Yuan Yan, Lee Hyunji, Newhill Christina E, Eack Shaun M, Fusco Rachel, Scott Lori N
School of Social Work, University of Pittsburgh, 2203 Cathedral of Learning, 4200 Fifth Ave, Pittsburgh, PA, 15260, USA.
College of Social Work, Florida State University, Tallahassee, USA.
Borderline Personal Disord Emot Dysregul. 2023 Feb 6;10(1):4. doi: 10.1186/s40479-023-00210-7.
Borderline Personality Disorder (BPD) is characterized by pervasive instability in a range of areas including interpersonal relationships, self-image, and affect. Extant studies have consistently identified significant correlations between childhood maltreatment (CM) and BPD. While exploring this CM-BPD link, a number of cross-sectional studies commonly emphasize the role of emotion dysregulation (ED). A better understanding of the associations between BPD and (1) CM and (2) ED are essential in formulating early, effective intervention approaches, and in addressing varied adverse impacts.
This cross-sectional study analyzed a subset of baseline data collected for a larger community-based longitudinal study. Given that our current focus on CM and ED, only those participants who completed the baseline CM assessment and ED measure (N = 144) were included for the primary analyses. We conducted stepwise multivariate linear models to examine the differential relationships between BPD features, ED, and multiple CM types. A path analysis with latent factors using the structural equation modeling (SEM) method was performed to test the indirect effect from CM to BPD features via ED.
Linear regression models revealed that only emotional abuse (relative to other trauma types) was significantly associated with high BPD features. The SEM, by constructing direct and indirect effects simultaneously, showed that (1) ED partially mediated the path from CM to BPD features; and (2) CM played an important role in which the direct effect remained significant even after accounting for the indirect effect through ED.
Our results highlight a most consistent association between emotional abuse and BPD, indicating its unique role in understanding BPD features in the context of CM. Further, shame-related negative appraisal and ED were found critical when examining the association between CM and BPD, possibly providing promising treatment targets for future practices.
边缘型人格障碍（BPD）的特征是在人际关系、自我形象和情感等一系列领域普遍存在不稳定性。现有研究一致发现童年虐待（CM）与BPD之间存在显著关联。在探索这种CM - BPD联系时，许多横断面研究通常强调情绪失调（ED）的作用。更好地理解BPD与（1）CM和（2）ED之间的关联对于制定早期、有效的干预方法以及应对各种不利影响至关重要。
这项横断面研究分析了为一项更大规模的基于社区的纵向研究收集的基线数据子集。鉴于我们目前关注CM和ED，仅将那些完成基线CM评估和ED测量的参与者（N = 144）纳入主要分析。我们进行了逐步多元线性模型，以检验BPD特征、ED和多种CM类型之间的差异关系。使用结构方程模型（SEM）方法进行了带有潜在因素的路径分析，以测试从CM通过ED到BPD特征的间接效应。
线性回归模型显示，只有情感虐待（相对于其他创伤类型）与高BPD特征显著相关。SEM通过同时构建直接和间接效应表明：（1）ED部分介导了从CM到BPD特征的路径；（2）CM起着重要作用，即使在考虑了通过ED的间接效应后，直接效应仍然显著。
我们的结果突出了情感虐待与BPD之间最一致的关联，表明其在CM背景下理解BPD特征方面的独特作用。此外，在研究CM与BPD之间的关联时，发现与羞耻相关的负面评价和ED至关重要，这可能为未来的实践提供有希望的治疗靶点。
