Object representations in the early memories of sexually abused borderline patients

Article Abstract:

Borderline personality disorder is characterized in part by severe acting-out, attention-seeking behavior such as superficial suicidal gestures. In traditional psychodynamic theory it is said that this is the result of pathological object relations, or a disturbance in patients' internal, mental representations and expectations of themselves and the world around them. If the basis for object relations is formed early in life, it would therefore make sense that early childhood trauma might contribute to borderline personality disorder by affecting the development of healthy object relations. In fact, some studies have found a high incidence of reported childhood trauma, particularly sexual abuse, in borderline patients, and history of sexual abuse has been used as a tool in the differential diagnosis between borderline personality disorder and other personality disorders. In the present study, 29 borderline patients, 14 nonborderline patients with depression, and 15 normal subjects were given a battery of psychological tests. They were also asked to relate their earliest memory, their next earliest memory, their earliest memory of mother, of father, their most happy memory, their most sad memory, their earliest memory of feeling scared, angry, snug or cozy, excited, ashamed or guilty, and they were asked for their favorite early memory. A reported history of sexual abuse was correlated with bad memories of childhood and also with memories of having sustained deliberate injury, while reported physical abuse was not correlated, and these memories differentiated borderline from nonborderline subjects. It is therefore suggested that the pathological object relations seen in borderline patients in prior research may be partially related to childhood sexual abuse. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Evaluation, Causes of, Child sexual abuse, Early memories, Object relations (Psychoanalysis), Object attachment

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Substance use in borderline personality disorder

Article Abstract:

A survey of substance abuse among 137 inpatients diagnosed with borderline personality disorder revealed that 92 patients (67 percent) qualified for substance use disorder diagnoses. When substance abuse was removed from the diagnostic criteria for borderline personality disorder, 23 percent of these patients no longer qualified for this diagnosis. These patients showed significant differences in their pathology from the other borderline patients, suggesting that a more distinct subgroup of borderline substance users is necessary. These differences included age at both first outpatient and first inpatient psychiatric treatments. The 23 percent that no longer qualified as borderline were significantly older at these initial treatments than the remaining borderline group, and they also had significantly fewer psychiatric hospitalizations. They were also less likely to develop transient psychotic symptoms, and were generally less likely to meet four of the eight core symptom criteria of borderline personality disorder. The hypothesis that personality psychopathology may be a direct result of substance abuse rather than the other way around needs to be investigated. This survey checked for abuse of or dependence on nine classes of psychoactive drugs. Of the 92 patients who were categorized as substance abusers, 73 percent used alcohol and 70 percent used sedative-hypnotic drugs; 49 percent used both. This group may respond very well to a substance abuse treatment model. (Consumer Summary produced by Reliance Medical Information, Inc.)

Mentally ill persons, Development and progression, Mentally ill, Substance abuse, Drug use, Alcohol use

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