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Extending extant models of the pathogenesis of borderline personality disorder to childhood borderline personality symptoms: The roles of affective dysfunction, disinhibition, and self- and emotion-regulation deficits

  • Kim L. Gratz (a1), Matthew T. Tull (a1), Elizabeth K. Reynolds (a2), Courtney L. Bagge (a1), Robert D. Latzman (a1), Stacey B. Daughters (a2) and C. W. Lejuez (a2)...

Abstract

Although research has been conducted on the course, consequences, and correlates of borderline personality disorder (BPD), little is known about its emergence in childhood, and no studies have examined the extent to which theoretical models of the pathogenesis of BPD in adults are applicable to the correlates of borderline personality symptoms in children. The goal of this study was to examine the interrelationships between two BPD-relevant personality traits (affective dysfunction and disinhibition), self- and emotion-regulation deficits, and childhood borderline personality symptoms among 263 children aged 9 to 13. We predicted that affective dysfunction, disinhibition, and their interaction would be associated with childhood borderline personality symptoms, and that self- and emotion-regulation deficits would mediate these relationships. Results provided support for the roles of both affective dysfunction and disinhibition (in the form of sensation seeking) in childhood borderline personality symptoms, as well as their hypothesized interaction. Further, both self- and emotion-regulation deficits partially mediated the relationship between affective dysfunction and childhood borderline personality symptoms. Finally, results provided evidence of different gender-based pathways to childhood borderline personality symptoms, suggesting that models of BPD among adults are more relevant to understanding the factors associated with borderline personality symptoms among girls than boys.

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Corresponding author

Address correspondence and reprint requests to: Kim L. Gratz, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216; E-mail: klgratz@aol.com.

References

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Ad-Dab'Bagh, Y., & Greenfield, B. (2001). Multiple complex developmental disorder: The “multiple and complex” evolution of the “childhood borderline syndrome” construct. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 954964.
Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Thousand Oaks, CA: Sage.
Aluja, A., Cuevas, L., Garcia, L. F., & Garcia, O. (2007). Zuckerman's personality model predicts MCMI-III personality disorders. Personality and Individual Differences, 42, 13111321.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Arlington, VA: Author.
Asendorpf, J. B., & van Aken, M. A. (1999). Resilient, overcontrolled, and undercontrolled personality prototypes in childhood: Replicability, predictive power, and the trait-type issue. Journal of Abnormal and Social Psychology, 77, 815832.
Aspelmeier, J. E., Elliot, A. N., & Smith, C. H. (2007). Childhood sexual abuse, attachment, and trauma symptoms in college females: The moderating role of attachment. Child Abuse and Neglect, 31, 549566.
Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 11731182.
Barone, L. (2003). Developmental protective and risk factors in borderline personality disorder: A study using the Adult Attachment Interview. Attachment and Human Development, 5, 6477.
Baumeister, R. F. (1998). The self. In Gilbert, D. T., Fiske, S. T., & Gardner, L. (Eds.), The handbook of social psychology (Vol. 1, pp. 680740). New York: McGraw–Hill.
Bemporad, J. R., Smith, H. F., Hanson, G., & Cicchetti, D. (1982). Borderline syndromes in childhood: Criteria for diagnosis. American Journal of Psychiatry, 139, 596602.
Bernstein, D. P., Cohen, P., Velez, C. N., Schwab-Stone, M., Siever, L. J., & Shinsato, L. (1993). Prevalence and stability of the DSM-III-R personality disorders in a community-based survey of adolescents. American Journal of Psychiatry, 150, 12371243.
Block, J. H., & Block, J. (1980). The role of ego-control and ego-resiliency in the organization of behavior. In Collins, W. A. (Ed.), Development of cognition, affect, and social relations. The Minnesota Symposia on Child Psychology (Vol. 13, pp. 39101). Hillsdale, NJ: Erlbaum.
Block, J., Block, J. H., & Keyes, S. (1988). Longitudinally foretelling drug usage in adolescence: Early childhood personality and environmental precursors. Child Development, 59, 336355.
Bornovalova, M. A., Gratz, K. L., Daughters, S. B., Bettina, N., Delany-Brumsey, A., Lynch, T. R., et al. (2008). A multimodal assessment of the relationship between emotion dysregulation and borderline personality disorder among inner-city substance users in residential treatment. Journal of Psychiatric Research, 42, 717726.
Bornovalova, M. A., Gratz, K. L., Delany-Brumsey, A., Paulson, A., & Lejuez, C. W. (2006). Temperamental and environmental risk factors for borderline personality disorder among inner-city substance users in residential treatment. Journal of Personality Disorders, 20, 218231.
Calkins, S. D., & Johnson, M. C. (1998). Toddler regulation of distress to frustrating events: Temperamental and maternal correlates. Infant Behavior and Development, 21, 379395.
Carlson, S. M., & Wang, T. S. (2007). Inhibitory control and emotion regulation in preschool children. Cognitive Development, 22, 489510.
Centers for Disease Control (CDC). (2001). Youth risk behavior surveillance system. Atlanta, GA: Author.
Chorpita, B. F., Moffitt, C. E., & Gray, J. (2005). Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample. Behaviour Research and Therapy, 43, 309322.
Chorpita, B. F., Yim, L., Moffitt, C., Umemoto, L. A., & Francis, S. E. (2000). Assessment of symptoms of DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behaviour Research and Therapy, 38, 835855.
Cicchetti, D., & Lynch, M. (1993). Toward an ecological/transactional model of community violence and child maltreatment: Consequences for children's development. Psychiatry, 53, 96118.
Cicchetti, D., & Rogosch, F. A. (1996). Equifinality and multifinality in developmental psychopathology. Development and Psychopathology, 8, 597600.
Cicchetti, D., & Rogosch, F. A. (2002). A developmental psychopathology perspective on adolescence. Journal of Consulting and Clinical Psychology, 70, 620.
Cicchetti, D., & Toth, S. L. (2009). The past achievements and future promises of developmental psychopathology: The coming of age of a discipline. Journal of Child and Adolescent Psychiatry, 50, 1625.
Cohen, P., & Crawford, T. N. (2005). Developmental issues. In Oldham, J. M., Skodol, A. E., & Bender, D. S. (Eds.), The textbook of personality disorders (pp. 171185). Washington, DC: American Psychiatric Publishing.
Cole, P. M., Michel, M. K., & Teti, L. O. (1994). The development of emotion regulation and dysregulation: A clinical perspective. Monographs of the Society for Research in Child Development, 59(2–3, Serial No. 240), 73100.
Collins, R. P., Litman, J. A., & Spielberger, C. D. (2004). The measurement of perceptual curiosity. Personality and Individual Differences, 36, 11271141.
Coolidge, F. L. (2005). Coolidge Personality and Neuropsychological Inventory for Children manual: CPNI. Colorado Springs, CO: Author.
Coolidge, F. L., Segal, D. L., Stewart, S. E., & Ellett, J. A. (2000). Neuropsychological dysfunction in children with borderline personality disorder features: A preliminary investigation. Journal of Research in Personality, 34, 554561.
Coolidge, F. L., & Thede, L. L. (2000). Heritability and the comorbidity of ADHD with behavioral disorders and executive function deficits: A preliminary investigation. Developmental Neuropsychology, 17, 273287.
Coolidge, F. L., Thede, L. L., & Jang, K. L. (2001). Heritability of childhood personality disorders: A preliminary study. Journal of Personality Disorders, 15, 3340.
Coolidge, F. L., Thede, L. L., Stewart, S. E., & Segal, D. L. (2002). The Coolidge Personality and Neuropsychological Inventory for Children (CPNI): Preliminary psychometric characteristics. Behavior Modification, 26, 550566.
Crick, N. R., Murray-Close, D., & Woods, K. (2005). Borderline personality features in childhood: A short-term longitudinal study. Development and Psychopathology, 17, 10511070.
Depue, R. A., & Lenzenweger, M. F. (2001). A neurobehavioral dimensional model. In Livesley, W. J. (Ed.), Handbook of personality disorders: Theory, research, and treatment (pp. 136176). New York: Guilford Press.
Donegan, N. H., Sanislow, C. A., Blumberg, H. P., Fulbright, R. K., Lacadie, C., Skudlarski, P., et al. (2003). Amygdala hyperreactivity in borderline personality disorder: Implications for emotional dysregulation. Biological Psychiatry, 54, 12841293.
Dowson, J., Bazanis, E., Rogers, R., Prevost, A., Taylor, P., Meux, C., et al. (2004). Impulsivity in patients with borderline personality disorder. Comprehensive Psychiatry, 45, 2936.
Duggal, S., Carlson, E. A., Sroufe, L. A., & Egeland, B. (2001). Depressive symptomology in childhood and adolescence. Development and Psychopathology, 13, 143164.
Eisenberg, N., Guthrie, I. K., Fabes, R. A., Reiser, M., Murphy, B. C., Holgren, R., et al. (1997). The relations of regulation and emotionality to resiliency and competent social functioning in elementary school children. Child Development, 68, 295311.
Eisenberg, N., Valiente, C., Fabes, R. A., Smith, C. L., Reiser, M., Shepard, S. A., et al. (2003). The relations of effortful control and ego control to children's resiliency and social functioning. Developmental Psychology, 39, 761776.
Ekstein, R., & Wallerstein, J. (1954). Observations on the psychology of borderline and psychotic children. Psychoanalytic Study of the Child, 9, 344372.
Feinberg, M. E., Greenberg, M. T., Osgood, D. W., Sartorius, J., & Bontempo, D. (2007). Effects of the communities that care model in Pennsylvania on youth risk and problem behaviors. Preventative Science, 8, 261270.
Flett, G. L., Blankstein, K. R., & Obertynski, M. (1996). Affect intensity, coping styles, mood regulation expectancies and depressive symptoms. Personality and Individual Differences, 20, 221228.
Fox, N. A. (1994). Emotion regulation: Behavioral and biological considerations. Monographs of the Society for Research in Child Development, 59.
Freud, A. (1969). The assessment of borderline cases. In The writings of Anna Freud (Vol. 5, pp. 301314). New York: International Universities Press.
Frijling-Schreuder, E. (1969). Borderline states in children. Psychoanalytic Study of the Child, 24, 307327.
Gibb, B. E., Wheeler, R., Alloy, L. B., & Abramson, L. Y. (2001). Emotional, physical, and sexual maltreatment in childhood versus adolescence and personality dysfunction in young adulthood. Journal of Personality Disorders, 15, 505511.
Gjerde, P. F., & Block, J. (1996). A developmental perspective on depressive symptoms in adolescence: Gender differences in autocentric-allocentric modes of impulse regulation. In Cicchetti, D. & Toth, S. L. (Eds.), Adolescence: Opportunities and challenges. Rochester Symposium on Developmental Psychopathology (Vol. 7, pp. 167196). Rochester, NY: University of Rochester Press.
Goldman, S. J., D'Angelo, E. J., DeMaso, D. R., & Mezzacappa, E. (1992). Physical and sexual abuse histories among children with borderline personality disorder. American Journal of Psychiatry, 149, 17231726.
Goldman, S. J., D'Angelo, E. J., & DeMaso, D. R. (1993). Psychopathology in the families of children and adolescents with borderline personality disorder. American Journal of Psychiatry, 150, 18321835.
Gratz, K. L. (2001). Measurement of deliberate self-harm: Preliminary data on the Deliberate Self-Harm Inventory. Journal of Psychopathology and Behavioral Assessment, 23, 253263.
Gratz, K. L. (2006). Risk factors for deliberate self-harm among female college students: The role and interaction of childhood maltreatment, emotional inexpressivity, and affect intensity/reactivity. American Journal of Orthopsychiatry, 76, 238250.
Gratz, K. L., & Chapman, A. C. (2007). The role of emotional responding and childhood maltreatment in the development and maintenance of deliberate self-harm among male undergraduates. Psychology of Men and Masculinity, 8, 114.
Gratz, K. L., Conrad, S. D., & Roemer, L. (2002). Risk factors for deliberate self-harm among college students. American Journal of Orthopsychiatry, 72, 128140.
Gratz, K. L., Rosenthal, M. Z., Tull, M. T., Lejuez, C. W., & Gunderson, J. G. (2006). An experimental investigation of emotion dysregulation in borderline personality disorder. Journal of Abnormal Psychology, 115, 850855.
Gratz, K. L., Tull, M. T., Baruch, D. E., Bornovalova, M. A., & Lejuez, C. W. (2008). Factors associated with co-occurring borderline personality disorder among inner-city substance users: The roles of childhood maltreatment, negative affect intensity/reactivity, and emotion dysregulation. Comprehensive Psychiatry, 49, 603615.
Greenman, D. A., Gunderson, J. G., Cane, M., & Saltzman, P. R. (1986). An examination of the borderline diagnosis in children. American Journal of Psychiatry, 143, 9981003.
Gualtieri, C. T., Koriath, U., & Van Bourgondien, M. E. (1983). “Borderline” children. Journal of Autism and Developmental Disorders, 13, 6772.
Gunderson, J. G., & Englund, D. W. (1981). Characterizing the families of borderlines: A review of the literature. Psychiatric Clinics of North America, 4, 159168.
Guzder, J., Paris, J., Zelkowitz, P., & Feldman, R. (1999). Psychological risk factors for borderline pathology in school-age children. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 206212.
Guzder, J., Paris, J., Zelkowitz, P., & Marchessault, K. (1996). Risk factors for borderline psychology in children. Journal of the American Academy of Child & Adolescent Psychiatry, 35, 2633.
Hart, D., Keller, M., Edelstein, W., & Hofmann, V. (1998). Childhood personality influences on social–cognitive development: A longitudinal study. Journal of Personality and Social Psychology, 74, 12781289.
Hartup, W. W., & van Lieshout, C. F. (1995). Personality development in social context. Annual Review of Psychology, 46, 655687.
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 Psychiatric Research, 35, 307312.
Herpertz, S. C., Dietrich, T. M., Wenning, B., Krings, T., Erberich, S. G., Willmes, K., et al. (2001). Evidence of abnormal amygdala functioning in borderline personality disorder: A functional MRI study. Biological Psychiatry, 50, 292298.
Hochhausen, N. M., Lorenz, A. R., & Newman, J. P. (2002). Specifying the impulsivity of female inmates with borderline personality disorder. Journal of Abnormal Psychology, 111, 495501.
Hoyle, R. H., Stephenson, M. T., Palmgreen, P., Lorch, E. P., & Donohew, R. L. (2002). Reliability and validity of a brief measure of sensation seeking. Personality and Individual Differences, 32, 401414.
Johnson, D. M., Shea, M. T., Yen, S., Battle, C. L., Zlotnick, C., Sanislow, C. A., et al. (2003). Gender differences in borderline personality disorder: Findings from the Collaborative Longitudinal Personality Disorders Study. Comprehensive Psychiatry, 44, 284292.
Johnson, J. J., Smailes, E. M., Cohen, P., Brown, J., & Bernstein, D. P. (2000). Associations between four types of childhood neglect and personality disorder symptoms during adolescence and early adulthood: Findings of a community-based longitudinal study. Journal of Personality Disorders, 14, 171187.
Kernberg, P. F. (1983). Borderline conditions: childhood and adolescent aspects. In Robinson, K. S. (Ed.), The borderline child (pp. 101119). New York: McGraw–Hill.
Kilpatrick, T., Joyce, E., Milton, J., Duggan, C., Tyrer, P., & Rogers, R. D. (2007). Altered emotional decision-making in prisoners with borderline personality disorder. Journal of Personality Disorders, 21, 243261.
Koenigsberg, H. W., Harvey, P. D., Mitropoulou, V., Schmeidler, J., New, A. S., Goodman, M., et al. (2002). Characterizing affective instability in borderline personality disorder. American Journal of Psychiatry, 159, 784788.
Kristensen, H., & Torgersen, S. (2007). The association between avoidant personality traits and motor impairment in a population-based sample of 11-12 year-old children. Journal of Personality Disorders, 21, 8797.
Kumra, S., Jacobsen, L. K., Lenane, M., Zahn, T. P., Wiggs, E., Alaghband-Rad, J. et al. (1998). “Multidimensionally impaired disorder”: Is it a variant of very early-onset schizophrenia? Journal of the American Academy of Child & Adolescent Psychiatry, 37, 9199.
Lejuez, C. W., Aklin, W. M., Bornovalova, M. A., & Moolchan, E. T. (2005). Differences in risk-taking propensity across inner-city adolescent ever-and never-smokers. Nicotine and Tobacco Research, 7, 7179.
Lejuez, C. W., Aklin, W., Daughters, S., Zvolensky, M. J., Kahler, C. W., & Gwadz, M. (2007). Reliability and validity of the youth version of the Balloon Analogue Risk Task (BART-Y) in the assessment of risk-taking behavior among inner-city adolescents. Journal of Clinical Child and Adolescent Psychology, 36, 106111.
Lejuez, C. W., Aklin, W. M., Zvolensky, M. J., & Pedulla, C. M. (2003). Evaluation of the Balloon Analogue Risk Task (BART) as a predictor of adolescent real-world risk-taking behaviors. Journal of Adolescence, 26, 475479.
Lenzenweger, M. F., Lane, M. C., Loranger, A. W., & Kessler, R. C. (2007). DSM-IV personality disorders in the National Comorbidity Survey replication. Biological Psychiatry, 62, 553564.
Levine, D., Marziali, E., & Hood, J. (1997). Emotion processing in borderline personality disorders. Journal of Nervous and Mental Disease, 185, 240246.
Linehan, M. M. (1993). Cognitive–behavioral treatment of borderline personality disorder. New York: Guilford Press.
Livesley, W. J., Jang, K. L., & Vernon, P. A. (1998). Phenotypic and genetic structure of traits delineating personality disorder. Archives of General Psychiatry, 55, 941948.
Muehlenkamp, J. J., & Gutierrez, P. M. (2004). An investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide and Life-Threatening Behavior, 34, 1223.
Muller, D., Judd, C. M., & Yzerbyt, V. Y. (2005). When moderation is mediated and mediation is moderated. Journal of Personality and Social Psychology, 89, 852863.
Nigg, J. T., Silk, K. R., Stavro, G., & Miller, T. (2005). Disinhibition and borderline personality disorder. Development and Psychopathology, 17, 11291149.
Palombo, J. (1982). Critical review of the concept of the borderline child. Clinical Social Work Journal, 10, 246264.
Paris, J. (1997). Childhood trauma as an etiological factor in the personality disorders. Journal of Personality Disorders, 11, 3449.
Paris, J. (2003). Personality disorders over time: Precursors, course and outcome. Washington, DC: American Psychiatric Publishing.
Paris, J. (2005). The development of impulsivity and suicidality in borderline personality disorder. Development and Psychopathology, 17, 10911104.
Paris, J., Zelkowitz, P., Guzder, J., Joseph, S., & Feldman, R. (1999). Neuropsychological factors associated with borderline pathology in children. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 770774.
Paris, J., Zweig-Frank, H., & Guzder, J. (1994a). Psychological risk factors for borderline personality disorder in female patients. Comprehensive Psychiatry, 35, 301305.
Paris, J., Zweig-Frank, H., & Guzder, J. (1994b). Risk factors for borderline personality in male outpatients. Journal of Nervous and Mental Disease, 182, 375380.
Petti, T. A., & Vela, R. M. (1990). Borderline disorders of childhood: An overview. Journal of the American Academy of Child & Adolescent Psychiatry, 29, 327337.
Pine, F. (1983). Borderline syndromes in childhood: A working nosology and its therapeutic implications. In Robson, K. S. (Ed.), The borderline child (pp. 83100). New York: McGraw–Hill.
Pukrop, R. (2002). Dimensional personality profiles of borderline personality disorder in comparison with other personality disorders and healthy controls. Journal of Personality Disorders, 16, 135147.
Putnam, K. M., & Silk, K. R. (2005). Emotion dysregulation and the development of borderline personality disorder. Development and Psychopathology, 17, 899925.
Reich, D. B., & Zanarini, M. C. (2001). Developmental aspects of borderline personality disorder. Harvard Review of Psychiatry, 9, 294301.
Reist, C., Haier, R. J., DeMet, E., & Chicz-DeMet, A. (1990). Platelet MAO activity in personality disorders and normal controls. Psychiatry Research, 33, 221227.
Rosenbloom, T. (2003). Risk evaluation and risky behavior of high and low sensation seekers. Social Behavior and Personality, 31, 375386.
Rosenfeld, S. K., & Sprince, M. P. (1963). An attempt to formulate the meaning of the concept “borderline.” Psychoanalytic Study of the Child, 18, 603635.
Rutter, M. (1996). Connections between child and adult psychopathology. European Child and Adolescent Psychiatry, 5(Suppl. 1), 47.
Ryan, R. M. (2005). The developmental line of autonomy in the etiology, dynamics, and treatment of borderline personality disorders. Development and Psychopathology, 17, 9871006.
Sack, A., Sperling, M. B., Fagen, G., & Foelsch, P. (1996). Attachment style, history, and behavioral contrasts for a borderline and normal sample. Journal of Personality Disorders, 10, 88102.
Santucci, A. K., Silk, J. S., Shaw, D. S., Gentzler, A., Fox, N. A., & Kovacs, M. (2008). Vagal tone and temperament as predictors of emotion regulation strategies in young children. Developmental Psychobiology, 50, 205216.
Shields, A. M., & Cicchetti, D. (1997). Emotion regulation in school-age children: The development of a new criterion Q-sort scale. Developmental Psychology, 33, 906916.
Shields, A. M., & Cicchetti, D. (1998). Reactive aggression among maltreated children: The contributions of attention and emotion dysregulation. Journal of Clinical Child Psychology, 27, 381395.
Siever, L. J., & Davis, K. L. (1991). A psychobiological perspective on the personality disorders. American Journal of Psychiatry, 148, 16471658.
Silverman, J. M., Pinkham, L., Horvath, T. B., Coccaro, E. F., Klar, H., Schear, S. et al. (1991). Affective and impulsive personality disorder traits in the relatives of patients with borderline personality disorder. American Journal of Psychiatry, 148, 13781385.
Skodol, A. E., Gunderson, J. G., Pfohl, B., Widiger, T. A., Livesley, W. J., & Siever, L. J. (2002). The borderline diagnosis I: Psychopathology, comorbidity, and personality structure. Biological Psychiatry, 51, 936950.
Skodol, A. E., Gunderson, J. G., Shea, M. T., McGlashan, T. H., Morey, L. C., Sanislow, C. A., et al. (2005). The Collaborative Longitudinal Personality Disorders Study (CLPS): Overview and implications. Journal of Personality Disorders, 19, 487504.
Snyder, S., & Pitts, W. M. (1988). Characterizing anxiety in the DSM-III borderline personality disorder. Journal of Personality Disorders, 2, 93101.
Sperling, M. B., Sharp, J. L., & Fishler, P. H. (1991). On the nature of attachment in a borderline population: A preliminary investigation. Psychological Reports, 68, 543546.
Stephenson, M. T., Hoyle, R. H., Palmgreen, P., & Slater, M. D. (2003). Brief measures of sensation seeking for screening and large-scale surveys. Drug and Alcohol Dependence, 72, 279286.
Tabachnick, B. G., & Fidell, L. S. (1996). Using multivariate statistics. New York: Harper Collins College.
Tangney, J. P., Baumeister, R. F., & Boone, A. L. (2004). High self-control predicts good adjustment, less pathology, better grades, and interpersonal success. Journal of Personality, 72, 271322.
Torgersen, S., Kringlen, E., & Cramer, V. (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry, 58, 590596.
Torgersen, S., Lygren, S., Oien, P. A., Skre, I., Onstad, S., Edvardsen, J., et al. (2000). A twin study of personality disorders. Comprehensive Psychiatry, 41, 416425.
Towbin, K. E., Dykens, E. M., Pearson, , & Cohen, D. J. (1993). Conceptualizing “borderline syndrome of childhood” and “childhood schizophrenia” as a developmental disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 32, 775782.
Trull, T. J. (2001). Structural relations between borderline personality disorder features and putative etiological correlates. Journal of Abnormal Psychology, 110, 471481.
Vela, R. M., Gottlieb, E. H., & Gottlieb, H. P. (1983). Borderline syndromes in childhood: A critical review. In Robson, K. S. (Ed.). The borderline child (pp. 3248). New York: McGraw–Hill.
Verheul, R. (2006). Impulsivity in the diagnosis of borderline personality disorder. Paper presented at the Phenotype Conference of the Borderline Personality Disorder Research Foundation, New York.
Widiger, T. A., & Weissman, M. M. (1991). Epidemiology of borderline personality disorder. Hospital and Community Psychiatry, 42, 10151021.
Work Group on Borderline Personality Disorder. (2001): Practice guideline for the treatment of patients with borderline personality disorder. American Journal of Psychiatry, 158, 152.
Zanarini, M. C., & Frankenburg, F. R. (1997). Pathways to the development of borderline personality disorder. Journal of Personality Disorders, 11, 93104.
Zanarini, M. C., Frankenburg, F. R., Dubo, E. D., Sickel, A. E., Trikha, A., Levin, A., et al. (1998a). Axis I comorbidity of borderline personality disorder. American Journal of Psychiatry, 155, 17331739.
Zanarini, M. C., Frankenburg, F. R., Dubo, E. D., Sickel, A. E., Trikha, A., Levin, A., et al. (1998b). Axis II comorbidity of borderline personality disorder. Comprehensive Psychiatry, 39, 296302.
Zanarini, M. C., Frankenburg, F. R., Khera, G. S., & Bleichmar, J. (2001). Treatment histories of borderline inpatients. Comprehensive Psychiatry, 42, 144150.
Zanarini, M. C., Frankenburg, F. R., Ridolfi, M. E., Jager-Hyman, S., Hennen, J., & Gunderson, J. G. (2006). Reported childhood onset of self-multilation among borderline patients. Journal of Personality Disorders, 20, 915.
Zanarini, M. C., Williams, A. A., Lewis, R. E., Reich, R. B., Soledad, C., Vera, M. A., et al. (1997). Reported pathological childhood experiences associated with the development of borderline personality disorder. American Journal of Psychiatry, 154, 11011106.
Zelkowitz, P., Paris, J., Guzder, J., & Feldman, R. (2001). Diathesis and stressors in borderline pathology of childhood: The role of neuropsychological risk and trauma. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 100105.
Zweig-Frank, H. & Paris, J. (1991). Parents’ emotional neglect and overprotection according to the recollections of patients with borderline personality disorder. American Journal of Psychiatry, 148, 648651.

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Extending extant models of the pathogenesis of borderline personality disorder to childhood borderline personality symptoms: The roles of affective dysfunction, disinhibition, and self- and emotion-regulation deficits

  • Kim L. Gratz (a1), Matthew T. Tull (a1), Elizabeth K. Reynolds (a2), Courtney L. Bagge (a1), Robert D. Latzman (a1), Stacey B. Daughters (a2) and C. W. Lejuez (a2)...

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