# A Systematic Review of Risk and Protective Factors of Borderline Personality Disorder

## TL;DR

This paper reviews risk and protective factors for borderline personality disorder to guide public health strategies.

## Contribution

It systematically identifies and analyzes risk and protective factors for BPD, focusing on family influences.

## Key findings

- Most studies highlight family risk factors for BPD development.
- Silent risk factors may have long-term effects on personality and increase BPD risk in adulthood.
- Only two studies examined protective factors for BPD.

## Abstract

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), certain criteria are used for the diagnosis of borderline personality disorder (BPD). Although there is evidence that several risk factors could predispose individuals to BPD, it is still not clear what the etiologic pathways of this personality disorder are. The aim of this systematic review has been to identify, classify, analyze and interpret data regarding risk and protective factors for BPD to inform policies and practices in terms of public health. In total, 15 studies were included in this systematic review. Ten longitudinal studies and three case-control studies analyzed individual and family risk factors for BPD. Two out of 15 were investigating possible protective factors for the disorder. Most studies were focused on family risk factors for BPD. This systematic review showed that many studies suggested possible family risk factors for the development of BPD. Evidence suggests that there are “silent” risk factors that have a long-term effect on a child’s personality and increase the risk for BPD in adult life. Following a public mental health framework, BPD prevention and promotion of mental health could contribute to an improved quality of life for all family members and better mental health status for the general population.