ABSTRACT
OBJECTIVE: To determine the relative contributions of neuropsychological deficits and psychosocial stressors to the presence of borderline pathology in children. METHOD: The subjects were 86 school-age children (75 males, 11 females) referred for psychiatric day treatment. Thirty-five of the children met criteria for borderline pathology. Data on psychosocial risk factors were obtained for each child from a questionnaire completed by members of the child's clinical team and were based on interviews with parents and children, as well as reports from schools and social agencies. Neuropsychological measures included computerized versions of the Wisconsin Card Sorting Test and the Continuous Performance Test. RESULTS: Both deficits in executive function and psychological trauma made significant and independent contributions to the variance in borderline pathology. Inclusion of both sets of risk factors produced a model that explained 48% of the variance in borderline diagnosis. CONCLUSIONS: Both environmental risks and neurobiological vulnerability should be taken into account to understand the etiology of borderline pathology in children.
Subject(s)
Borderline Personality Disorder/etiology , Child Abuse , Stress, Psychological , Borderline Personality Disorder/psychology , Child , Cross-Sectional Studies , Female , Humans , Male , Risk Factors , Social BehaviorABSTRACT
OBJECTIVE: To determine whether children with borderline pathology have a specific pattern of neuropsychological risk factors. METHOD: The subjects were 94 school-age children in day treatment, divided into borderline (n = 41) and nonborderline (n = 53) groups according to results of the Child version of the Diagnostic Interview for Borderlines. All children were assessed with the Child Behavior Checklist, the Schedule for Affective Disorders and Schizophrenia for School-Age Children, and a neuropsychological battery. RESULTS: Children with borderline pathology had abnormal scores on the Wisconsin Card Sorting Test and on the Continuous Performance Test, both of which suggested problems with executive function. Although borderline pathology was highly comorbid with conduct disorder, most results were independent of this comorbidity. CONCLUSIONS: Borderline pathology in children has a unique pattern of neuropsychological risk factors that may reflect a diathesis for this syndrome.
Subject(s)
Borderline Personality Disorder/physiopathology , Cognition Disorders/physiopathology , Neuropsychological Tests , Analysis of Variance , Borderline Personality Disorder/psychology , Case-Control Studies , Chi-Square Distribution , Child , Disease Susceptibility/physiopathology , Female , Humans , MaleABSTRACT
OBJECTIVE: To determine whether children with borderline pathology have a specific pattern of psychological risk factors. METHOD: The subjects were 94 school-age children in day treatment, divided into borderline (n = 41) and nonborderline (n = 53) groups using the child version of the Retrospective Diagnostic Interview for Borderlines. All children were assessed using the Child Behavior Checklist, the Schedule for Affective Disorders and Schizophrenia for School-Age Children, and the Psychosocial Questionnaire. Parental pathology was assessed by a computerized version of the Structured Clinical Interview for DSM-III-R. RESULTS: Children with borderline pathology had higher rates of physical abuse, sexual abuse, severe neglect, as well as family breakdown and parental criminality. In multivariate analyses, the discriminating factors were sexual abuse and parental criminality. Borderline pathology was highly comorbid with conduct disorder, but most of these results remained significant in reanalyses comparing children with and without conduct disorder. CONCLUSIONS: Borderline pathology in children has a unique pattern of risk factors not accounted for by conduct disorder alone.
Subject(s)
Borderline Personality Disorder/diagnosis , Borderline Personality Disorder/psychology , Conduct Disorder/psychology , Family/psychology , Psychiatric Status Rating Scales/standards , Psychology, Child , Chi-Square Distribution , Child , Child Abuse, Sexual , Conduct Disorder/diagnosis , Cross-Sectional Studies , Diagnosis, Differential , Female , Humans , Male , Parent-Child Relations , Risk Factors , Socioeconomic FactorsABSTRACT
The purpose of this study was to compare ratings of defense styles and hostility in male patients with personality disorders, to determine whether either of these is related to a borderline diagnosis, or to specific psychological risk factors. Subjects with personality disorders were divided into borderline personality disorder (BPD) (N = 61) and non-BPD (N = 60) groups were given both the Defense Style Questionnaire (DSQ) and the Buss-Durkee Guilt-Hostility Inventory (BDHI). Risk factors were measured by a developmental interview and the the Parental Bonding Index. The BPD group reported more maladaptive and image distorting defenses on the DSQ, as well as higher ratings on the BDHI. Ratings on both dependent measures were strongly related to diagnosis, and more weakly to measures of psychological risk factors. Thus, in men with personality disorders, immature defense styles and high levels of hostility are strongly associated with a borderline diagnosis.
Subject(s)
Defense Mechanisms , Hostility , Personality Disorders/diagnosis , Adolescent , Adult , Borderline Personality Disorder/diagnosis , Borderline Personality Disorder/psychology , Child Abuse/diagnosis , Child Abuse, Sexual/diagnosis , Humans , Life Change Events , Male , Middle Aged , Object Attachment , Parent-Child Relations , Personality Disorders/psychology , Personality Inventory , Psychiatric Status Rating Scales , Risk FactorsABSTRACT
OBJECTIVE: To examine risk factors associated with borderline pathology in latency-age children. METHOD: The subjects were 98 children assessed for day treatment. Borderline subjects were identified in a chart review using the Child Diagnostic Interview for Borderlines, which divided the sample into borderline (n = 41) and nonborderline (n = 57) groups. Functional levels were assessed by Children's Global Assessment Scale scores. The risk factors were also rated by chart review; all subjects were given a cumulative abuse score and a cumulative parental dysfunction score. RESULTS: Both groups demonstrated severe functional impairment. The risk factors that differentiated the borderline group were sexual abuse, physical abuse, severe neglect, and parental substance abuse or criminality. Sexual abuse and severe neglect were significant in multivariate analysis. Cumulative abuse and cumulative parental dysfunction scores were both higher in the borderline group. CONCLUSIONS: The findings indicate that the risk factors in borderline children are similar to those found in adults.
Subject(s)
Borderline Personality Disorder/psychology , Child of Impaired Parents/psychology , Personality Development , Borderline Personality Disorder/diagnosis , Borderline Personality Disorder/therapy , Child , Child Abuse/psychology , Child Abuse, Sexual/psychology , Day Care, Medical , Female , Humans , Male , Risk FactorsABSTRACT
The purpose of the study was to examine the role of several psychological risk factors--childhood sexual abuse (CSA) and its parameters, childhood physical abuse and its parameters, early separation or loss, and abnormal parental bonding--in male patients with borderline personality disorder (BPD). Subjects with personality disorders were divided into BPD (N = 61) and non-BPD (N = 60) groups. The risk factors were measured by a developmental interview and the Parental Bonding Index. The BPD group had a higher frequency of CSA, more severe CSA, a longer duration of physical abuse, increased rates of early separation or loss, and a higher paternal control score on the Parental Bonding Index. CSA and separation or loss were significant in the multivariate analysis. The risk factors suggest that trauma and loss, as well as problems with fathers, are important for the development of BPD in males.
Subject(s)
Ambulatory Care , Borderline Personality Disorder/epidemiology , Adolescent , Adult , Age of Onset , Borderline Personality Disorder/etiology , Borderline Personality Disorder/psychology , Child Abuse/statistics & numerical data , Child Abuse, Sexual/epidemiology , Child, Preschool , Comorbidity , Humans , Male , Multivariate Analysis , Object Attachment , Parent-Child Relations , Risk Factors , Sex FactorsABSTRACT
The purpose of this study was to examine the role of several psychological risk factors, i.e., childhood sexual abuse (CSA) and its parameters, childhood physical abuse (PA), early separation or loss, and abnormal parental bonding, in borderline personality disorder (BPD). Women with personality disorders were divided into BPD (n = 78) and non-BPD (n = 72) groups. Risk factors were measured by a developmental interview and the Parental Bonding Index (PBI). The BPD group had a greater frequency of CSA, more severe CSA, as well as more PA, and a lower maternal affection score on the PBI. Only CSA was significant in the multivariate analysis. CSA is the risk factor that most strongly discriminates between BPD and non-BPD. However, CSA has low specificity to BPD, and only a subgroup reported severe abuse experiences.
Subject(s)
Borderline Personality Disorder/psychology , Child Abuse, Sexual/psychology , Parent-Child Relations , Adult , Child , Child Abuse/psychology , Female , Humans , Maternal Deprivation , Middle Aged , Multivariate Analysis , Object Attachment , Odds Ratio , Paternal Deprivation , Risk FactorsABSTRACT
The purposes of this study were to determine whether or not dissociation in female patients suffering from personality disorder is related to sexual and physical abuse or to abuse parameters and whether or not self-mutilation in the personality disorders is related to psychological risk factors or to dissociation. The sample was divided into 78 borderline and 72 nonborderline personality disorders. Psychological risk factors were measured through histories of childhood sexual abuse, physical abuse and separation or loss as well as scores on the Parental Bonding Index. Dissociation was measured by the Dissociative Experiences Scale. On the diagnostic interview, 48 subjects scored positive for self-mutilation. Dissociative Experiences Scale scores were associated with a borderline diagnosis but not with childhood sexual abuse or physical abuse. The parameters of abuse were not related to dissociation. Subjects who mutilated themselves had higher rates of both childhood sexual abuse and dissociation in univariate analyses. However, in multivariate analyses only diagnosis was significant. None of the other psychological risk factors were significantly linked to self-mutilation. The findings do not support theories that dissociation and self-mutilation in borderline personality disorder are associated with childhood trauma.
Subject(s)
Borderline Personality Disorder/psychology , Dissociative Disorders/psychology , Self Mutilation/psychology , Adult , Borderline Personality Disorder/diagnosis , Child , Child Abuse, Sexual/diagnosis , Child Abuse, Sexual/psychology , Female , Humans , Object Attachment , Parent-Child Relations , Personality Assessment/statistics & numerical data , Personality Development , Psychometrics , Risk FactorsABSTRACT
The purpose of this study was to determine whether or not self-mutilation in patients with personality disorders is related to other psychological risk factors, dissociation or diagnosis. The sample included 61 subjects with borderline personality disorder and 60 subjects with nonborderline personality disorder; 32 subjects with borderline personality disorder reported self-mutilation. Psychological risk factors were measured through histories of childhood sexual abuse, physical abuse and separation or loss as well as through scores on the Parental Bonding Index. Dissociation was measured by the Dissociative Experiences Scale. There were no relationships between any of the psychological risk factors and self-mutilation. Subjects who mutilated themselves had higher scores on the Dissociative Experiences Scale in univariate analysis but the scores in multivariate analyses dissociation did not discriminate between subjects who mutilated themselves and those who did not. The results do not support the theory that abuse and dissociation account for self-mutilation in the personality disorders.