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Borderline symptoms and suicidality/self-injury in late adolescence: Prospectively observed relationship correlates in infancy and childhood
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The primary objective was to assess whether prospectively observed quality of parent-child interaction in infancy and middle childhood contributed to the prediction of borderline symptoms and recurrent suicidality/self-injury in late adolescence. Adolescents (mean 19.9 years) from 56 families participating in a longitudinal study since infancy (retention rate 74%) were assessed on the SCID-II for symptoms of borderline personality disorder (BPD), including suicidality/self-injury. Early clinical risk was indexed by clinical referral to parent-infant services. Attachment security and parent-child interaction were assessed from videotape at 18 months and 8 years. Severity of childhood abuse was rated from interview and self-report measures. Maternal withdrawal in infancy was a significant predictor of both borderline symptoms and suicidality/self-injury in late adolescence. Disorganized controlling child behavior at age 8 contributed independently to the prediction of borderline symptoms. The effect of maternal withdrawal was independent of, and additive to, variability explained by severity of childhood abuse. Borderline symptoms and suicidality/self-injury may be preceded developmentally by disturbed interactions as early as 18 months of age. A parent-child transactional model is proposed to account for the findings.
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“Disorganized attachment in infancy and middle childhood has been found to subsequently predict BPD symptoms in adolescence and young adulthood [110].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [110]
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“Adult BPD also may be preceded by BPD in adolescence [194], or by BPD-like symptoms that manifest earlier in childhood among adolescents and adults diagnosed with BPD (e.g., self-harm; disorganized controlling behavior; regulatory problems) [110, 187, 191].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [110]
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“Validity of maternal AMBIANCE classification has been confirmed by meta-analysis in relation to infant attachment disorganization (57) and, in individual studies, in relation to adolescent psychiatric outcomes (72, 75, 76).”
From Disorganized attachment in infancy predicts greater amygdala volume in adulthood (2016) · cites this paper as [72]
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“…attachment is per se a predictor of psychopathological risk in adolescence and adulthood, in particular for dissociative disorders (Sroufe, 2005) and borderline personality disorder (Lyons-Ruth et al., 2013), while the insecure attachment patterns represent a general factor of vulnerability.”
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“In another recent longitudinal study, maternal withdrawal to infant attachment cues, as coded at 18 months of age, was found to predict BPF in late adolescence, independent of childhood abuse and mood disorder symptoms [13].”
BackgroundPreoccupied but not dismissing attachment states of mind are associated with nonsuicidal self-injury
Martin, J., Bureau, J., Lafontaine, M., Cloutier, P., Hsiao, C., Pallanca, D., & Meinz, P. (2017) · Development and Psychopathology · doi:10.1017/s0954579417000050 · Cited by 17
Self-citationFinger, B., Byun, S., Melnick, S. M., & Lyons‐Ruth, K. (2015) · Translational Developmental Psychiatry · doi:10.3402/tdp.v3.28785 · Cited by 20
“In light of strong current interest in identifying childhood precursors of BPD and ASPD features (9, 10, 37), these emerging representational distortions would be important targets for early identification.”
BackgroundSelf-citationChildhood Precursors of Adult Borderline Personality Disorder Features
Cramer, P. (2016) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000514 · Cited by 15
“Further, although the current CAQ measure has no item referring to suicidality, research has shown that Suicidality/self-injury has different developmental predictors than those associated with overall BPD features (Lyons-Ruth et al., 2013, p. 280).”
BackgroundBenzi, I. M. A., Fontana, A., Pierro, R. D., Perugini, M., Cipresso, P., Madeddu, F., Clarkin, J. F., & Preti, E. (2021) · Assessment · doi:10.1177/1073191120988157 · Cited by 15
“In this sense, a significant contribution derives from attachment theory, which underlined developmental pathways for the emergence of personality pathology and other mental disorders (De Carli et al., 2016; De Carli et al., 2018; Lyons-Ruth et al., 2013).”
BackgroundFrancis, J., Sawyer, A. C. P., Roberts, R., Yelland, C., Drioli‐Phillips, P., & Williams, A. S. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23465 · Cited by 14
Ariav‐Paraira, I., Oppenheim, D., & Sagi‐Schwartz, A. (2021) · Child Development · doi:10.1111/cdev.13679 · Cited by 16
Moser, D. A., Aue, T., Suardi, F., Manini, A., Rossignol, A. S., Cordero, M. I., Merminod, G., Ansermet, F., Serpa, S. R., Favez, N., et al. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01575 · Cited by 13
“…signals (such as baby cries) (Lorberbaum et al., 2002; Kim et al., 2011; Laurent and Ablow, 2012; De Pisapia et al., 2013) or visual child signals such as facial expressions or behavior (Noriuchi et al., 2008; Strathearn et al., 2009; Mascaro et al., 2013; Moser et al., 2013; Swain et al., 2014).”
BackgroundTorrisi, R., Arnautovic, E., Perizzolo, V. C., Vital, M., Manini, A., Suardi, F., Gex‐Fabry, M., Serpa, S. R., & Schechter, D. S. (2018) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2018.04.008 · Cited by 13
The Influence of Family-Related Factors on Suicide in Major Depression Patients
Wang, W., Guo, X., Kang, L.-J., Zhang, N., Ma, S.-M., Cheng, J., Fang, L., & Liu, Z.-C. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.919610 · Cited by 8
Williams, K., Fleck, L., Fuchs, A., Koenig, J., & Kaess, M. (2023) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-023-00645-4 · Cited by 11
“…disorganized-controlling behavior at age 8 and less collaborative, more mutual punitive and disoriented/out-of-context behavior during discussions between young adults and their parents seem to be influenced by the severity of the trauma the child/adolescent has experienced in the past [60, 61].”
BackgroundResultInfluentialWittkowski, A., Crompton, C., & Wan, M. W. (2024) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-024-00497-0 · Cited by 18
“…in early caregiver-infant relationships has also been associated with later mental health difficulties (Catanzaro & Wei, 2010; Doron et al., 2009; Illing et al., 2010; Lyons-Ruth et al., 2013) and physical health difficulties (Anno et al., 2015; McWil-liams & Bailey, 2010) in the child.”
Høivik, M. S., Lydersen, S., Ranøyen, I., & Berg‐Nielsen, T. S. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1789-5 · Cited by 11
“It might be possible that these mothers showed behaviours when they were not video-taped, which instigated the child’s involvement [65, 66].”
BackgroundBigras, N., & Godbout, N. (2020) · Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement · doi:10.1037/cbs0000177 · Cited by 18
Formulation and Treatment of Chronic Suicidality in Patients with Developmental Trauma
Chalfin, M., & Kallivayalil, D. (2017) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-017-9362-y · Cited by 10
Wolf, J., Reinhard, M. A., Goerigk, S. A., Barton, B. B., Burkhardt, G., Tang, J., Eder, J., Amann, B. L., Bertsch, K., Jobst, A., et al. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115562 · Cited by 11
Sajadi, S. F., Zargar, Y., Honarmand, M. M., & Arshadi, N. (2015) · International Journal of School Health · doi:10.17795/intjsh-26742 · Cited by 8
“(57)) and low educational performance (consistent with Proche et al (58); Trull et al.”
BackgroundLinking maternal disrupted interaction and infant limbic volumes: The role of infant cortisol output
Khoury, J. E., Ahtam, B., Ou, Y., Jenkins, E., Klengel, T., Enlow, M. B., Grant, P. E., & Lyons‐Ruth, K. (2023) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2023.106379 · Cited by 11
Self-citationRansley, R., Sleed, M., Baradon, T., & Fonagy, P. (2019) · Infant Mental Health Journal · doi:10.1002/imhj.21787 · Cited by 10
Perceived Parenting and Borderline Personality Features during Adolescence
Armour, J., Joussemet, M., Mageau, G. A., & Varin, R. (2022) · Child Psychiatry & Human Development · doi:10.1007/s10578-021-01295-3 · Cited by 12
“Consequently, most research on the etiology of BPD has been conducted retrospectively, among diagnosed adult patients [8].”
Attachment Theory and Research and Clinical Work
Eagle, M. N. (2017) · Psychoanalytic Inquiry · doi:10.1080/07351690.2017.1322420 · Cited by 10
A Neuroscience-Oriented Research Approach to Borderline Personality Disorder
Stanley, B., Pérez-Rodríguez, M. M., Labouliere, C. D., & Roose, S. P. (2018) · Journal of Personality Disorders · doi:10.1521/pedi_2018_32_326 · Cited by 18
Malafanti, A., Yotsidi, V., Sideridis, G., Giannouli, E., Galanaki, E. P., & Malogiannis, I. (2024) · Acta Psychologica · doi:10.1016/j.actpsy.2024.104181 · Cited by 9
Brumariu, L. E., Kerns, K. A., Giuseppone, K. R., & Lyons‐Ruth, K. (2021) · Journal of Applied Developmental Psychology · doi:10.1016/j.appdev.2021.101324 · Cited by 13
Self-citationEarly Parent–Child Relationship in the Shadow of War-Related Trauma: A Systematic Review
Chasson, M., Shlomo, S. B., & Lyons‐Ruth, K. (2025) · Trauma Violence & Abuse · doi:10.1177/15248380251325222 · Cited by 12
“…Van Ee et al., 2016), which is further associated with the child’s disorganized attachment behavior when needing comfort (Madigan et al., 2006), and with alterations in child stress regulation and neurobiological development (Khoury et al., 2023; Lyons-Ruth et al., 2013; Madigan et al., 2007).”
Self-citationMeier, M., & Bureau, J. (2018) · Journal of Child and Family Studies · doi:10.1007/s10826-018-1028-1 · Cited by 10
Self-citationCruciani, G., Boccia, M., Lingiardi, V., Giovanardi, G., Zingaretti, P., & Spitoni, G. F. (2021) · Brain Sciences · doi:10.3390/brainsci11111539 · Cited by 9
“UD pattern appears to be overrepresented in psychiatric patients (43%) and predicts a vulnerability to dissociative disorders [15] and borderline personality disorder [16,17]; nevertheless, individuals with a UD pattern are also found among non-clinical samples (18%) and, although at a lower extent, they display emoti…”
BackgroundLyons‐Ruth, K., Ahtam, B., Li, F. H., Dickerman, S., Khoury, J. E., Sisitsky, M. D., Ou, Y., Enlow, M. B., Teicher, M. H., & Grant, P. E. (2023) · Human Brain Mapping · doi:10.1002/hbm.26401 · Cited by 9
“…al., 2006) and are associated with problematic outcomes in infancy (Madigan et al., 2006), middle childhood (Bureau et al., 2009; Lyons-Ruth et al., 1997), and late adolescence (Brumariu et al., 2020; Khoury, Rajamani, et al., 2020; Lyons-Ruth et al., 2013; Pechtel et al., 2012; Shi et al., 2012).”
BackgroundSelf-citationVulliez‐Coady, L., Solheim, E., Nahum, J. P., & Lyons‐Ruth, K. (2016) · The European Journal of Counselling Psychology · doi:10.5964/ejcop.v4i2.62 · Cited by 9
Self-citation
Metadata
- Authors
- Lyons-Ruth, K., Bureau, J.-F., Holmes, B., Easterbrooks, A., & Brooks, N. H.
- Affiliations
- Harvard University (US)
- Tufts University (US)
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2013-04
- Volume
- 206
- Issue
- 2-3
- Pages
- 273-281
- ISSN
- 0165-1781 (ISSN-L)
- PMC
- PMC3605274
- OpenAlex
- W2154870167
- Cited by
- 170
- References
- 89
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 9 · 2023: 12 · 2022: 11 · 2021: 18 · 2020: 14 · 2019: 10 · 2018: 18 · 2017: 13 · 2016: 15 · 2015: 19 · 2014: 8 · 2013: 4
- FWCI
- 11.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- Sid W. Richardson Foundation
- Harvard University
- National Institute of Mental Health (R01MH35122, R01MH062030, R01MH06030)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- borderline symptoms, suicidality, self-harm, late adolescence, parent-child interaction, attachment security, childhood abuse, infancy, middle childhood, transactional model, developmental prediction
- MeSH terms
- Adolescent, Borderline Personality Disorder, Child, Child Abuse, Female, Humans, Infant, Longitudinal Studies, Male, Mother-Child Relations, Object Attachment, Parent-Child Relations, Prospective Studies, Risk Factors, Cohort Studies, Linear Models, Logistic Models, Self-Injurious Behavior, Young Adult, Suicidal Ideation
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