Positive childhood experiences: resilience and recovery from personality disorder in early adulthood.
OBJECTIVE
Recent follow-along studies of personality disorders have shown significant improvement in psychopathology over time. The purpose of this study was to prospectively investigate the association between positive childhood experiences related to resiliency and remission from personality disorder.


METHODS
Five hundred twenty patients with DSM-IV-based semistructured interview diagnoses of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders were evaluated 6 times over 4 years between September 1996 and June 2002. Positive childhood experiences, including achievements, positive interpersonal relationships with others, and caretaker competencies, were measured using the Childhood Experiences Questionnaire-Revised. The effects of positive childhood experiences on clinically significant remission from personality disorder were determined using survival and proportional hazard regression analyses.


RESULTS
Positive achievement experiences and positive interpersonal relationships during childhood or adolescence were significantly associated with remission from avoidant and schizo-typal personality disorders. The greater the number of positive experiences and the broader the developmental period they spanned, the better the prognosis of these personality disorders.


CONCLUSIONS
The prognosis of certain personality disorders is better in patients whose developmental histories include positive experiences. Early treatment designed to foster personal strengths and competencies and to develop interpersonal skills might benefit young patients diagnosed with personality disorders.
New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, USA. askodol@imhr.org
Andrew E
AE
Skodol
Donna S
DS
Bender
Maria E
ME
Pagano
M Tracie
MT
Shea
Shirley
S
Yen
Charles A
CA
Sanislow
Carlos M
CM
Grilo
Maria T
MT
Daversa
Robert L
RL
Stout
Mary C
MC
Zanarini
Thomas H
TH
McGlashan
John G
JG
Gunderson
D000293:Adolescent; D000328:Adult; D002648:Child; D002652:Child Behavior; D002657:Child Development; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000523:psychology*; D011379:Prognosis; D011446:Prospective Studies; D012075:Remission, Spontaneous