Childhood recollections as predictors of specific features of borderline personality disorder

Abstract

Previous studies indicate that four childhood factors - trauma, neglect, separations, and parental psychopathology, are relevant to the etiology of borderline personality disorder (BPD). The present sought to tease apart the relative strength of relationship between these childhood factors and specific features of BPD in adults. Four hypotheses were tested. The first two are: childhood neglect is the best predictor of the BPD features 1) "chronic feelings of emptiness" and 2) "general anxiety and impulsiveness". The second two are: childhood trauma is the best predictor of 3) "self-destructive behaviors" and 4) "depersonalization and brief psychotic episodes". The sample consisted of sixty-six subjects with borderline, antisocial or schizotypal personality disorder or bipolar type II affective disorder. The latter three groups were used as psychiatric control groups. Subjects were obtained from outpatient mental health settings and advertisements for symptomatic volunteers. Thirty-four subjects met full DSM-III criteria for BPD. Ascertainment of the severity of eleven features of BPD was made using a semi-structured interview (BPD Scale). Childhood and parental psychopathology variables were assessed using semi-structured interviews based on subjects' recollections of childhood experiences. statistical procedures included stepwise multiple regression analyses designed to test the hypotheses and to determine the strongest predictor (s) for each of the remaining BPD features. The results supported all four hypotheses. In addition, the results indicated that childhood trauma was the best predictor of the BPD features "regressive behavior in psychiatric treatment", "anger and hostility in relationships", "overdependence in relationships" and overall severity of borderline psychopathology. Parental psychopathology added significant additional variance to the prediction of "overdependence in relationships" and the overall severity of borderline psychopathology. The findings suggest that, in a group of adults with a range of psychiatric illnesses, specific childhood factors are uniquely associated with specific elements of BPD. Additionally, the findings showed that the four childhood factors were significantly inter-correlated, suggesting that BPD is, in part, the result of multiple developmental factors.