Poster #90 - Early Gonadal Pubertal Timing Predicts Adolescent Borderline Personality Disorder Symptoms in Girls

• In Event: Poster Session 05

Abstract

Borderline personality disorder (BPD) is a highly impairing disorder that emerges by adolescence or early adulthood. Given the high rates of suicidal and impulsive behavior associated with BPD, identifying risk factors is critical. Although early pubertal timing has been identified as a risk factor for mood and anxiety disorders (Barendse et al., 2022), there is a dearth of research on how pubertal factors influence BPD development, save for Penner and Sharp’s (2018) finding with inpatient adolescent females that more advanced puberty for age predicts higher BPD symptoms even while covarying for internalizing and externalizing symptoms. The current study sought to replicate and extend this finding by (1) using a more diverse sample including males and females and (2) investigating separable components of pubertal development, adrenal and gonadal, both assessed earlier in development at age 10.

We conducted a multiple linear regression predicting adolescent BPD symptoms in a longitudinal sample (N=115, female=56, male=59, 57% White, 32% Black) recruited during preschool and enriched for preschool-age depressive and disruptive symptoms. Adolescent BPD symptoms (Borderline Personality Features Scale for Children (Crick et al., 2005)) and covariates were measured once between ages 13-19 (M=16.27). Predictors of interest included gonadal (growth spurts; breast development and menarche for girls; voice deepening and facial hair growth for boys) and adrenal (pubic hair growth and skin changes) puberty scores measured at age 10 via the Pubertal Development Scale (Petersen et al., 1988); higher scores indicate earlier pubertal timing (i.e. more advanced development than same-age peers). Covariates included sex, race, adolescent age, adolescent internalizing and externalizing scores (MacArthur Health and Behavior Questionnaire (Essex et al., 2002)), and income-to-needs ratio. Significant results were further probed by examining sex differences and by adding preschool-age (ages 3-5) adverse childhood experiences (ACEs), a robust risk factor for BPD, to the model.

Sex/puberty interaction terms were significant in the multiple regression (p<.001 and p=.037 for gonadal and adrenal scores, respectively), thus the multiple regression was repeated with only female subjects and again with only male subjects. Gonadal, but not adrenal, puberty scores at age 10 were a significant predictor of adolescent BPD symptoms among female subjects (Beta=.44, p=.003) and male subjects (Beta=-.23, p=.039). When preschool ACEs were added to the model, gonadal puberty scores remained a significant predictor among female (Beta=.44, p=.006) but not male subjects (Beta=-.21, p=.075). In females, earlier gonadal timing was associated with higher BPD symptoms in adolescence.

We replicate and extend prior work showing an association between earlier pubertal timing and higher BPD symptoms in adolescence, significant above and beyond the effect of early adversity, and identify the significance of gonadal pubertal timing specifically among girls. Our findings imply that early gonadal development could serve as a valuable screening target for BPD risk in girls as early as age 10, before BPD symptoms typically emerge. Further work is needed to identify the causal mechanisms linking pubertal timing, BPD symptom emergence, and other risk factors, and to identify interventions that could target these associations and reduce BPD risk early on in development.

Authors

• Kiran Boone, Washington University in St. Louis
  Presenting Author

• Diana Whalen, Washington University in St. Louis

• Deanna Barch, Washington University in St. Louis

• Joan L Luby, Washington University in St. Louis

• Katherine Luking, Saint Louis University