학술논문

Developmental predictors of young adult borderline personality disorder: a prospective, longitudinal study of females with and without childhood ADHD
Document Type
article
Source
BMC Psychiatry. 23(1)
Subject
Clinical and Health Psychology
Social and Personality Psychology
Psychology
Pediatric
Attention Deficit Hyperactivity Disorder (ADHD)
Prevention
Mind and Body
Clinical Research
Brain Disorders
Behavioral and Social Science
Serious Mental Illness
Basic Behavioral and Social Science
Mental Health
Mental health
Child
Adolescent
Humans
Male
Female
Young Adult
Attention Deficit Disorder with Hyperactivity
Borderline Personality Disorder
Prospective Studies
Longitudinal Studies
Emotions
Borderline personality disorder
Attention-deficit hyperactivity disorder
Risk factors
Longitudinal studies
Adverse childhood experiences
Clinical Sciences
Public Health and Health Services
Psychiatry
Clinical sciences
Epidemiology
Clinical and health psychology
Language
Abstract
BackgroundResearch on the precursors of borderline personality disorder (BPD) reveals numerous child and adolescent risk factors, with impulsivity and trauma among the most salient. Yet few prospective longitudinal studies have examined pathways to BPD, particularly with inclusion of multiple risk domains.MethodsWe examined theory-informed predictors of young-adult BPD (a) diagnosis and (b) dimensional features from childhood and late adolescence via a diverse (47% non-white) sample of females with (n = 140) and without (n = 88) carefully diagnosed childhood attention-deficit hyperactivity disorder (ADHD).ResultsAfter adjustment for key covariates, low levels of objectively measured executive functioning in childhood predicted young adult BPD diagnostic status, as did a cumulative history of childhood adverse experiences/trauma. Additionally, both childhood hyperactivity/impulsivity and childhood adverse experiences/trauma predicted young adult BPD dimensional features. Regarding late-adolescent predictors, no significant predictors emerged regarding BPD diagnosis, but internalizing and externalizing symptoms were each significant predictors of BPD dimensional features. Exploratory moderator analyses revealed that predictions to BPD dimensional features from low executive functioning were heightened in the presence of low socioeconomic status.ConclusionsGiven our sample size, caution is needed when drawing implications. Possible future directions include focus on preventive interventions in populations with enhanced risk for BPD, particularly those focused on improving executive functioning skills and reducing risk for trauma (and its manifestations). Replication is required, as are sensitive measures of early emotional invalidation and extensions to male samples.