ArticleFrontiers in psychiatry2021
Risk and Protective Factors for Personality Disorders: An Umbrella Review of Published Meta-Analyses of Case-Control and Cohort Studies.
Article in Frontiers in psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Global research landscape, knowledge structure, and emerging trends in adverse childhood experiences and personality disorders: a bibliometric analysis.Frontiers in psychiatry · 2026Pooled it
- An umbrella review of candidate predictors of response, remission, recovery, and relapse across mental disorders.Molecular psychiatry · 2023Pooled it
- From child sexual abuse to psychiatric diagnoses and complex trauma in adolescence.European child & adolescent psychiatry · 2025Article
- Using Avoidant Emotion-Focused Coping and being a Woman with Adverse Childhood Experiences as the Worst-Case Scenario for Internalising Problems.Journal of child & adolescent trauma · 2025Article
- Article
- New horizons in personality disorders-from neglect to necessity in geriatric care.Age and ageing · 2025Review
- Modelling the impact of environmental and social determinants on mental health using generative agents.NPJ digital medicine · 2025Review
- Article
- Maternal exposure to childhood maltreatment and mental and behavioral disorders in children.European child & adolescent psychiatry · 2023Article
- Childhood Emotional Neglect and Cardiovascular Disease: A Narrative Review.Frontiers in cardiovascular medicine · 2022Review
- Article
- Risk and protective factors for mental disorders beyond genetics: an evidence-based atlas.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2021Article
Corrections and comments
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Authors and funding
13 authors at 12 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The putative risk/protective factors for several personality disorders remain unclear. The vast majority of published studies has assessed personality characteristics/traits rather than disorders. Thus, the current umbrella review of meta-analyses (MAs) aims to systematically assess risk or protective factors associated with personality disorders. We searched PubMed-MEDLINE/PsycInfo databases, up to August 31, 2020. Quality of MAs was assessed with AMSTAR-2, while the credibility of evidence for each association was assessed through standard quantitative criteria. Out of 571 initial references, five meta-analyses met inclusion criteria, encompassing 56 associations of 26 potential environmental factors for antisocial, dependent, borderline personality disorder, with a median of five studies per association, and median 214 cases per association. Overall, 35 (62.5%) of the associations were nominally significant. Six associations met class II (i.e., highly suggestive) evidence for borderline personality disorder, with large effect sizes involving childhood emotional abuse (OR = 28.15, 95% CI 14.76-53.68), childhood emotional neglect (OR = 22.86, 95% CI 11.55-45.22), childhood any adversities (OR = 14.32, 95% CI 10.80-18.98), childhood physical abuse (OR = 9.30, 95% CI 6.57-13.17), childhood sexual abuse (OR = 7.95, 95% CI 6.21-10.17), and childhood physical neglect (OR = 5.73, 95% CI 3.21-10.21), plus 16 further associations supported by class IV evidence. No risk factor for antisocial or dependent personality disorder was supported by class I, II, and III, but six and seven met class IV evidence, respectively. Quality of included meta-analyses was rated as moderate in two, critically low in three. The large effect sizes found for a broad range of childhood adversities suggest that prevention of personality disorders should target childhood-related risk factors. However, larger cohort studies assessing multidimensional risk factors are needed in the field.
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