Childhood abuse as a risk factor for suicidal behavior in borderline personality disorder.
A childhood history of sexual or physical abuse is highly prevalent in borderline personality disorder (BPD) and is associated with self-destructive behavior in clinical and nonclinical samples. Viewing BPD as a "high risk" disorder, we asked if childhood abuse was a risk factor for adult suicidal behavior or if it was related to other known risk factors for suicide in BPD. A semistructured Abuse History was obtained in 61 criteria-defined BPD patients, who were characterized by structured interviews and self-reports for Axis I disorders, Suicide History, BPD severity, hopelessness, impulsivity, impulsive-aggression, and antisocial traits. Occurrence and severity of childhood sexual abuse, but not physical abuse, predicted adult suicidal behavior independent of other known risk factors. The odds of a sexually abused patient attempting suicide in adulthood was over 10 times that of a patient who was never sexually abused. Given a history of childhood sexual abuse, the risk of adult suicidal behavior in BPD was increased by antisocial traits, severity of BPD, hopelessness, or comorbid major depressive episode (MDE).
Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh, USA. soloffph@msx.upmc.edu
Paul H
PH
Soloff
Kevin G
KG
Lynch
Thomas M
TM
Kelly
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001883:Borderline Personality Disorder / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*