Advertisement

Journal of Abnormal Child Psychology

, Volume 40, Issue 1, pp 7–20 | Cite as

Trajectories of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms as Precursors of Borderline Personality Disorder Symptoms in Adolescent Girls

  • Stephanie D. Stepp
  • Jeffrey D. Burke
  • Alison E. Hipwell
  • Rolf Loeber
Article

Abstract

Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD share clinical features of impulsivity, poor self-regulation, and executive dysfunction, while ODD and BPD share features of anger and interpersonal turmoil. The study is based on annual, longitudinal data from the two oldest cohorts in the Pittsburgh Girls Study (N = 1,233). We used piecewise latent growth curve models of ADHD and ODD scores from age 8 to 10 and 10 to 13 years to examine the prospective associations between dual trajectories of ADHD and ODD symptom severity and later BPD symptoms at age 14 in girls. To examine the specificity of these associations, we also included conduct disorder and depression symptom severity at age 14 as additional outcomes. We found that higher levels of ADHD and ODD scores at age 8 uniquely predicted BPD symptoms at age 14. Additionally, the rate of growth in ADHD scores from age 10 to 13 and the rate of growth in ODD scores from 8 to 10 uniquely predicted higher BPD symptoms at age 14. This study adds to the literature on the early development of BPD by providing the first longitudinal study to examine ADHD and ODD symptom trajectories as specific childhood precursors of BPD symptoms in adolescent girls.

Keywords

Borderline personality disorder Female children and adolescents Attention deficit hyperactivity disorder Oppositional defiant disorder Development 

Notes

Acknowledgements

This research was supported by grants from the National Institute of Mental Health (MH056630), the National Institute on Drug Abuse (DA012237), and by funding from the Office of Juvenile Justice and Delinquency Prevention, the FISA Foundation and the Falk Fund. Dr. Burke’s effort was supported by K01 MH074148. Dr. Hipwell’s effort was supported by K01 MH07179. Dr. Stepp’s effort was supported by K01 MH086713.

References

  1. American Psychiatric Association (APA). (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington: American Psychiatric Association.Google Scholar
  2. American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text Revision). Washington: American Psychiatric Association.Google Scholar
  3. Andrulonis, P. A. (1991). Disruptive behavior disorders in boys and the borderline personality disorder in men. Annals of Clinical Psychiatry, 3, 23–26.CrossRefGoogle Scholar
  4. Angold, A., Costello, J. E., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 57–87.PubMedCrossRefGoogle Scholar
  5. Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive function: constructing a unified theory of ADHD. Psychological Bulletin, 121, 65–94.PubMedCrossRefGoogle Scholar
  6. Barnow, S., Völker, K. A., Möller, B., Freyberger, H. J., Spitzer, C., Grabe, H. J., et al. (2009). Neuropsychological correlates of borderline personality disorder: a transcranial magnetic stimulation study. Biological Psychiatry, 65, 313–318.PubMedCrossRefGoogle Scholar
  7. Becker, D. F., McGlashan, T. H., & Grilo, C. M. (2006). Exploratory factor analysis of borderline personality disorder criteria in hospitalized adolescents. Comprehensive Psychiatry, 47, 99–105.PubMedCrossRefGoogle Scholar
  8. Biederman, J., Newcorn, J., & Sprich, S. (1991). Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. The American Journal of Psychiatry, 148, 564–577.PubMedGoogle Scholar
  9. Black, D. W., Gunter, T., Allen, J., Blum, N., Arndt, S., Wenman, G., et al. (2007). Borderline personality disorder in male and female offenders newly committed to prison. Comprehensive Psychiatry, 48, 400–405.PubMedCrossRefGoogle Scholar
  10. Bollen, K. A., & Curran, P. J. (2006). Latent curve models: A structural equation perspective. New York: Wiley.Google Scholar
  11. Burke, J. D., Loeber, R., & Birmaher, B. (2002). Oppositional defiant disorder and conduct disorder: a review of the past 10 years, Part II. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1275–1293.PubMedCrossRefGoogle Scholar
  12. Burke, J. D., Loeber, R., Lahey, B. B., & Rathouz, P. J. (2005). Developmental transitions among affective and behavioral disorders in adolescent boys. Journal of Child Psychology and Psychaitry, 46, 1200–1210.CrossRefGoogle Scholar
  13. Burke, J. D., Hipwell, A. E., & Loeber, R. (2010). Dimensions of oppositional defiant disorder as predictors of depression and conduct disorder in preadolescent girls. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 484–492.PubMedGoogle Scholar
  14. Buss, D. M., & Plomin, R. (1984). Temperament: Early developing personality traits. Hillsdale: Erlbaum.Google Scholar
  15. Carlson, E. A., Egeland, B., & Sroufe, L. A. (2009). A prospective investigation of the development of borderline personality symptoms. Development and Psychopathology, 21, 1311–1334.PubMedCrossRefGoogle Scholar
  16. Ceballos, N. A., Houston, R. J., Hesselbrock, V. M., & Bauer, L. O. (2006). Brain maturation in conduct disorder versus borderline personality disorder. Neuropsychobiology, 53(2), 94–100.PubMedCrossRefGoogle Scholar
  17. Clark, L. A. (2007). Assessment and diagnosis of personality disorder: perennial issues and an emerging reconceptualization. Annual Review of Psychology, 58, 227–257.PubMedCrossRefGoogle Scholar
  18. Clarkin, J. F., & Posner, M. (2005). Defining the mechanisms of borderline personality disorder. Psychopathology, 38, 56–63.PubMedCrossRefGoogle Scholar
  19. Cohen, P., Crawford, T. N., Johnson, J. G., & Kasen, S. (2005). The children in the community study of developmental course of personality disorder. Journal of Personality Disorders, 19, 466–486.PubMedCrossRefGoogle Scholar
  20. Cohen, P., Chen, H., Gordon, K., Johnson, J., Brook, J., & Kasen, S. (2008). Socioeconomic background and the developmental course of schizotypal and borderline personality disorder symptoms. Development and Psychopathology, 20, 633–650.PubMedCrossRefGoogle Scholar
  21. Coolidge, F. L., Segal, D. L., Steward, S. E., & Ellett, J. A. C. (2000). Neuropsychological dysfunction in children with borderline personality disorder features: a preliminary investigation. Journal of Research in Personality, 34, 554–561.CrossRefGoogle Scholar
  22. Copeland, W. E., Shanahan, L., Costello, E. J., & Angold, A. (2009). Which childhood and adolescent psychiatric disorders predict which young adult disorders? Archives of General Psychiatry, 66, 764–772.PubMedCrossRefGoogle Scholar
  23. Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60, 837–844.PubMedCrossRefGoogle Scholar
  24. Coy, K., Speltz, M. L., DeKlyen, M., & Jones, K. (2001). Social-cognitive processes in preschool boys with and without oppositional defiant disorder. Journal of Abnormal Child Psychology, 29, 107–119.PubMedCrossRefGoogle Scholar
  25. Crawford, T. N., Cohen, P. R., Chen, H., Anglin, P. M., & Ehrensaft, M. (2009). Early maternal separation and the trajectory of borderline personality symptoms. Development and Psychopathology, 21, 1013–1030.PubMedCrossRefGoogle Scholar
  26. Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: elaborating and extending Linehan’s theory. Psychological Bulletin, 135, 495–510.PubMedCrossRefGoogle Scholar
  27. Daruna, J., & Barnes, P. A. (1993). A neurodevelopmental view of impulsivity. In W. G. McCann, J. L. Johnson, & M. B. Shire (Eds.), The impulsive client: Theory, research and treatment. Washington: American Psychological Association.Google Scholar
  28. De Clercq, B., De Fruyt, F., Van Leeuwen, K., & Mervielde, I. (2006). The structure of maladaptive personality traits in childhood: a step toward an integrative developmental perspective for DSM-V. Journal of Abnormal Psychology, 115, 639–657.PubMedCrossRefGoogle Scholar
  29. Dowson, J. H., McLean, A., Bazanis, E., Toone, B., Young, S., Robbins, T. W., et al. (2004). The specificity of clinical characteristics in adults with attention-deficit/hyperactivity disorder: a comparison with patients with borderline personality disorder. European Psychiatry, 19, 72–78.PubMedCrossRefGoogle Scholar
  30. Evenden, J. (1999). Impulsivity: a discussion of clinical and experimental findings. Journal of Psychopharmacology, 13, 180–192.PubMedCrossRefGoogle Scholar
  31. Fischer, M., Barkley, R. A., Smallish, L., & Fletcher, K. (2002). Young adult follow-up of hyperactive children: self-reported psychiatric disorders, comorbidity, and the role of childhood conduct problems and teen CD. Journal of Abnormal Child Psychology, 30, 463–475.PubMedCrossRefGoogle Scholar
  32. Fisher, P. A., & Kim, H. K. (2007). Intervention effects on foster preschoolers’ attachment-related behaviors from a randomized trial. Prevention Science, 8, 161–170.PubMedCrossRefGoogle Scholar
  33. Fontaine, N., Carbonneau, R., Vitaro, F., Barker, E., & Tremblay, R. (2009). Research review: a critical review of studies on the developmental trajectories of antisocial behavior in females. Journal of Child Psychology and Psychiatry, 50, 363–385.PubMedCrossRefGoogle Scholar
  34. 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. Comprehensive Psychiatry, 43, 369–377.PubMedCrossRefGoogle Scholar
  35. Frankel, F., & Feinberg, D. (2002). Social problems associated with ADHD vs ODD in children referred for friendship problems. Child Psychiatry and Human Development, 33, 125–146.PubMedCrossRefGoogle Scholar
  36. Gadow, K. D., & Sprafkin, J. (1994). Child symptom inventories manual. Stony Brook: Checkmate Plus.Google Scholar
  37. Gadow, K. D., & Sprafkin, J. (1998). Child symptom inventory-4 screening manual. Stony Brook: Checkmate Plus.Google Scholar
  38. Gilbert, D. L., Bansal, A. S., Sethuraman, G., Sallee, F. R., Zhang, J., Lipps, T., et al. (2004). Association of cortical disinhibition with tic, ADHD, and OCD severity in Tourette syndrome. Movement Disorders, 19, 416–425.PubMedCrossRefGoogle Scholar
  39. Goodyer, I. M., Ashby, L., Altham, P. M. E., Vize, C., & Cooper, P. J. (1993). Temperament and major depression in 11 to 16 year olds. Journal of Child Psychology and Psychiatry, 34, 1409–1423.PubMedCrossRefGoogle Scholar
  40. Greene, R. W., Biederman, J., Zerwas, S., Monuteaux, M., Goring, J. C., & Faraone, S. V. (2002). Psychiatric comorbidity, family dysfunction, and social impairment in referred youth with oppositional defiant disorder. The American Journal of Psychiatry, 159(7), 1214–1224.PubMedCrossRefGoogle Scholar
  41. Grilo, C. M., & McGlashan, T. H. (2005). Course and outcome of personality disorders. In J. M. Oldham, A. E. Skodol, & D. S. Bender (Eds.), The American Psychiatric Publishing textbook of personality disorders (pp. 103–115). Washington: American Psychiatric.Google Scholar
  42. Gunderson, J. (2007). Disturbed relationships as a phenotype for borderline personality disorder. The American Journal of Psychiatry, 164, 1637–1640.PubMedCrossRefGoogle Scholar
  43. Gunderson, J., Stout, R., Sanislow, C., Shea, M., McGlashan, T., Zanarini, M., et al. (2008). New episodes and new onsets of major depression in borderline and other personality disorders. Journal of Affective Disorders, 111, 40–45.PubMedCrossRefGoogle Scholar
  44. Henry, C., Mitropoulou, V., New, A. S., Koenigsberg, H. W., Silverman, J., & Siever, L. J. (2001). Affective instability and impulsivity in borderline personality and bipolar II disorders: similarities and differences. Journal of Psychiatry Research, 35, 307–312.CrossRefGoogle Scholar
  45. Hipwell, A. E., Loeber, R., Southamer-Loeber, M., Keenan, K., White, H. R., & Kroneman, L. (2002). Characteristics of girls with early onset disruptive and antisocial behavior. Criminal Behavior and Mental Health, 12, 99–118.CrossRefGoogle Scholar
  46. Hussong, A. M., Flora, D. B., Curran, P. J., Chassin, L. A., & Zucker, R. A. (2008). Defining risk heterogeneity for internalizing symptoms among children of alcoholic parents. Development and Psychopathology, 20, 165–193.PubMedCrossRefGoogle Scholar
  47. Joyce, P. R., McKenzie, J. M., Luty, S. E., Mulder, R. T., Carter, J. D., Sullivan, P. F., et al. (2003). Temperament, childhood environment and psychopathology as risk factors for avoidant and borderline personality disorders. The Australian and New Zealand Journal of Psychiatry, 37(6), 756–764.PubMedGoogle Scholar
  48. Kasen, S., Cohen, P., Skodol, A. E., Johnson, J. G., & Brook, J. S. (1999). Influence of child and adolescent psychiatric disorders on young adult personality disorder. The American Journal of Psychiatry, 156(10), 1529–1535.PubMedGoogle Scholar
  49. Kuder, G. F., & Richardson, M. W. (1937). The theory of the estimation of test reliability. Psychometrika, 2, 151–160.CrossRefGoogle Scholar
  50. Lampe, K., Konrad, K., Kroener, S., Kunert, H. J., & Herpertz, S. C. (2007). Neuropsychological and behavioral disinhibition in adult ADHD compared to borderline personality disorder. Psychological Medicine, 37, 1717–1729.PubMedCrossRefGoogle Scholar
  51. Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004). Borderline personality disorder. The Lancet, 364, 453–461.CrossRefGoogle Scholar
  52. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford.Google Scholar
  53. Loeber, R., & Keenan, K. (1994). The interaction between conduct disorder and its comorbid conditions: effects of age and gender. Clinical Psychology Review, 14, 497–523.CrossRefGoogle Scholar
  54. Loeber, R., Burke, J. D., Lahey, B. B., Winters, A., & Zera, M. (2000). Oppositional defiant and conduct disorder: a review of the past 10 years, part I. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1468–1484.PubMedCrossRefGoogle Scholar
  55. Loranger, A. W., Sartorius, N., Andreoli, A., Berger, P., Buchheim, P., Channabasavanna, S. M., et al. (1994). The international personality disorder examination. Archives of General Psychiatry, 51, 215–224.PubMedCrossRefGoogle Scholar
  56. Maughan, B., Rowe, R., Messer, J., Goodman, R., & Meltzer, H. (2004). Conduct disorder and oppositional defiant disorder in a national sample: developmental epidemiology. Journal of Child Psychology and Psychiatry, 45, 609–621.PubMedCrossRefGoogle Scholar
  57. McDonald, R. P., & Ho, M.-H. R. (2002). Principles and practice in reporting structural equation analyses. Psychological Methods, 7, 64–82.PubMedCrossRefGoogle Scholar
  58. Miller, A. L., Muehlenkamp, J. J., & Jacobson, C. M. (2008). Fact or fiction: diagnosing borderline personality disorder in adolescents. Clinical Psychology Review, 28, 969–981.PubMedCrossRefGoogle Scholar
  59. Muthén, L., & Muthén, B. (2008). MPlus user’s guide: Version 5.2. Los Angeles: Muthén & Muthén.Google Scholar
  60. Nagin, D., & Tremblay, R. E. (1999). Trajectories of boys’ physical aggression, opposition, and hyperactivity on the path to physically violent and nonviolent juvenile delinquency. Child Development, 70, 1181–1196.PubMedCrossRefGoogle Scholar
  61. Nigg, J. T., Silk, K. R., Stavro, G., & Miller, T. (2005). Disinhibition and borderline personality disorder. Development and Psychopathology, 17, 1129–1149.PubMedGoogle Scholar
  62. Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed.). New York: McGraw- Hill.Google Scholar
  63. Philipsen, A. (2006). Differential diagnosis and comorbidity of attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) in adults. European Archives of Psychiatry and Clinical Neuroscience, 256, 42–46.CrossRefGoogle Scholar
  64. Philipsen, A., Limberger, M. F., Lieb, K., Feige, B., Kleindienst, N., Ebner-Priemer, U., et al. (2008). Attention-deficit hyperactivity disorder as a potentially aggravating factor in borderline personality disorder. The British Journal of Psychiatry, 192, 118–123.PubMedCrossRefGoogle Scholar
  65. Richter, M. M., Ehlis, A. C., Jacob, C. P., & Fallgatter, A. J. (2007). Cortical excitability in adult patients with attention-deficit/hyperactivity disorder (ADHD). Neuroscience Letters, 419, 137–141.PubMedCrossRefGoogle Scholar
  66. Rösler, M., Retz, W., Yaqoobi, K., Burg, E., & Retz-Junginger, P. (2009). Attention deficit/hyperactivity disorder in female offenders: prevalence, psychiatric comorbidity and psychosocial implications. European Archives of Psychiatry and Clinical Neuroscience, 259, 98–105.PubMedCrossRefGoogle Scholar
  67. Russell, J. J., Moskowitz, D. S., Zuroff, D. C., Sookman, D., & Paris, J. (2007). Stability and variability of affective experiences and interpersonal behavior in borderline personality disorder. Journal of Abnormal Psychology, 116, 578–588.PubMedCrossRefGoogle Scholar
  68. Shiner, R. (2009). The development of personality disorders: perspectives from normal personality development in childhood and adolescence. Development and Psychopathology, 21, 715–734.PubMedCrossRefGoogle Scholar
  69. Siever, L. J., & Davis, K. L. (1991). A psychobiological perspective on personality disorder. The American Journal of Psychiatry, 148, 1647–1658.PubMedGoogle Scholar
  70. Skodol, A. E., & Bender, D. S. (2003). Why are women diagnosed borderline more than men? Psychiatric Quarterly, 74, 349–360.PubMedCrossRefGoogle Scholar
  71. Smith, D. J., Muir, W. J., & Blackwood, D. H. R. (2005). Borderline personality disorder characteristics in young adults with recurrent mood disorders: a comparison of bipolar and unipolar depression. Journal of Affective Disorders, 87, 17–23.PubMedCrossRefGoogle Scholar
  72. Spencer, T. J., Biederman, J., Wilens, T. E., & Faraone, S. V. (2002). Overview of neurobiology of attention-deficit/hyperactivity disorder. The Journal of Clinical Psychiatry, 63, 3–9.PubMedCrossRefGoogle Scholar
  73. Stepp, S. D., Pilkonis, P. A., Yaggi, K. E., Morse, J. Q., & Feske, U. (2009). Interpersonal and emotional experiences of social interactions in borderline personality disorder. The Journal of Nervous and Mental Disease, 197, 484–491.PubMedCrossRefGoogle Scholar
  74. Stringaris, A., & Goodman, R. (2009). Three dimensions of oppositionality in youth. The Journal of Child Psychology and Psychiatry, 50, 216–223.CrossRefGoogle Scholar
  75. Torgersen, S., Kringlen, E., & Cramer, J. (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry, 58, 590–596.PubMedCrossRefGoogle Scholar
  76. Trull, T. J. (2001). Structural relations between borderline personality features and putative etiological correlates. Journal of Abnormal Psychology, 110, 471–481.PubMedCrossRefGoogle Scholar
  77. Trull, T. J., Tragresser, S. L., Jahng, S., Wood, P. K., Piasecki, T. M., & Watson, D. (2008). Affective instability: measuring a core feature of borderline personality disorder with ecological momentary assessment. Journal of Abnormal Psychology, 117, 647–661.PubMedCrossRefGoogle Scholar
  78. Willcutt, E. G., Pennington, B. F., Olson, R. K., Chhabildas, N., & Hulslander, J. (2005). Neuropsychological analyses of comorbidity between reading disability and attention deficit hyperactivity disorder: in search of the common deficit. Developmental Neuropsychology, 27, 35–78.PubMedCrossRefGoogle Scholar
  79. Winograd, G., Cohen, P., & Chen, H. (2008). Adolescent borderline symptoms in the community: prognosis for functioning over 20 years. Journal of Child Psychology and Psychiatry, 49, 933–941.PubMedCrossRefGoogle Scholar
  80. Zanarini, M. C., Frankenburg, F. R., Ridolfi, M. E., Jager-Hyman, S., Hennen, J., & Gunderson, J. G. (2006). Reported childhood onset of self-mutilation among borderline patients. Journal of Personality Disorders, 20, 9–15.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Stephanie D. Stepp
    • 1
  • Jeffrey D. Burke
    • 1
  • Alison E. Hipwell
    • 1
  • Rolf Loeber
    • 1
  1. 1.Western Psychiatric Institute and ClinicUniversity of Pittsburgh Medical CenterPittsburghUSA

Personalised recommendations