Early family environments and traumatic experiences associated with borderline personality disorder.
Abstract
Childhood trauma experiences (e.g., sexual abuse, physical abuse, witnessed violence, and early separation experiences) and family environment characteristics were assessed with a questionnaire from a sample of depressed female inpatients; 17 were diagnosed as having borderline personality disorder (BPD), and 19 received no such diagnosis (NBPD). Significantly more BPD individuals than NBPD individuals reported histories of sexual abuse, physical abuse, and witnessed violence. Of these trauma variables, sexual abuse emerged as the only significant predictor of dimensional BPD score, even after physical abuse, subjective depression score, diagnostic differences between groups, and family environment were controlled. Early separation experiences were nonsignificantly different between groups. Although the BPD families were reported to be distinctive for several different family environment characteristics, the control dimension significantly predicted dimensional borderline score even after sexual abuse was controlled. These results suggest that sexual abuse and general family environment need further study for a fuller understanding of BPD symptomatology.
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The AVPDSI is modelled after the Borderline Personality Disorder Severity Index (BPDSI), which was originally developed by Weaver and Clum and further developed and validated in Dutch by Arntz et al. and Giesen-Bloo et al.
“The AVPDSI is modelled after the Borderline Personality Disorder Severity Index (BPDSI), which was originally developed by Weaver and Clum [41] and further developed and validated in Dutch by Arntz et al. [42] and Giesen-Bloo et al. [43].”
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Childhood Maltreatment Increases Risk for Personality Disorders During Early Adulthood
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“…studies regarding the types of abuse and neglect most salient in the childhood histories of BPD patients, childhood sexual abuse has often been identified as a factor that discriminates patients with BPD from those diagnosed with other PDs or other psychiatric disorders (Weaver & Clum, 1993).”
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“However, at least four other studies have failed to confirm these findings ~Brennan & Shaver, 1998; Ogata, Silk, & Goodrich, 1990; Paris, Zweig– Frank, & Guzder, 1994; Weaver & Clum, 1993!.”
Reliability and Validity of the Borderline Personality Disorder Severity Index
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“The BPDSI (as its predecessor, Weaver & Clum, 1993 ) assesses both emptiness and boredom, avoidance of these feelings, and problems with being alone.”
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Hobson, R. P., Patrick, M. P. H., Crandell, L. E., García-Pérez, R. M., & Lee, A. (2005) · Development and Psychopathology · doi:10.1017/s0954579405050169 · Cited by 168 · see citing works
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“In such studies, BPD patients portray the parenting that they received as children quite unfavorably (Sansone & Sansone, 2009b), often describing their parents as neglectful, invalidating, overinvolved, and indifferent (Gunderson & Lyoo, 1997; Weaver & Clum, 1993; Zweig-Frank & Paris, 1991).”
BackgroundMultidimensional Dichotomous Thinking Characterizes Borderline Personality Disorder
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“The finding that multidimensional dichotomous thinking, and not unidimensional good‐bad thinking, is characteristic of patients with BPD is consistent with theories emphasizing that the developmental phase of 6 to 12 years is essential in the development of BPD pathology (e.g., Arntz, 1994; Weaver & Clum, 1993 ).”
BackgroundResultBurden and Support Needs of Carers of Persons with Borderline Personality Disorder
Bailey, R. C., & Grenyer, B. F. S. (2013) · Harvard Review of Psychiatry · doi:10.1097/hrp.0b013e3182a75c2c · Cited by 116 · see citing works
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“…in particular, but also emotional and physical abuse and neglect (Bryer, Nelson, Miller, & Krol, 1987; Stone, Unwin, Beacham, & Swenson, 1988; Coons, Bowman, Pellow, & Schneider, 1989; Herman, Perry, & van der Kolk, 1989; Ogata, Silk, Goodrich, Lohr, Westen, & Hil, 1990; Weaver & Clum, 1993).”
Traumatic Victimization in Childhood and Persistent Problems with Oppositional-Defiance
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“…linked with borderline personality disorder (BPD) including : abuse and neglect (Guzder et al. 1999; Zanarini et al. 2006), parent hostility and resentment (Hooley & Hoffman, 1999; Johnson et al. 2006) and exposure to domestic violence and parent conflict (Herman et al. 1989 ; Weaver & Clum, 1993).”
BackgroundEmotion Regulation Deficits as Mediators between Trauma Exposure and Borderline Symptoms
Gaher, R. M., Hofman, N. L., Simons, J. S., & Hunsaker, R. (2013) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9515-y · Cited by 84 · see citing works
“…those diagnosed with other personality disorders (Paris et al. 1994; Zanarini et al. 2000; Zweig-Frank et al. 1994), depression (Ogata et al. 1990; Weaver and Clum 1993), and various other psychological disorders (Brown and Anderson 1991; Ludolph et al. 1990; Spitzer et al. 2000; Yen et al. 2002).”
BackgroundRole of childhood traumatic experience in personality disorders in China
Zhang, T., Chow, A., Wang, L., Dai, Y., & Xiao, Z. (2012) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2011.10.004 · Cited by 83 · see citing works
“The role of childhood traumatic experiences contributing to various types of PDs, such as avoidant PD [14], borderline PD [15-17], and antisocial PD [18] has been remarkable.”
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Guzder, J., Paris, J., Zelkowitz, P., & Marchessault, K. (1996) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199601000-00009 · Cited by 79 · see citing works
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“BPD symptoms were confirmed using the Personality Disorder Severity Index (BPDSI; Weaver & Clum, 1993; Dutch version IV, Arntz et al., 2003).”
MethodHecht, K. F., Cicchetti, D., Rogosch, F. A., & Crick, N. R. (2014) · Development and Psychopathology · doi:10.1017/s0954579414000406 · Cited by 81 · see citing works
“However, this relation was not significant for sexual abuse, a finding contrary to previous literature linking sexual abuse and BPD (Johnson et al., 1999; Weaver & Clum, 1993).”
ResultDialectical Behavior Therapy ‐ Family Skills Training
Hoffman, P. D., Fruzzetti, A. E., & Swenson, C. R. (1999) · Family Process · doi:10.1111/j.1545-5300.1999.00399.x · Cited by 79 · see citing works
Predictors of Development of Adult Psychopathology in Female Victims of Childhood Sexual Abuse
Katerndahl, D. A., Burge, S. K., & Kellogg, N. D. (2005) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000158362.16452.2e · Cited by 71 · see citing works
“Do BPD and PTSD represent different presentations of the same phenomenon?”
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“Consistent with the tenets of social baseline theory, adults with BPD often report that caretakers were unavailable or unpredictable in providing emotional support (Gunderson and Lyoo 1997; Weaver and Clum 1993).”
Johnson, D. M., Sheahan, T. C., & Chard, K. M. (2003) · Journal of Child Sexual Abuse · doi:10.1300/j070v12n02_02 · Cited by 71 · see citing works
“…has reported a history of CSA in between 26-71% of individuals with BPD (Herman et al., 1989; Ogata, Silk, Goodrich, Lohr, Westen, & Hill, 1990; Weaver & Clum, 1993; Zanarini, Gunderson, Marino, Schwartz, & Frankenburg, 1989; Zanarini et al., 1997), as well as incidence rates of between 52-92%…”
BackgroundChild Physical Abuse And Neglect
Brown, C. L., & Rabbitt, A. L. (2019) · SpringerReference · doi:10.1007/springerreference_44617 · Cited by 3 · see citing works
Rinne, T., de Kloet, E. R., Wouters, L. F., Goekoop, J. G., Rijk, R. H. D., & van den Brink, W. (2003) · Neuropsychopharmacology · doi:10.1038/sj.npp.1300003 · Cited by 67 · see citing works
No evidence for overgeneral memories in borderline personality disorder
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“Retrospectively, adults with BPD report more childhood sexual abuse, physical abuse, neglect, and separation from or loss of a parent than do people with other disorders (Laporte & Guttman, 1996; Weaver & Clum, 1993; Zanarini, 2000).”
Stressful life events and major depressive disorders
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“We chose psychiatric controls as those diagnosed with borderline personality disorder since they are found to have an excess of SLE (Bandelow et al., 2005; Weaver and Clum, 1993) but not necessarily the specific ones that the depressed participants will have.”
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“The Borderline Personality Disorder Severity Index (BPDSI; Dutch version IV, Arntz, 1999; Weaver & Clum, 1993) is a semi-structured interview that contains nine sections and 70 items (Abandonment, 7 items; Relation-ships, 8 items; Self-image, 8 items; Impulsivity, 11 items; Parasuicide, 13 items;…”
Perceived Parental Rejection, Psychological Maladjustment, and Borderline Personality Disorder
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“Second, there was a positive association between BPD and the death of a close family member, which has only been reported in studies involving the death of a parent in childhood [41].”
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McDermid, J., Sareen, J., El-Gabalawy, R. M., Pagura, J., Spiwak, R. P., & Enns, M. W. (2015) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2015.01.004 · Cited by 49 · see citing works
“psychiatric disorders, but the importance of traumatic experience is particularly prominent in studies of BPD [22–26].”
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Substance Abuse in Borderline Personality Disorder: Clinical and Etiological Correlates
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“Similarly, women who have been traumatized, either as children or as adults, are likely to have difficulty regulating their emotions and report borderline personality features accordingly (Allen & Farmer, 1996; Weaver & Clum, 1993).”
BackgroundAdult attachment and emotion dysregulation in borderline personality and somatoform disorders
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“The Borderline Personality Disorder Severity Index (BPDSI; [18]; Dutch version IV, [19]) is a semistructured interview that contains nine sections (abandonment, relationships, self-image, impulsivity, parasuicide, emotion, emptiness, anger, and dissociation and paranoia) corresponding to the nine symptom clusters of B…”
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“…as loss and maltreatment may also contribute to the development of BPD (Liotti & Pasquini, 2000; van der Kolk, Hoestetler, Herron, & Fisler, 1994; Weaver & Clum, 1993; Zanarini, 2000), together with dimensions of parenting assessed in adolescence such as intrusiveness and inconsistency…”
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Deficits in Degraded Facial Affect Labeling in Schizophrenia and Borderline Personality Disorder
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“For inclusion in this study a cut-off score of 20 also was used and mean BPDSI (22 out of 30 participants) was 33.96 (SD 8.65), range 22 – 58.”
InfluentialDoes Childhood Sexual Abuse Cause Borderline Personality Disorder?
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Altered State and Trait Disgust in Borderline Personality Disorder
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“This has led to the developmental hypothesis that BPD may result from traumatic experiences early in life (Weaver and Clum, 1993).”
BackgroundWeaver, T. L., & Clum, G. A. (1996) · Journal of Traumatic Stress · doi:10.1007/bf02104102 · Cited by 34 · see citing works
Self-citationSimon, E., Raats, M., & Erens, B. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.106802 · Cited by 34 · see citing works
Shibari: Double Hanging During Consensual Sexual Asphyxia
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“…a risk factor for BPD (Katerndahl et al., 2005; Linehan, 1993; McLean & Gallop, 2003; Ogata et al., 1990; Soloff, Lynch, & Kelly, 2002; Trull, 2001; Weaver & Clum, 1993; Zanarini et al., 2002), research examining potential protective factors and other influential variables is gaining momentum to…”
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Different Traumatic Experiences are Associated with Different Pathologies
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“The significant association between child sexual abuse and borderline pathology has repeatedly been demonstrated (31,59,60).”
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“The BPDSI (Arntz et al., 2003, adapted from Weaver & Clum, 1993), a semistructured interview, was administered, to assess the frequency and severity of manifestations of BPD during the last 3 months.”
MethodElucidating the relationship between borderline personality disorder and intimate partner violence
Munro, O. E., & Sellbom, M. (2020) · Personality and Mental Health · doi:10.1002/pmh.1480 · Cited by 26 · see citing works
Fatimah, H., Wiernik, B. M., Gorey, C. M., McGue, M. K., Iacono, W. G., & Bornovalova, M. A. (2019) · Psychological Medicine · doi:10.1017/s0033291719001260 · Cited by 28 · see citing works
“It is also consistent with several major etiological theories of BPD that highlight the role of familial environment (Weaver and Clum, 1993; Carr and Francis, 2009) and mother–offspring conflict (Crowell, Baucom et al., 2013).”
ResultUtzinger, L. M., Haukebo, J. E., Simonich, H. K., Wonderlich, S. A., Cao, L., Lavender, J. M., Mitchell, J. E., Engel, S. G., & Crosby, R. D. (2016) · International Journal of Eating Disorders · doi:10.1002/eat.22532 · Cited by 23 · see citing works
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“At baseline all patients will be assessed with the Borderline Personality Severity Index (BPDSI) for severity of borderline symptoms [31], the Brief Symptom Inventory (BSI) [32] for severity of general psychological symptoms, the Inventory of Depressive Symptomatology (IDS-SR) [24] for severity of depressive symptoms,…”
MethodKrvavac, S., & Jansson, B. (2021) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2021.100213 · Cited by 25 · see citing works
Williams, R. C., Holliday, R. P., Clem, M. A., Anderson, E. H., Morris, E. E., & Surís, A. (2015) · Journal of Interpersonal Violence · doi:10.1177/0886260515596149 · Cited by 22 · see citing works
“This finding is contrary to the research literature (Herman & Van der Kolk, 1987; Jonas et al., 2011; McLean & Gallop, 2003; Paris et al., 1994; Weaver & Clum, 1993; Westphal et al., 2013; Zanarini & Frankenburg, 1997).”
BackgroundResultLahti, M., Pesonen, A., Räikkönen, K., Heinonen, K., Wahlbeck, K., Kajantie, E., Osmond, C., Barker, D., & Eriksson, J. (2012) · Journal of Personality Disorders · doi:10.1521/pedi.2012.26.5.751 · Cited by 22 · see citing works
Davoren, M., Kallis, C., González, R. A., Freestone, M. C., & Coid, J. W. (2016) · Journal of Forensic Psychiatry and Psychology · doi:10.1080/14789949.2016.1172659 · Cited by 21 · see citing works
Psychopharmacology of Human Aggression: Laboratory and Clinical Studies
Cherek, D. R., Tcheremissine, O. V., & Lane, S. D. (2005) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780195168761.003.0017 · Cited by 20 · see citing works
Face and gaze perception in borderline personality disorder: An electrical neuroimaging study.
Berchio, C., Piguet, C., Gentsch, K., Küng, A.-L., Rihs, T., Hasler, R., Aubry, J., Dayer, A., Michel, C., & Perroud, N. (2017) · Psychiatry research. Neuroimaging · doi:10.1016/j.pscychresns.2017.08.011 · Cited by 21 · see citing works
Harris, J., Loth, E., & Sethna, V. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1331256 · Cited by 18 · see citing works
The Relationship Between Codependency and Borderline and Dependent Personality Traits
Hoenigmann-Lion, N. M., & Whitehead, G. I. (2007) · Alcoholism Treatment Quarterly · doi:10.1300/j020v24n04_05 · Cited by 16 · see citing works
“Interestingly, Weaver and Clum (1993) reported that the borderline pattern is often predicted by early sexual abuse, characteristics not necessarily found in studies of codependency or dependent personality disorder.”
BackgroundCrossing borders: theory, assessment and treatment in borderline personality disorder
Giesen-Bloo, J. H. (2006) · doi:10.26481/dis.20060908jg · Cited by 16 · see citing works
van Dijke, A., Hopman, J. A. B., & Ford, J. D. (2018) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2017.11.002 · Cited by 15 · see citing works
Straussner, S. L. A., & Nemenzik, J. M. (2007) · Journal of Social Work Practice in the Addictions · doi:10.1300/j160v07n01_02 · Cited by 15 · see citing works
“Researchers have also found that a history of repeated childhood abuse, particularly sexual abuse, is highly correlated with BPD (Oldham, Skodol, Gallaher, & Kroll, 1996; Weaver & Clum, 1993).”
BackgroundPrevalence of Personality Disorders Across Veteran Samples: A Meta-Analysis
Edwards, E. R., Tran, H., Wrobleski, J. T., Rabhan, Y., Yin, J., Chiodi, C., Goodman, M. S., & Geraci, J. C. (2022) · Journal of Personality Disorders · doi:10.1521/pedi.2022.36.3.339 · Cited by 14 · see citing works
Yuan, Y., Lee, H., Newhill, C. E., Eack, S. M., Fusco, R. A., & Scott, L. N. (2023) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-023-00210-7 · Cited by 14 · see citing works
Personality Disorder Traits, Trauma, and Risk in Perpetrators of Domestic Violence
Green, K., & Browne, K. D. (2019) · International Journal of Offender Therapy and Comparative Criminology · doi:10.1177/0306624x19826516 · Cited by 14 · see citing works
“When compared with control groups, patients with borderline PD are significantly more likely to report histories of sexual abuse, physical abuse, and witnessing violence (Weaver & Clum, 1993).”
BackgroundSchizoidia in schizophrenia spectrum and personality disorders: Role of dissociation
Modestin, J., Hermann, S., & Endrass, J. (2007) · Psychiatry Research · doi:10.1016/j.psychres.2006.03.003 · Cited by 14 · see citing works
“Sexual abuse has indeed been associated with (borderline) personality disorder (Herman et al., 1989; Weaver and Clum, 1993; Modestin et al., 2005) and with psychotic (Goodman et al.”
BackgroundAmbiguity, Powerlessness, and the Psychologizing of Trauma
Caplan, P. J. (2006) · Journal of Trauma Practice · doi:10.1300/j189v05n01_02 · Cited by 11 · see citing works
“…1997, 2000; Goodwin, Cheeves, & Connell, 1990; Herman, Perry, & van der Kolk, 1989; Ogata et al., 1990; Surrey, Swett, Michaels, & Levin, 1990; Weaver & Clum, 1993; Zanarini, Gunderson, Marino, Schwartz, & Frankenburg, 1989), and the BPD diagnosis tends to carry extremely pejorative…”
WILKESON, A., Lambert, M. T., & Petty, F. (2000) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200008000-00005 · Cited by 11 · see citing works
Borderline Personality Disorder
Hooley, J. M., & Masland, S. R. (2017) · Psychopathology · doi:10.1002/9781394258949.ch14 · Cited by 11 · see citing works
Behaviour vs. perception: An investigation into the components of emotional invalidation
Elzy, M. B., & Karver, M. S. (2017) · Personality and Mental Health · doi:10.1002/pmh.1403 · Cited by 10 · see citing works
The Externalizing Pathway to Borderline Personality Disorder in Youth
Stepp, S. D., Whalen, D. J., & Pedersen, S. L. (2014) · Springer eBooks · doi:10.1007/978-1-4939-0591-1_17 · Cited by 10 · see citing works
Post-separation violence:The male perspective
McMurray, A. M. (2001) · Springer eBooks · doi:10.1007/978-1-4757-6238-9_26 · Cited by 10 · see citing works
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 · see citing works
Pongpitpitak, N., Wongpakaran, N., Wongpakaran, T., & Nuansri, W. (2022) · Healthcare · doi:10.3390/healthcare10101895 · Cited by 11 · see citing works
“, low warmth, hostility, and punishment [21], less family cohesiveness, more family control and family conflicts [22].”
Background
- Authors
- Weaver, T. L., & Clum, G. A.
- Affiliations
- Medical University of South Carolina (US)
- ORCID
- Weaver, Terri L.
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 1993-12
- Volume
- 61
- Issue
- 6
- Pages
- 1068-1075
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W2137089344
- Cited by
- 184
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 8 · 2023: 5 · 2022: 7 · 2021: 2 · 2020: 2 · 2019: 5 · 2018: 4 · 2017: 4 · 2016: 6 · 2015: 12 · 2014: 10 · 2013: 7 · 2012: 9
- FWCI
- 4.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- borderline personality disorder, child sexual abuse, child physical abuse, witnessing violence, family environment, depression, female inpatients
- MeSH terms
- Adolescent, Adult, Aged, Borderline Personality Disorder, Child Abuse, Child Abuse, Sexual, Family, Female, Humans, Life Change Events, Middle Aged, Personality Development, Psychiatric Status Rating Scales, Social Environment, Violence
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