Am J Psychiatry 1991; 148:864-869
Copyright © 1991 by American Psychiatric Association
Object representations in the early memories of sexually abused borderline patients
JT Nigg, KR Silk, D Westen, NE Lohr, LJ Gold, S Goodrich and S Ogata
Department of Psychiatry, University of Michigan, Ann Arbor.
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.
