A systematic literature review of the etiology of borderline personality disorder from an ecological systems PERSPECTIVE

Borderline Personality Disorder (BPD) is one of the most common, complex, costly, and severely impairing personality disorders, affecting an estimated 2% to 9% of the general population and 40% to 44% of the inpatient psychiatric population. A review of the literature was conducted using a systematic methodology. By incorporating an ecological systems perspective, a holistic and comprehensive critique of the literature surrounding the etiology of BPD is presented. The findings reveal that the etiology of BPD is a complex integration of psychological, biological, and social factors. More specifically, however, this review found that: (1) the etiology of BPD is complex and has many factors, (2) the dominant discourse about the etiology of BPD is based primarily in the psychological and biological literature, and (3) the examination of BPD etiology has focused solely on the individual and microsystems levels, neglecting to consider systemic factors such as the impact of discriminatory health and mental healthcare practices. Findings and future directions are explored through the ecological systems theory lens.