Borderline Personality Disorder in Youth: The Prospective Impact of Child Abuse on Non-Suicidal Self-Injury and Suicidality

• Published in: Comprehensive psychiatry Vol. 71; pp. 86 - 94
• Main Authors: Kaplan, Cynthia, Tarlow, Naomi, Stewart, Jeremy G, Aguirre, Blaise, Galen, Gillian, Auerbach, Randy P
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2016; Elsevier Limited
• Subjects: Adolescent; Adult Survivors of Child Abuse - psychology; Adults; Borderline Personality Disorder - epidemiology; Borderline Personality Disorder - psychology; Case-Control Studies; Child abuse & neglect; Child development; Comorbidity; Family income; Female; Humans; Interviews; Mortality; Personality disorders; Prospective Studies; Psychiatry; Self destructive behavior; Self-Injurious Behavior - epidemiology; Self-Injurious Behavior - psychology; Sex crimes; Studies; Suicidal Ideation; Suicide, Attempted - statistics & numerical data; Suicides & suicide attempts; United States - epidemiology; Young Adult
• ISSN: 0010-440X; 1532-8384
• DOI: 10.1016/j.comppsych.2016.08.016

Abstract Background Borderline Personality Disorder (BPD) is characterized by greater engagement in non-suicidal self-injury (NSSI) and suicidality. The aim of the study is to test whether the occurrence of child abuse contributes to these high-risk behaviors in BPD youth. Materials and Methods BPD female youth aged 13–21 years with ( n = 29) and without ( n = 29) a history of child abuse were administered clinical interviews assessing diagnostic history, child abuse, NSSI and suicidality (i.e., ideation, plans, attempts). NSSI and suicidality were subsequently reevaluated at the 1- and 2-month follow-up assessments. Results Several findings emerged. First, relative to BPD youth without abuse, the abuse group reported greater past NSSI; however, no significant differences emerged in the follow-up period. Second, the occurrence of child abuse was associated with a 5-fold increase in the rate of lifetime suicide attempts relative to the no abuse group and additionally, prospectively predicted suicide ideation (but not attempts). Last, exploratory analyses indicated that the co-occurrence of physical and sexual abuse was associated with greater past NSSI and suicidality as compared to the no abuse and sexual abuse only participants. Conclusion As a whole, child abuse—particularly co-occurring physical and sexual abuse— increases risk for NSSI and suicidality among BPD youth, which may have important treatment implications in this high-risk population.