Risk Factors Associated with the Dissociative Experiences of Borderline Patients

Abstract

The objective of this study was to identify the risk factors associated with the dissociative symptomatology of borderline patients. The Dissociative Experiences Scale--a 28-item self-report measure that has well documented reliability and validity--was administered to 290 criteria-defined borderline patients and 72 axis II comparison subjects. Semistructured interviews pertaining to difficult childhood experiences and adult experiences of being a victim of violence were administered to these patients blind to diagnostic status. In the sample of borderline patients alone, multiple regression analyses revealed that four risk factors were found to be significantly associated with the level of dissociation reported by these 290 patients: inconsistent treatment by a caretaker, sexual abuse by a caretaker, witnessing sexual violence as a child, and adult rape history. In the combined sample of axis II patients, the borderline diagnosis joined these four "traumatic" factors as a significant predictor of the overall level of dissociation reported by these 362 personality-disordered inpatients. The results of this study suggest that both sexual trauma and something intrinsic to the borderline diagnosis itself are risk factors for dissociative phenomena among borderline patients.

Inconsistency and social decision making in patients with Borderline Personality Disorder

“…As also described in the introduction, unpredictable and inconsistent behavior in BPD may be the result of experienced parental rejection and inconsistent treatment by caregivers during childhood (Zanarini et al, 2000). Fear of abandonment is one of the core features in BPD (Berenson et al, 2011;Rosenbach and Renneberg, 2014;Staebler et al, 2011).…”

Psychopathy: Simple or Syndromal Disorder of Personality

“…Some authors (Allport, 1961;Benjamin, 2003;Black & Larsen, 1999;Meloy, 1988;Raine, 2013;van der Hart et al, 2006;Zanarini et al, 2000;Zuckerman, 2005) found that a high prevalence of the early traumatisation and insecure attachment frequently cause development of the psychopathic personality. As it is described in DSM-5 criteria (APA, 2013), the classic vision of psychological trauma considers that the trauma event(s) and its characteristics had been a threat to the physical and/or psychological integrity to oneself or other people.…”

“…Zanarini et al (2000) had reported that female patients, who recalled their mother as neglectful and father as abusive, were more likely to have been sexually abused by a non-caretaker. They hypothesised that a neglectful mother not being able to protect the child from sexual abuse by a non-caretaker and an abusive father might lead his daughter to believe that being used or abused is unavoidable.…”

“…However, in insecure early attachment, defensive action systems could be activated in adult time with a fight of the apparently "normal part" of the personality which, in fact, does not have self-perspective "if you leave me I will kill myself". Zanarini et al (2000) reviewed the empirical literature that described estimates of childhood sexual abuse in borderline personality disorder between 40-70% compared with the rate of childhood sexual abuse in other DSM-5 Axis II disordered patients (19-26%). The study revealed a significant relationship between a sexual abuse and childhood maltreatment which lead to the development not only of the psychopathic personality, but to other mental disorders too.…”

Comprendre la dissociation chez les patients avec un trouble de personnalité limite

“…Il s'agit d'un cercle vicieux qui se perpétue à l'âge adulte car les femmes atteintes de TPL ont plus de risque d'être violées ou battues par leur partenaire surtout lors d'abus de drogue précoce, d'abus sexuel durant l'enfance et de retrait émotif d'un parent (Kluft, 1990 ;Herman, 1992 ;Shearer, 1994 ;Zanarini et al, 1999 ;Zanarini et al, 2000b ;Timmerman et Emmelkamp, 2001). Il y aurait une association de cause à effet entre abus sexuel et TPL mais aucune relation causale prouvée ni d'association spécifique entre traumatisme et trouble de personnalité (Links et al, 1988 ;Zanarini et al, 1989 ;Paris et al, 1994 ;Timmerman et Emmelkamp, 2001 ;Yen et Shea, 2001 ;Goodman et al, 2003 ;Ball et Links, 2009).…”