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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, a controversial diagnosis applied to about 20 percent of hospitalized psychiatric patients and people seeking psychotherapy.

Child abuse alone does not cause borderline personality disorder, say psychiatrist Judith L. Herman and her colleagues at Harvard Medical School, but it appears to play an influential role in many cases.

"Borderlines" are characterized by intense and unstable relationships, self-destructive and impulsive behavior (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 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 (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. 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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Author:Bower, B.
Publication:Science News
Date:Apr 22, 1989
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