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Socioeconomic background and the developmental course of schizotypal and borderline personality disorder symptoms

Published online by Cambridge University Press:  21 April 2008

Patricia Cohen*
Columbia University New York State Psychiatric Institute
Henian Chen
Columbia University Research Foundation for Mental Hygiene
Kathy Gordon
Research Foundation for Mental Hygiene
Jeffrey Johnson
Columbia University Research Foundation for Mental Hygiene
Judith Brook
New York University
Stephanie Kasen
Columbia University Research Foundation for Mental Hygiene
Address correspondence and reprint requests to: Patricia Cohen, Unit 47, Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032; E-mail:


Low socioeconomic status (SES) background has been identified as a risk for several mental disorders. However evidence regarding SES and the developmental course of personality disorder (PD) has not been addressed. Nor is it clear whether an SES relationship to PD symptom course may be attributable to known associated risks. Further, specificity of such relationships to a particular PD diagnostic pattern independent of comorbidity with other PD or with depression has not been investigated. Data are from a general population studied longitudinally between ages 10 and 36 in four assessment waves. Effects of SES-associated risks on the level of symptoms of schizotypal and borderline disorders are estimated and compared to effects on depressive symptoms. Low family SES had robust modest independent effects on both PDs over the entire age span despite substantial cumulative effects of trauma history, stressful recent life events, IQ, poor parenting, and comorbid symptoms. SES effects on depressive symptoms were generally absent, but a small “protective” effect of low SES appeared when comorbidity with PD symptoms was taken into account. Cumulatively, these risks account for developmental failures of substantial magnitude and consequence, marking the importance of understanding the remaining mechanisms of SES effects and programmatic implications for minimizing associated risk.

Research Article
Copyright © Cambridge University Press 2008

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This study was supported by the New York State Office of Mental Hygiene, National Institute of Mental Health (R01-MH36971, MH38916, MH49191, MH60911, P.C., Principal Investigator), and National Institute on Drug Abuse (R01-DA03188, J.B., Principal Investigator).


Adler, N. E., Marmot, M., McEwen, B. S., & Stewart, J. (Eds.). (1999). Socioeconomic status and health in industrialized nations. New York: Academic Science.Google Scholar
Ammons, R. S., & Ammons, C. H. (1962). The Quick Test: Provisional manual. Psychological Reports, 11, 11161.Google Scholar
Black, M. M., & Krishnakumar, A. (1998). Children in low-income, urban settings. American Psychologist, 53, 635646.CrossRefGoogle ScholarPubMed
Boomsma, D., de Geus, E. J., van Baal, G. C., & Koopmans, J. R. (1999). A religious upbringing reduces the influence of genetic factors on disinhibition: Evidence for interaction between genotype and environment on personality. Twin Research, 2, 115125.CrossRefGoogle ScholarPubMed
Bradley, R. H., & Corwyn, R. F. (2002). Socioeconomic status and child development. Annual Review of Psychology, 53, 371399.CrossRefGoogle ScholarPubMed
Brandt, D. E. (2006). Delinquency, development, and social policy. New Haven, CT: Yale University Press.CrossRefGoogle Scholar
Brown, G. W., & Harris, T. (1978). Social origins of depression: A study of psychiatric disorder in women. New York: Free Press.Google Scholar
Button, T. M. M., Scourfield, J., Martin, N., Purcell, S., & McGuffin, P. (2005). Family dysfunction interacts with genes in the causation of antisocial symptoms. Behavior Genetics, 35 115120.CrossRefGoogle ScholarPubMed
Carpenter, W. T., & Gunderson, J. G. (1977). Five year follow-up comparison of borderline and schizophrenic patients. Comprehensive Psychiatry, 18, 567571.CrossRefGoogle ScholarPubMed
Caspi, A., McClay, J., Moffitt, T. E., Mill, J., Martin, J., Craig, I. W., et al. (2002). Role of genotype in the cycle of violence in maltreated children. Science, 297, 851854.CrossRefGoogle ScholarPubMed
Caspi, A., Moffitt, T. E., Morgan, J., Rutter, M., Taylor, A., Arseneault, L., et al. (2004). Maternal expressed emotion predicts children's externalizing behavior problems: Using MZ-twin differences to identify environmental effects on behavioural development. Developmental Psychology, 40, 149161.CrossRefGoogle Scholar
Caspi, A., Roberts, B. W., & Shiner, R. L. (2005). Personality development: Stability and change. Annual Review of Psychology, 56, 453486.CrossRefGoogle ScholarPubMed
Caspi, A., Sugden, K., Moffitt, T. E., Taylor, A., Craig, I. W., Harrington, H. L., et al. (2003). Influence of life stress on depression, Moderation by a polymorphism in the 5-HTT gene. Science, 301, 291293.CrossRefGoogle ScholarPubMed
Caspi, A., Wright, B. R. E., Moffitt, T. E., & Silva, P. A. (1998). Early failure in the labor market: Childhood and adolescent predictors of unemployment in the transition to adulthood. American Sociological Review, 63, 424451.CrossRefGoogle Scholar
Cicchetti, D. (2003). Experiments of nature: Contributions to developmental theory. Development and Psychopathology, 15, 833835.CrossRefGoogle ScholarPubMed
Coddington, R. D. (1972). The significance of life events as etiological factors in the diseases of children: II. A study of a normal population. Journal of Psychosomatic Research, 16, 205213.CrossRefGoogle Scholar
Cohen, P., Crawford, T., Johnson, J. G., & Kasen, S. (2005) The Children in the Community study of the development of personality disorders. Journal of Personality Disorders, 19, 466486.CrossRefGoogle Scholar
Costello, E. J., Compton, S. N., Keeler, G., & Angold, A. (2003). Relationships between poverty and psychopathology. Journal of the American Medical Association, 290, 20232029.CrossRefGoogle ScholarPubMed
Crawford, T. N., Cohen, P., Johnson, J. G., Kasen, S., First, M. B., Gordon, K., et al. (2005). Self-reported personality disorder in the children in the community sample: Convergent and prospective validity in late adolescence and adulthood. Journal of Personality Disorders, 10, 3052.CrossRefGoogle Scholar
Derogotis, L. R., Lipman, R. S., Rickels, K., Uhlenhuth, E. H., & Covi, L. (1974). The Hopkins Symptom Checklist (HSCL): A self-report symptom inventory. Behavioral Science, 19, 115.CrossRefGoogle Scholar
Dohrenwend, B. P., & Dohrenwend, B. S. (1969). Social status and psychological disorder. New York: Wiley.Google ScholarPubMed
Dohrenwend, B. P., Levav, I., Shrout, P. E., Schwartz, S., Naveh, G., Link, B. G., et al. (1992). Socioeconomic status and psychiatric disorders: The causation-selection issue. Science, 255, 946952.CrossRefGoogle ScholarPubMed
Eley, T. C., Sugden, K., Corsico, A., Gregory, A. M., Sham, P., McGuffin, P., et al. (2004). Gene–environment interaction analysis of serotonin system markers with adolescent depression. Molecular Psychiatry, 9, 908915.CrossRefGoogle ScholarPubMed
Entwisle, D. R., Alexander, K. L., & Olson, L. S. (1997) Children, schools, and inequality. New York: Westview Press.Google Scholar
First, M. B., Gibbon, M. Spitzer, R. L., Williams, J. B. W., & Benjamin, L. S. (1997). User' guide for the Structured Clinical Interview for DSM IV Personality Disorders. Washington, DC: American Psychiatric Press.Google Scholar
Gottfredson, L. (2004). Intelligence: Is it the epidemiologists' elusive “fundamental cause” of social class inequalities in health? Journal of Social & Personality Psychology, 86, 174199..CrossRefGoogle ScholarPubMed
Harper, L. V. (2005). Epigenetic inheritance and the intergenerational transfer of experience. Psychological Bulletin, 131, 340360.CrossRefGoogle ScholarPubMed
Hauser, R. M. (1994). Measuring socioeconomic status in studies of child development. Child Development, 65, 15411545.CrossRefGoogle ScholarPubMed
Hollingshead, A. B., & Redlich, F. C. (1958). Social class and mental illness: A community study. New York: Wiley.CrossRefGoogle ScholarPubMed
Jang, K. L, Dick, D. M., Wolf, H., Livesley, W. J., & Paris, J. (2005). Psychosocial adversity and emotional instability: An application of gene–environment interaction models. European Journal of Personality, 19, 359372.CrossRefGoogle Scholar
Jang, K. L., Wolf, H., & Larstone, R. (2006). What is the role of personality in psychopathology?: A view from behavior genetics. In Krueger, R. F. & Tackett, J. L. (Eds.), Personality and psychopathology (pp. 153173). New York: Guilford Press.Google Scholar
Johnson, J. G., Bromley, E., & McGeoch, P. G. (2005). Role of childhood experiences in the development of maladaptive and adaptive personality traits. In Oldham, J. M., Skodol, A. E., & Bender, D. S. (Eds.), Textbook of personality disorders. Washington, DC: American Psychiatric Press.Google Scholar
Johnson, J. G., Cohen, P., Dohrenwend, B. P., Link, B. G., & Brook, J. S. (1999). A longitudinal investigation of social causation and social selection processes involved in the association between socioeconomic status and psychiatric disorders. Journal of Abnormal Psychology, 108, 490499.CrossRefGoogle ScholarPubMed
Johnson, J. G., Cohen, P., Kasen, S., Skodol, A. & Brook, J. (2000). Age-related change in personality disorder symptom levels between early adolescence and adulthood. Acta Psychiatrica Scandinavica, 102, 265275.CrossRefGoogle Scholar
Johnson, J. G., Cohen, P., Kasen, S., Smailes, E., & Brook, J. S. (2001). Association of maladaptive parental behavior with psychiatric disorder among parents and their offspring. Archives of General Psychiatry, 58, 453460.CrossRefGoogle ScholarPubMed
Johnson, J. G., Cohen, P., Smailes, E., Kasen, S., Oldham, J. M., & Skodol, A. E. (2000). Adolescent personality disorders associated with violence and criminal behavior during adolescence and early adulthood. American Journal of Psychiatry, 157, 14061412.CrossRefGoogle ScholarPubMed
Johnson, J. G., Quigley, J. F., & Sherman, M. F. (1997). Adolescent personality disorder symptoms mediate the relationship between perceived parental behavior and Axis I symptomatology. Journal of Personality Disorders, 11, 381390.CrossRefGoogle ScholarPubMed
Jones, A. F., & Weinberg, D. H. (2000). The changing shape of the nation's income distribution: 1947–1998. Current population reports (series P 60-201), Bureau of the Census. Retrieved from Scholar
Judge, T. A., Higgins, C. A., Thoreson, C. J., & Barrick, M. R. (1999). The big five personality traits, general mental ability, and career success across the life span. Personnel Psychology, 52, 621652.CrossRefGoogle Scholar
Kessler, R. C., Davis, C. G., & Kendler, K. S. (1997). Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychological Medicine, 27, 11011119.CrossRefGoogle ScholarPubMed
Kohn, M. (1995). Social structure and personality through time and space. In Moen, P., Elder, G. H., & Luscher, K. (Eds.), Examining lives in context: Perspectives on the ecology of human development (pp. 141168). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Lenzenweger, M. F., & Castro, D. D. (2005). Predicting change in borderline personality: Using neurobehavioral systems indicators within an individual growth curve framework. Development and Psychopathology, 17, 12071237.CrossRefGoogle ScholarPubMed
Lenzenweger, M. F., & Cicchetti, D. (2005). Toward a developmental psychopathology approach to borderline personality disorder. Development and Psychopathology, 17, 893898.CrossRefGoogle Scholar
Link, B. G., & Phelan, J. C. (1995). Social conditions as fundamental causes of disease. Journal of Health & Social Behavior, 56(Suppl.), 8094.CrossRefGoogle Scholar
Masten, A. S., Burt, K. B., Roisman, G. J., Obradovic, H., Long, J. D., & Tellegan, A. (2004). Resources and resilience in the transition to adulthood: Continuity and change. Development and Psychopathology, 16, 10711094.CrossRefGoogle ScholarPubMed
McCord, J. (Ed.). (1995). Coercion and punishment in long-term perspectives. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
McLeod, J., & Shanahan, M. (1993). Poverty, parenting, and children's mental health. American Sociological Review, 58, 351366.CrossRefGoogle Scholar
Miech, R. A., Caspi, A., Moffitt, T. E., Wright, B. R. E., & Silva, P. A. (1999). Low socioeconomic status and mental disorders: A longitudinal study of selection and causation during young adulthood. American Journal of Sociology, 104, 10961131.CrossRefGoogle Scholar
Moffitt, T. E. (2005). The new look of behavioral genetics in developmental psychopathology. Psychological Bulletin, 131, 533554.CrossRefGoogle ScholarPubMed
Moffitt, T. E., Caspi, A., & Rutter, M. (2006). Measured gene–environment interactions in psychopathology: Concepts, research strategies, and implications for research, intervention, and public understanding of genetics. Perspectives on Psychological Science, 1, 527.CrossRefGoogle ScholarPubMed
Muntaner, C., Eaton, W. W., Misch, R., & O'Campo, P. (2004). Socioeconomic position and major mental disorders. Epidemiologic Reviews, 26, 5362.CrossRefGoogle ScholarPubMed
Pagani, L., Boulerice, B., Vitaro, F., & Tremblay, R. E. (1999). Effects of poverty on academic failure and delinquency in boys: A change and process model approach. Journal of Child Psychology and Psychiatry, 40, 12091219.CrossRefGoogle ScholarPubMed
Paris, J. (1996). Social factors in the personality disorders. Cambridge: Cambridge University Press.CrossRefGoogle ScholarPubMed
Parke, R. S., & Clarke-Stewart, K. A. (2003). Effects of parental incarceration on children: Perspectives, promises and policies. In Travis, J., Waul, M., & Solomon, A. (Eds.), From prison to home (pp. 189232). Washington, DC: Urban Institute Press.Google Scholar
Petras, H., Schaeffer, C. M., Ialongo, N., Hubbard, S., Muthen, B., Lambert, S. F., et al. (2004). When the course of aggressive behavior in childhood does not predict antisocial outcomes in adolescence and young adulthood: An examination of potential explanatory variables. Development and Psychopathology, 16, 919941.CrossRefGoogle ScholarPubMed
Pilkonis, P. A., & Frank, E. (1988). Personality pathology in recurrent depression: Nature, prevalence, and relationship to treatment response. American Journal of Psychiatry, 145, 435441.Google ScholarPubMed
Rank, M. R. (2000). Socialization of socioeconomic status. In Nichols, W. C. (Ed.), Handbook of family development and intervention (pp. 129142). New York: Wiley.Google Scholar
Rutter, M. (2005). Environmentally mediated risks for psychopathology: Research strategies and findings. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 318.CrossRefGoogle ScholarPubMed
Rutter, M., & Maughan, B. (1997). Psychosocial adversities in childhood and adult psychopathology. Journal of Personality Disorders, 11, 418.CrossRefGoogle ScholarPubMed
Schell, L. M. (1997). Culture as stressor: A revised model of biocultural interaction. American Journal of Physical Anthropology, 102, 6777.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
Sen, A. (1973). On economic inequality. Oxford: Oxford University Press.CrossRefGoogle Scholar
Serbin, L. A., & Karp, J. (2004). The intergenerational transfer of psychosocial risk: Mediators of vulnerability and resilience. Annual Review of Psychology, 55, 333363.CrossRefGoogle ScholarPubMed
Shanahan, M. J., & Bauer, D. J. (2004). Developmental properties of transactional models: The case of life events and mastery from adolescence to young adulthood. Development and Psychopathology, 16, 10951117.CrossRefGoogle ScholarPubMed
Shea, M. T., Glass, D. R., Pilkonis, P. A., Watkins, J., & Docherty, J. P. (1987). Frequency and implications of personality disorders in a sample of depressed outpatients. Journal of Personality Disorders, 1, 2742.CrossRefGoogle Scholar
Timms, D. W. G. (1996). Social mobility and mental health in a Swedish cohort. Social Psychiatry, 31, 3848.Google Scholar
Torgersen, S., Kringlen, E., & Cramer, V. (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry, 58, 590596.CrossRefGoogle Scholar
Walker, E., Kestler, L., Bollini, A., & Hochman, K. M. (2004). Schizophrenia: Etiology and course. Annual Review of Psychology, 55, 401430.CrossRefGoogle ScholarPubMed
White, K. R. (1982). The relation between socioeconomic status and academic achievement. Psychological Bulletin, 91, 461481.CrossRefGoogle Scholar
Zanarini, M., Frankenburg, F. R., Hennen, J., & Silk, K. R. (2003). The longitudinal course of borderline psychopathology: 6-year prospective follow-up of the phenomenology of borderline personality disorder. American Journal of Psychiatry, 160, 274283.CrossRefGoogle ScholarPubMed
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