![]() ![]() Successfully identifying such markers would hasten the refinement of developmental theories, accelerate the discovery of etiological mechanisms, enable early detection and diagnosis, and may provide fruitful targets for early intervention. These devastating consequences speak to the urgent need to identify signs that harbinger onset of the acute, fully developed illness. The level of impairment associated with BPD and its public health significance are reflected in its prevalence across adult and adolescent clinical settings, with approximately 10–20% of outpatients and up to 50% of inpatients meeting criteria ( Glenn & Klonsky, 2013 Korzekwa, Dell, Links, Thabane, & Webb, 2008 Widiger & Weissman, 1991). Furthermore, severe psychosocial impairment can linger for decades after remission ( Bagge et al., 2004 Paris & Zweig-Frank, 2001 Skodol et al., 2005). The disorder is associated with a high mortality rate: up to 10% of patients commit suicide ( Paris & Zweig-Frank, 2001 Zanarini, Frankenburg, Hennen, & Silk, 2003). Though increased risk for BPD was reliably attributed to multiple factors within social, family, maltreatment, and child domains, the most striking limitation of this research is its lack of disorder-specific findings Additional limitations, including notable heterogeneity in sampling methodology, symptom assessment methodology, and developmental timing of assessments, are discussed in terms of how close are we to pinpointing who is most at risk and why in an attempt to provide a roadmap for future research.īorderline personality disorder (BPD) is a serious mental illness that typically emerges during adolescence or young adulthood and is characterized by multiple debilitating symptoms, including emotional dysregulation, tumultuous interpersonal relationships, and impulsive behaviors ( Chanen, 2015 Lieb, Zanarini, Schmahl, Linehan, & Bohus, 2004). Electronic databases were systematically searched for prospective, longitudinal studies that examined risk factors of subsequent BPD outcomes (features, symptoms, diagnosis) resulting in a total of 39 studies, reflecting 24 unique samples. To address this limitation, we conducted a systematic review to summarize and synthesize the current literature. Though many studies have supported a wide range of factors that increase subsequent risk for BPD, this literature has yet to be critically evaluated, and there are no comprehensive reviews that examine and integrate these findings. ![]() Advancement in this area is required to refine developmental theories, discover etiological mechanisms, improve early detection, and achieve our ultimate goal of prevention. ![]() There is an urgent need to identify signs that harbinger onset of borderline personality disorder (BPD). ![]()
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