Borderline personality disorder in youth: The prospective impact of child abuse on non-suicidal self-injury and suicidality

Abstract

Background Borderline personality disorder (BPD) is characterized by greater engagement in non-suicidal self-injury (NSSI) and suicidality. The aim of the study is to test whether the occurrence of child abuse contributes to these high-risk behaviors in BPD youth. Materials and methods BPD female youth aged 13–21 years with (n = 29) and without (n = 29) a history of child abuse were administered clinical interviews assessing diagnostic history, child abuse, NSSI and suicidality (i.e., ideation, plans, and attempts). NSSI and suicidality were subsequently reevaluated at the 1- and 2-month follow-up assessments. Results Several findings emerged. First, relative to BPD youth without abuse, the abuse group reported greater past NSSI; however, no significant differences emerged in the follow-up period. Second, the occurrence of child abuse was associated with a 5-fold increase in the rate of lifetime suicide attempts relative to the no abuse group and additionally, prospectively predicted suicide ideation (but not attempts). Last, exploratory analyses indicated that the co-occurrence of physical and sexual abuse was associated with greater past NSSI and suicidality as compared to the no abuse and sexual abuse only participants. Conclusion As a whole, child abuse – particularly co-occurring physical and sexual abuse – increases risk for NSSI and suicidality among BPD youth, which may have important treatment implications in this high-risk population.

Association of Childhood Maltreatment With Suicide Behaviors Among Young People

“…However, an additional 328 studies were excluded because they did not meet the inclusion criteria for this review. This process left 79 individual studies eligible for inclusion 24 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 ,…”

“…Sexual abuse was associated with 2.5-fold increased odds for suicide ideation (33 studies 35 , 36 , 38 , 41 , 42 , 45 , 46 , 48 , 49 , 50 , 51 , 53 , 55 , 61 , 65 , 67 , 69 , 76 , 77 , 78 , 83 , 85 , 92 , 93 , 94 , 95 , 101 , 103 , 104 , 106 , 107 , 109 , 110 ; OR, 2.46; 95% CI, 2.08-2.90; I 2 = 94.6%), and heterogeneity was high. Physical abuse (23 studies 35 , 45 , 46 , 48 , 51 , 55 , 64 , 67 , 69 , 70 , 71 , 78 , 83 , 85 , 91 , 92 , 93 , 95 , 98 , 103 , 104 , 107 , 109 ; OR, 1.95; 95% CI, 1.67-2.27; I 2 = 81.9%), emotional abuse (7 studies 35…”

The Relationship between Childhood Maltreatment and Non-Suicidal Self-Injury: A Systematic Review

“…Overall, three studies [all of moderate quality (mean quality score 6.3)] prospectively investigated the association between CM and NSSI. Kaplan and colleagues ( 33 ) reported that abused individuals were at increased risk of NSSI at baseline. Isohookana and colleagues ( 13 ) found, in their study with 508 adolescent inpatients, that maltreatment, and specifically sexual abuse, was associated with an increased risk of NSSI and suicide attempts, although only in females.…”

Childhood Adversity and Psychophysiological Reactivity to Pain in Adolescent Nonsuicidal Self-Injury

“…Among nonpsychiatric college students, the majority (about 79%) of those engaging in NSSI report childhood abuse or neglect [8]. While longitudinal studies have partly confirmed an association between childhood adversity and NSSI [9][10][11], the exact pathways between childhood adversity and NSSI remain unclear [12][13][14]. Some studies have reported on related risk factors explaining the association (e.g., increased risk of anxiety disorders and assault victimization [13] or poor family functioning [12]), whereas others provided evidence for a direct association between childhood abuse and NSSI [14].…”