Am J Psychiatry 1995; 152:1059-1064
Copyright © 1995 by American Psychiatric Association
Borderline personality disorder symptoms and severity of sexual abuse
KR Silk, S Lee, EM Hill and NE Lohr
Department of Psychiatry, University of Michigan, Ann Arbor, USA.
OBJECTIVE: This study explored the relationship of specific symptoms of
borderline personality disorder to dimensions of severity of sexual abuse
experiences in childhood. METHOD: A group of 41 patients with borderline
personality disorder who retrospectively reported a childhood history of
sexual abuse on the Familial Experiences Interview were studied. Six items
from the Diagnostic Interview for Borderline Patients (DIB) were chosen on
the basis of their univariate (chi- square) association with a sexual abuse
severity scale that was developed by the authors and their research team.
These six DIB items were each modeled in a logistic regression. Predictor
variables were the most severe experience within each of three dimensions
of sexual abuse: 1) perpetrator (sexual abuse by a parent), 2) duration
(sexual abuse that was ongoing), and 3) type (sexual abuse that involved
penetration). RESULTS: The severity dimension that was most frequently
found to be a significant predictor of the sum of the six DIB items as well
as the total scaled DIB score was the duration dimension. Ongoing sexual
abuse predicted parasuicidal behavior as well. CONCLUSIONS: Ongoing sexual
abuse may be a strong determinant of specific aspects of the disordered
interpersonal behavior and functioning found in patients with borderline
personality disorder. The expectation that the world is an empty,
malevolent place may have some of its roots in the repetition of sexual
abuse experiences in childhood. This expectation of malevolence among
patients with borderline personality disorder may manifest itself in
psychotherapy through regressive and distancing behavior.
