Cited by 320Personality Disorders and PsychopathologyChild Abuse and TraumaPsychoanalysis and Psychopathology Research

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Borderline personality disorder and childhood trauma: Evidence for a causal relationship

Ball, Jeffrey S., Links, Paul S.·2009·Current Psychiatry Reports

DOI 10.1007/s11920-009-0010-4

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Abstract

The debate over whether childhood trauma is a causative factor in the development of borderline personality disorder continues in the literature despite decades of research. This review examines this body of literature published from 1995 through 2007 to assess the strength of evidence for such a causal relationship. A unique conceptual approach was used, as we considered the literature in the context of Hill's classic criteria for demonstrating causation. Results of this review suggest that evidence supports the causal relationship, particularly if the relationship is considered as part of a multifactorial etiologic model. Directions for future research and clinical implications are discussed.

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Borderline personality disorder
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“However, it is not uncommon for individuals to experience suicidality in the absence of acute mental disorders or in the presence of chronic conditions such as borderline personality disorder or a history of childhood trauma (Ball & Links, 2009; Bozzatello et al., 2021; Pompili et al., 2005).”
Emergence of Borderline Personality Features in the Context of Normative and Traumatic Parenthood: Theoretical and Clinical Reflections
Terradas, M. M., & Didier, O. (2025) · Psicologia Teoria e Pesquisa · doi:10.1590/0102.3772e41nspe09.en
Temporal Summation of Pain Unpleasantness Is Increased in Borderline Personality Disorder
Löffler, A., Kleinböhl, D., Steinmann, S., Herpertz, S. C., Habel, U., Bekrater‐Bodmann, R., & Flor, H. (2025) · European Journal of Pain · doi:10.1002/ejp.70042
Childhood abuse and maladaptive coping in care leavers: An exploratory study on attachment and Early Maladaptive Schemas
Jarvis, M., Sivyer, K., Selwood, E., & Willoughby, K. (2025) · Journal of Child Health Care · doi:10.1177/13674935251341921
“High rates of childhood abuse have been reported within care leavers (Bazalgette and Trevelyan, 2015; Department for Education, 2014), and such abuse experiences have been associated with a range of psychological dif ﬁ culties (Ball and Links, 2009; McFetridge et al., 2015).”
Navigating parenthood: A qualitative exploration of the experience of mothers with a Borderline Personality diagnosis
Tzikas, N., Midgley, N., & Taylor, B. L. (2025) · Journal of Child and Family Studies · doi:10.1007/s10826-024-02952-6
“Other researchers have associated BPD with adverse childhood experiences including trauma, abuse and neglect (Bradley et al., 2005; Ball & Links, 2009; Porter et al., 2019).”
Psychotic Experiences in Borderline Personality Disorder: The Relationship with Childhood Trauma
Zein, M. A., Kovalenko, J., & Nasr, R. A. (2025) · The Open Psychology Journal · doi:10.2174/0118743501406346250823065311
Additional file 4 of Self-reported impulsivity in women with borderline personality disorder: the role of childhood maltreatment severity and emotion regulation difficulties
Krause-Utz, A., Erol, E., Brousianou, A. V., Cackowski, S., Paret, C., Ende, G., & Elzinga, B. M. (2020) · Figshare · doi:10.6084/m9.figshare.12010461
Additional file 2 of Self-reported impulsivity in women with borderline personality disorder: the role of childhood maltreatment severity and emotion regulation difficulties
Krause-Utz, A., Erol, E., Brousianou, A. V., Cackowski, S., Paret, C., Ende, G., & Elzinga, B. M. (2020) · Figshare · doi:10.6084/m9.figshare.12010443
Additional file 1 of Self-reported impulsivity in women with borderline personality disorder: the role of childhood maltreatment severity and emotion regulation difficulties
Krause-Utz, A., Erol, E., Brousianou, A. V., Cackowski, S., Paret, C., Ende, G., & Elzinga, B. M. (2020) · Figshare · doi:10.6084/m9.figshare.12010431
Additional file 3 of Self-reported impulsivity in women with borderline personality disorder: the role of childhood maltreatment severity and emotion regulation difficulties
Krause-Utz, A., Erol, E., Brousianou, A. V., Cackowski, S., Paret, C., Ende, G., & Elzinga, B. M. (2020) · Figshare · doi:10.6084/m9.figshare.12010452
Additional file 1 of Linking experiences of child sexual abuse to adult sexual intimate partner violence: the role of borderline personality features, maladaptive cognitive emotion regulation, and dissociation
Krause-Utz, A., Dierick, T., Josef, T., Chatzaki, E., Willem, A., Hoogenboom, J., & Elzinga, B. M. (2021) · Figshare · doi:10.6084/m9.figshare.14355721
Additional file 1 of Neural correlates of social exclusion and overinclusion in patients with borderline personality disorder: an fMRI study
Látalová, A., Radimecká, M., Lamoš, M., Jáni, M., Damborská, A., Theiner, P., Bartečková, E., Bartys, P., Vlčková, H., Školiaková, K., et al. (2023) · Figshare · doi:10.6084/m9.figshare.24708972
Additional file 2 of Linking experiences of child sexual abuse to adult sexual intimate partner violence: the role of borderline personality features, maladaptive cognitive emotion regulation, and dissociation
Krause-Utz, A., Dierick, T., Josef, T., Chatzaki, E., Willem, A., Hoogenboom, J., & Elzinga, B. M. (2021) · Figshare · doi:10.6084/m9.figshare.14355724
Additional file 6 of Self-reported impulsivity in women with borderline personality disorder: the role of childhood maltreatment severity and emotion regulation difficulties
Krause-Utz, A., Erol, E., Brousianou, A. V., Cackowski, S., Paret, C., Ende, G., & Elzinga, B. M. (2020) · Figshare · doi:10.6084/m9.figshare.12010470
Additional file 1 of The role of sense of coherence and loneliness in borderline personality disorder traits: a longitudinal twin study
Skaug, E., Czajkowski, N. O., Waaktaar, T., & Torgersen, S. O. (2022) · Figshare · doi:10.6084/m9.figshare.20409568
Additional file 3 of Linking experiences of child sexual abuse to adult sexual intimate partner violence: the role of borderline personality features, maladaptive cognitive emotion regulation, and dissociation
Krause-Utz, A., Dierick, T., Josef, T., Chatzaki, E., Willem, A., Hoogenboom, J., & Elzinga, B. M. (2021) · Figshare · doi:10.6084/m9.figshare.14355727
Additional file 5 of Self-reported impulsivity in women with borderline personality disorder: the role of childhood maltreatment severity and emotion regulation difficulties
Krause-Utz, A., Erol, E., Brousianou, A. V., Cackowski, S., Paret, C., Ende, G., & Elzinga, B. M. (2020) · Figshare · doi:10.6084/m9.figshare.12010467
Associations between abuse, neglect, and at-risk family interactions with adolescent psychiatric disorders
Belbèze, J., Silva, J., Corcos, M., & Robin, M. (2026) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2025.107871

Authors: Ball, J. S., & Links, P. S.
Affiliations: St. Michael's Hospital (CA)
Corresponding author: Ball, Jeffrey S.
ORCID: Ball, Jeffrey S.
Links, Paul S.
Venue: Current Psychiatry Reports
Publisher: Springer Science and Business Media LLC
Published: 2009-01-22
Volume: 11
Issue: 1
Pages: 63-68
ISSN: 1523-3812 (ISSN-L)
1535-1645
DOI: 10.1007/s11920-009-0010-4
OpenAlex: W1994608326
Cited by: 320
References: 53
Citations by year: 2026: 10 · 2025: 18 · 2024: 25 · 2023: 11 · 2022: 26 · 2021: 31 · 2020: 26 · 2019: 33 · 2018: 22 · 2017: 10 · 2016: 20 · 2015: 22 · 2014: 21 · 2013: 17 · 2012: 10
FWCI: 1.21
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Current Psychiatry Reports (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords: borderline personality disorder, childhood trauma, causal relationship, etiology, multifactorial etiology, quality of evidence
MeSH terms: Adult, Borderline Personality Disorder, Brain, Child, Child Abuse, Child Abuse, Sexual, Cross-Sectional Studies, Humans, Interpersonal Relations, Life Change Events, Object Attachment, Risk Factors, Self Concept, Causality

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Borderline personality disorder and childhood trauma: Evidence for a causal relationship

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