Cited by 170Personality Disorders and PsychopathologyChild and Adolescent Psychosocial and Emotional DevelopmentPsychoanalysis and Psychopathology Research

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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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Lyons-Ruth, Karlen, Bureau, Jean-Francois, Holmes, Bjarne, Easterbrooks, Ann, Brooks, Nancy Hall·2013·Psychiatry Research

DOI 10.1016/j.psychres.2012.09.030PMC PMC3605274

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Abstract

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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“States of intense arousal to stressors characterize patients with BPD and suicidality/self-injury (Stiglmayr et al., 2001) and randomized animal models have established that poor quality caregiving can up-regulate the expression of genes related to stress reactivity (Francis et al., 1999; Barr et…”
Background
Family Studies of Borderline Personality Disorder: A Review
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Allen, B. (2008) · Child Maltreatment · doi:10.1177/1077559508318394 · Cited by 147
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Appelbaum, M. I., Belsky, J., Booth, C. L., Bradley, R. H., Brownell, C., Burchinal, M., Caldwell, B. M., Campbell, S. B. G., Clarke‐Stewart, A., Cox, M. J., et al. (2001) · Developmental Psychology · Cited by 146
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“However, when abuse is noted, this is often only the tip of the iceberg and indexes pervasive difficulties in the family in establishing caregiving routines, managing anger, establishing appropriate discipline, and having appropriate expectations for child behavior, as well as in protecting the child (Bradley et al.,…”
Background
Attachment and behavior problems in middle childhood as reported by adult and child informants
Moss, E., Smolla, N., Cyr, C. P., Dubois‐Comtois, K., Mazzarello, T., & Berthiaume, C. (2006) · Development and Psychopathology · doi:10.1017/s0954579406060238 · Cited by 142 · cited 1×
“Controlling or disorganized behavior in preschool has also been associated with childhood behavior problems (van IJzendoorn et al., 1999; Moss et al., 2006; O’Connor et al., 2011).”
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Early maternal separation and the trajectory of borderline personality disorder symptoms
Crawford, T. N., Cohen, P. R., Chen, H., Anglin, D. M., & Ehrensaft, M. K. (2009) · Development and Psychopathology · doi:10.1017/s0954579409000546 · Cited by 134 · cited 1×
“However, Crawford et al. (2009) noted that structured observations of parent-child interactions would strengthen the validity of these assessments.”
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Maternal depressive symptoms in infancy: unique contribution to children's depressive symptoms in childhood and adolescence?
Bureau, J.-F., Easterbrooks, M. A., & Lyons-Ruth, K. (2009) · Development and Psychopathology · doi:10.1017/s0954579409000285 · Cited by 132 · cited 1×
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Self-Injury in Youth: The Essential Guide to Assessment and Intervention
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MethodSelf-citation
Risks and outcomes associated with disorganized/controlling patterns of attachment at age three years in the National Institute of Child Health & Human Development Study of Early Child Care and Youth Development
O'connor, E., Bureau, J., McCartney, K., & Lyons‐Ruth, K. (2011) · Infant Mental Health Journal · doi:10.1002/imhj.20305 · Cited by 100 · cited 1×
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Self-citation
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Griffin, M. L., & Amodeo, M. (2010) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2010.03.005 · Cited by 94
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Self-citation
A controlled study of Hostile-Helpless states of mind among borderline and dysthymic women
Lyons-Ruth, K., Melnick, S., Patrick, M., & Hobson, R. P. (2007) · Attachment & Human Development · doi:10.1080/14616730601151417 · Cited by 69 · cited 1×
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Predicting long-term outcomes for women sexually abused in childhood: Contribution of abuse severity versus family environment
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McCartney, K., Bub, K. L., & Burchinal, M. (2006) · Cited by 18

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Dearing, 2006, Contemporary advances and classic advice for analyzing mediating and moderating variables, Monographs of the Society for Research in Child Development, 71, 88

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Ford, J. D., & Courtois, C. A. (2021) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-021-00155-9 · Cited by 209
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“For individuals with a history of childhood maltreatment, basic skills deficits in emotion regulation may result from substantial disruptions in attachment-related development (Herman, 1992; Lyons-Ruth et al., 2013).”
Background
ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice
Fonagy, P., Speranza, M., Luyten, P., Kaess, M., Hessels, C. J., & Bohus, M. (2015) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-015-0751-z · Cited by 165
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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)
DOI: 10.1016/j.psychres.2012.09.030
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
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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Borderline symptoms and suicidality/self-injury in late adolescence: Prospectively observed relationship correlates in infancy and childhood

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