Citation

Geselowitz B, Whalen DJ, Tillman R, Barch DM, Luby JL, Vogel A. J. Am. Acad. Child Adolesc. Psychiatry 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, American Academy of Child Adolescent Psychiatry, Publisher Lippincott Williams and Wilkins)

DOI

10.1016/j.jaac.2020.07.908

PMID

32950651

Abstract

OBJECTIVE: Developmental models of Borderline Personality Disorder (BPD) have highlighted the interplay of psychological variables (i.e., impulsivity and emotional reactivity) with social risk factors including invalidating parenting and childhood trauma. Prospective longitudinal studies have demonstrated the association of BPD with social, familial and psychological antecedents. However, to date, few of these studies have studied the interaction of multiple risk domains and their potential manifestations in the preschool period.

METHOD: Participants were 170 children enrolled in a prospective longitudinal study of early childhood depression. Participants completed a baseline assessment between ages 3-6 years. Psychopathology, suicidality and self-harm were assessed using a semi-structured age appropriate psychiatric interview before age 8 as well as self-report after age 8. BPD symptoms were assessed between ages 14-19 by self-report. Adverse childhood experiences (ACEs) and peer relations were reported by parents. Maternal support was assessed using an observational measure at ages 3-6.

RESULTS: Preschool ACEs accounted for 14.9% of adolescent BPD symptom variance in a regression analysis. Controlling for gender and preschool ACEs, preschool and school-age externalizing symptoms, preschool internalizing symptoms and low maternal support were significant predictors of BPD symptoms in multivariate analyses. Preschool and school age suicidality composite scores significantly predicted BPD symptoms.

CONCLUSION: These findings suggest that preschool factors may be early predictors of BPD symptomatology.

FINDINGS demonstrate that preschoolers with internalizing and externalizing psychopathology, high ACEs, and early suicidality are at greater risk of developing BPD symptoms. However, further research is needed to guide key factors for targeted early intervention.

Language: en

Keywords

adverse childhood experiences; early childhood; maternal support; preschool onset disorders; suicidality