BPD is not a neurodevelopmental disorder.

[Portent]

Quick fact check - BPD is not a neurodevelopmental disorder.

A neurodevelopmental disorders is a mental disorder involing impairments in the physical growth and development of the brain or central nervous system. The most accurate use of the term refers to a disorder of brain function that affects emotion, learning ability, self-control and memory and that unfolds as the individual grows.

Disorders considered neurodevelopmental in origin, or that have neurodevelopmental consequences when they occur in infancy and childhood, include:

I beg to differ. Brain imagery is showing exactly what is wrong in the borderline brain. The amygdala is over active and the dorsal lateral prefrontal cortex and the Subgenual Anterior Cingulate Cortex are underactive to the point that they almost shut down when they are needed to regulate negative emotions from the amygdala.

It is at its root a neurodevelopmental disorder that manifests itself as a personality disorder as a coping mechanism. IMHO while the since is new I would argue that most cluster B's are this root cause with the personality disorder that develops to cope, if one does develop, being determined by environment.

[Skip]

It is at its root a neurodevelopmental disorder that manifests itself as a personality disorder as a coping mechanism. IMHO while the since is new I would argue that most cluster B's are... .

Portent,

Your theory is one shared with some other, however, we want to be evidence based here, especially when we talk about clearly clinical matters like the origin and cause of BPD.

Back in 1989, Marsha Linehan reported that efforts to link neurodevelopment to BPD were ongoing and inconclusive.

Fast forward 28 years, and this is the most recent position on the subject (May 2016):

Age-related parieto-occipital and other gray matter changes in borderline personality disorder: A meta-analysis of cortical and subcortical structures
Psychiatry Research: Neuroimaging
Volume 251, 30 May 2016, Pages 15–25
Christine L. Kimmela

Previous research suggests that core borderline personality disorder (BPD) symptoms vary in severity with advancing age. While structural neuroimaging studies show smaller limbic and prefrontal gray matter volumes (GMV) in primarily adult and adolescent BPD patients, respectively, findings are inconsistent.

[Portent]

I agree that the evidence is inconclusive on structural differences on the brain. However, tests I have seen that look at only activation of the brain are rather conclusive. The amygdala is over active and the dorsal lateral prefrontal cortex and Subgenual Anterior Cingulate Cortex are under active. Its as if the person never learned how to use their higher emotional brain.

[balletomane]

I have a PhD in the field of neurodevelopmental disorders. BPD is not one of them. Examples of actual neurodevelopmental problems include Tourette's syndrome, dyspraxia, dyslexia, autistic spectrum conditions, etc. These are not mental illnesses. It is absolutely possible for someone with a neurodevelopmental disorder to be happy, mentally healthy, and well-adjusted - it all depends on how well they're supported.

Portent, I think you are misunderstanding the clinical use of MRI and CAT scans - just because you can see different neurological functions in people with a diagnosis of X or Y condition does not mean those conditions are neurodevelopmental in origin (and trying to pin specific difficulties on specific parts of the brain is contentious among doctors for many reasons). There are studies showing changes in brain function among people with depression and anxiety, but these aren't neurodevelopmental disorders either.

[Portent]

Portent, I think you are misunderstanding the clinical use of MRI and CAT scans - just because you can see different neurological functions in people with a diagnosis of X or Y condition does not mean those conditions are neurodevelopmental in origin (and trying to pin specific difficulties on specific parts of the brain is contentious among doctors for many reasons). There are studies showing changes in brain function among people with depression and anxiety, but these aren't neurodevelopmental disorders either.

That is your argument? You cant prove causality? As an engineer I want to vomit. You have an inability to control negative emotion to the point that affect instability is an almost perfect negative predictor for BPD. What more evidence do you want? We know what is happening we know whey it happened. Their brains function like a child's because at some point they never got the nurturing needed to make that step and they were forever stuck at that stage of mental development.

Let me give you another rational the grey hairs that write the DSM don't want to invalidate some paper they wrote three decades ago that they based on a lot of speculation and zero empirical data.

[Skip]

Portend,

Respectfully, you appear to be confusing neurological impairment, neurodevelopment, soft sign neurological abnormalities, etc.

Your "perfect predictor" is also not by any means a perfect predictor - its a screening test. Look at the data.
https://bpdfamily.com/message_board/index.php?topic=302879.0

You are transposing hypothesis and deductive reasoning with evidence based information.

From an engineering point of view, remember correlation does not imply causation and be careful of illusory correlation.

Regardless, we're evidenced based here so that we don't need to speculate or debate neuroscience and political aspects the scientific fields.

If you have a clinical reference, lets take a look.  

[balletomane]

I am a specialist in neurodevelopmental disorders. I actually teach medical students about these conditions and have written a book in the field. As Skip says, you're making a number of false conflations. BPD is caused by adverse life experiences and poor nurturing, you're right... .but neurodevelopmental disorders are not! They are typically observable from very early infancy and present from birth. A child with Down's Syndrome, dyslexia, or a motor co-ordination disorder is still going to have Down's Syndrome, dyslexia, or a motor co-ordination disorder no matter what kind of nurturing they receive. Having loving attuned parents and a supportive environment will help a child with neurodevelopmental issues, of course, and not having those things will injure them just as their absence would injure any other child - in fact it would injure them more, as these kids need extra help. But the neurodevelopmental issues would still be there no matter what kind of life experiences they had. BPD is not in this category. I don't want to get into a debate on this, and I have to say I'm a little taken aback by how strongly you would react to someone trying to give the technical definition of a neurodevelopmental disorder - you "want to vomit" because you feel that as an engineer you know more than people who work in this area, and the possibility that doctors don't want to admit they're wrong seems more likely to you than the idea that you might not understand something?

No one here is saying that BPD isn't serious. It is. It has had a huge impact on our lives. But trying to insist it's neurodevelopmental doesn't help anyone or change anything.

[GlennT]

I agree that BPD may not be a neurodevelopmental disorder of origin, however MRI and CAT scans show us that there are certain features in the brains of people with BPD that are similar compared to others who do not have BPD... the current theory is that chemicals caused by on-going trauma may have had an adverse effect on certain neuro-pathways. But like Skip said, there is no evidence of a perfect predictor. I have witnessed though, in the postings by members here over the years, that indeed there are similarities in behavior of people with BPD. I have been trying to understand for years why this is. 

[Skip]

I have witnessed though, in the postings by members here over the years, that indeed there are similarities in behavior of people with BPD. I have been trying to understand for years why this is.  

The Diagnostic Statistical Manual is, in a basic sense, a list of statistically similar clusters (constellations) of mental behavior.

It means that there are clusters of traits that are both statistically similar and statistically discrete (unique) from other clusters.  Our pwBPD have some common traits that are discrete from other constellations of traits and therefore people with a similar mental/emotional make-up.

Many members think that the commonality is so sophisticated that every move can be predicted but this far over-reaching.

The fact is that relationship break-ups (of all people) also have similar characteristic clusters. The overlap of these two cluster, creates the image that BPD seem more predictable than it is. If you look at all the boards, you will not that the commonalities of s"BPD family member" is much higher on the breakup board than any other board. Its because a PD cluster and a general population Breakup cluster are overlapping.

[Portent]

I am a specialist in neurodevelopmental disorders. I actually teach medical students about these conditions and have written a book in the field. As Skip says, you're making a number of false conflations. BPD is caused by adverse life experiences and poor nurturing, you're right... .but neurodevelopmental disorders are not!

Then why is schizophrenia characterized as a neurodevelopmental disorder? I dont believe that all neurodevelopmental disorders have to be genetic. If BPD is caused by nurturing than that is only just another environmental factor that stunts development of the brain.

[Skip]

Then why is schizophrenia characterized as a neurodevelopmental disorder?

The person you want to speak with is Shaloo Gupta, MS
(shaloo.gupta@kantarhealth.com).

Here is a clinical discussion on the specific question you pose:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824976/

[Portent]

As to people talking about "perfect predictor" I never said that please re-read. I'm an engineer and know that there is a world of difference between a predictor and a negative predictor. IMHO a negative predictor is more of an indication of causality than positive predictors.

As for causality. We have a near perfect negative predictor, affect instability, brain scans that show exactly what is going on and why they physically have affect instability, and an explanation for how this affect instability develops into a personality disorder as the child develops maladaptive coping mechanisms, and evidence that fixing the problem in the brain is the first step towards untying the Gordian knot that is the personality disorder which is what the first phase of DBT does.

It doesn't get much better than that int he real world to establish causality. Are we to instead start brain scanning children, giving half that test for affect instability treatment and denying the other half treatment to test?