The Relationship between Adverse Childhood Experiences, Emotion Dysregulation and Personality Disorder Traits: A Systematic Review and Mediation Analysis

Abstract

This multi-study aimed to elucidate the complex relationship between Adverse Childhood Experiences (ACEs), emotion dysregulation and personality disorder (PD). The systematic review included 14 studies that simultaneously analysed/modelled the relationship between all three variables. All were cross-sectional and explored childhood abuse rather than the broader term of ACEs. All investigated only borderline personality disorder (BPD). All but one showed emotion dysregulation mediated, or was associated with, BPD and childhood abuse. Study Two investigated all PDs to extend knowledge beyond BPD, finding emotion dysregulation mediated between childhood abuse (an ACEs subtype) and all PDs. These effects did not hold when ACE was modelled instead of abuse. The studies highlight the centrality of abuse, and emotion dysregulation as transdiagnostic across all PDs.