Western Psychiatric Institute and Clinic, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
J Abnorm Child Psychol. 2012 Jan;40(1):35-44. doi: 10.1007/s10802-011-9558-7.
Very few studies have prospective information, especially regarding males, on the prediction of Borderline Personality Disorder (BPD) in adulthood from psychiatric disorders in childhood. Certain childhood disorders, however, have notably similar features in common with BPD. In particular, the affective dysfunction, hostility and interpersonal conflict of Oppositional Defiant Disorder (ODD) and the impulsivity of Attention Deficit Hyperactivity Disorder (ADHD) in particular may be indicative of an early developmental path towards BPD. The present study uses longitudinal data from a clinical sample of 177 boys, initially between the ages of 7 and 12, who were followed up annually to age 18, and who were reassessed at age 24 (n = 142). The study examines the prediction from repeated childhood measures of psychopathology measured annually through adolescence to BPD symptoms assessed at age 24, accounting for the effects of covariates including substance use, other personality disorders at age 24 and harsh physical punishment. The prevalence of BPD in this sample was consistent with other population estimates. Attention Deficit Hyperactivity Disorder (ADHD) and ODD were the only child psychiatric disorders to predict BPD symptoms, and the oppositional behavioral dimension of ODD was particularly predictive of BPD. These results indicate possible developmental links between early psychiatric disorders and BPD.
很少有研究提供前瞻性信息,特别是关于男性的,即从儿童期的精神疾病预测成年期的边缘型人格障碍(BPD)。然而,某些儿童期疾病与 BPD 具有明显相似的特征。特别是对立违抗性障碍(ODD)的情感功能障碍、敌意和人际冲突,以及注意缺陷多动障碍(ADHD)的冲动,可能预示着朝着 BPD 发展的早期路径。本研究使用了来自一个临床样本的纵向数据,该样本包括 177 名男孩,他们最初的年龄在 7 至 12 岁之间,每年随访至 18 岁,并在 24 岁时重新评估(n=142)。该研究通过每年一次的青少年时期的精神病理学重复测量来检验对 BPD 症状的预测,这些症状在 24 岁时进行评估,同时考虑了包括物质使用、24 岁时的其他人格障碍和严厉的身体惩罚等协变量的影响。该样本中的 BPD 患病率与其他人群估计值一致。注意缺陷多动障碍(ADHD)和 ODD 是唯一预测 BPD 症状的儿童期精神障碍,而 ODD 的对立行为维度对 BPD 具有特别的预测作用。这些结果表明早期精神疾病与 BPD 之间可能存在发育联系。