Childhood Maltreatment and Borderline Personality Disorder: the mediating role of difficulties with emotion regulation

Nina Bertele*, Anat Talmon, James J. Gross, Christian Schmahl, Marius Schmitz, Inga Niedtfeld

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Exposure to childhood maltreatment (CM) increases the risk of developing borderline personality disorder (BPD). However, it remains unclear what mechanisms might mediate this link. One candidate of interest is difficulties with emotion regulation. This study aims to examine the pattern of relations among CM, difficulties with emotion regulation, and the risk of developing BPD. A total of 162 individuals diagnosed with current BPD and 162 matched healthy controls completed self-reported questionnaires assessing CM and difficulties with emotion regulation. The authors found high correlations between CM and BPD diagnosis (r = .73, p < .001). Difficulties with emotion regulation were found to mediate the link between CM and BPD diagnosis (p < .001). Results suggest that CM may play a key role in the etiology of BPD and that difficulties with emotion regulation might be a mediating component between CM and BPD.

Original languageAmerican English
Pages (from-to)264-276
Number of pages13
JournalJournal of Personality Disorders
Issue number3
StatePublished - Jun 2022
Externally publishedYes

Bibliographical note

Funding Information:
The study was supported by grants from the German Research Foundation (DFG) awarded to Christian Schmahl (KFO 256, SCHM 1526/15-1) and Inga Niedtfeld (NI 1591/1-1).

Funding Information:
Data were collected between 2012 and 2016 after receiving approval from the Ethics Committee II of the University of Heidelberg at the Medical Faculty Mannheim, and obtaining informed consent from the participants. Data collection was conducted by the Clinical Research Unit (CRU) 256 at Heidelberg University; for further descriptions, see Schmahl et al. (2014). The project was funded by Deutsche Forschungsgemeinschaft (DFG). Participants were invited to the department and while on site filled out the questionnaires in paper form or on a tablet PC. Then all participants underwent the Structured Clinical Interview for DSM-IV Axis-I (SCID-I; Wittchen et al., 1997) and the International Personality Disorder Examination (IPDE; Loranger et al., 1998). All participants received a compensation of 12€ per hour. All participants had a negative drug urine screening.

Funding Information:
Dr. Schmahl received advisory panel payments and research grants from Boehringer Ingelheim International GmbH.

Publisher Copyright:
© 2022 The Guilford Press.


  • borderline personality disorder
  • childhood maltreatment
  • emotion regulation difficulties


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