Crossing the 'borderline' of child abuse.Crossing the 'borderline' of child abuse Boston researchers report that child abuse often lurks in the background of adults with borderline personality disorder bor·der·line personality disorder n. A personality disorder marked by a long-standing pattern of instability in interpersonal relationships, behavior, mood, and self-image that can interfere with social or occupational functioning or cause extreme , a controversial diagnosis applied to about 20 percent of hospitalized psychiatric patients and people seeking psychotherapy psychotherapy, treatment of mental and emotional disorders using psychological methods. Psychotherapy, thus, does not include physiological interventions, such as drug therapy or electroconvulsive therapy, although it may be used in combination with such methods. . Child abuse alone does not cause borderline personality disorder, say psychiatrist Judith L. Herman and her colleagues at Harvard Medical School Harvard Medical School (HMS) is one of the graduate schools of Harvard University. It is a prestigious American medical school located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts. , but it appears to play an influential role in many cases. "Borderlines" are characterized by intense and unstable relationships, self-destructive and impulsive behavior impulsive behavior, n action initiated without due consideration or thought as to the costs, results, or consequences. (such as drug abuse), fears of abandonment, suicide attempts aimed at manipulating others, feelings of emptiness, and rage alternating with a childish dependency on others. Many borderlines slip into a temporary psychosis psychosis (sīkō`sĭs), in psychiatry, a broad category of mental disorder encompassing the most serious emotional disturbances, often rendering the individual incapable of staying in contact with reality. under stress or the influence of drugs. Herman and her co-workers conducted intensive interviews with 21 individuals meeting diagnostic criteria for borderline personality disorder, 11 falling short of the diagnosis but possessing several "borderline traits" and 23 with related diagnoses such as antisocial personality disorder antisocial personality disorder n. A personality disorder characterized by chronic antisocial behavior and violation of the law and the rights of others. (persistent violence and lawbreaking). The great majority of the borderlines--17 of 21 -- reported a history of trauma before age 18, including physical abuse, sexual abuse and witnessing serious domestic violence. Childhood trauma was reported by 8 of 11 individuals with borderline traits and 12 fo 23 subjects with related disorders, the researchers note, but their abusive experiences were less frequent and less severe than those of the borderlines. Multiple episodes of abuse before age 6 were almost exclusively reported by subjects with borderline personality disorder, the scientists say. The psychological vulnerability imposed by child abuse may help explain why women borderlines outnumber men 2.5 to 1, they maintain. Girls are at far greater risk for sexual abuse than boys, and their sexual abuse apparently is more common and longer in duration than the physical abuse boys are more likely to experience. The findings have significant treatment implications, the researchers conclude in the April AMERICAN JOURNAL OF PSYCHIATRY The American Journal of Psychiatry (AJP) is the most widely read psychiatric journal in the world. It covers topics on biological psychiatry, treatment innovations, forensic, ethical, economic, and social issues. . Many borderline patients may need to confront traumatic memories and explore the intense emotions surrounding childhood abuse before they can develop rewarding relations with others. |
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