Skip to main content

Advertisement

SpringerLink
Log in

Differences in the association between childhood trauma history and borderline personality disorder or attention deficit/hyperactivity disorder diagnoses in adulthood

  • Original Paper
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Common environmental etiological factors between borderline personality disorder (BPD) and attention deficit/hyperactivity disorder (ADHD) have not been fully studied. The main aim of this study was to investigate the relationship between childhood trauma histories, assessed by the Childhood Trauma Questionnaire-Short Form (CTQ-SF), with adult BPD, ADHD or BPD-ADHD diagnoses. Comorbid BPD-ADHD patients exhibited significantly higher clinical severity and higher scores in the Total Neglect Scale, compared to BPD and ADHD patients, and only a marginal difference was observed for Sexual Abuse when BPD and ADHD patients were compared. Physical Trauma Scales were associated with ADHD diagnosis, whereas Emotional Abuse and Sexual Abuse Scales were associated with BPD or BPD-ADHD diagnoses. The study findings support the association between experiencing traumatic events in childhood and a higher clinical severity of BPD in adulthood. Furthermore, physical trauma history in childhood could be associated with the persistence of ADHD in adulthood and emotional or sexual abuse with later development of BPD or comorbid BPD-ADHD. Whereas experiencing childhood traumas is associated with later development of more general psychopathology, our study supports that a specific type of traumatic event could increase the risk for the consolidation of a concrete psychiatric disorder in the trajectory from childhood to adulthood of vulnerable subjects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ferrer M, Andion O, Matali J, Valero S, Navarro JA, Ramos-Quiroga JA, Torrubia R, Casas M (2010) Comorbid attention-deficit/hyperactivity disorder in borderline patients defines an impulsive subtype of borderline personality disorder. J Pers Disord 24:812–822

    Article  PubMed  Google Scholar 

  2. Fossati A, Novella L, Donati D, Donini M, Maffei C (2002) History of childhood attention deficit/hyperactivity disorder symptoms and borderline personality disorder: a controlled study. Compr Psychiatry 43:369–377

    Article  PubMed  Google Scholar 

  3. Miller CJ, Flory JD, Miller SR, Harty SC, Newcorn JH, Halperin JM (2008) Childhood attention-deficit/hyperactivity disorder and the emergence of personality disorders in adolescence: a prospective follow-up study. J Clin Psychiatry 69:1477–1483

    Article  PubMed  PubMed Central  Google Scholar 

  4. Philipsen A, Limberger MF, Lieb K, Feige B, Kleindienst N, Ebner-Priemer U, Barth J, Schmahl C, Bohus M (2008) Attention-deficit hyperactivity disorder as a potentially aggravating factor in borderline personality disorder. Br J Psychiatry 192:118–123

    Article  PubMed  Google Scholar 

  5. Philipsen A (2006) Differential diagnosis and comorbidity of attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) in adults. Eur Arch Psychiatry Clin Neurosci 256(Suppl 1):I/42–I/46

    Article  PubMed  Google Scholar 

  6. Prada P, Hasler R, Baud P, Bednarz G, Ardu S, Krejci I, Nicastro R, Aubry JM, Perroud N (2014) Distinguishing borderline personality disorder from adult attention deficit/hyperactivity disorder: a clinical and dimensional perspective. Psychiatry Res 217:107–114

    Article  PubMed  Google Scholar 

  7. Stepp SD, Burke JD, Hipwell AE, Loeber R (2012) Trajectories of attention deficit hyperactivity disorder and oppositional defiant disorder symptoms as precursors of borderline personality disorder symptoms in adolescent girls. J Abnorm Child Psychol 40:7–20

    Article  PubMed  PubMed Central  Google Scholar 

  8. Van Dijk FE, Lappenschaar M, Kan CC, Verkes RJ, Buitelaar JK (2012) Symptomatic overlap between attention-deficit/hyperactivity disorder and borderline personality disorder in women: the role of temperament and character traits. Compr Psychiatry 53:39–47

    Article  PubMed  Google Scholar 

  9. Distel MA, Carlier A, Middeldorp CM, Derom CA, Lubke GH, Boomsma DI (2011) Borderline personality traits and adult attention-deficit hyperactivity disorder symptoms: a genetic analysis of comorbidity. Am J Med Genet B Neuropsychiatr Genet 156:817–825

    Article  CAS  Google Scholar 

  10. Matthies S, Philipsen A (2016) Comorbidity of personality disorders and adult attention deficit hyperactivity disorder (ADHD)–review of recent findings. Curr Psychiatry Rep 18:33

    Article  PubMed  Google Scholar 

  11. Linehan MM (1993) Skills training manual for treating borderline personality disorder. Guilford Press, New York

    Google Scholar 

  12. Crowell SE, Beauchaine TP, Linehan MM (2009) A biosocial developmental model of borderline personality: elaborating and extending Linehan’s theory. Psychol Bull 135:495–510

    Article  PubMed  PubMed Central  Google Scholar 

  13. Links PS, Heslegrave R, van Reekum R (1999) Impulsivity: core aspect of borderline personality disorder. J Pers Disord 13:1–9

    Article  CAS  PubMed  Google Scholar 

  14. Zanarini MC, Frankenburg FR (2007) The essential nature of borderline psychopathology. J Pers Disord 21:518–535

    Article  PubMed  Google Scholar 

  15. Dowson JH, Blackwell AD (2010) Impulsive aggression in adults with attention-deficit/hyperactivity disorder. Acta Psychiatr Scand 121:103–110

    Article  CAS  PubMed  Google Scholar 

  16. Valero S, Ramos-Quiroga JA, Gomà-i-Freixanet M, Bosch R, Gómez-Barros N, Nogueira M, Palomar G, Corrales M, Casas M (2012) Personality profile of adult ADHD: the alternative five factor model. Psychiatry Res 198:130–134

    Article  PubMed  Google Scholar 

  17. Winstanley CA, Eagle DM, Robbins TW (2006) Behavioral models of impulsivity in relation to ADHD: translation between clinical and preclinical studies. Clin Psychol Rev 26:379–395

    Article  PubMed  PubMed Central  Google Scholar 

  18. Carpenter RW, Trull TJ (2013) Components of emotion dysregulation in borderline personality disorder: a review. Curr Psychiatry Rep 15:335

    Article  PubMed  PubMed Central  Google Scholar 

  19. Shaw P, Stringaris A, Nigg J, Leibenluft E (2014) Emotion dysregulation in attention deficit hyperactivity disorder. Am J Psychiatry 171:276–293

    Article  PubMed  PubMed Central  Google Scholar 

  20. Carpenter RW, Tomko RL, Trull TJ, Boomsma DI (2013) Gene-environment studies and borderline personality disorder: a review. Curr Psychiatry Rep 15:336

    Article  PubMed  PubMed Central  Google Scholar 

  21. Thapar A, Cooper M, Eyre O, Langley K (2013) Practitioner review: What have we learnt about the causes of ADHD? J Child Psychol Psychiatry 54:3–16

    Article  PubMed  PubMed Central  Google Scholar 

  22. Amad A, Ramoz N, Thomas P, Jardri R, Gorwood P (2014) Genetics of borderline personality disorder: systematic review and proposal of an integrative model. Neurosci Biobehav Rev 40:6–19

    Article  PubMed  Google Scholar 

  23. Larsson H, Chang Z, D’Onofrio BM, Lichtenstein P (2013) The heritability of clinically diagnosed attention deficit hyperactivity disorder across the lifespan. Psychol Med 10:1–7

    Google Scholar 

  24. Johnson JG, Cohen P, Brown J, Smailes EM, Bernstein DP (1999) Childhood maltreatment increases risk for personality disorders during early adulthood. Arch Gen Psychiatry 56:600–606

    Article  CAS  PubMed  Google Scholar 

  25. Martin-Blanco A, Soler J, Villalta L, Feliu-Soler A, Elices M, Pérez V, Arranz MJ, Ferraz L, Álvarez E, Pascual JC (2014) Exploring the interaction between childhood maltreatment and temperamental traits on the severity of borderline personality disorder. Compr Psychiatry 55:311–318

    Article  PubMed  Google Scholar 

  26. Soloff PH, Lynch KG, Kelly TM (2002) Childhood abuse as a risk factor for suicidal behavior in borderline personality disorder. J Pers Disord 16:201–214

    Article  PubMed  Google Scholar 

  27. Spataro J, Mullen PE, Burgess PM, Wells DL, Moss SA (2004) Impact of child sexual abuse on mental health: prospective study in males and females. Br J Psychiatry 184:416–421

    Article  PubMed  Google Scholar 

  28. Zanarini MC, Yong L, Frankenburg FR, Hennen J, Reich DB, Marino MF, Vujanovic AA (2002) Severity of reported childhood sexual abuse and its relationship to severity of borderline psychopathology and psychosocial impairment among borderline inpatients. J Nerv Ment Dis 190:381–387

    Article  PubMed  Google Scholar 

  29. Zanarini MC (2000) Childhood experiences associated with the development of borderline personality disorder. Psychiatry Clin North Am 23:89–101

    Article  CAS  Google Scholar 

  30. Widom CS, Czaja SJ, Paris J (2009) A prospective investigation of borderline personality disorder in abused and neglected children followed up into adulthood. J Pers Disord 23:433–446

    Article  PubMed  Google Scholar 

  31. De Sanctis VA, Nomura Y, Newcorn JH, Halperin JM (2012) Childhood maltreatment and conduct disorder: independent predictors of criminal outcomes in ADHD youth. Child Abuse Negl 36:782–789

    Article  PubMed  PubMed Central  Google Scholar 

  32. Guendelman MD, Owens EB, Galán C, Gard A, Hinshaw SP (2015) Early-adult correlates of maltreatment in girls with attention-deficit/hyperactivity disorder: increased risk for internalizing symptoms and suicidality. Dev Psychopathol 27:1–14

    Article  Google Scholar 

  33. Nogueira M, Bosch R, Valero S, Gómez-Barros N, Palomar G, Richarte V, Corrales M, Nasillo V, Vidal R, Casas M, Ramos-Quiroga JA (2014) Early-age clinical and developmental features associated to substance use disorders in attention-deficit/hyperactivity disorder in adults. Compr Psychiatry 55:639–649

    Article  CAS  PubMed  Google Scholar 

  34. Rucklidge JJ, Brown DL, Crawford S, Kaplan BJ (2006) Retrospective reports of childhood trauma in adults with ADHD. J Atten Disord 9:631–641

    Article  PubMed  Google Scholar 

  35. Fossati A, Gratz KL, Borroni S, Maffei C, Somma A, Carlotta D (2015) The relationship between childhood history of ADHD symptoms and DSM-IV borderline personality disorder features among personality disordered outpatients: the moderating role of gender and the mediating roles of emotion dysregulation and impulsivity. Compr Psychiatry 56:121–127

    Article  PubMed  Google Scholar 

  36. Lampe K, Konrad K, Kroener S, Fast K, Kunert HJ, Herpetz SC (2007) Neuropsychological and behavioural disinhibition in adult ADHD compared to borderline personality disorder. Psychol Med 37:1717–1729

    Article  CAS  PubMed  Google Scholar 

  37. Ramos-Quiroga JA, Bosch R, Richarte V, Valero S, Gómez-Barros N, Nogueira M, Palomar G, Corrales M, Sáez-Francàs N, Corominas M, Real A, Vidal R, Chalita PJ, Casas M (2012) Criterion and concurrent validity of Conner’s adult ADHD diagnostic interview for DSM-IV (CAADID) Spanish version. Rev Psiquiatr Salud Ment 5:229–235

    Article  PubMed  Google Scholar 

  38. Vilar M, Pérez JF, Herández M, Renovell M, Leal C, Gómez M (1995) Preparation of a SCID-II based diagnostic tool for personality disorders. Spanish version. Translation and adaptation. Actas Luso Esp Neurol Psiquiatr Cienc Afines 23:178–183

    Google Scholar 

  39. Barrachina J, Soler J, Campins MJ, Tejero A, Pascual JC, Alvarez E, Zanarini MC, Pérez Sola V (2004) Validation of a Spanish version of the diagnostic interview for borderlines-revised (DIB-R). Actas Esp Psiquiatr 32:293–298

    CAS  PubMed  Google Scholar 

  40. Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, Stokes J, Handelsman L, Medrano M, Desmond D, Zule W (2003) Development and validation of a brief screening version of the childhood trauma questionnaire. Child Abuse Negl 27:169–190

    Article  PubMed  Google Scholar 

  41. Rodríguez-Jiménez R, Ponce G, Monasor R, Jiménez-Giménez M, Pérez-Rojo JA, Rubio G, Jiménez Arriero PT (2001) Validation in the adult Spanish population of the Wender Utah Rating Scale for the retrospective evaluation in adults of attention deficit/hyperactivity disorder in childhood. Rev Neurol 33:138–144

    Google Scholar 

  42. First MB, Gibbon M, Spitzer RL, Williams JBW, Benjamin LS (1997) The structured clinical interview for DSM-IV axis II disorder (SCID-II). Biometrics Research Department, New York State Psychiatric Institute, New York

    Google Scholar 

  43. Zanarini MC, Gunderson JG, Frankenburg FR, Chauncey DL (1989) The revised diagnostic interview for borderlines: discriminating borderline personality disorders from other axis II disorders. J Pers Disord 3:10–18

    Article  Google Scholar 

  44. Epstein JN, Johnson D, Conners CK (2006) Conners’ adult ADHD diagnostic interview for DSM-IV. Multi-Health Systems Inc, North Tonawanda

    Google Scholar 

  45. Epstein JN, Kollins SH (2006) Psychometric properties of an adult ADHD diagnostic interview. J Atten Disord 9:504–514

    Article  PubMed  Google Scholar 

  46. Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, Sapareto E, Ruggiero J (1994) Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry 151:1132–1136

    Article  CAS  PubMed  Google Scholar 

  47. Ward MF, Wender PH, Reimherr FW (1993) The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry 150:885–890

    Article  CAS  PubMed  Google Scholar 

  48. Andión Ó, Ferrer M, Calvo N, Gancedo B, Barral C, Di Genova A, Arbos MA, Torrubia R, Casas M (2013) Exploring the clinical validity of borderline personality disorder components. Compr Psychiatry 54:24–40

    Article  Google Scholar 

  49. Bornovalova MA, Levy R, Gratz KL, Lejuez CW (2010) Understanding the heterogeneity of BPD symptoms through latent class analysis: initial results and clinical correlates among inner-city substance users. Psychol Assess 22:233–245

    Article  PubMed  PubMed Central  Google Scholar 

  50. Zimmerman M, Chelminski I, Young D, Dalrymple K, Martinez J (2012) Does the presence of one feature of borderline personality disorder have clinical significance? Implications for dimensional ratings of personality disorders. J Clin Psychiatry 73:8–12

    Article  PubMed  Google Scholar 

  51. Teicher MH, Samson JA (2013) Childhood maltreatment and psychopathology: a case for ecophenotypic variants as clinically and neurobiologically distinct subtypes. Am J Psychiatry 170:1114–1133

    Article  PubMed  PubMed Central  Google Scholar 

  52. Herman JL, Perry JC, van der Kolk BA (1989) Childhood trauma in borderline personality disorder. Am J Psychiatry 146:490–495

    Article  CAS  PubMed  Google Scholar 

  53. Zanarini MC, Williams AA, Lewis RE, Reich RB, Vera SC, Marino MF, Levin A, Yong L, Frankenburg FR (1997) Reported pathological childhood experiences associated with the development of borderline personality disorder. Am J Psychiatry 154:1101–1106

    Article  CAS  PubMed  Google Scholar 

  54. Kaess M, Brunner R, Chanen A (2014) Borderline personality disorder in adolescence. Pediatrics 134:782–793

    Article  PubMed  Google Scholar 

  55. Baer RA, Peters JR, Eisenlohr-Moul TA, Geiger PJ, Sauer SE (2012) Emotion-related cognitive processes in borderline personality disorder: a review of the empirical literature. Clin Psychol Rev 32:359–369

    Article  PubMed  Google Scholar 

  56. Gunderson JG, Daversa MT, Grilo CM, McGlashan TH, Zanarini MC, Shea MT, Skodol AE, Yen S, Sanislow CA (2006) Predictors of 2-year outcome for patients with borderline personality disorder. Am J Psychiatry 163:822–826

    Article  PubMed  Google Scholar 

  57. Golier JA, Yehuda R, Bierer LM, Mitropoulou V, New AS, Schmeidler J, Silverman JM, Siever LJ (2003) The relationship of borderline personality disorder to posttraumatic stress disorder and traumatic events. Am J Psychiatry 160:2018–2024

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Financial support was provided by public funds from the Pla Director de Salut Mental i Addiccions (Generalitat de Catalunya Health Department) and grants from the Obra Social–Fundació ‘la Caixa.’

Author information

Authors and Affiliations

  1. BPD Program, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Psychiatry Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain

    Marc Ferrer, Óscar Andión, Natalia Calvo, Josep A. Ramos-Quiroga, Mònica Prat, Montserrat Corrales & Miguel Casas

  2. Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain

    Marc Ferrer, Óscar Andión, Natalia Calvo, Josep A. Ramos-Quiroga, Mònica Prat, Montserrat Corrales & Miguel Casas

  3. Grup TLP Barcelona (BPD Barcelona Group), Barcelona, Spain

    Marc Ferrer, Natalia Calvo, Mònica Prat & Miguel Casas

Authors
  1. Marc Ferrer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Óscar Andión
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Natalia Calvo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Josep A. Ramos-Quiroga
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mònica Prat
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Montserrat Corrales
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Miguel Casas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marc Ferrer.

Ethics declarations

Conflict of interest

There are no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ferrer, M., Andión, Ó., Calvo, N. et al. Differences in the association between childhood trauma history and borderline personality disorder or attention deficit/hyperactivity disorder diagnoses in adulthood. Eur Arch Psychiatry Clin Neurosci 267, 541–549 (2017). https://doi.org/10.1007/s00406-016-0733-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-016-0733-2

Keywords

Search

Navigation