Developmental history and object relations in psychiatrically disturbed adolescent girls

Article Abstract:

Psychiatric illness has much of its origin in early childhood, when traumatic events and early relationships contribute to its development. Infants and children whose basic needs are not met, which occurs through failures in maternal responsiveness, develop disruptions in their early attachment relationships. This results in the development of disturbed social functioning, known as object-relational pathology, which is an integral part of most personality disorders. Research has revealed that severe stresses such as early loss, inconsistent caretaking, violence, alcoholism, sexual abuse, chaos and neglect lead to these personality disorders. These risk factors are thought to create expectations that intimate relationships are not safe and nurturing. This study was done to identify predictable outcomes in object relations according to stressors in the developmental histories of psychiatric patients. One prediction was that victims of sexual abuse would later experience a malevolent object world in which a sense of trust would be difficult to maintain because they had experienced their early caretakers as hostile and unprotective. Another prediction was that the inconsistent parenting experienced in an alcoholic home would later lead to difficulties making logical and accurate associations between people's behavior and their causes. Thirty-six girls between the ages of 14 and 18 who had been hospitalized for a psychiatric disorder were assessed for developmental history and object relations variables. There were significant correlations between parental pathology and abnormal object relations of the teenagers. Psychiatric illness in the mother was the best predictor of pathological object relations in the daughter; paternal variables were found to be far less predictive. Much of this disturbance originates with a mother who was not securely attached to her own mother, and therefore cannot securely attach to her child. Maternal alcohol abuse, maternal separations, and number of mother surrogates also had a pervasive effect on object relations variables; the profound effect of maternal separation was shown by the scores of the adopted subjects in this study. A history of sexual abuse showed a strong correlation with malevolence in object relations, as predicted. Moving frequently during childhood was also correlated with several variables. Premature delivery and "difficult" infancy also were strongly predictive of later dysfunction in all four object relations variables assessed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Children, Mental illness, Mental disorders, Parent and child, Parent-child relations, Mentally disabled persons, Infant psychology, Developmental psychology, Abusive parents, Children of the mentally ill, Absentee mothers

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Childhood sexual and physical abuse in adult patients with borderline personality disorder

Article Abstract:

The diagnosis of borderline personality disorder is dependent on a pattern of instability in self-image, interpersonal relationships, and mood which begins by early adulthood. Research has noted a high prevalence of childhood abuse histories among borderline patients. Sexual abuse seems to be common in our culture, with the incidence being approximately one in three for females and one in 10 for males. Most physical and sexual abuse is perpetrated by male relatives of the victims. This study was done to reveal whether 24 borderline inpatients had a greater incidence of abuse during childhood than 18 depressed inpatients, and if so, in what way. The study also investigated whether borderline symptoms could somehow predict a past history of sexual abuse. The Diagnostic Interview for Borderline Patients (DIB) was used to obtain a borderline personality disorder diagnosis. The depressed patients were diagnosed with the Research Diagnostic Criteria (RDC) for depressive disorder. Researchers who did not know the DIB and RDC results interviewed the patients regarding their recollection of a variety of childhood and family events. The borderline patients (17 out of 24) reported significantly more childhood sexual abuse than depressed patients (4 out of 18). Of the seven borderline patients who did not report sexual abuse, four were men. Physical abuse was relatively frequent in both groups, and multiple abuse experiences were common, supporting the theory that borderline patients come from disturbed families which do not protect or meet the children's needs. Inquiry into a history of sexual and physical abuse should become standard in assessing borderline patients, as many of their symptoms may be sequelae of this type of abuse. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Child abuse, Child sexual abuse, Adult child abuse victims

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The borderline diagnosis in adolescents: symptoms and developmental history

Article Abstract:

The symptoms and developmental histories of 27 adolescent girls who were diagnosed with borderline personality disorder were evaluated. This disorder is more frequently seen in girls than in boys. Diagnoses were made on the basis of the Diagnostic Interview for Borderlines criteria used for adults. These 27 inpatients were compared with 23 nonborderline psychiatric patients, and the features which distinguished the borderline group were assessed. A number of variables are thought to influence the development of borderline personality, including early separation and loss conflicts, severe trauma and abuse, violence, and alcoholism in the family. Constitutional factors have also been implicated in this disorder, and a family predisposition, as seen in conditions such as schizophrenia or bipolar disorders, may be involved. The factors examined in this study consisted of selected family features and early episodes of trauma. The psychiatric histories of the biological mothers and fathers and first-degree relatives of the borderline patients and the comparison subjects were also considered. The resulting data indicated that the adult criteria are valid for use in diagnosing borderline personality in adolescents. Strong correlations were made between this condition and developmental factors such as prior incidence of rejection, abuse, disrupted attachments, and disharmony in the family unit. The effect of early trauma appeared to be cumulative, rather than the result of one incident during any single phase of development. It was concluded that early trauma in combination with a chaotic environment are predictive for the development of borderline personality. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Adolescent psychology

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