Objective: The study explored the relationship of specific symtoms 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 (DIB) were choosen on the basis of their univariate (chi-square) association with 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 almost frequently found to be a significant predictor for the sum of the six DIB items as well as the total scaled DIB score was the duration dimension. Ongoing sexual abuse predicted parasuicidal behaviour as well.
Conclusions: Ongoing sexual abuse may be a strong determinant of specific aspects of the disordered interpersonal behaviour 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 behaviour.
Results from our studies support these correlations (13). Among a cohort of 37 inpatients with borderline personality disorder, 76% (N=28) reported a history of some sort of sexual abuse in childhood, and of these, 40% - 50% (ore one-third of all patients with borderline personality disorder) reported childhood sexual abuse that has been ongoing or that involved penetration. This high prevalence was not found among depressed patients without borderline personality disorder (6, 13) or in a group of normal nonpsychiatric comparison subjects. Conversely, abused subjects who reported that their sexual abuse history involved "only" a single, nonpenetrating event with someone other than a nuclear family member or relative constituted two-thirds of the normal subjects and over 50% of the depressed subjects who reported abuse but only 25% of abused patients with borderline personality disorder (13). The majority of sexual abuse reported by patients with borderline personality disorder was not a single, nonperpentrating event with a stranger. Clearly then, studies that attempt to understand the relationship between sexual abuse and borderline personality disorder symptoms need to examine not only the occurrence of sexual abuse but the nature and the severity of that abuse as well. [...]
A previous study (6) of 24 patients with borderline personality disorders and 18 depressed control subjects used a stepwise logistic regression to determine which itemsfrom the Diagnostic Interview for Borderline Patients (DIB) (25) predicted sexual abuse. The best predictors were derealization; chronic dysphoria (as manifested by emptiness, loneliness, or boredom); and having the diagnosis of borderline personality disorder.
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[p.1063:] This study is not without limitations. As stated previously, the Familial Experiences Interview is a retrospective measure and subject to all the vicissitudes involved in the recall of past events and distortion of memory. Also, the severity of the Sexual Abuse Severity Scale were developed by the researchers rather than empirically derived. [...]