A Review of the Role of Childhood Trauma in the Development of Borderline Personality Disorder: Integrating Psychodynamic and Cognitive-Behavioral Perspectives

Childhood trauma is a critical risk factor for borderline personality disorder (BPD), yet its complex pathways demand integrative theoretical approaches. This systematic review synthesizes psychodynamic and cognitive-behavioral perspectives to elucidate how early adverse experiences shape BPD's etiology and guide clinical interventions. Adhering to PRISMA guidelines, we systematically searched PubMed, PsycINFO, Scopus, and Web of Science for peer-reviewed studies from ۲۰۱۰ to ۲۰۲۵, focusing on the neurobiological, psychological, and relational mechanisms linking childhood trauma to BPD. Findings reveal that trauma disrupts emotional regulation, identity cohesion, and interpersonal functioning through altered hypothalamic-pituitary-adrenal axis activity, impaired mentalization, and maladaptive schemas. Psychodynamic models highlight unconscious relational deficits, such as compromised epistemic trust, while cognitive-behavioral frameworks emphasize invalidating environments that foster cognitive distortions and impulsive behaviors. These perspectives converge on emotional dysregulation and relational instability as core mediators, informing a proposed integrative framework that unifies their insights. Clinically, trauma-focused adaptations of Mentalization-Based Therapy and Dialectical Behavior Therapy demonstrate efficacy in addressing BPD's trauma-related symptoms, though challenges like treatment accessibility and clinician burnout persist. Future research should prioritize longitudinal designs, mixed-methods approaches, and interdisciplinary collaborations to refine integrative models and explore epigenetic mechanisms. By bridging psychodynamic and cognitive-behavioral paradigms, this review advocates for holistic, trauma-informed interventions that enhance theoretical understanding and clinical outcomes. It calls for renewed efforts to address BPD's complexity, fostering resilience and recovery for affected individuals through evidence-based, integrative practices.

کلیدواژه ها:

Borderline personality disorder ، childhood trauma ، psychodynamic ، cognitive-behavioral ، integrative framework ، trauma-informed interventions