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Childhood adversity and personality disorders: Results from a nationally representative population-based study
Abstract
Background Although, a large population-based literature exists on the relationship between childhood adversity and Axis I mental disorders, research on the link between childhood adversity and Axis II personality disorders (PDs) relies mainly on clinical samples. The purpose of the current study was to examine the relationship between a range of childhood adversities and PDs in a nationally representative sample while adjusting for Axis I mental disorders.Methods Data were from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; n=34,653; data collection 2004-2005); a nationally representative sample of the United States population aged 20 years and older.Results The results indicated that many types of childhood adversity were highly prevalent among individuals with PDs in the general population and childhood adversity was most consistently associated with schizotypal, antisocial, borderline, and narcissistic PDs. The most robust childhood adversity findings were for child abuse and neglect with cluster A and cluster B PDs after adjusting for all other types of childhood adversity, mood disorders, anxiety disorders, substance use disorders, other PD clusters, and sociodemographic variables (Odd Ratios ranging from 1.22 to 1.63). In these models, mood disorders, anxiety disorders, and substance use disorders also remained significantly associated with PD clusters (Odds Ratios ranging from 1.26 to 2.38).Conclusions Further research is necessary to understand whether such exposure has a causal role in the association with PDs. In addition to preventing child maltreatment, it is important to determine ways to prevent impairment among those exposed to adversity, as this may reduce the development of PDs.
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“Other studies confirmed that childhood adversities most consistently predicted personality disorders from clusters A and B—most notably schizotypal, antisocial, borderline, and narcissistic profiles [12].”
From The link of adverse childhood experiences and attachment to maladaptive personality traits in adults diagnosed with substance use disorder (2025) · cites this paper as [12]
In the citing paper
“These findings are in line with previous work indicating that cumulative maltreatment increases the risk of Cluster A and B personality disorders [11, 12], and that specific forms of neglect and abuse contribute to the development of maladaptive personality traits [10].”
From The link of adverse childhood experiences and attachment to maladaptive personality traits in adults diagnosed with substance use disorder (2025) · cites this paper as [12]
In the citing paper
“An increase in PD diagnoses from adolescence to adulthood in this sample, may, thus, be explained by the fact that many adolescents in residential care and juvenile-justice institutions have experienced severe childhood adversities (e.g., child abuse and neglect), which are shown to significantly contribute to the development of PDs (59, 60).”
From Prevalence and 10-year stability of personality disorders from adolescence to young adulthood in a high-risk sample (2022) · cites this paper as [59]
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Metadata
- Authors
- Afifi, T. O., Mather, A., Boman, J., Fleisher, W., Enns, M. W., MacMillan, H., & Sareen, J.
- Affiliations
- University of Manitoba (CA)
- McMaster University (CA)
- Corresponding author
- Afifi, Tracie O.
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2011-06
- Volume
- 45
- Issue
- 6
- Pages
- 814-822
- ISSN
- 0022-3956 (ISSN-L)
- OpenAlex
- W2121138841
- Cited by
- 410
- References
- 64
- Citations by year
- 2026: 12 · 2025: 31 · 2024: 27 · 2023: 29 · 2022: 31 · 2021: 27 · 2020: 46 · 2019: 29 · 2018: 35 · 2017: 22 · 2016: 24 · 2015: 29 · 2014: 29 · 2013: 24 · 2012: 10
- FWCI
- 13.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- Canadian Institutes of Health Research
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Keywords
- childhood adversity, personality disorders, child abuse, child neglect, schizotypal personality disorder, antisocial personality disorder, borderline personality disorder, narcissistic personality disorder, Cluster A personality disorders, cluster B personality disorders, mood disorders, anxiety disorders, substance use disorders, child abuse prevention
- MeSH terms
- Adult, Age Factors, Antisocial Personality Disorder, Anxiety Disorders, Mental Disorders, Borderline Personality Disorder, Canada, Child, Child Abuse, Female, Health Surveys, Humans, Male, Personality Disorders, Risk Factors, Sampling Studies, Schizotypal Personality Disorder, Stress, Psychological, Mood Disorders, Substance-Related Disorders
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