needs.

Our goal in sharing this research is to improve understanding and support informed, compassionate conversations between individuals, families, and care teams.

Study 1

Psychotherapies for Borderline Personality Disorder: A Focused Systematic Review and Meta-Analysis

Citation
Stoffers-Winterling JM, Storebø OJ, Kongerslev MT, et al. (2022).
Psychotherapies for borderline personality disorder: A focused systematic review and meta-analysis.
British Journal of Psychiatry, 221(3), 538–552.

Key Findings (Summary)

  • Thirty-one randomized controlled trials involving 1,870 participants were reviewed.

  • Psychotherapy showed meaningful benefits for individuals with BPD.

  • Evidence supported several treatments, including:

    • Dialectical Behavior Therapy (DBT) – reductions in self-harm and improvements in functioning

    • Mentalization-Based Treatment (MBT) – reductions in self-harm and suicide-related outcomes

    • DBT skills training as an adjunctive intervention

  • Improvements were seen in areas such as self-harm, emotional regulation, psychosocial functioning, and suicide risk.

Takeaway
There is solid evidence that structured psychotherapies are effective treatments for BPD, though further research is needed to strengthen confidence in specific approaches.

Study 2

Pharmacological Treatments for Borderline Personality Disorder: A Systematic Review and Meta-Analysis

Citation
Gartlehner G, Crotty K, Kennedy S, et al. (2021).
Pharmacological treatments for borderline personality disorder: A systematic review and meta-analysis.
CNS Drugs, 35(10), 1053–1067.

Key Findings (Summary)

  • Although medications are widely prescribed for BPD, no medications are currently approved specifically to treat BPD.

  • Twenty-one randomized controlled trials involving 1,768 participants were reviewed.

  • Overall findings showed:

    • Limited effectiveness of medications in reducing overall BPD severity

    • Some low-certainty evidence that anticonvulsants may help specific symptoms (e.g., anger, emotional instability)

    • Second-generation antipsychotics may reduce general psychiatric symptoms, but not core BPD features

Takeaway
Medications alone do not effectively treat the core symptoms of BPD and should generally be considered adjuncts to psychotherapy rather than primary treatment.

Study 3

Borderline Personality Disorder and Sexual Abuse: A Systematic Review

Citation
de Aquino Ferreira LF, Pereira FHQ, Benevides AMLN, Melo MCA. (2018).
Borderline personality disorder and sexual abuse: A systematic review.
Psychiatry Research, 262, 70–77.

Key Findings (Summary)

  • Forty studies were reviewed examining the relationship between sexual abuse and BPD.

  • Sexual abuse—especially childhood sexual abuse—was identified as a major risk factor for BPD.

  • Individuals with BPD and a history of sexual abuse experienced:

    • More severe symptoms

    • Higher rates of suicidality and self-harm

    • Greater likelihood of PTSD, dissociation, and chronic illness course

  • Adult sexual abuse rates were higher among people with BPD compared to other personality disorders.

Takeaway
Trauma plays a significant role in the development, severity, and prognosis of BPD, underscoring the importance of trauma-informed care.

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