The Role of Incest in Developmental Theory and Treatment of Women Diagnosed with Borderline Personality Disorder

The incidence of incest in the histories of women diagnosed with borderline personality disorder (BPD) has been noted recently by a number of clinicians (e.g., Barnard & Hirsch, 1985; Herman, Perry, & van der Kolk, 1989). However, the experience of child sexual abuse is virtually ignored in the developmental theory of the borderline syndrome. This paper presents a critical review of theoretical and clinical literature on child sexual abuse and BPD to explore three major goals: to describe the overlapping clinical picture of adult female survivors of incest and of women diagnosed with BPD, to examine the ways in which mother-blaming in psychoanalytic thought has contributed to the neglect of this experience in borderline clients, and to integrate treatment strategies from the child sexual abuse literature, traditional object relations theory, and feminist clinical theory.     

Childhood Emotional Abuse and Young Adulthood Dating Violence: The Moderating Role of Stress Reactivity

Dating violence has been linked to past experiences of childhood emotional abuse; however, little research has explored how stress reactivity functions within interpersonal relationships to amplify or attenuate these associations. The present study investigated the moderating effects of cortisol stress reactivity on associations between retrospective self-reported childhood emotional abuse and later self-reported interpersonal violence in young adult dating relationships. The current sample consisted of 57 young adult heterosexual dating partners (46 females, 11 males) between the ages of 18 and 24. Salivary cortisol samples were collected before and after a stress task to measure stress reactivity. Moderation analyses were conducted through the PROCESS macro in SPSS version 22. The relation between childhood emotional abuse and dating violence varied depending on cortisol reactivity, such that the association between childhood emotional abuse and young adult dating violence was stronger for those who demonstrated low levels of cortisol reactivity. The association between childhood emotional abuse and dating violence was not significant for those who demonstrated high cortisol reactivity. Findings underscore the importance of studying physiological mechanisms that may confer risk in the relationship between child emotional abuse and later interpersonal consequences.     

A Developmental Psychopathology and Neurobiological Model of Borderline Personality Disorder in Adolescence

The antecedents and risk factors and for developing borderline personality disorder (BPD) are now well documented, but there is a paucity of developmental models to understand the key processes through which they impact on the development of BPD in adolescents. In this article, we present a developmental psychopathology model of BPD in adolescence and link the difficulties adolescents with BPD have with impulsivity and self regulation, with risk factors such as genetic vulnerability, parenting and trauma. We propose a number of psychological processes through which these risk factors undermine personal and interpersonal functioning, and makes it particularly difficult to engage with the challenges of adolescence. These key psychological processes undermine the integration of the self, with extreme unintegrated affects and extreme representations of self and others, undermining the capacity to mentalize. We then make links to possible neurobiological underpinnings of the disturbances in affect, Theory of Mind and interpersonal difficulties in adolescents with BPD.     

A systematic review of the evidence-based psychosocial risk factors for understanding of borderline personality disorder

Borderline personality disorder (BPD) is a serious personality disorder characterized by affective instability, impulsivity and interpersonal disturbance. Currently, intensive research is being conducted concerning the aetiology of BPD, including research on neurobiological, temperamental, psychosocial and cultural risk factors. This study focuses on psychosocial risk factors while other risk factors are taken into account in the discussion of the development of BPD. To our knowledge, no systematic review of the evidence-based medicine literature concerning this theme has been made thus far. However, understanding psychosocial risk factors of BPD is important in order to develop psychotherapeutic treatment models and methods. We provide a systematic review of the literature focusing on psychosocial risk factors for BPD. Utilizing this knowledge, we discuss how these data may be used when studying the development of borderline personality disorder and the treatment of borderline personality disorder.     

The role of pornography in the etiology of sexual aggression

Despite the public and scientific attention the topic has received, the evidence for a causal link between pornography use and sexual offending remains equivocal. This article critically examines the research literature on the association of pornography and sexual offending, focusing on relevant experimental work. The difficulty of this research is highlighted in a discussion of operational definitions of the term pornography, the choice of proxy measures for sexual offending in experimental research, and the emphasis given sexual assault of adult females over other kinds of criminal sexual behavior such as child molestation, exhibitionism, and voyeurism. We also review the major theoretical perspectives conditioning, excitation transfer, feminist, and social learning—and some of the hypotheses that can be derived from them. From the existing evidence, we argue that individuals who are already predisposed to sexually offend are the most likely to show an effect of pornography exposure and are the most likely to show the strongest effects. Men who are not predisposed are unlikely to show an effect; if there actually is an effect, it is likely to be transient because these men would not normally seek violent pornography. Finally, we present a Darwinian perspective on the possible relationship between pornography use and sexual aggression.     

Temperament and Psychopathy: A Dual-Pathway Model

ABSTRACT— The concept of psychopathy refers to a pattern of chronic antisocial behavior and personality features, such as emotional detachment, lovelessness, and guiltlessness, attributable in part to a temperament deficit. Historically, that deficit has been seen as a low reactivity to fear, but recent research has documented a second temperament deficit in adults that involves poor emotional and behavioral control. Both pathways are found in the child psychopathology literature, pointing to multifactorial developmental pathways from childhood to adult psychopathy.     

Borderline personality disorder features and cognitive,emotional, and predicted behavioral reactions to teasing

Borderline personality disorder (BPD) involves interpersonal dysfunction. It is unknown to what extent these problems are due to perceptual biases, emotional reactivity, or impulsivity above and beyond emotional reactions. The present study experimentally tested these mechanisms in the context of predicted reactions to teasing. Participants completed the Personality Assessment Inventory-Borderline Features scale [PAI-BOR; Morey, L. C. (1991). Personality assessment inventory: Professional manual. Odessa, FL: Psychological Assessment Resources], and the Rejection Sensitivity Questionnaire [Downey, G., & Feldman, S. I. (1996). Implications of rejection sensitivity for intimate relationships. Journal of Personality and Social Psychology, 70(6), 1327–1343], and imagined a scenario that involved teasing. Participants rated the teaser and their own predicted emotional and behavioral reactions. Analysis of Covariance results indicated that individuals who endorsed more BPD features showed elevated emotional reactions and predicted behavioral reactions to teasing, but not perceptual biases. Ratings of predicted behavioral responses could be accounted for by emotional responses, supporting the emotional reactivity perspectives of BPD [Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford].     

Affect Dysregulation in Individuals With Borderline Personality Disorder: Persistence and Interpersonal Triggers

We hypothesized that affect dysregulation among individuals with borderline personality disorder (BPD) would involve greater persistence of negative affect between interpersonal events and heightened reactivity to stimuli indicating risk of rejection or disapproval, specifically perceptions of others’ communal (agreeable-quarrelsome) behaviors. A total of 38 participants with BPD and 31 controls collected information about affect and perceptions of the interaction partner's behavior during interpersonal events for a 20-day period. Negative and positive affect persisted more across interpersonal events for individuals with BPD than for controls. In addition, individuals with BPD reported a greater increase in negative affect when they perceived less communal behavior and a smaller increase in positive affect when they perceived more communal behavior in others. Findings indicate the importance of interpersonal perceptions in the affect dysregulation of individuals with BPD.     

Affect dysregulation in individuals with borderline personality disorder: persistence and interpersonal triggers

We hypothesized that affect dysregulation among individuals with borderline personality disorder (BPD) would involve greater persistence of negative affect between interpersonal events and heightened reactivity to stimuli indicating risk of rejection or disapproval, specifically perceptions of others' communal (agreeable-quarrelsome) behaviors. A total of 38 participants with BPD and 31 controls collected information about affect and perceptions of the interaction partner's behavior during interpersonal events for a 20-day period. Negative and positive affect persisted more across interpersonal events for individuals with BPD than for controls. In addition, individuals with BPD reported a greater increase in negative affect when they perceived less communal behavior and a smaller increase in positive affect when they perceived more communal behavior in others. Findings indicate the importance of interpersonal perceptions in the affect dysregulation of individuals with BPD.     

Dynamics of identity development and separation–individuation in parent–child relationships during adolescence and emerging adulthood – A conceptual integration

Identity development and separation–individuation in parent–child relationships are widely perceived as related tasks of psychosocial maturation. However, a dynamic, developmental perspective that explains how intra-personal change in identity evolves from transactions between parents and children is not sufficiently represented in the literature. In this article, a selective literature review of psychological approaches to identity development and separation–individuation is presented with a focus on how the role of parents has been covered by approaches to identity development and on how general mechanisms of identity change could be filled with content by processes of separation–individuation. Afterwards, dynamics of identity development and separation–individuation are integrated based on the conceptualization of parents and children as two interrelated identity systems. Specifically, it is illustrated how interpersonal differences in long-term related changes in identity formation, identity evaluation, autonomy, and separateness and attachment between parents and children, could be explained by parent–child transactions in the transition between childhood and adolescence and between adolescence and emerging adulthood. Finally, implications of an integrative perspective for future empirical research are discussed.     

The impact of parental borderline personality disorder on vulnerability to depression in children of affectively ill parents

Children of parents with major depressive disorder (MDD) are four to six times more likely than other children to develop MDD. Little research has examined whether comorbid parental diagnoses further increase children's risk. This study examines whether children of parents with comorbid MDD and Borderline Personality Disorder (BPD) (1) are at greater risk for experiencing depressive symptoms and/or episodes and (2) whether such increased risk may be due, in part, to their exhibiting higher levels of cognitive/interpersonal vulnerability factors. Children (n = 140; ages 6-14) of parents with MDD completed measures assessing cognitive/interpersonal vulnerability factors. Parents completed semi-structured clinical interviews assessing severity of current depressive symptoms and BPD. Both children and parents completed a semi-structured clinical interview assessing the child's current and past history of MDD. Children of parents with comorbid MDD and BPD exhibited higher levels of current depressive symptoms and higher levels of cognitive/interpersonal vulnerability factors than children of parents with MDD but no BPD, even after controlling for parents' current levels of depressive symptoms. The relationship between parental BPD and chil-dren's current levels of depressive symptoms was partially mediated by children's cognitive/interpersonal vulnerability factors. Last, children of parents with comorbid BPD and MDD were 6.84 times more likely to exhibit a current or past diagnosis of MDD.     

Adolescent Disruptive Behavior and Borderline Personality Disorder Symptoms in Young Adult Men

Very few studies have prospective information, especially regarding males, on the prediction of Borderline Personality Disorder (BPD) in adulthood from psychiatric disorders in childhood. Certain childhood disorders, however, have notably similar features in common with BPD. In particular, the affective dysfunction, hostility and interpersonal conflict of Oppositional Defiant Disorder (ODD) and the impulsivity of Attention Deficit Hyperactivity Disorder (ADHD) in particular may be indicative of an early developmental path towards BPD. The present study uses longitudinal data from a clinical sample of 177 boys, initially between the ages of 7 and 12, who were followed up annually to age 18, and who were reassessed at age 24 (n = 142). The study examines the prediction from repeated childhood measures of psychopathology measured annually through adolescence to BPD symptoms assessed at age 24, accounting for the effects of covariates including substance use, other personality disorders at age 24 and harsh physical punishment. The prevalence of BPD in this sample was consistent with other population estimates. Attention Deficit Hyperactivity Disorder (ADHD) and ODD were the only child psychiatric disorders to predict BPD symptoms, and the oppositional behavioral dimension of ODD was particularly predictive of BPD. These results indicate possible developmental links between early psychiatric disorders and BPD.     

Associations in the course of personality disorders and Axis I disorders over time

In this study, the authors examined time-varying associations between schizotypal (STPD), borderline (BPD), avoidant (AVPD), or obsessive-compulsive (OCPD) personality disorders and co-occurring Axis I disorders in 544 adult participants from the Collaborative Longitudinal Personality Disorders Study. The authors tested predictions of specific longitudinal associations derived from a model of crosscutting psychobiological dimensions (L. J. Siever & K. L. Davis, 1991) with participants with the relevant Axis I disorders. The authors assessed participants at baseline and at 6-, 12-, and 24-month follow-up evaluations. BPD showed significant longitudinal associations with major depressive disorder and posttraumatic stress disorder. AVPD was significantly associated with anxiety disorders (specifically social phobia and obsessive-compulsive disorder). Two of the four personality disorders under examination (STPD and OCPD) showed little or no association with Axis I disorders.     

Retrospective treatment of incest victims: suggested analytic attitudes.

This paper includes a brief consideration of literature relevant to childhood sexual abuse detection and prevalence. That literature indicates that such detection may be difficult and that the occurrence of childhood sexual abuse is widespread. These findings, as well as a consideration of literature relevant to trauma, stress, and the identification of survivors of sexual abuse, suggest an analytic attitude of receptivity to the hypothesis of the event of sexual abuse as well as the fantasy of sexual abuse. A second analytic attitude suggested concerns diagnosis. Childhood trauma is implicated in the development of BPD, as the majority of borderline patients have experienced the trauma of child abuse. Further, trauma can lead to dissociation as a defense against stress, and multiple personality disorder is an extreme example of dissociation. The analytic attitude suggested here is that the diagnosis of BPD or MPD may be a necessary but not a sufficient explanation when the symptomatology is a defensive reaction to the traumatic event of childhood sexual abuse. Lastly, it is suggested that the abuse may need to be central to the treatment in analytic work with sexually abused victims. This is suggested in light of the importance of recovery and integration of traumatic memories with their associated affects.     

An analogue investigation of the relationships among perceived parental criticism, negative affect, and borderline personality disorder features: the role of thought suppression

The current study examined the relationships among biological predisposition, social environment, emotion regulation, and features characteristic of Borderline Personality Disorder (BPD). Using an analogue sample, we examined whether thought suppression mediated the relationship of negative affective intensity/reactivity and perceived parental criticism with a composite of BPD features including impulsivity, interpersonal sensitivity, and aggression. Results indicated that thought suppression fully mediated the relationship between negative affect intensity/reactivity and BPD features and partially mediated the relationship between BPD features and perceived parental criticism. Clinical implications, directions for further research, and limitations of the present study are discussed.     

Developing Together: Parents Meeting Children��s Developmental Imperatives

It is well known that the parent influences the child, but few realize how much the child changes the adult. This paper reports research that explored how adults change when they learn to nurture their child??s developmental needs. It also explores how empathy with the child impacts an adult??s ability to move through his or her own unresolved childhood issues into new meaning and relationships. Using qualitative methods and quantitative measures, the research captures perspectives of 20 parents about their own development from using child development principles. Analysis resulted in the identification of five themes: (a) cognitive development in perspective, differentiation from past ways, and new meaning-making; (b) emotional development of trust, empathy, and affective complexity; (c) personal agency of intentional effort and use of critical self-inquiry; (d) adult well-being; and (e) emergence of wisdom. More research is needed to determine the association between child development competence and adult development.     

A Developmental Neuroscience of Borderline Pathology: Emotion Dysregulation and Social Baseline Theory

Theoretical and empirical research has linked poor emotion regulation abilities with dysfunctional frontolimbic circuitry. Consistent with this, research on borderline personality disorder (BPD) finds that frontolimbic dysfunction is a predominant neural substrate underlying the disorder. Emotion regulation is profoundly compromised in BPD. However, BPD is also associated with broad impairment across multiple domains, including impulse control, interpersonal relationships, and cognitive functioning. To date, BPD research has focused largely on single areas of dysfunction, failing to account for overlap at either the biological or behavioral levels of analysis. We examine the literature on frontolimbic dysfunction in BPD within the context of Coan’s social baseline theory. Social baseline theory proposes that healthy human functioning is dependent upon adequate social support and that, at baseline, biological systems are adapted to operate interdependently rather than independently. The social baseline perspective is particularly useful for understanding borderline personality development because the impulsive and emotionally dysregulated behaviors common among those with BPD occur almost invariably within an interpersonal context. We discuss clinical and research implications of this work.     

Is the child ‘father of the Man’? Evaluating the stability of genetic influences across development

This selective review considers findings in genetic research that have shed light on how genes operate across development. We will address the question of whether the child is ‘father of the Man’ from a genetic perspective. In other words, do the same genetic influences affect the same traits across development? Using a ‘taster menu’ approach and prioritizing newer findings on cognitive and behavioral traits, examples from the following genetic disciplines will be discussed: (a) developmental quantitative genetics (such as longitudinal twin studies), (b) neurodevelopmental genetic syndromes with known genetic causes (such as Williams syndrome), (c) developmental candidate gene studies (such as those that link infant and adult populations), (d) developmental genome‐wide association studies (GWAS), and (e) DNA resequencing. Evidence presented here suggests that there is considerable genetic stability of cognitive and behavioral traits across development, but there is also evidence for genetic change. Quantitative genetic studies have a long history of assessing genetic continuity and change across development. It is now time for the newer, more technology‐enabled fields such as GWAS and DNA resequencing also to take on board the dynamic nature of human behavior.     

Trajectories of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms as Precursors of Borderline Personality Disorder Symptoms in Adolescent Girls

Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD share clinical features of impulsivity, poor self-regulation, and executive dysfunction, while ODD and BPD share features of anger and interpersonal turmoil. The study is based on annual, longitudinal data from the two oldest cohorts in the Pittsburgh Girls Study (N = 1,233). We used piecewise latent growth curve models of ADHD and ODD scores from age 8 to 10 and 10 to 13 years to examine the prospective associations between dual trajectories of ADHD and ODD symptom severity and later BPD symptoms at age 14 in girls. To examine the specificity of these associations, we also included conduct disorder and depression symptom severity at age 14 as additional outcomes. We found that higher levels of ADHD and ODD scores at age 8 uniquely predicted BPD symptoms at age 14. Additionally, the rate of growth in ADHD scores from age 10 to 13 and the rate of growth in ODD scores from 8 to 10 uniquely predicted higher BPD symptoms at age 14. This study adds to the literature on the early development of BPD by providing the first longitudinal study to examine ADHD and ODD symptom trajectories as specific childhood precursors of BPD symptoms in adolescent girls.