OBJECTIVE: This study analyzed psychological representations in 58
subjects in order to achieve a better understanding of the relation between
adult borderline personality disorder and reported histories of childhood
sexual and physical abuse. METHOD: The subjects were 29 inpatients with
borderline personality disorder diagnosed according to the Diagnostic
Interview for Borderlines, 14 nonborderline inpatients with major
depressive disorder according to the Research Diagnostic Criteria, and 15
normal comparison subjects recruited from the community and screened for
the absence of psychopathology. Earliest memories were used as the source
of mental representations in all subjects. The memories were reliably coded
for malevolent affect tone, presence of deliberate injury, and
effectiveness of helpers. Family histories of childhood sexual and physical
abuse were obtained with the Familial Experiences Interview, a structured
interview. Abuse histories for a subset of the subjects were corroborated
by interviews with family members. RESULTS: A reported history of sexual
abuse, but not a reported history of physical abuse, predicted the presence
of extremely malevolent representations in these earliest memories as well
as representations involving deliberate injury. These two kinds of
representations also discriminated borderline patients who reported
histories of sexual abuse from borderline patients who did not report
sexual abuse. Mean affect tone (from malevolent to benevolent) did not,
however, discriminate sexually abused or physically abused subjects.
CONCLUSION: The results suggest that malevolent representations associated
with the borderline diagnosis in previous research may be partially related
to a history of childhood sexual abuse. Implications for the object
relations theory of borderline personality disorder are noted.
Abstract Teaser