Linking childhood adversity with borderline and depressive symptoms: the role of reward processing

Background: Childhood adversity (CA) predicts borderline personality disorder (BPD) and depression. Although underlying mechanisms are unclear, emerging data draw attention to reward processing (RP).Objective: Building on these, we investigated associations between variables and tested the mediating role of distinct RP dimensions in the associations between CA and both BPD and depressive symptoms using structural equation modeling.Method: Participants (N = 1048; m = 25.24; SD = 5.34) completed self-report measures on variables of interest.Results: We found significant associations between CA, BPD and depressive symptoms, and RP dimensions. Both reward responsiveness and learning mediated the association between CA and BPD symptoms, while only reward learning mediated the association between CA and depressive symptoms.Conclusions: These findings illustrate the key role of RP in the association between CA and both BPD and depressive symptoms and underscore the transdiagnostic nature of reward learning. Together, they suggest that this RP dimension may be an important treatment target in those with a history of CA experiencing BPD and depressive symptoms.