[p.50:] Herman, Perry, and van der Kolk (1988) investigated childhood trauma with in-depth interviews conducted by researchers blind to the clinical diagnosis. Abuse histories were more common among definite BPD, less frequent among subjects with borderline traits, and least common in the cases with other diagnosis (schizotypal, antisocial, bipolar II). Histories of trauma before age six were found almost exclusively in borderline subjects. Ogata, Silk, Goddrich, and Lohr (1988) reported that borderlines had a significantly higher rate of sexual abuse than manic-depressives; and abuse was related to higher frequency of psychoticlike symptoms. Stone (1988c) showed that 19 percent of female borderlines but only 5 percent of female schizophrenics had an incest history; in general, borderlines of either sex had been more frequently abused by their parents than schizophrenic patients.
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[p.545:] Gunderson, Kerr, and Englund (1980) have reported a more properly conducted analysis of twelve adolescents (ages 15 - 24) BPD families matched to twelve schizophrenic and twelve neurotic families. Although numerous methodologic difficulties make conclusions tentative, they did note that adolescent BPD families shared some characteristics that differentiate them both from schizophrenic and neurotic groups. Adolescent BPD families showed more maternal psychosis, poorer rule enforcement, and more parental neglect. [...]
Societal factors may play a role in the development of adolescent BPD symptomatology. Millon (1987) suggests that an increase in "divisive and diffusing social customs," such as increased mobility, separation, divorce, drug abuse, and "capricious" TV role models; along with a descreas in "reparative and cohering social customs," and extended family association play an importand role in producing BPD. [...]
[p.546:] Ongoing sexual abuse in childhood may lead to a variety of behavioral, social, and interpersonal disturbances. A neglected area of social and developmental study in the adolescent borderline is the relationship of sexual abuse to adolescent borderline pathology. In a detailed asessment of fifteen adolescent inpatients at Sunnybrook Medical Centre meeting DSM-III-R criteria for BPD (9 female, 6 male; mean age 17.1 years) 47 percent reported childhood sexual abuse. The effect of such trauma on personality development is unclear but needs to be addressed. Further, the symptomatic manifestations of sexual abuse in the adolescent also need to be clarified. Acting out, running away from home, substance abuse, self-damaging acts, mood lability, uncontrolled anger autbursts, and suicide attempts may reflect the adolescents' attempts to deal with ongoing sexual abuse in a society which denies, ignores, or even subtly condones it. Certainty this entire issue demands detailed study in the borderline adolescent.
[...] In an ongoing study of adolescent prostitutes in Toronto, Kutcher and Hillier (unpublished) using clinical interviews and detailed history reviews assigned DSM-III diagnoses ot seventy-five "street-kids"; forty-one females and thirty-for males, mean age 17.9 years. Eighty-six percent met DSM-II criteria for BPD, 89 percent of the females and 82 percent of the males. A diagnosis of BPD in both sexes was associated with drug and alcohol abuse, a history of sexual and physical abuse, school failure, suicide attempts, a family history of psychiatric illness, and in the females, an Axis I diagnosis of attention deficit disorder.
[...] the report by McManus et al. (1984) which identified a high rate of BPD in incarcerated male juvenile delinquents.