Biopsychosocial theories of borderline personality disorder: a meta-synthesis and psychopathological network model from a systematic review

Riv Psichiatr. 2023 Nov-Dec;58(6):258-270. doi: 10.1708/4143.41406.


Background: Borderline personality disorder (BPD) is a complex mental health condition with an altered image of self, impulsive acts, suicidal ideation, and self-harm requiring intensive care in outpatient and inpatient settings. The biopsychosocial (BPS) model adopted in the current study extracted the outcomes of a research about the diagnosis, causes and treatment of BPD. A network model helped link these results in a unitary model with applications in clinical practice for assessment and intervention.

Methods: We conducted a literature review of current studies on the BPS causes of BPD and merged them through meta-synthesis. The results were then elaborated with a psychopathological network analysis for linking the extracted factors with higher degree of centrality in the network and merged in a final comprehensive model.

Results: The theoretical modelisation suggests that BPS causes merged with the diathesis-stress model persistently activate the cortico-limbic system and prefrontal cortex, induce neuroinflammation, and stimulate suicidal and parasuicidal ideation and behaviours modulated by psychological and pharmacological treatment.

Conclusions: Using a network model in psychopathology allowed the merging of data about BPD into a unitary and dynamic pattern which can be helpful to direct assessments and interventions in clinical practice.

Publication types

  • Systematic Review

MeSH terms

  • Borderline Personality Disorder* / psychology
  • Humans
  • Impulsive Behavior
  • Psychopathology
  • Self-Injurious Behavior*
  • Suicidal Ideation