Study concludes that self-loathing and self-pity are central mechanisms in the development of borderline traits in adolescence

A research team from the University of Coimbra (UC) is carrying out the first Portuguese study focused on adolescents, aimed at the early detection of Borderline Personality Disorder (BPD), as well as the risk and protective factors that allow the design of effective intervention programmes to combat this pathology.

Borderline personality disorder is a serious disorder associated with a high suicidal tendency. It is estimated that 2-6% of the world's population suffers from this condition, which is characterised by intense emotional instability, impulsivity and self-harm. As it is a developmental disorder, there is no sudden onset, but rather a progression over time. Therefore, early detection is essential to prevent the pathology from worsening.

The aim of this study is to "detect and signal this disorder as early as possible to prevent it from worsening". In adolescence, we were able to immediately detect the dysfunctional features of this pathology, which eventually crystallise and intensify with age, with serious consequences", explains Diogo Carreiras, the principal investigator of the study, stressing that this is the major novelty of the project, since "instead of studying this serious disorder from a remedial perspective, that is, the person already has the disorder, our focus is to act first, intervene and prevent the disorder".

The first results of this study, which involved 1,007 adolescents (420 boys and 587 girls) from seven primary and secondary schools in central and northern Portugal, with an average age of 15.3 years, and their parents, suggest that adolescent girls have, on average, higher borderline traits than boys.

Protective and risk factors for the development and evolution of borderline characteristics were also examined. "We looked at two opposing variables: One of risk, self-loathing, which is characterised by a relationship of great criticism, aversion and attack towards the "self"; and a protective variable, self-compassion (self-care relationship), which translates into the ability to be sensitive to one's own suffering, to recognise it and to act in a genuine and committed way to alleviate it", explains the researcher from the Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC) of the Faculty of Psychology and Educational Sciences of the University of Coimbra (FPCEUC).

It was found that these two variables, regardless of gender, play an important role in the development of borderline symptoms in adolescents, showing that they are essential variables to consider when understanding borderline traits in this age group.

Due to the lack of research on borderline traits in adolescents in Portugal, the team developed instruments to assess and signal these traits, namely two self-administered questionnaires, one for adolescents and one for parents, and a clinical interview for psychologists, psychiatrists and paediatricians to use with adolescents, with an adapted language that translates the causes and mechanisms of borderline traits.

Another finding of the study, funded by the Portuguese Foundation for Science and Technology (FCT), is that there are differences between girls and boys in non-suicidal self-injurious behaviours. Girls are more likely to use methods involving superficial cuts to certain parts of the body (e.g. arms, wrists), while boys' self-injurious behaviour is more likely to involve hitting (e.g. punching). In terms of impulsivity, there are no overall differences between the sexes, but boys seem to have more difficulty in controlling behaviours related to alcohol and drug use.

According to Diogo Carreiras, the results of this research could be fundamental for the development of programmes aimed at this at-risk population, "allowing to find guidelines for the design of psychotherapeutic interventions in the context of prevention and future empirical studies". The data from this investigation highlight essential variables for understanding borderline traits in adolescents, as well as the differences in these psychological mechanisms between girls and boys, with important implications for clinical practice and prevention."

The study, which began in 2018, is part of the broader research project 'Borderline Traits in Adolescence: Prospective study of the development of borderline personality disorder', and is part of the researcher's doctoral thesis, supervised by Professors Paula Castilho and Marina Cunha.

^{Translation by Diana Taborda}