Skip to main content
SpringerLink
Log in

Persönlichkeitsfunktionsniveau, maladaptive Traits und Kindheitstraumata

Personality functioning, maladaptive traits, and childhood trauma

  • Schwerpunkt: Behandlung und Prävention von Borderline-Persönlichkeitsstörungen - Originalien
  • Published:
Psychotherapeut Aims and scope Submit manuscript

Zusammenfassung

Traumatische Erlebnisse in der Kindheit gelten als bedeutsamer Risikofaktor für Persönlichkeitsstörungen (PS). Allerdings ist die empirische Befundlage zu verschiedenen Formen von Kindheitstraumata und PS inkonsistent. Darüber hinaus fehlt bislang der Einbezug dimensionaler Maße für PS trotz ihres gegenwärtigen Einzugs in diagnostische Manuale. Die vorliegende Studie untersucht die Beziehung zwischen selbstberichteten Kindheitstraumata, dem Funktionsniveau der Persönlichkeit (Kriterium A) sowie maladaptiven Traits (Kriterium B) mithilfe von Strukturgleichungsmodellen in einer Stichprobe junger Erwachsener (n = 473). Alle Assoziationen zwischen Traumata, Kriterium A und B sind signifikant. Traumatische Erlebnisse sind stärker mit der Schwere der Funktionsbeeinträchtigung (Kriterium A) assoziiert als mit spezifischen maladaptiven Traits (Kriterium B), wo sich die stärksten Zusammenhänge mit der Persönlichkeitsdomäne „Verschlossenheit“ zeigen. Während körperlicher Missbrauch und körperliche Vernachlässigung sowie sexueller Missbrauch v. a. mit Antagonismus und Enthemmtheit assoziieren, sind emotionaler Missbrauch und emotionale Vernachlässigung mit negativer Affektivität, Verschlossenheit und Psychotizismus verknüpft. Die Ergebnisse zeigen, dass das Funktionsniveau und Traits der Persönlichkeit differenziell mit retrospektiven Traumata assoziiert sind, was die Relevanz dimensionaler Maße von PS für ein differenziertes Verständnis der Beziehung von Persönlichkeitspathologie und Kindheitstraumata unterstreicht.

Abstract

Childhood trauma is an important risk factor for the development of personality disorders (PD) but the empirical evidence on the differential associations is inconsistent and heterogeneous. There is also a lack of studies on trauma and dimensional measures of PD, despite the inclusion in the current diagnostic manuals. The present study investigated the relationship between self-reported forms of childhood trauma, personality functioning (criterion A) and maladaptive traits (criterion B) using structural equation models in a sample of young adults (n = 473). All associations between childhood trauma, criterion A and criterion B were significant. The severity of personality impairment (criterion A) was more strongly associated with traumatic experiences than with specific maladaptive traits (criterion B), where the strongest associations were shown in the personality domain “withdrawnness”. The association between detachment and childhood trauma was highest within criterion B. Antagonism and disinhibition were mostly associated with physical and sexual abuse, whilst negative affectivity, detachment and psychoticism were mostly associated with emotional trauma and neglect. The results show that levels of functioning and traits are differentially linked to retrospective reports of trauma, underlining the relevance of dimensional models of PD for a better understanding of the association between childhood trauma and personality pathologies.

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

Abb. 1

Notes

  1. 5. Ausgabe des Diagnostic and Statistical Manual of Mental Disorders

  2. 11. Auflage der Internationalen statistischen Klassifikation der Krankheiten und verwandter Gesundheitsprobleme

Literatur

  • Abbassi A, Aslinia SD (2010) Family violence, trauma and social learning theory. J Prof Couns Pract Theory Res 38(1):16–27

    Google Scholar 

  • American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5. Aufl. American Psychiatric Association, Washington, DC

    Book  Google Scholar 

  • Arata CM, Langhinrichsen-Rohling J, Bowers D, O’Farrill-Swails L (2005) Single versus multi-type maltreatment: An examination of the long-term effects of child abuse. J Aggress Maltreat Trauma 11(4):29–52

    Google Scholar 

  • Bandura A, Walters RH (1977) Social learning theory Bd. 1. Prentice-Hall, Englewood Cliffs

    Google Scholar 

  • Berenz EC, Amstadter AB, Aggen SH, Knudsen GP, Reichborn-Kjennerud T, Gardner CO, Kendler KS (2013) Childhood trauma and personality disorder criterion counts: a co-twin control analysis. J Abnorm Psychol 122(4):1070

    PubMed  PubMed Central  Google Scholar 

  • Bernstein DP, Iscan C, Maser J, Boards of Directors of the Association for Research in Personality Disorders and the International Society for the Study of Personality Disorders (2007) Opinions of personality disorder experts regarding the DSM-IV personality disorders classification system. J Pers Disord 21(5):536–551

    PubMed  Google Scholar 

  • Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, Zule W (2003) Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl 27(2):169–190

    PubMed  Google Scholar 

  • Borroni S, Somma A, Krueger RF, Markon KE, Perego G, Pietrobon A, Turano E, Fossati A (2019) Assessing the relationships between self-reports of childhood adverse experiences and DSM‑5 alternative model of personality disorder traits and domains: A study on Italian community-dwelling adults. Personal Ment Health 13(3):180–189

    PubMed  Google Scholar 

  • Brown DW, Anda RF, Tiemeier H, Felitti VJ, Edwards VJ, Croft JB, Giles WH (2009) Adverse childhood experiences and the risk of premature mortality. Am J Prev Med 37(5):389–396

    PubMed  Google Scholar 

  • Clark LA (2007) Assessment and diagnosis of personality disorder: Perennial issues and an emerging reconceptualization. Annu Rev Psychol 58:227–257

    PubMed  Google Scholar 

  • Cohen LJ, Tanis T, Bhattacharjee R, Nesci C, Halmi W, Galynker I (2014) Are there differential relationships between different types of childhood maltreatment and different types of adult personality pathology? Psychiatry Res 215(1):192–201

    PubMed  Google Scholar 

  • Felitti VJ (1998) The relationship of adult health status to childhood abuse and household dysfunction. Am J Prev Med 14:245–258

    CAS  PubMed  Google Scholar 

  • Fischer-Kern M, Buchheim A, Hörz S, Schuster P, Doering S, Kapusta ND, Taubner S, Tmej A, Rentrop M, Buchheim P, Fonagy P (2010) The relationship between personality organization, reflective functioning, and psychiatric classification in borderline personality disorder. Psychoanal Psychol 27(4):395–409

    Google Scholar 

  • Flory JD, Yehuda R, Grossman R, New AS, Mitropoulou V, Siever LJ (2009) Childhood trauma and basal cortisol in people with personality disorders. Compr Psychiatry 50(1):34–37

    PubMed  Google Scholar 

  • Foa EB, Hearst-Ikeda D (1996) Emotional dissociation in response to trauma. In: Michelson LK, Ray WJ (Hrsg) Handbook of dissociation. Springer, Boston

    Google Scholar 

  • Gander M, Buchheim A, Astrid B, Steppan M, Sevecke K, Goth K (2020) Unresolved attachment mediates the relationship between childhood trauma and impaired personality functioning in adolescence. J Pers Disord 34:1–20

    Google Scholar 

  • Gibb BE, Wheeler R, Alloy LB, Abramson LY (2001) Emotional, physical, and sexual maltreatment in childhood versus adolescence and personality dysfunction in young adulthood. J Pers Disord 15(6):505–511

    CAS  PubMed  Google Scholar 

  • Gilbert P, McEwan K, Irons C, Bhundia R, Christie R, Broomhead C, Rockliff H (2010) Self-harm in a mixed clinical population: the roles of selfcriticism, shame, and social rank. Br J Clin Psychol 49:563–576

    PubMed  Google Scholar 

  • Grant BF, Stinson FS, Hasin DS, Dawson DA, Chou SP, Ruan W, Huang B (2005) Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 66(10):1205–1215

    PubMed  Google Scholar 

  • Gunderson JG, Stout RL, McGlashan TH, Shea MT, Morey LC, Grilo CM, Ansell E (2011) Ten-year course of borderline personality disorder: psychopathology and function from the Collaborative Longitudinal Personality Disorders study. Arch Gen Psychiatry 68(8):827–837

    PubMed  PubMed Central  Google Scholar 

  • Hailes HP, Yu R, Danese A, Fazel S (2019) Long-term outcomes of childhood sexual abuse: an umbrella review. Lancet Psychiatry 6(10):795–797

    Google Scholar 

  • Häuser W, Schmutzer G, Brähler E, Glaesmer H (2011) Misshandlungen in Kindheit und Jugend. Dtsch Arztebl 108(17):287–294

    Google Scholar 

  • Hooley JM, Gotlib IH (2000) A diathesis-stress conceptualization of expressed emotion and clinical outcome. Appl Prev Psychol 9(3):135–151

    Google Scholar 

  • Hopwood CJ, Kotov R, Krueger RF, Watson D, Widiger TA, Althoff RR, Bornovalova MA (2018) The time has come for dimensional personality disorder diagnosis. Personal Ment Health 12(1):82–86

    PubMed  Google Scholar 

  • Hyman SE (2010) The diagnosis of mental disorders: the problem of reification. Annu Rev Clin Psychol 6:155–179

    PubMed  Google Scholar 

  • Jogems-Kosterman BJ, De Knijff DW, Kusters R, van Hoof JJ (2007) Basal cortisol and DHEA levels in women with borderline personality disorder. J Psychiatr Res 41(12):1019–1026

    PubMed  Google Scholar 

  • Johansen M, Karterud S, Pedersen G, Gude T, Falkum E (2004) An investigation of the prototype validity of the borderline DSM-IV construct. Acta Psychiatr Scand 109(4):289–298

    CAS  PubMed  Google Scholar 

  • 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(7):600–606

    CAS  PubMed  Google Scholar 

  • Klinitzke G, Romppel M, Häuser W, Brähler E, Glaesmer H (2012) The German Version of the Childhood Trauma Questionnaire (CTQ): psychometric characteristics in a representative sample of the general population. Psychother Psychosom Med Psychol 62(2):47–51

    PubMed  Google Scholar 

  • Kotov R, Krueger RF, Watson D, Achenbach TM, Althoff RR, Bagby RM, Eaton NR (2017) The Hierarchical Taxonomy of Psychopathology (HiTOP): a dimensional alternative to traditional nosologies. J Abnorm Psychol 126(4):454

    PubMed  Google Scholar 

  • Krischer MK, Sevecke K (2008) Early traumatization and psychopathy in female and male juvenile offenders. Int J Law Psychiatry 31(3):253–262

    PubMed  Google Scholar 

  • Krueger RF, Markon KE (2014) The role of the DSM‑5 personality trait model in moving toward a quantitative and empirically based approach to classifying personality and psychopathology. Annu Rev Clin Psychol 10:477–501

    PubMed  Google Scholar 

  • Krueger RF, Derringer J, Markon KE, Watson D, Skodol AE (2013) The personality inventory for DSM-5—brief form (PID-5-BF)—adult. American Psychiatric Association, Washington, DC

    Google Scholar 

  • Krueger RF, Hopwood CJ, Wright AG, Markon KE (2014) DSM‑5 and the path toward empirically based and clinically useful conceptualization of personality and psychopathology. Clin Psychol Sci Pract 21(3):245–261

    Google Scholar 

  • Manly JT (2005) Advances in research definitions of child maltreatment. Child Abuse Negl 29(5):425–439

    PubMed  Google Scholar 

  • Metzler M, Merrick MT, Klevens J, Ports KA, Ford DC (2017) Adverse childhood experiences and life opportunities: shifting the narrative. Child Youth Serv Rev 72:141–149

    Google Scholar 

  • Modestin J, Oberson B, Erni T (1998) Possible antecedents of DSM-III‑R personality disorders. Acta Psychiatr Scand 97(4):260–266

    CAS  PubMed  Google Scholar 

  • Morey LC (2017) Development and initial evaluation of a self-report form of the DSM–5 Level of Personality Functioning Scale. Psychol Assess 29(10):1302

    PubMed  Google Scholar 

  • Morey LC, Skodol AE, Oldham JM (2014) Clinician judgments of clinical utility: a comparison of DSM-IV-TR personality disorders and the alternative model for DSM‑5 personality disorders. J Abnorm Psychol 123(2):398

    PubMed  Google Scholar 

  • Rosseel Y (2012) Lavaan: An R package for structural equation modeling and more. Version 0.5–12 (BETA). J Stat Softw 48(2):1–36

    Google Scholar 

  • Scheffers F, Van Vugt E, Lanctôt N, Lemieux A (2019) Experiences of (young) women after out of home placement: an examination of personality disorder symptoms through the lens of child maltreatment. Child Abus Negl 92:116–125

    Google Scholar 

  • Scher CD, Stein MB, Asmundson GJ, McCreary DR, Forde DR (2001) The childhood trauma questionnaire in a community sample: psychometric properties and normative data. J Trauma Stress 14(4):843–857

    CAS  PubMed  Google Scholar 

  • Taubner S, White LO, Zimmermann J, Fonagy P, Nolte T (2013) Attachment-related mentalization moderates the relationship between psychopathic traits and proactive aggression in adolescence. J Abnorm Child Psychol 41(6):929–938

    PubMed  Google Scholar 

  • Tyrer P, Reed GM, Crawford MJ (2015) Classification, assessment, prevalence, and effect of personality disorder. Lancet 385(9969):717–726

    PubMed  Google Scholar 

  • Tyrka AR, Wyche MC, Kelly MM, Price LH, Carpenter LL (2009) Childhood maltreatment and adult personality disorder symptoms: influence of maltreatment type. Psychiatry Res 165(3):281–287

    PubMed  PubMed Central  Google Scholar 

  • Veith AC, Russell TD, King AR (2017) PID‑5 trait mediation of childhood maltreatment effects. Pers Individ Dif 104:58–63

    Google Scholar 

  • Zanarini MC, Frankenburg FR, Reich DB, Fitzmaurice G (2012) Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and axis II comparison subjects: a 16-year prospective follow-up study. Am J Psychiatry 169(5):476–483

    PubMed  PubMed Central  Google Scholar 

  • Zimmerman M, Rothschild L, Chelminski I (2005) The prevalence of DSM-IV personality disorders in psychiatric outpatients. Am J Psychiatry 162(10):1911–1918

    PubMed  Google Scholar 

  • Zimmermann J, Altenstein D, Krieger T, Holtforth MG, Pretsch J, Alexopoulos J, Leising D (2014) The structure and correlates of self-reported DSM‑5 maladaptive personality traits: Findings from two German-speaking samples. J Personal Disord 28(4):518–540

    Google Scholar 

  • Zimmermann J, Brakemeier EL, Benecke C (2015) Alternatives DSM-5-Modell zur Klassifikation von Persönlichkeitsstörungen. Psychotherapeut 60(4):269–279

    Google Scholar 

  • Zimmermann J, Kerber A, Rek K, Hopwood CJ, Krueger RF (2019) A brief but comprehensive review of research on the Alternative DSM‑5 Model for Personality Disorders. Curr Psychiatry Rep 21(9):92

    PubMed  Google Scholar 

  • Zweig-Frank H, Paris J (2002) Predictors of outcome in a 27-year follow-up of patients with borderline personality disorder. Compr Psychiatry 43(2):103–107

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinische Psychologie und Psychotherapie, Fakultät für Psychologie, Ludwig-Maximilians-Universität, Leopoldstr. 13, 80802, München, Deutschland

    Sarah N. Back &  Katja Bertsch

  2. Institut für Psychosoziale Prävention, Universitätsklinikum Heidelberg, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Deutschland

    Max Zettl &  Svenja Taubner

Authors
  1. Sarah N. Back
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Max Zettl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Katja Bertsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Svenja Taubner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sarah N. Back.

Ethics declarations

Interessenkonflikt

S.N. Back, M. Zettl, K. Bertsch und S. Taubner geben an, dass kein Interessenkonflikt besteht.

Alle beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Studienteilnehmern liegt eine Einverständniserklärung vor.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Back, S.N., Zettl, M., Bertsch, K. et al. Persönlichkeitsfunktionsniveau, maladaptive Traits und Kindheitstraumata. Psychotherapeut 65, 374–382 (2020). https://doi.org/10.1007/s00278-020-00445-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00278-020-00445-7

Schlüsselwörter

Keywords

Search

Navigation