title: Borderline symptoms and suicidality/self-injury in late adolescence: prospectively observed relationship correlates in infancy and childhood.
abstract: The primary objective was to assess whether prospectively observed quality of parent-child interaction in infancy and middle childhood contributed to the prediction of borderline symptoms and recurrent suicidality/self-injury in late adolescence. Adolescents (mean 19.9 years) from 56 families participating in a longitudinal study since infancy (retention rate 74%) were assessed on the SCID-II for symptoms of borderline personality disorder (BPD), including suicidality/self-injury. Early clinical risk was indexed by clinical referral to parent-infant services. Attachment security and parent-child interaction were assessed from videotape at 18 months and 8 years. Severity of childhood abuse was rated from interview and self-report measures. Maternal withdrawal in infancy was a significant predictor of both borderline symptoms and suicidality/self-injury in late adolescence. Disorganized controlling child behavior at age 8 contributed independently to the prediction of borderline symptoms. The effect of maternal withdrawal was independent of, and additive to, variability explained by severity of childhood abuse. Borderline symptoms and suicidality/self-injury may be preceded developmentally by disturbed interactions as early as 18 months of age. A parent-child transactional model is proposed to account for the findings.
authors.affiliation: Department of Psychiatry, Harvard Medical School, Cambridge Hospital, 1493 Cambridge Street, Cambridge, MA 02139, USA. klruth@hms.harvard.edu
authors.forename: Karlen
authors.initials: K
authors.lastname: Lyons-Ruth
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Bureau
authors.forename: Bjarne
authors.initials: B
authors.lastname: Holmes
authors.forename: Ann
authors.initials: A
authors.lastname: Easterbrooks
authors.forename: Nancy Hall
authors.initials: NH
authors.lastname: Brooks
mesh_terms: D000293:Adolescent; D001883:Borderline Personality Disorder / Q000523:psychology*; D002648:Child; D002649:Child Abuse; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009034:Mother-Child Relations; D009769:Object Attachment; D010287:Parent-Child Relations; D011446:Prospective Studies; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000523:psychology*; D059020:Suicidal Ideation; D055815:Young Adult