Association of childhood-trauma-by-primary caregiver and affect dysregulation with borderline personality disorder symptoms in adulthood.

Abstract

Potentially traumatizing experiences by a primary caregiver during childhood (TPC) may lead to affect dysregulation, which is a hallmark of borderline personality disorder (BPD) in adulthood. Path analyses with bootstrap confidence intervals were used to explore the relationships of TPC and under- and overregulation of affect to BPD symptoms. Almost 63% of a sample of 472 patients diagnosed with either BPD alone, comorbid BPD + somatoform disorder, or other mental disorder, reported childhood TPC. TPC and underregulation of affect were associated with severity of BPD symptoms, but overregulation was not. Underregulation of affect partially mediated the relationship between TPC and BPD symptoms. Study findings suggest that also addressing underregulation of affect as a sequela of TPC rather than as only on feature of BPD, may enhance treatment of BPD symptoms. Research is needed to determine if targeting overregulation of affect, next to TPC and underregulation of affect, enhances the efficacy of treatment for severe BPD symptoms with childhood TPC and with comorbid other mental disorders, especially somatoform disorder.