Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with borderline personality disorder and healthy controls.

Patients with borderline personality disorder (BPD) were compared with a healthy control group with regard to traumatic life events during childhood. The patients (n=66) and controls (n=109) were investigated using a comprehensive retrospective interview with 203 questions about childhood traumatic life events, parental attitudes, family history of psychiatric disorders and birth risk factors. The frequency of reports of traumatic childhood experiences was significantly higher in patients than in controls, including sexual abuse, violence, separation from parents, childhood illness, and other factors. On a 0- to 10-point "severe trauma scale," patients had significantly more severe traumatic events (mean score=3.86, SD=1.77) than control subjects (0.61, SD=0.93). Only four (6.1%) of the BPD patients, but 67 (61.5%) of the controls did not report any severe traumatic events at all. Compared with controls, patients described the attitude of their parents as significantly more unfavorable in all aspects. Patients reported significantly higher rates of psychiatric disorders in their families in general, especially anxiety disorders, depression, and suicidality. Among birth risk factors, premature birth was reported more often in BPD subjects. In a logistic regression model of all possible etiological factors examined, the following factors showed a significant influence: familial neurotic spectrum disorders, childhood sexual abuse, separation from parents and unfavorable parental rearing styles. The present data support the hypothesis that the etiology of BPD is multifactorial and that familial psychiatric disorders and sexual abuse are contributing factors.