Childhood sexual abuse in adult patients with borderline personality disorder

Abstract

Background:Researchers have found elevated rates of childhood sexual abuse (CSA) in borderline personality disorder (BPD) patients. They have also implicated the role of CSA later in BPD. However, there has been a scarcity of studies regarding this in Indian population.Objectives:To profile the occurrence of CSA and its parameters in BPD patients and to document symptomatology of BPD associated with CSA.Materials and Methods:Thirty-six consecutive patients with BPD were administered with a two-staged semi-structured interview by different interviewers with the first stage for collecting sociodemographic details and confirming BPD diagnosis and the second stage for collecting information about CSA.Results:Of 36 BPD patients, 16 (44.44%) reported a history of definite CSA. The majority of CSA associated with BPD were having characteristics of onset at 7–12 years, <10 occasions of abuse, perpetrator being a close relative or a close acquaintance and genital type of CSA. Identity disturbances (P = 0.0354), recurrent suicidal/self-harm behavior (P = 0.0177), and stress-related paranoid/dissociative symptoms (P = 0.0177) were significantly associated with the presence of CSA while unstable interpersonal relationships (P = 0.001) were significantly associated with the absence of CSA.Conclusion:Significant proportion of BPD patients reported CSA. The specific symptom profile of BPD patients can be used to predict the presence of CSA in these patients, which has a direct implication in the treatment of these patients.

Mixed‐methods evaluation of an educational intervention to change mental health nurses' attitudes to people diagnosed with borderline personality disorder

“…For some, the idea that BPD might have an underlying biological and genetic basis came as a surprise. It is our experience from the UK-service setting that BPD is largely understood within a psychological trauma-informed paradigm in which it is seen as inherently linked with adverse childhood experiences including childhood sexual abuse (Menon, Chaudhari, Saldanha, Devabhaktuni, & Bhattacharya, 2016), severe neglect, attachment ruptures, overprotection and invalidating environments (Mosquera, Gonzalez, & Leeds, 2014 BPD-diagnosed individuals seem to feel is required actually improve care, or is it an impossible demand whose purpose is largely to shift responsibility for changing practice onto "the system"? Some nurses appeared resistant to change from the outset, maintaining an adverse attitude towards BPD-diagnosed patients which led to frustration when the training did not validate that.…”

Late manifestation of borderline personality disorder: Characterization of an under‐recognized phenomenon

“…This includes childhood emotional trauma and/or neglect (Porter et al, 2020) and sexual trauma (Porter et al, 2020;Zanarini et al, 2002). In fact, the proportion of study participants who had experienced childhood sexual trauma is at the upper end of the previously reported range (Menon et al, 2016;Merza et al, 2015;Porter et al, 2020;Zanarini et al, 2002). Given the lack of a comparison group in the present study, it is unclear whether this is characteristic of late manifestation BPD or simply a reflection of this study population.…”

“…Meeting a past perpetrator, revealing childhood sexual trauma to a therapist or family for the first time, and recent sexual assault were recorded as precipitating factors for approximately a third of participants. The well documented association between BPD and sexual trauma (Menon et al, 2016;Ogata et al, 1990;Zanarini et al, 2002) raises an important diagnostic question regarding the association between BPD and complex PTSD, and whether this study cohort may embody the latter with delayed-manifestation of PTSD symptoms, especially given the high proportion of PTSD symptoms noted in this group.…”

Personality Disorders in Adult Female Child Sexual Abuse Survivors: Dimensions of Personality Pathology and Characteristics of Abuse

“…, which all constitute symptoms observable in PDs. In fact, some studies also documented the link between the aforementioned CSA features and the development of borderline personality disorder (BPD; Menon et al, 2016;Ogata et al, 1990).…”

“…Second, there is no consensus on whether CSA could increase the likelihood of any type of PD or whether this pattern refers to selected PDs. So far, most attention has been given to BPD (e.g., Elzy, 2011;Menon et al, 2016;Ogata et al, 1990). Nonetheless, there are studies (e.g., Bernstein et al, 1998;Lobbestael et al, 2010), which suggested that CSA might not be associated with any specific PD, but with many or even any type of them.…”