Hallie Zweig-Frank

Psychological risk factors for dissociation and self-mutilation in female patients with borderline personality disorder

The purposes of this study were to determine whether or not dissociation in female patients suffering from personality disorder is related to sexual and physical abuse or to abuse parameters and whether or not self-mutilation in the personality disorders is related to psychological risk factors or to dissociation. The sample was divided into 78 borderline and 72 nonborderline personality disorders. Psychological risk factors were measured through histories of childhood sexual abuse, physical abuse and separation or loss as well as scores on the Parental Bonding Index. Dissociation was measured by the Dissociative Experiences Scale. On the diagnostic interview, 48 subjects scored positive for self-mutilation. Dissociative Experiences Scale scores were associated with a borderline diagnosis but not with childhood sexual abuse or physical abuse. The parameters of abuse were not related to dissociation. Subjects who mutilated themselves had higher rates of both childhood sexual abuse and dissociation in univariate analyses. However, in multivariate analyses only diagnosis was significant. None of the other psychological risk factors were significantly linked to self-mutilation. The findings do not support theories that dissociation and self-mutilation in borderline personality disorder are associated with childhood trauma.

Risk Factors for Borderline Personality in Male Outpatients

The purpose of the study was to examine the role of several psychological risk factors-childhood sexual abuse (CSA) and its parameters, childhood physical abuse and its parameters, early separation or loss, and abnormal parental bonding-in male patients with borderline personality disorder (BPD). Subjects with personality disorders were divided into BPD (N = 61) and non-BPD (N = 60) groups. The risk factors were measured by a developmental interview and the Parental Bonding Index. The BPD group had a higher frequency of CSA, more severe CSA, a longer duration of physical abuse, increased rates of early separation or loss, and a higher paternal control score on the Parental Bonding Index. CSA and separation or loss were significant in the multivariate analysis. The risk factors suggest that trauma and loss, as well as problems with fathers, are important for the development of BPD in males.

A critical review of the role of childhood sexual abuse in the etiology of borderline personality disorder

A number of recent reports have indicated that there is a high incidence of sexual abuse during childhood among patients with borderline personality disorder. Although these findings are important, a simple association between abuse and the disorder is an oversimplification. Community studies of the long term effects of abuse indicate that the parameters of abuse are crucial to the patients outcome. In addition, correlations have been found between sexual abuse during childhood and factors related to the family environment. A multifactorial model of the etiology of borderline personality disorder is proposed in which biological vulnerability, psychological factors and social influences are considered along with their interactions.

Defense styles, hostility, and psychological risk factors in male patients with personality disorders

The purpose of this study was to compare ratings of defense styles and hostility in male patients with personality disorders, to determine whether either of these is related to a borderline diagnosis, or to specific psychological risk factors. Subjects with personality disorders were divided into borderline personality disorder (BPD) (N = 61) and non-BPD (N = 60) groups and were given both the Defense Style Questionnaire (DSQ) and the Buss-Durkee Guilt-Hostility Inventory (BDHI). Risk factors were measured by a developmental interview and by the Parental Bonding Index. The BPD group reported more maladaptive and image distorting defenses on the DSQ, as well as higher ratings on the BDHI. Ratings on both dependent measures were strongly related to diagnosis, and more weakly to measures of psychological risk factors. Thus, in men with personality disorders, immature defense styles and high levels of hostility are strongly associated with a borderline diagnosis.

Psychological risk factors and self-mutilation in male patients with BPD

The purpose of this study was to determine whether or not self-mutilation in patients with personality disorders is related to other psychological risk factors, dissociation or diagnosis. The sample included 61 subjects with borderline personality disorder and 60 subjects with nonborderline personality disorder; 32 subjects with borderline personality disorder reported self-mutilation. Psychological risk factors were measured through histories of childhood sexual abuse, physical abuse and separation or loss as well as through scores on the Parental Bonding Index. Dissociation was measured by the Dissociative Experiences Scale. There were no relationships between any of the psychological risk factors and self-mutilation. Subjects who mutilated themselves had higher scores on the Dissociative Experiences Scale in univariate analysis but the scores in multivariate analyses dissociation did not discriminate between subjects who mutilated themselves and those who did not. The results do not support the theory that abuse and dissociation account for self-mutilation in the personality disorders.

The five-factor model of personality in borderline and nonborderline personality disorders

Objective The purpose of this study was to examine to what extent the phenomena associated with a diagnosis of borderline personality disorder (BPD) can be described by the five-factor model of personality. Method The sample consisted of female patients with BPD (n=29) and a control group with a mixture of nonborderline personality disorders (n=30). All subjects were given the NEO-PI-R. Results Borderline patients differed from community norms on all five factors, and were particularly high on Neuroticism, and particularly low on Agreeableness. The scores on the five factors did not differ significantly between the 2 clinical groups. Two facets of the conscientiousness scale (competence and deliberation) were significantly lower in the BPD group. Conclusions Dimensional profiles only partially account for the clinical symptomatology seen in formally diagnosed cases of BPD.

The role of psychological risk factors in recovery from borderline personality disorder

This study examined the role of psychological risk factors in recovery from borderline personality disorder (BPD). A lifetime BPD group (n = 13) was composed of female subjects who had met the criteria for BPD in the past but no longer did so in the present. The comparison group was a sample with active BPD (n = 26). Psychological risk factors were measured by a developmental interview, which scored childhood sexual abuse (CSA) and its parameters, childhood physical abuse (PA), and separation or loss, as well as by the Parental Bonding Index (PBI). Subjects from the active BPD group showed a trend toward higher rates of CSA, and had a significantly higher CSA severity score. The results suggest that a history of severe CSA may adversely influence recovery from BPD.

Neuroendocrine Study of Serotonin Function in Female Borderline Personality Disorder Patients: A Pilot Study

Preliminary findings suggest that patients with borderline personality disorder (BPD) have disturbed serotonin (5-hydroxytryptamine (5HT) neurotransmission. At least some patients have decreased cerebrospinal fluid (CSF) concentrations of the 5HT metabolite, 5-hydroxyindoleacteic acid (5HIAA) (Gardner et al 1990), decreased prolactin responses to both fenfluramine (Coccaro et al 1989), and meta-chlorophenylpiperazine (mCPP) (Hollander et al 1994), and increased cortisol release following mCPP (Hollander et al 1994). Serotonergic disturbances in BPD patients might be different in men and women. Hollander et al (1994) reported that men, but not women patients differed from healthy controls in their mCPP-stimulated release of prolactin and cortisol. As the authors noted, a gender difference might be attributable to circulating ovarian hormones. Perhaps related to this hypothesized difference, prepubertal boys (males who might be hormonally more similar to women than men) with attention deficit hyperactivity disorder (ADHD) plus aggressive features have increased, rather than decreased, prolactin responses to fenfluramine (Halperin et al 1994). The possibility of a gonadal hormone mediated difference in 5HT function among BPD patients indicated the need for an explicit test. Moreover, the relative absence of physiologic studies of BPD women is striking given that the majority of patients are women. Therefore, we investigated 5HT functioning in BPD women as assessed by fenfluramine stimulated pituitaryadrenal activity, and all were tested during their luteal phase. We hypothesized that, if women BPD patients have disturbed serotonergic activity, then, compared to healthy controls, they would have different plasma levels of prolactin and cortisol following the administration of fenfluramine.