Childhood Trauma as a Risk Factor for High Risk Behaviors in Adolescents with Borderline Personality Disorder
,
Abstract
Objective: Childhood trauma is associated with many major short-term and lifelong consequences, such as deterioration of mental health, higher frequency of affective dysregulation, changes in consciousness and attention, personality disorders, etc. Therefore, this study aims to examine childhood trauma as a possible factor in the incidence of high risk behaviors in adolescents with borderline personality disorder (BPD).
Method: 120 individuals aged 12-18 years were selected based on purposive sampling and included in the research group (including 60 BPD adolescents and 60 non-BPD adolescents). After receiving ethical approval from official institutions, data was collected from the participants through demographic, childhood trauma, sexual addiction screening, eating attitudes, RAFFT, and suicidal behavior questionnaires. The collected data was analyzed using chi-square test, independent t-test, prevalence, odds ratio and correlation analyses using the SPSS V21.0 software.
Results: All adolescents with BPD had experienced some forms of psychotraumatic events in childhood. The BPD group experienced more traumatic events than the non-BPD group (P < 0.05). After controlling for gender, age and years of education, all differences remained significant. Furthermore, statistically significant correlations were found between the scores of the emotional abuse and eating disorders scales in the group of girls with BPD (r = 0.788, P < 0.01). Moderate correlations were discovered between emotional abuse and suicidal behaviors in boys with BPD (r = 0.641, P < 0.01). Moreover, it was found that the most significant factors in the formation of addictive behaviors among adolescents with BPD were emotional abuse (r = 0.527) and emotional neglect (r = 0.513, P < 0.05).
Conclusion: These findings reinforce the role of childhood trauma in the formation of BPD symptoms during adolescence. Successful detection of the earliest risk factors in the form of childhood trauma and its different forms can provide specific high risk behavior targets for early intervention.
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8. Porter C, Palmier-Claus J, Branitsky A, Mansell W, Warwick H, Varese F. Childhood adversity and borderline personality disorder: a meta-analysis. Acta Psychiatr Scand. 2020;141(1):6-20.
9. Perrotta G. Borderline personality disorder: Definition, differential diagnosis, clinical contexts, and therapeutic approaches. Annals of Psychiatry and Treatment. 2020;4(1):43-56.
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12. Khaleghi A, Mohammadi MR, Zandifar A, Ahmadi N, Alavi SS, Ahmadi A, et al. Epidemiology of psychiatric disorders in children and adolescents; in Tehran, 2017. Asian J Psychiatr. 2018;37:146-53.
13. Mendez-Miller M, Naccarato J, Radico JA. Borderline Personality Disorder. Am Fam Physician. 2022;105(2):156-61.
14. Cattane N, Rossi R, Lanfredi M, Cattaneo A. Borderline personality disorder and childhood trauma: exploring the affected biological systems and mechanisms. BMC Psychiatry. 2017;17(1):221.
15. Pohl S, Steuwe C, Mainz V, Driessen M, Beblo T. Borderline personality disorder and childhood trauma: Exploring the buffering role of self-compassion and self-esteem. J Clin Psychol. 2021;77(3):837-45.
16. Ball JS, Links PS. Borderline personality disorder and childhood trauma: evidence for a causal relationship. Curr Psychiatry Rep. 2009;11(1):63-8.
17. Zatti C, Rosa V, Barros A, Valdivia L, Calegaro VC, Freitas LH, et al. Childhood trauma and suicide attempt: A meta-analysis of longitudinal studies from the last decade. Psychiatry Res. 2017;256:353-8.
18. Barbosa LP, Quevedo L, da Silva Gdel G, Jansen K, Pinheiro RT, Branco J, et al. Childhood trauma and suicide risk in a sample of young individuals aged 14-35 years in southern Brazil. Child Abuse Negl. 2014;38(7):1191-6.
19. Bahk YC, Jang SK, Choi KH, Lee SH. The Relationship between Childhood Trauma and Suicidal Ideation: Role of Maltreatment and Potential Mediators. Psychiatry Investig. 2017;14(1):37-43.
20. O'Connor DB, Green JA, Ferguson E, O'Carroll RE, O'Connor RC. Effects of childhood trauma on cortisol levels in suicide attempters and ideators. Psychoneuroendocrinology. 2018;88:9-16.
21. Pourdehghan P, Mohammadi MR, Mostafavi SA, Khaleghi A, Ahmadi N. The Relationship of Parental Personality Disorders with Offspring Eating Disorders at Childhood and Adolescence Age. Child Psychiatry Hum Dev. 2022.
22. Simeon D, Nelson D, Elias R, Greenberg J, Hollander E. Relationship of personality to dissociation and childhood trauma in borderline personality disorder. CNS Spectr. 2003;8(10):755-62.
23. Sansone RA, Pole M, Dakroub H, Butler M. Childhood trauma, borderline personality symptomatology, and psychophysiological and pain disorders in adulthood. Psychosomatics. 2006;47(2):158-62.
24. Watson S, Chilton R, Fairchild H, Whewell P. Association between childhood trauma and dissociation among patients with borderline personality disorder. Aust N Z J Psychiatry. 2006;40(5):478-81.
25. Soloff PH, Lynch KG, Kelly TM. Childhood abuse as a risk factor for suicidal behavior in borderline personality disorder. J Pers Disord. 2002;16(3):201-14.
26. Wang L, An CX, Song M, Li N, Gao YY, Zhao XC, et al. Evaluation of childhood traumatic experience as a risk factor for alcohol use disorder in adulthood. BMC Psychiatry. 2020;20(1):15.
27. Liebschutz JM, Buchanan-Howland K, Chen CA, Frank DA, Richardson MA, Heeren TC, et al. Childhood Trauma Questionnaire (CTQ) correlations with prospective violence assessment in a longitudinal cohort. Psychol Assess. 2018;30(6):841-5.
28. Spinhoven P, Penninx BW, Hickendorff M, van Hemert AM, Bernstein DP, Elzinga BM. Childhood Trauma Questionnaire: factor structure, measurement invariance, and validity across emotional disorders. Psychol Assess. 2014;26(3):717-29.
29. Seegers JA. The prevalence of sexual addiction symptoms on the college campus. Sexual Addiction & Compulsivity. 2003;10(4):247-58.
30. Chumakov EM, Petrova NN, Kraus SW. Compulsive sexual behavior in HIV-infected men in a community based sample, Russia. Sexual Addiction & Compulsivity. 2019;26(1-2):164-75.
31. Chiba H, Nagamitsu S, Sakurai R, Mukai T, Shintou H, Koyanagi K, et al. Children's Eating Attitudes Test: Reliability and validation in Japanese adolescents. Eat Behav. 2016;23:120-5.
32. Dunn TM, Hawkins N, Gagliano S, Stoddard K. Individuals who self-identify as having "orthorexia nervosa" score in the clinical range on the Eating Attitudes Test-26. Eat Weight Disord. 2019;24(6):1025-30.
33. Rukavishnikov GV, Verbitskaya EV, Vekovischeva OY, Bobrovsky AV, Kibitov AO, Mazo GE. The association of obesity with eating disorders risk: online survey of a large cohort of Russian-speaking individuals seeking medical weight correction assistance. J Eat Disord. 2021;9(1):100.
34. Seksenbayev NZ, Inoue K, Moldagaliyev TM, Sarsembina ZZ, Altybayeva GK, Almagambetova AA, et al. Features Of Risk Behavior And Suicidal Ideation In Medical Students. Science & Healthcare. 2021;23(4): 138-46.
35. Bastiaens L, Francis G, Lewis K. The RAFFT as a screening tool for adolescent substance use disorders. Am J Addict. 2000;9(1):10-6.
36. Crow S, Eisenberg ME, Story M, Neumark-Sztainer D. Suicidal behavior in adolescents: relationship to weight status, weight control behaviors, and body dissatisfaction. Int J Eat Disord. 2008;41(1):82-7.
37. Sidhartha T, Jena S. Suicidal behaviors in adolescents. Indian J Pediatr. 2006;73(9):783-8.
38. Sheftall AH, Schoppe-Sullivan SJ, Bridge JA. Insecure attachment and suicidal behavior in adolescents. Crisis. 2014;35(6):426-30.
39. Itzhaky L, Galfalvy H, Keilp JG, Gratch I, Brodsky BS, Stanley BH. Stress Response in Suicide Attempters with Borderline Personality Disorder: The Role of Behavioral Problems in Childhood. Psychiatry. 2020;83(3):221-30.
40. Herpers PCM, Neumann JEC, Staal WG. Treatment Refractory Internalizing Behaviour Across Disorders: An Aetiological Model for Severe Emotion Dysregulation in Adolescence. Child Psychiatry Hum Dev. 2021;52(3):515-32.
41. Foxhall M, Hamilton-Giachritsis C, Button K. The link between rejection sensitivity and borderline personality disorder: A systematic review and meta-analysis. Br J Clin Psychol. 2019;58(3):289-326.
42. Battle CL, Shea MT, Johnson DM, Yen S, Zlotnick C, Zanarini MC, et al. Childhood maltreatment associated with adult personality disorders: findings from the Collaborative Longitudinal Personality Disorders Study. J Pers Disord. 2004;18(2):193-211.
43. Yen S, Shea MT, Battle CL, Johnson DM, Zlotnick C, Dolan-Sewell R, et al. Traumatic exposure and posttraumatic stress disorder in borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders: findings from the collaborative longitudinal personality disorders study. J Nerv Ment Dis. 2002;190(8):510-8.
44. Tomko RL, Trull TJ, Wood PK, Sher KJ. Characteristics of borderline personality disorder in a community sample: comorbidity, treatment utilization, and general functioning. J Pers Disord. 2014;28(5):734-50.
45. Bottaccioli AG, Bottaccioli F, Minelli A. Stress and the psyche-brain-immune network in psychiatric diseases based on psychoneuroendocrineimmunology: a concise review. Ann N Y Acad Sci. 2019;1437(1):31-42.
46. Munson KA, Janney CA, Goodwin K, Nagalla M. Cultural Representations of Borderline Personality Disorder. Front Sociol. 2022;7:832497.
47. Infurna MR, Fuchs A, Fischer-Waldschmidt G, Reichl C, Holz B, Resch F, et al. Parents' childhood experiences of bonding and parental psychopathology predict borderline personality disorder during adolescence in offspring. Psychiatry Res. 2016;246:373-8.
48. Geselowitz B, Whalen DJ, Tillman R, Barch DM, Luby JL, Vogel A. Preschool Age Predictors of Adolescent Borderline Personality Symptoms. J Am Acad Child Adolesc Psychiatry. 2021;60(5):612-22.
2. Surís JC, Michaud PA, Akre C, Sawyer SM. Health risk behaviors in adolescents with chronic conditions. Pediatrics. 2008;122(5):e1113-8.
3. Lyons-Ruth K, Brumariu LE, Bureau JF, Hennighausen K, Holmes B. Role Confusion and Disorientation in Young Adult-Parent Interaction Among Individuals With Borderline Symptomatology. J Pers Disord. 2015;29(5):641-62.
4. Reising K, Farrington DP, Ttofi MM, Piquero AR, Coid JW. Childhood risk factors for personality disorder symptoms related to violence. Aggress Violent Behav. 2019;49:101315.
5. Frewen P, Zhu J, Lanius R. Lifetime traumatic stressors and adverse childhood experiences uniquely predict concurrent PTSD, complex PTSD, and dissociative subtype of PTSD symptoms whereas recent adult non-traumatic stressors do not: results from an online survey study. Eur J Psychotraumatol. 2019;10(1):1606625.
6. Mohammadi MR, Hojjat SK, Mostafavi SA, Khaleghi A, Hooshyari Z, Ahmadi N, et al. Parents' Personality Disorders as Predictor of Substance Use Disorder in Children and Adolescents. Arch Iran Med. 2021;24(6):478-86.
7. Chanen AM, Nicol K, Betts JK, Thompson KN. Diagnosis and Treatment of Borderline Personality Disorder in Young People. Curr Psychiatry Rep. 2020;22(5):25.
8. Porter C, Palmier-Claus J, Branitsky A, Mansell W, Warwick H, Varese F. Childhood adversity and borderline personality disorder: a meta-analysis. Acta Psychiatr Scand. 2020;141(1):6-20.
9. Perrotta G. Borderline personality disorder: Definition, differential diagnosis, clinical contexts, and therapeutic approaches. Annals of Psychiatry and Treatment. 2020;4(1):43-56.
10. Mohammadi MR, Pourdehghan P, Mostafavi S-A, Hooshyari Z, Alavi SS, Khaleghi A, et al. Personality Disorders and Unhealthy Lifestyle: A Cross-Sectional Study. Acta Med Iran. 2021;59(3):161-8.
11. Mohammadi MR, Ahmadi N, Khaleghi A, Mostafavi SA, Kamali K, Rahgozar M, et al. Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents. Iran J Psychiatry. 2019;14(1):1-15.
12. Khaleghi A, Mohammadi MR, Zandifar A, Ahmadi N, Alavi SS, Ahmadi A, et al. Epidemiology of psychiatric disorders in children and adolescents; in Tehran, 2017. Asian J Psychiatr. 2018;37:146-53.
13. Mendez-Miller M, Naccarato J, Radico JA. Borderline Personality Disorder. Am Fam Physician. 2022;105(2):156-61.
14. Cattane N, Rossi R, Lanfredi M, Cattaneo A. Borderline personality disorder and childhood trauma: exploring the affected biological systems and mechanisms. BMC Psychiatry. 2017;17(1):221.
15. Pohl S, Steuwe C, Mainz V, Driessen M, Beblo T. Borderline personality disorder and childhood trauma: Exploring the buffering role of self-compassion and self-esteem. J Clin Psychol. 2021;77(3):837-45.
16. Ball JS, Links PS. Borderline personality disorder and childhood trauma: evidence for a causal relationship. Curr Psychiatry Rep. 2009;11(1):63-8.
17. Zatti C, Rosa V, Barros A, Valdivia L, Calegaro VC, Freitas LH, et al. Childhood trauma and suicide attempt: A meta-analysis of longitudinal studies from the last decade. Psychiatry Res. 2017;256:353-8.
18. Barbosa LP, Quevedo L, da Silva Gdel G, Jansen K, Pinheiro RT, Branco J, et al. Childhood trauma and suicide risk in a sample of young individuals aged 14-35 years in southern Brazil. Child Abuse Negl. 2014;38(7):1191-6.
19. Bahk YC, Jang SK, Choi KH, Lee SH. The Relationship between Childhood Trauma and Suicidal Ideation: Role of Maltreatment and Potential Mediators. Psychiatry Investig. 2017;14(1):37-43.
20. O'Connor DB, Green JA, Ferguson E, O'Carroll RE, O'Connor RC. Effects of childhood trauma on cortisol levels in suicide attempters and ideators. Psychoneuroendocrinology. 2018;88:9-16.
21. Pourdehghan P, Mohammadi MR, Mostafavi SA, Khaleghi A, Ahmadi N. The Relationship of Parental Personality Disorders with Offspring Eating Disorders at Childhood and Adolescence Age. Child Psychiatry Hum Dev. 2022.
22. Simeon D, Nelson D, Elias R, Greenberg J, Hollander E. Relationship of personality to dissociation and childhood trauma in borderline personality disorder. CNS Spectr. 2003;8(10):755-62.
23. Sansone RA, Pole M, Dakroub H, Butler M. Childhood trauma, borderline personality symptomatology, and psychophysiological and pain disorders in adulthood. Psychosomatics. 2006;47(2):158-62.
24. Watson S, Chilton R, Fairchild H, Whewell P. Association between childhood trauma and dissociation among patients with borderline personality disorder. Aust N Z J Psychiatry. 2006;40(5):478-81.
25. Soloff PH, Lynch KG, Kelly TM. Childhood abuse as a risk factor for suicidal behavior in borderline personality disorder. J Pers Disord. 2002;16(3):201-14.
26. Wang L, An CX, Song M, Li N, Gao YY, Zhao XC, et al. Evaluation of childhood traumatic experience as a risk factor for alcohol use disorder in adulthood. BMC Psychiatry. 2020;20(1):15.
27. Liebschutz JM, Buchanan-Howland K, Chen CA, Frank DA, Richardson MA, Heeren TC, et al. Childhood Trauma Questionnaire (CTQ) correlations with prospective violence assessment in a longitudinal cohort. Psychol Assess. 2018;30(6):841-5.
28. Spinhoven P, Penninx BW, Hickendorff M, van Hemert AM, Bernstein DP, Elzinga BM. Childhood Trauma Questionnaire: factor structure, measurement invariance, and validity across emotional disorders. Psychol Assess. 2014;26(3):717-29.
29. Seegers JA. The prevalence of sexual addiction symptoms on the college campus. Sexual Addiction & Compulsivity. 2003;10(4):247-58.
30. Chumakov EM, Petrova NN, Kraus SW. Compulsive sexual behavior in HIV-infected men in a community based sample, Russia. Sexual Addiction & Compulsivity. 2019;26(1-2):164-75.
31. Chiba H, Nagamitsu S, Sakurai R, Mukai T, Shintou H, Koyanagi K, et al. Children's Eating Attitudes Test: Reliability and validation in Japanese adolescents. Eat Behav. 2016;23:120-5.
32. Dunn TM, Hawkins N, Gagliano S, Stoddard K. Individuals who self-identify as having "orthorexia nervosa" score in the clinical range on the Eating Attitudes Test-26. Eat Weight Disord. 2019;24(6):1025-30.
33. Rukavishnikov GV, Verbitskaya EV, Vekovischeva OY, Bobrovsky AV, Kibitov AO, Mazo GE. The association of obesity with eating disorders risk: online survey of a large cohort of Russian-speaking individuals seeking medical weight correction assistance. J Eat Disord. 2021;9(1):100.
34. Seksenbayev NZ, Inoue K, Moldagaliyev TM, Sarsembina ZZ, Altybayeva GK, Almagambetova AA, et al. Features Of Risk Behavior And Suicidal Ideation In Medical Students. Science & Healthcare. 2021;23(4): 138-46.
35. Bastiaens L, Francis G, Lewis K. The RAFFT as a screening tool for adolescent substance use disorders. Am J Addict. 2000;9(1):10-6.
36. Crow S, Eisenberg ME, Story M, Neumark-Sztainer D. Suicidal behavior in adolescents: relationship to weight status, weight control behaviors, and body dissatisfaction. Int J Eat Disord. 2008;41(1):82-7.
37. Sidhartha T, Jena S. Suicidal behaviors in adolescents. Indian J Pediatr. 2006;73(9):783-8.
38. Sheftall AH, Schoppe-Sullivan SJ, Bridge JA. Insecure attachment and suicidal behavior in adolescents. Crisis. 2014;35(6):426-30.
39. Itzhaky L, Galfalvy H, Keilp JG, Gratch I, Brodsky BS, Stanley BH. Stress Response in Suicide Attempters with Borderline Personality Disorder: The Role of Behavioral Problems in Childhood. Psychiatry. 2020;83(3):221-30.
40. Herpers PCM, Neumann JEC, Staal WG. Treatment Refractory Internalizing Behaviour Across Disorders: An Aetiological Model for Severe Emotion Dysregulation in Adolescence. Child Psychiatry Hum Dev. 2021;52(3):515-32.
41. Foxhall M, Hamilton-Giachritsis C, Button K. The link between rejection sensitivity and borderline personality disorder: A systematic review and meta-analysis. Br J Clin Psychol. 2019;58(3):289-326.
42. Battle CL, Shea MT, Johnson DM, Yen S, Zlotnick C, Zanarini MC, et al. Childhood maltreatment associated with adult personality disorders: findings from the Collaborative Longitudinal Personality Disorders Study. J Pers Disord. 2004;18(2):193-211.
43. Yen S, Shea MT, Battle CL, Johnson DM, Zlotnick C, Dolan-Sewell R, et al. Traumatic exposure and posttraumatic stress disorder in borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders: findings from the collaborative longitudinal personality disorders study. J Nerv Ment Dis. 2002;190(8):510-8.
44. Tomko RL, Trull TJ, Wood PK, Sher KJ. Characteristics of borderline personality disorder in a community sample: comorbidity, treatment utilization, and general functioning. J Pers Disord. 2014;28(5):734-50.
45. Bottaccioli AG, Bottaccioli F, Minelli A. Stress and the psyche-brain-immune network in psychiatric diseases based on psychoneuroendocrineimmunology: a concise review. Ann N Y Acad Sci. 2019;1437(1):31-42.
46. Munson KA, Janney CA, Goodwin K, Nagalla M. Cultural Representations of Borderline Personality Disorder. Front Sociol. 2022;7:832497.
47. Infurna MR, Fuchs A, Fischer-Waldschmidt G, Reichl C, Holz B, Resch F, et al. Parents' childhood experiences of bonding and parental psychopathology predict borderline personality disorder during adolescence in offspring. Psychiatry Res. 2016;246:373-8.
48. Geselowitz B, Whalen DJ, Tillman R, Barch DM, Luby JL, Vogel A. Preschool Age Predictors of Adolescent Borderline Personality Symptoms. J Am Acad Child Adolesc Psychiatry. 2021;60(5):612-22.
| Files | ||
| Issue | Vol 18 No 1 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v18i1.11414 | |
| Keywords | ||
| Adolescent Borderline Personality Disorder Health Risk Behaviors Psychological Trauma | ||
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How to Cite
1.
Zashchirinskaia O, Isagulova E. Childhood Trauma as a Risk Factor for High Risk Behaviors in Adolescents with Borderline Personality Disorder. Iran J Psychiatry. 2022;18(1):65-71.
