Etiological Significance of Associations Between Childhood Trauma and Borderline Personality Disorder: Conceptual and Clinical Implications

Abstract

Numerous studies over the past decade have pointed to the fre quent occurrence of trauma and neglect in the childhood expe rience of patients with Borderline Personality Disorder (BPD). Advancing research on Posttraumatic Stress Disorder (PTSD) and Dissociative Disorders offers further insight into under standing shared clinical phenomena with BPD. Drawing upon attachment theory, models of learned helplessness, and early primate deprivation, empirical, theoretical and clinical data are integrated to conceptualize the role of trauma and neglect in the etiology of BPD.One hundred years after Breuer and Freud postulated a traumatic etiology of the hysterical neuroses in their Studies on Hysteria (1893-1895), there is still considerable debate about the exact role of trauma in the etiology of what we now call Borderline Personality Disorder (BPD). While Freud retreated from his original proposition, a wealth of recent literature has reestablished its importance in the development of BPD. Any sensible review of this literature must begin with a warning that we are still working with hypotheses, and our understanding is far from complete. Those who neatly package their theories now may be humbled by research that emerges over the next fifty years. Nevertheless, clinical and scientific interests dictate that we develop working hypotheses based on available data, to more effectively understand and treat our patients. The following account re mains highly speculative.There is a wealth of retrospectively gathered data associating significant childhood trauma, especially before the age of 10, and BPD (reviewed by Gunderson & Sabo, 1993a). Recent examination of the reliability of memo ries of abuse raises questions about whether these memories are reliable

The role of childhood traumatization in the development of borderline personality disorder in Hungary

“…North American and Western European studies have provided a large body of evidence on the numerous intrafamilial pathological childhood experiences, such as a history of physical, emotional, sexual abuse and neglect that are commonly reported by borderline patients 1,[4][5][6] . More specifically, 40-86% of subjects with BPD have reported being sexually abused during their childhood [7][8][9][10][11][12][13][14] , to a maximum of 94.7% reported by McLean and Gallop in 2003 15 .…”

“…A meta-analytic study of the published literature (containing 19 North-American and two European studies) before 1999, conducted by Fossati, Mededdu and Maffei 25 , has found that in Western society there is only a moderate association between childhood sexual abuse and BPD diagnosis. Sexual abuse does not occur in a vacuum, it occurs in the context of other forms of abuse and dysfunctional parental behavior 26,27 and contributes to the development of BPD through interaction with other pathological childhood experiences 4,5 . For example, sexually abused BPD patients are more likely to report physical neglect, emotional withdrawal, and inconsistent treatment by caretakers 13 .…”

Intérêt clinique d’une conception neuroscientifique du trouble de personnalité limite : dysfonctionnements du système exécutif et de la théorie de l’esprit

“…Notamment, les difficultés sociales des céré -brolésés traumatiques orbitaux frontaux sont relativement stables 2 , sauf pour les cas de démences fronto-temporales, alors que celles des personnes avec un TPL ont tendance à varier dans le temps en fonction des stresseurs interpersonnels plus spécifiques. Aussi il est important de rappeler que le TPL est d'origine neurodéveloppementale et non la consé quence directe d'un trauma cérébral spécifique (Sabo, 1997). À cet effet, Mesulam (2002) souligne que chez des individus « neurologiquement intacts », mais avec un faible degré d'intégration neuronale, il est possible d'observer la résurgence de tendances comportementales latentes 3 qui rappellent étrangement les conséquences d'une lésion frontale.…”

Propuesta de especificadores diagnósticos vinculados al estrés y el trauma : una aportación a la nosología psicopatológica

“…Sin afán de exhaustividad señalaremos que hay datos que indican la presencia de traumatismos en los trastornos disociativos (Gershimy y Thayer, 1999;Pérez y Galdón, 2003), los trastornos de personalidad, espedalmoite el limite (Sabo, 1997), la bulimia y otros trastornos alimentarios (Everyll y Waller, 1995;Everyll, Waller y MacDonald, 1995;Terr, 1995), los trastornos de ansiedad (Mancini, Van Ameringen y MacMillan, 1995), los trastornos del estado de animo (Hall, Sachs, Ráyeos y Lutenbacher, 1993), el alcoholismo (Windle, Windle, Scheidt y Miller, 1995) y muchos otros (véase para una revisión completa el texto de Everly y Latíng (1995).…”