"Role of Childhood Maltreatment and Alexithymia in Predicting Borderline Personality Disorder: A Study in a Non-Clinical Population "
Subject Areas :
Turaj
Hashemi
1
(دانشگاه تبریز)
محمد امین
شریفی
2
Abbas
Bakhshipour
3
Majid
Mahmoud Alilou
4
Mansor
Beyrami
5
Keywords: borderline personality disorder childhood maltreatment alexithymia ,
Abstract :
Borderline personality disorder (BPD) is a multidimensional and heterogeneous disorder. Research has shown substantially in the last three decades that child abuse is a pathogenic factor for borderline personality disorder. The main purpose of this study was to predict the borderline personality disorder on the basis of childhood maltreatment and alexithymia, in nonclinical young adults. In this regard, 413 participants were selected using multistage sampling among all students studying in Tehran University. The Borderline Personality Scale (BPS), Child Abuse Self Report Scale (CASRS), and Toronto Alexi-thymia Scale (TAS-20) were used to measure variables. The raw data collected, was analyzed by structural equation modeling. The findings were similar to results of previous studies. The results indicate that theoretical model has a good fitness and childhood traumatic experiences (specially emotional abuse) and alexithymia are good predictors for borderline personality disorder. In addition, results revealed that alexithymia mediated rela-tionship between maltreatment and BPD symptoms
"اینگرام، ریک. ای. و پرایس، جوزف. ام. (1397). زمینههای آسیبشناسی روانی: عوامل خطرساز در گستره زندگی (ترجمه: فاطمه زرگر، الهام اشتاد، شیما تمنایی‌فر). تهران: ارجمند. (تاریخ انتشار به زبان اصلی، 2010).
احدی، بتول (1388). نقش ویژگی¬های شخصیتی ناگویی خلقی در پیش¬بینی نشانه¬های آسیب¬شناسی روانی در بیماران مبتلا به افسردگی اساسی. تحقیقات علوم رفتاری(1)7 .
بشارت، محمدعلی (1388). ناگویی هیجانی و مشکلات بین¬شخصی. مطالعات تربیتی و روان¬شناسی دانشگاه فردوسی مشهد، 20(1)، 145-129.
بیجاری¬اعظم، فرح؛ حسینی، سیدحمزه، و نصیری، مهدیه (1395). بررسی رابطه آسیب¬های دوران کودکی و سبک دلبستگی با خودشناسی انسجامی در افراد مبتلا به اختلال شخصیت مرزی. مجله علمی پژوهشی دانشگاه بابل، (7)18، 18-14.
پورشهريار، حسين؛ علي¬زاده، حسين؛ و رجايي¬نيا، كاظم (1397). تجربه آزار هیجانی کودکی و ویژگی¬های اختلال شخصیت مرزی در بزرگسالی: نقش واسطه¬ای سبک-های دلبستگی و تنظیم هیجانی. مجله روان¬پزشکی و روان¬شناسی بالینی ایران (اندیشه و رفتار)، (2)24، 162-153.
پیوسته¬گر، مهرانگیز (1397). اختلال شخصیت مرزی و ناگویی هیجانی در میان دختران دانشجوی دارای مشکلات بین فردی. علوم اعصاب شفای خاتم، (2)6، 59-51.
علوی، خدیجه (1388). اثربخشی رفتاردرمانی دیالکتیکی گروهی در کاهـش نشانه¬های افسردگی دانشجویان مشهد. پایان¬نامه کارشناسی ارشد، دانشگاه فردوسی مشهد.
محمدزاده، علی؛ گودرزی، محمدعلی؛ تقوی، محمدرضا؛ ملازاده، جواد (1384). بررسی ساختار عاملی، روایی، پایایی و هنجاریابی مقیاس شخصیتی مرزی (STB) در دانشجویان دانشگاه شیراز: فصلنامه اصول بهداشت روانی، 28-27، 89-75.
مک¬لم، گایل (1390). تنظیم هیجان کودکان: راهنمای گام به گام برای والدین، معلمان، مشاوران و روانشناسان (ترجمه احمدرضا کیانی و فاطمه بهرامی). تهران: ارجمند. (تاریخ انتشار به زبان اصلی 2007).
Adler, G., Buie, D. H., Jr. (1979). Aloneness and borderline psychopathology: the possible relevance of child development issues. The International Journal of Psychoanalysis, 60(1), 83-96.
American psychiatric association (2013). Diagnostic and statistical manual of mental disorder.
Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia scale-I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(1), 23-32.
Bagby, R. M., Taylor, G. J., & Parker, J. D. A. (1994). The twenty-item Toronto Alexithymia Scale: II. Convergent, discriminant, and concurrent validity. Journal of Psychosomatic Research, 38, 33-40.
Balaban, H., Semiz, M., Sentürk, I. A., Kavaç, Ö., Çmar, Z., Dikici, A., & Topaktas, S. (2012). Migraine prevalence, alexithymia, and post-traumatic stress disorder among medical students in Turkey. Journal of Headache and Pain, 13(6), 459-467.
Beck, J. G., Woodward, M. J., Pickover, A. M., Lipinski, A. J., Dodson, T. S., & Tran, H. N. (2019). Does a history of childhood abuse moderate the association between symptoms of posttraumatic stress disorder and borderline personality disorder in survivors of intimate partner violence? Journal of Clinical Psychology, 75(6), 1114-1128.
Berenson, K. R., Dochat, C., Martin, C. G., Yang, X., Rafaeli, E., & Downey, G. (2018). Identification of mental states and interpersonal functioning in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 9(2), 172-181.
Berzenski, S. R., Madden, A. R., & Yates, T. M. (2019). Childhood emotional abuse characteristics moderate associations with adult psychopathology and caregiving. Child Abuse & Neglect, 87, 77-87.
Bezirganian, S., Cohen, P., & Brook, J. S. (1993). The impact of mother-child interaction on the development of borderline personality disorder. The American Journal of Psychiatry, 150, 1836-1842.
Bornovalova, M. A., Huibregtse, B. M., Hicks, B. M., Keyes, M., McGue, M., & Iacono, W. (2013). Tests of a direct effect of childhood abuse on adult borderline personality disorder traits: A longitudinal discordant twin design. Journal of Abnormal Psychology, 122(1), 180-194.
Bornovalova, M. A., Matusiewicz, A., & Rojas, E. (2011). Distress tolerance moderates the relationship between negative affect intensity with borderline personality disorder levels. Comprehensive Psychiatry, 52(6), 744-753.
Castelli, L., De Santis, F., De Giorgi, I., Deregibus, A., Tesio, V., Leombruni, P., Granieri, A., Debernardi, C., & Torta, R. (2013). Alexithymia, anger and psychological distress in patients with myofascial pain. Frontiers in Psychology, 4, 1-8.
Castelli, L., et al. (2013). Alexithymia, anger and psychological distress in patients with myofascial pain. Frontiers in Psychology, 4, 1-8
Deborde, A. S., Miljkovitch, R., Roy, C., Bigre, C. D. L., Pham-Scottez, A., Speranza, M., & Corcos, M. (2012). Alexithymia as a mediator between attachment and the development of borderline personality disorder in adolescence. Journal of Personality Disorders, 26(5), 676-688.
Dubey, A., Pandey, R. and Mishra, K. (2010) Role of Emotion Regulation Difficulties and Positive/Negative Affectivity in Explaining Alexithymia-Health Relationship: An Overview. Indian Journal of Social Science, 7, 20-31.
Elzy, M. B. (2009). Exploring the relationship between childhood sexual abuse and borderline personality features using social support as a moderating factor. A thesis submitted for the degree of Master of Arts, University of South Florida.
Elzy, M. B. (2011). Examining the Relationship between Childhood Sexual Abuse and Borderline Personality Disorder: Does Social Support Matter? Journal of Child Sexual Abuse, 20(3), 284-304
Frias, A., Palma, C., Farriols, N., Gonzalez, L., & Horta, A. (2016). Anxious adult attachment may mediate the relationship between childhood emotional abuse and borderline personality disorder. Personal Mental Health, 10(4), 274-284.
Garralda, M. E. (1996). Somatisation in children. Journal of Child Psychology Psychiatry, 37, 13-33.
Godbout, N., Daspe, M. È., Runtz, M., Cyr, G., & Briere, J. (2018). Childhood maltreatment, attachment, and borderline personality-related symptoms: Gender-specific structural equation models. Psychological Trauma: Theory, Research, Practice and Policy, 11(1), 90-98.
Golomb, A., Ludolph, P., Westen, D., Block, M. J., Maurer, P. F., & Wiss, C. (1994). Maternal empathy, family chaos, and the etiology of borderline personality disorder. Journal of the American Psychoanalytic Association, 42, 525-548.
Goodman, M., & Yehuda, R. (2002). The relationship between psychological trauma and borderline personality disorder. Psychiatric Annals, 32, 337-345.
Graeme, J., Taylor, R., & Bagby, M. (2013). Psychoanalysis and Empirical Research : The Example of Alexithymia. Journal of the American Psychoanalytic Association, 61, 99-133.
Graeme, J., Taylor, R., & Bagby, M. (2013). Psychoanalysis and Empirical Research: The Example of Alexithymia. Journal of the American Psychoanalytic Association, 61, 99-133.
Gratz, K. L., Latzman, R. D., Tull, M. T., Reynolds, E. K., & Lejuez, C.W. (2010). Exploring the Association Between Emotional Abuse and Childhood Borderline Personality Features: The Moderating Role of Personality Traits. Behavior Therapy, 42(3), 493-508.
Gunnar, M. R., & Davis, E. P. (2013). The Effects of Stress on Early Brain and Behavioral Development. In Neural Circuit Development and Function in the Heathy and Diseased Brain, 21, 447-465.
Heinzel, A., Minnerop, M., Schäfer, R., Müller, H. W., Franz, M., & Hautzel, H. (2012). Alexithymia in healthy young men: A voxel-based morphometric study. Journal of Affective Disorders, 136(3), 1252-1256.
Hiraoka, R., Crouch, J. L., Reo, G., Wagner, M. F., Milner, J. S., & Skowronski, J. J. (2016). Borderline personality features and emotion regulation deficits are associated with child physical abuse potential. Child Abuse & Neglect, 52, 177-184.
Huang, J., Yang, Y., Wu, J., Napolitano, L. A., Xi, Y., Cui, Y. (2012). Childhood abuse in Chinese patients with borderline personality disorder. Journal of Personality Disorders, 26, 238-254.
Johnson, J. G., Cohen, P., Smailes, E. M., Skodol, A. E., Brown, J., & Oldham, J. M. (2001). Childhood verbal abuse and risk for personality disorders during adolescence and early adulthood. Comprehensive Psychiatry, 42(1), 16-23.
Judd, P. H., & McGlashan, T. H. (2003). A developmental model of borderline personality disorder: Understanding variations in course and outcome. English: American Psychiatric Publishing.
Kaplan, C., Tarlow, N., Stewart, J. G., Aguirre, B., Galen, G., Auerbach, R. P. (2016). Borderline personality disorder in youth: The prospective impact of child abuse on non-suicidal self-injury and suicidality. Comprehensive Psychiatry, 71, 86-94.
Keng, S. L. & Soh, C. Y. (2018). Association between childhood in-validation and borderline personality symptoms: self-construal and conformity as moderating factors. Borderline Personality Disorder and Emotion Dysregulation, 7, 5-19.
Kernberg, O. F. (1975). Borderline conditions and pathological narcissism. New York: Aronson.
Kernberg, O. F. (1976). Object Relations Theory and Clinical Psychoanalysis. New York: Jason Aronson Inc.
Kernberg, O. F. (1996). A psychoanalytic theory of personality disorders. In J. F. Clarkin & M. F. Lenzenweger (Eds.), Major theories of personality disorder (pp. 106-140). New York, NY, US: Guilford Press.
Kuo, J. R., Khoury, J. E., Metcalfe, R., Fitzpatrick, S., & Goodwill, A. (2015). An examination of the relationship between childhood emotional abuse and borderline personality disorder features: the role of difficulties with emotion regulation. Child Abuse Neglect, 39, 147-155.
Linehan, M. M . (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford.
Links, P. S., Heslegrave, R., & van Reekum, R. (1998). Prospective Follow-up Study of Borderline Personality Disorder: Prognosis, Prediction of Outcome, and Axis II Comorbidity. The Canadian Journal of Psychiatry, 43(3), 265-270.
Machizawa-Summers, S. (2007). Childhood trauma and parental bonding among Japanese female patients with borderline personality disorder. International Journal of Psychology, 42(4), 265-273.
MacMillan, H. L., Fleming, J. E., Streiner, D. L., Lin, E., Boyle, M. H., Jamieson, E., & Beardslee, W. R. (2001). Childhood abuse and lifetime psychopathology in a community sample. The American Journal of Psychiatry, 158(11), 1878-1883.
Masterson, J. F. (1981). The narcissistic and borderline disorders: An Integrated Developmental Approach. UK: Routledge.
Modestin, J., Furrer, R., & Malti. T. (2004). Study on alexithymia in adult non-patients. Journal of Psychosomatic Research, 56(6), 707-709.
Mosquera, D., Gonzalez, A., Van der Hart, O. (2011) Borderline personality disorder, childhood trauma and structural dissociation of the personality. Revista Persona, 1(11), 44-73.
Naughton, A. M., Maguire, S. A., Mann, M. K., Lumb, R. C., Tempest, V., Gracias, S., & Kemp, A. M. (2013). Emotional, Behavioral, and Developmental Features Indicative of Neglect or Emotional Abuse in Preschool Children: A Systematic Review. Journal of the American Medical Association, Pediatrics, 167(8), 769-775.
Nelson, D. A., Coyne, S. M., Swanson, S. M., Hart, C. H., & Olsen J. A. (2014). Parenting, relational aggression, and borderline personality features: associations over time in a Russian longitudinal sample. Development and Psychopathology, 26(3), 773-87.
New, A. S., aan het Rot, M., Ripoll, L. H., Perez-Rodriguez, M. M., Lazarus, S., Zipursky, E., Weinstein, S. R., Koenigsberg, H. W., Hazlett, E. A., Goodman, M., & Siever, L. J. (2012). Empathy and alexithymia in borderline personality disorder: clinical and laboratory measures. Journal of Personality Disorders, 26(5), 660-675.
Paivio, S. C., & McCulloch, C. R. (2004). Alexithymia as a mediator between childhood trauma and self-injurious behaviors. Child Abuse & Neglect, 28(3), 339-354.
Pearl, K. N., Preece, P. M., Ades, A., Peckham, C. S. (1986). Neuro-developmental assessment after congenital cytomegalovirus infection. Archives of Disease in Childhood, 61(4), 323-326.
Pereda, N., Gallardo-Pujol, D., & Padilla, R. (2011). Personality disorders in child sexual abuse victims. Actas Espanolas de Psiquiatra, 39(2), 131-139.
Pinaquy, S., Chabrol, H., Simon, C., Louvet, J. P., & Barbe, P. (2003). Emotional eating, alexithymia, and binge-eating disorder in obese women. Obesity Research, 11, 195-201.
Polcari, A., Rabi, K., Bolger, E., & Teicher, M. H. (2014). Parental verbal affection and verbal aggression in childhood differentially influence psychiatric symptoms and wellbeing in young adulthood. Child Abuse and Neglect, 38(1), 91-102.
Pollak, S. D., Cicchetti, D., Hornung, K., & Reed, A. (2000). Recognizing emotion in faces: developmental effects of child abuse and neglect. Developmental Psychology, 36(5), 679-688.
Rosenstein, L. K., Ellison, W. D., Walsh, E., Chelminski, I., Dalrymple, K., & Zimmerman, M. (2018). The role of emotion regulation difficulties in the connection between childhood emotional abuse and borderline personality features. Personal Disorder, 9(6), 590-594.
Sadock, B. J., & Sadock, V. A. (2009). Concise Textbook of Child and Adolescent Psychiatry (1st Edition). New York: Lippincott Williams & Wilkins.
Sansone, R. A., & Sansone, L. A. (2009). The families of borderline patients: the psychological environment revisited. Psychiatry (Edgmont), 6(2), 19-24.
Sharp, C., & Tackett, J. L. (2014). Handbook of Borderline Personality Disorder in Children and Adolescents. Switzerland: Springer.
Simeon, D., & Favazza, A. R. (2001). Self-injurious behaviors: Phenomenology and assessment. In D. Simeon, & E. Hollander (Eds.), Self-injurious behaviors: Assessment and treatment. Washington, DC: American Psychiatric Publishing.
Smith, A. L. (2015). The Dialectical Behavior Therapy Wellness Planner: 365 Days of Healthy Living for Your Body, Mind, and Spirit (The Borderline Personality Disorder Wellness Series). Unhooked Media: USA.
Steine, I. M., Winje, D., Krystal, J. H., Bjorvatn, B., Milde, A. M., Grønli, J., Nordhus, I. H., & Pallesen, S. (2017). Cumulative childhood maltreatment and its dose-response relation with adult symptomatology: Findings in a sample of adult survivors of sexual abuse. Child Abuse & Neglect, 65, 99-111.
Suyemoto, K. L. (1998). The functions of self-mutilation. Clinical Psychology Review, 18, 531-554.
Tutkun, H., Savas, H. A., Zoroglu, S. S., Esgi, K., Herken, H., Tiryaki, N., (2004) Relationship between alexithymia, dissociation and anxiety in psychiatric outpatients from Turkey. The Israel Journal of Psychiatry and Related Sciences,41(2), 118-124.
Van Den Bosch, L., Verheul, R., Langelund, W., & Van Den Brink, W. (2003). Trauma, dissociation, and posttraumatic stress disorder in female borderline disorder patients with and without substance abuse problems. Australian and New Zealand Journal of Psychiatry, 37, 549-555.
Van der Kolk, B. A., & Fisler, R. E. (1994). Childhood abuse and neglect and loss of self-regulation. Bulletin of the Menninger Clinic, 58, 145-168.
Van Dijke, A. (2008). The clinical assessment and treatment of trauma-related self and affect dysregulation. In A. Vingerhoets, I. Nyklíček, & J. Denollet (Eds.), Emotion regulation: Conceptual and clinical issues (pp. 150-169). New York, NY, US: Springer Science.
Van Dijke, A., & Ford, J. D. (2015). Adult attachment and emotion dysregulation in borderline personality and somatoform disorders. Borderline Personality Disorder and Emotion Dysregulation, 28, 2-6.
Van Vreeswijk, M., Broersen, J., Nardort, M., eds. (2012). The Wiley-Blackwell handbook of schema therapy: theory, research, and practice. Chichester, West Sussex; Hoboken, NJ: John Wiley & Sons.
Venta, A., Hart, J., & Sharp. C. (2013). The relation between experiential avoidance, alexithymia and emotion regulation in inpatient adolescents. Clinical Child Psychology and Psychiatry, 18, 398-410.
Vieira, R. V., Vieira, D. C., Gomes, W.B., & Gauer, G. (2013). Alexithymia and its impact on quality of life in a group of Brazilian women with migraine without aura. The Journal of Headache and Pain, 14(18), 14-18.
Webb, D., & McMurran, M. (2008). Emotional intelligence, alexithymia and borderline personality disorder traits in young adults. Personality and Mental Health, 2(4), 265-273.
Westbrook, J., & Berenbaum. H. (2017). Emotional awareness moderates the relationship between childhood abuse and borderline personality disorder symptom factors. Journal of Clinical Psychology, 73(7), 910-921.
Winsper, C., Zanarini, M., & Wolke, D. (2012). Prospective study of family adversity and maladaptive parenting in childhood and borderline personality disorder symptoms in a non-clinical population at 11 years. Psychological Medicine, 42(11), 2405-2420.
Yates, T. M. (2004). The developmental psychopathology of self-injurious behavior: Compensatory regulation in posttraumatic adaptation. Clinical Psychology Review, 24, 35-74.
Yen, S., Shea, M.T., Pagano, M., Sanislow, C.A., Grilo, C.M., McGlashan, T. H., Skodol, A. E., Bender, D. S., Zanarini, M. C., Gunderson, J. G., & Morey, L. C. (2003). Axis I and Axis II disorders as predictors of prospective suicide attempts: findings from the Collaborative Longitudinal Personality Disorders Study. Journal of Abnormal Psychology, 113(2), 375-381.
Young, J. E., Klosko, J., & Weishaar, M. E., (2003). Schema therapy: A practitioner’s guide. New York: Guilford Press.
Zanarini, M. C. & Frankenburg, F. R. (1994). Emotional hypochondriasis, hyperbole and the borderline patient. Journal of Psychotherapy Practice and Research, 3, 25-36.
Zanarini, M. C. (2005). Borderline Personality Disorder. In K.R. Silk., T. L. Wolf., & D. A. Ben-Ami (Eds), Environmental Factors in the Etiology of Borderline Personality Disorder. Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, U.S.A. Ernest W. Poortinga Center for Forensic Psychiatry, Milan, Michigan, U.S.A. NY: Taylor & Francis Group.
Zanarini, M. C. (2018). In the Fullness of Time (Recovery from Borderline Personality Disorder). USA: Oxford University Press.
Zanarini, M. C. (2019). In the Fullness of Time: Recovery from Borderline Personality Disorder. UK: Oxford University Press.
Zanarini, M. C., & Frankenburg, F. R. (1997). Pathways to the development of borderline personality disorder. Journal of Personality Disorders, 11, 93-104.
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., Marino, M. F., Lewis, R. E., Williams, A. A., & Khera, G. S. (2000). Biparental failure in the childhood experiences of borderline patients. Journal of Personality Disorders, 14, 264-273.
Zanarini, M. C., Temes, C. M., Magni, L. R., Aguirre, B. A., Hein, K. E., & Goodman, M. (2019). Risk Factors for Borderline Personality Disorder in Adolescents. Journal of Personality Disorders, 28, 1-8.
Zhang, T. H., Chow, A., Wang, L. L., Yu, J. H., Dai, Y. F., Lu, X., Good, M. J., Good, B. J., & Xiao, Z. P. (2013). Childhood maltreatment profile in a clinical population in China: A further analysis with existing data of an epidemiologic survey. Comprehensive Psychiatry, 54, 856-864.
Zlotnick, C., Mattia, J. I., & Zimmerman, M. (2001). The relationship between posttraumatic stress disorder, childhood trauma, and alexithymia in an outpatient sample. Journal of Traumatic Stress, 14, 177-188.
"