Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
Department of Psychology, University of Warwick, Coventry CV4 7AL, UK.
Clin Psychol Rev. 2016 Mar;44:13-24. doi: 10.1016/j.cpr.2015.12.001. Epub 2015 Dec 9.
Controversy surrounds the diagnosis of Borderline Personality Disorder (BPD) in youth. This meta-analysis summarised evidence regarding the aetiological and psychopathological validity of youth BPD (the extent to which youth and adult BPD share common risk factors and psychopathology). We identified 61 studies satisfying predetermined inclusion criteria. Statistically significant pooled associations with youth (19 years of age and under) BPD were observed for sexual abuse (all youth: odds ratio=4.88; 95% confidence interval=3.30, 7.21; children: OR=3.97; 95% CI=1.51, 10.41; adolescents: OR=5.41; 95% CI=3.43, 8.53); physical abuse (all youth: 2.79 [2.03, 3.84]; children: 2.86 [1.98, 4.13]; adolescents: 2.60 [1.38, 4.90]); maternal hostility/verbal abuse (all youth: 3.28 [2.67, 4.03]; children: 3.15 [2.55, 3.88]; adolescents: 4.71 [1.77, 12.53]); and neglect (all youth: 3.40 [2.27, 5.11]; children: 2.87 [1.73, 4.73]; adolescents: 4.87 [2.24, 10.59]). Several psychopathological features were also associated with youth BPD, including comorbid mood (3.21 [2.13, 4.83]), anxiety (2.30 [1.44, 3.70]) and substance use (2.92 [1.60, 5.31]) disorders; self-harm (2.81 [1.61, 4.90]); suicide ideation (all youth: 2.02 [1.23, 3.32]; children: 6.00 [1.81, 19.84]; adolescents: 1.75 [1.20; 2.54]) and suicide attempt (2.10 [1.21, 3.66]). Results demonstrate that adult and youth BPD share common aetiological and psychopathological correlates. This offers some support for the diagnostic validity of youth BPD and indicates the need for clinical recognition in this age group.
边缘型人格障碍（BPD）在年轻人中的诊断存在争议。这项荟萃分析总结了关于年轻人 BPD 的病因学和精神病理学有效性的证据（即年轻人和成年人 BPD 共享共同的风险因素和精神病理学的程度）。我们确定了 61 项符合预定纳入标准的研究。观察到与年轻人（19 岁及以下）BPD 具有统计学显著关联的有性虐待（所有年轻人：比值比=4.88；95%置信区间=3.30，7.21；儿童：OR=3.97；95%CI=1.51，10.41；青少年：OR=5.41；95%CI=3.43，8.53）；身体虐待（所有年轻人：2.79 [2.03，3.84]；儿童：2.86 [1.98，4.13]；青少年：2.60 [1.38，4.90]）；母亲敌意/言语虐待（所有年轻人：3.28 [2.67，4.03]；儿童：3.15 [2.55，3.88]；青少年：4.71 [1.77，12.53]）；以及忽视（所有年轻人：3.40 [2.27，5.11]；儿童：2.87 [1.73，4.73]；青少年：4.87 [2.24，10.59]）。一些精神病理学特征也与年轻人 BPD 相关，包括合并心境（3.21 [2.13，4.83]）、焦虑（2.30 [1.44，3.70]）和物质使用（2.92 [1.60，5.31]）障碍；自残（2.81 [1.61，4.90]）；自杀意念（所有年轻人：2.02 [1.23，3.32]；儿童：6.00 [1.81，19.84]；青少年：1.75 [1.20，2.54]）和自杀企图（2.10 [1.21，3.66]）。结果表明，成人和年轻人 BPD 具有共同的病因学和精神病理学相关性。这为年轻人 BPD 的诊断有效性提供了一些支持，并表明需要在这个年龄段进行临床识别。
