Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-06T07:50:22.511Z Has data issue: false hasContentIssue false
  • English
  • Français

The development of impulsivity and suicidality in borderline personality disorder

Published online by Cambridge University Press:  12 December 2005

JOEL PARIS
JOEL PARIS
Affiliation:
SMBD Jewish General Hospital, Québec
Get access Rights & Permissions [Opens in a new window]

Abstract

Borderline personality disorder (BPD) is characterized by a broad pattern of impulsivity and suicidality. BPD usually begins in adolescence; the full clinical picture of the disorder is associated with developmental increases in impulsivity. However, BPD also has childhood precursors. The developmental pathways are similar to those found in other impulsive spectrum disorders, but children who later develop BPD probably have both externalizing and internalizing symptoms. Research in this area has made use of retrospective data from adults, prospective data from community studies, follow-up studies from children at risk, as well as research on “borderline pathology of childhood” (a condition with symptoms similar to adult BPD). Existing evidence suggests that both temperamental and environmental risk factors play a role in the development of the behavioral patterns associated with the disorder. These pathways also help account for the life course and outcome of BPD in adulthood.This paper benefited from suggestions made by Jenny Macfie.

Type
Research Article
Information
Development and Psychopathology , Volume 17 , Issue 4 , December 2005 , pp. 1091 - 1104
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Achenbach, T. M., & McConaughy, S. H. (1997). Empirically based assessment of child and adolescent psychopathology, practical applications (2nd ed.). Thousand Oaks, CA: Sage.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders—Text revision (4th ed.). Washington, DC: Author.
Becker, D. F., Grilo, C. M., Edell, W. S., & McGlashan, T. H. (2002). Diagnostic efficiency of borderline personality disorder criteria in hospitalized adolescents, comparison with hospitalized adults. American Journal of Psychiatry 159, 2042–2047.Google Scholar
Bemporad, J. R., Smith, H. F., Hanson, G., & Cicchetti, D. (1982). Borderline syndromes in childhood, criteria for diagnosis. American Journal of Psychiatry 139, 596–601.Google Scholar
Bernstein, D. P., Cohen, P., Skodol, A., Bezirganian, S., & Book, J. S. (1993). Prevalence and stability of the DSM-III personality disorders in a community based survey of adolescents. American Journal of Psychiatry 150, 1237–1243.Google Scholar
Black, D. W. (1999). Bad boys, bad men, confronting antisocial personality. New York: Oxford University Press.
Block, M. J., Westen, D., Ludolph, P., Wixom, J., & Jackson, A. (1991). Distinguishing female borderline adolescents from normal and other disturbed female adolescents. Psychiatry 54, 89–103.Google Scholar
Brent, D. A. (2001). Assessment and treatment of the youthful suicidal patient. Annals of the New York Academy of Sciences 932, 106–128.Google Scholar
Browne, A., & Finkelhor, D. (1986). Impact of child sexual abuse, a review of the literature. Psychological Bulletin 99, 66–77.Google Scholar
Cadoret, R. J., Yates, W. R., Troughton, E., Woodworth, G., & Stewart, M. A. (1995). Genetic environmental interaction in the genesis of aggressivity and conduct disorders. Archives of General Psychiatry 52, 916–924Google Scholar
Caspi, A. (2000). The child is the father of the man, personality continuities from childhood to adulthood. Journal of Personality and Social Psychology 78, 158–172.Google Scholar
Caspi, A., Moffitt, T. E., Morgan, J., Rutter, M., Taylor, A., Arseneault, L., et al. (2004). Maternal expressed emotion predicts children's antisocial behavior problems, using monozygotic-twin differences to identify environmental effects on behavioral development. Developmental Psychology 40, 149–161.Google Scholar
Caspi, A., Moffitt, T. E., Newman, D. L., & Silva, P. A. (1996). Behavioral observations at age three predict adult psychiatric disorders, longitudinal evidence from a birth cohort. Archives of General Psychiatry 53, 1033–1039.Google Scholar
Caspi, A., Sugden, K., Moffitt, T. E., Taylor, A., Craig, I. W., Harrington, H., et al. (2003). Influence of life stress on depression, moderation by a polymorphism in the 5-HTT gene. Science 301, 386–389.Google Scholar
Chambers, R. A., Taylor, J. R., & Potenza, M. N. (2003). Developmental neurocircuitry of motivation in adolescence, a critical period of addiction vulnerability. American Journal of Psychiatry 160, 1041–1052.Google Scholar
Cicchetti, D. (1984). The emergence of developmental psychopathology. Child Development 55, 1–7.Google Scholar
Cicchetti, D. (1993). Developmental psychopathology: Reactions, reflections, projections. Developmental Review 13, 471–502.Google Scholar
Cicchetti, D., & Rogosch, F. A. (1996). Equifinality and multifinality in developmental psychopathology. Development and Psychopathology 8, 597–600.Google Scholar
Cicchetti, D., & Rogosch, F. A. (2002). A developmental psychopathology perspective on adolescence. Journal of Consulting and Clinical Psychology 70, 6–20.Google Scholar
Cloninger, R. C. (1987). A systematic method for clinical description and classification of personality variants. Archives of General Psychiatry 44, 573–588.Google Scholar
Coccaro, E. F., Siever, L. J., Klar, H. M., Maurer, G., Cochrane, K., Cooper, T. B., et al. (1989). Serotonergic studies in patients with affective and personality disorders. Archives of General Psychiatry 46, 587–599.Google Scholar
Cohen, D. J., Paul, R., & Volkmar, F. (1987). Issues in the classification of pervasive developmental disorders and associated conditions. In D. J. Cohen & A. M. Donnelean (Eds.), Handbook of autism and pervasive developmental disorders (pp. 20–39). New York: Wiley.
Cohen, P., Cohen, J., Kasen, S., & Velez, C. N. (1993). An epidemiological study of disorders in late childhood and adolescence, I. Age- and gender-specific prevalence. Journal of Child Psychology & Psychiatry & Allied Disciplines 34, 851–867.Google Scholar
Costa, P. T., & Widiger, T. A. (Eds.). (2001). Personality disorders and the five factor model of personality (2nd ed.). Washington, DC: American Psychological Association.
Cote, S., Tremblay, R. E., Nagin, D., Zoccolillo, M., & Vitaro, F. (2002). The development of impulsivity, fearfulness, and helpfulness during childhood: Patterns of consistency and change in the trajectories of boys and girls. Journal of Child Psychology & Psychiatry & Allied Disciplines 43, 609–618.Google Scholar
Crawford, T. N., Cohen, P., & Brook, J. S. (2001a). Dramatic-erratic personality disorder symptoms. I. Continuity from early adolescence to adulthood. Journal of Personality Disorders 15, 319–335.Google Scholar
Crawford, T. N., Cohen, P., & Brook, J. S. (2001b). Dramatic-erratic personality disorder symptoms, II. Developmental pathways from early adolescence to adulthood. Journal of Personality Disorders 15, 336–350.Google Scholar
Crick, N. R., & Zahn–Waxler, C. (2003). The development of psychopathology in females and males, current progress and future challenges. Development and Psychopathology 15, 719–742.Google Scholar
Depue, R. A., & Collins, P. F. (1999). Neurobiology of the structure of personality: Dopamine, facilitation of incentive motivation, and extraversion. Behavioral & Brain Sciences 22, 491–517.Google Scholar
Depue, R. A., & Lenzenweger, M. (2001). A neurobehavioral dimensional model. In W. J. Livesley (Ed.), Handbook of personality disorders: Theory, research, and treatment (pp. 137–176). New York: Guilford Press.
Derryberry, D., & Rothbart, M. K. (1997). Reactive and effortful processes in the organization of temperament. Development and Psychopathology 9, 633–652.Google Scholar
Dubreuil, E., Ditto, B., Dionne, G., Pihl, R. O., Tremblay, R. E., Boivin, M., et al. (2003). Familiality of heart rate and cardiac-related autonomic activity in five-month-old twins, the Quebec newborn twins study. Psychophysiology 40, 849–862.Google Scholar
Feldman, R. B., Zelkowitz, P., Weiss, M., Heyman, M., Vogel, J., & Paris, J. (1995). A comparison of the families of borderline personality disorder mothers and the families of other personality disorder mothers. Comprehensive Psychiatry 36, 157–163.Google Scholar
Fergusson, D. M., Lynskey, M. T., & Horwood, J. (1996). Childhood sexual abuse and psychiatric disorder in young adulthood. II: Psychiatric outcomes of childhood sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry 34, 1365–1374.Google Scholar
Fergusson, D. M., & Mullen, P. E. (1999). Childhood sexual abuse: An evidence based perspective. Thousand Oaks, CA: Sage.
Garner, D. M., & Garfinkel, P. E. (1980). Socio-cultural factors in the development of anorexia nervosa. Psychological Medicine 10, 647–656.Google Scholar
Garnet, K. E., Levy, K. N., Mattanah, J. F., Edell, W. S., & McGlashan, T. H. (1994). Borderline personality disorder in adolescents: ubiquitous or specific? American Journal of Psychiatry 151, 1380–1382.Google Scholar
Gerson, J., & Stanley, B. (2002). Suicidal and self-injurious behavior in personality disorder: Controversies and treatment directions. Current Psychiatry Reports 4, 30–38.Google Scholar
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, 1832–1835.Google Scholar
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, 1723–1726.Google Scholar
Goodman, G., Hull, J. W., Clarkin, J. F., & Yeomans, F. E. (1999). Childhood antisocial behaviors as predictors of psychotic symptoms and DSM-III-R borderline criteria among inpatients with borderline personality disorder. Journal of Personality Disorders 13, 35–46.Google Scholar
Gray, J. A. (1987). Perspectives on anxiety and impulsivity. Journal of Research in Personality 21, 493–509.Google Scholar
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, 998–1002.Google Scholar
Grilo, C. M., Becker, D. F., Edell, W. S., & McGlashan, T. H. (2001). Stability and change of DSM-III-R personality disorder dimensions in adolescents followed up 2 years after psychiatric hospitalization. Comprehensive Psychiatry 42, 364–368.Google Scholar
Grilo, C. M., McGlashan, T. H., & Skodol, A. E. (2000). Stability and course of personality disorders. Psychiatric Quarterly 71, 291–307.Google Scholar
Gunderson, J. G. (2001). Borderline personality disorder, a clinical guide. Washington, DC: American Psychiatric Association.
Gunderson, J. G., Bender, D., Sanislow, C., Yen, S., Rettew, J. B., Dolan–Sewell, R., et al. (2003). Plausibility and possible determinants of sudden “remissions” in borderline patients. Psychiatry 66, 111–119.Google Scholar
Gunderson, J. G., & Zanarini, M. E. (1989). Pathogenesis of borderline personality. In A. Tasman, R. E. Hales, & A. J. Frances (Eds.), Review of psychiatry (Vol. 8, pp. 25–48). Washington, DC: American Psychiatric Press.
Guzder, J., Paris, J., Zelkowitz, P., & Feldman, R. (1999). Psychological risk factors for borderline pathology in school-aged children. Journal of the American Academy of Child & Adolescent Psychiatry 38, 206–212.Google Scholar
Guzder, J., Paris, J., Zelkowitz, P., & Marchessault, K. (1996). Risk factors for borderline pathology in children. Journal of the American Academy of Child & Adolescent Psychiatry 35, 26–33.Google Scholar
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, 307–312.Google Scholar
Herman, J. L. (1992). Trauma and recovery. New York: Basic Books.
Hinshaw, S. P. (2002). Process, mechanism, and explanation related to externalizing behavior in developmental psychopathology. Journal of Abnormal Child Psychology 30, 431–446.Google Scholar
Hinshaw, S. P. (2003). Impulsivity, emotion regulation, and developmental psychopathology, specificity versus generality of linkages. Annals of the New York Academy of Sciences 1008, 149–159.Google Scholar
Horwitz, A. V., Widom, C. S., McLaughlin, J., & White, H. R. (2001). The impact of childhood abuse and neglect on adult mental health, a prospective study. Journal of Health & Social Behavior 42, 184–201.Google Scholar
Jang, K. L., Livesley, W. J., Vernon, P. A., & Jackson, D. N. (1996). Heritability of personality traits, a twin study. Acta Psychiatrica Scandinavica 94, 438–444.Google Scholar
Johnson, J. G., Cohen, P., Brown, J., Smailes, E. M., & Bernstein, D. P. (1999). Childhood maltreatment increases risk for personality disorders during early adulthood. Archives of General Psychiatry 56, 600–606.Google Scholar
Johnson, J. G., Cohen, P., Skodol, A. E., Oldham, J. M., Kasen, S., & Brook, J. S. (1999). Personality disorders in adolescence and risk of major mental disorders and suicidality during adulthood Archives of General Psychiatry 56, 805–811.Google Scholar
Kagan, J. (1994). Galen's prophecy. New York: Basic Books.
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. American Journal of Psychiatry 156, 1529–1535.Google Scholar
Kernberg, P. F., Weiner, A. S., & Bardenstein, K. K. (2000). Personality disorders in children and adolescents. New York: Basic Books.
Kestenbaum, C. J. (1983). The borderline child at risk for major psychiatric disorder in adult life. In K. R. Robson (Ed.), The borderline child (pp. 49–82). New York: McGraw–Hill.
Koenigsberg, H. W., Harvey, P. D., Mitropolou, V., Schmeidler, J., New, A. S., Goodman, M., et al. (2002). Characterizing affective instability in borderline personality disorder. American Journal of Psychiatry 159, 784–788.Google Scholar
Krueger, R. F. (1999). The structure of common mental disorders. Archives of General Psychiatry 56, 921–926.Google Scholar
Krueger, R. F., Caspi, A., Moffitt, T. E., Silva, P. A., & McGee, R. (1996). Personality traits are differentially linked to mental disorders: A multitrait multidiagnosis study of an adolescent birth cohort. Journal of Abnormal Psychology 105, 299–312.Google Scholar
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, 91–99.Google Scholar
Lenzenweger, M. F., Loranger, A. W., Korfine, L., & Neff, C. (1997). Detecting personality disorders in a nonclinical population. Application of a 2-stage procedure for case identification. Archives of General Psychiatry 54, 345–351.Google Scholar
Lewinsohn, P. M., Rohde, P., Seeley, J. R., Klein, D. N., & Gotlib, I. H. (2000). Natural course of adolescent major depressive disorder in a community sample, predictors of recurrence in young adults. American Journal of Psychiatry 157, 1584–1591.Google Scholar
Leyton, M., Okazawa, H., Diksic, M., Paris, J., Rosa, P., & Mzengeza, S. (2001). Brain regional rate alpha-methyl {11} trapping in impulsive subjects with borderline personality disorder. American Journal of Psychiatry 158, 775–782.Google Scholar
Lincoln, A. J., Bloom, D., Katz, M., & Boksenbaym, N. (1998). Neuropsychological and neurophysiological indices of auditory processing impairment in children with multiple complex developmental disorder. Journal of the American Academy of Child & Adolescent Psychiatry 37, 100–112.Google Scholar
Linehan, M. M. (1993). Dialectical behavioral therapy of borderline personality disorder. New York: Guilford Press.
Links, P. S., Heslegrave, R., & van Reekum, R. (1999). Impulsivity, core aspect of borderline personality disorder. Journal of Personality Disorders 13, 131–139.Google Scholar
Livesley, W. J., Jang, K. L., & Vernon, P. A. (1998). Phenotypic and genetic structure of traits delineating personality disorder. Archives of General Psychiatry 55, 941–948.Google Scholar
Lofgren, D. P., Bemporad, J., King, J., Lindem, K., & O'Driscoll, G. (1991). A prospective follow-up study of so-called borderline children. American Journal of Psychiatry 148, 1541–1545.Google Scholar
Looper, K., & Paris, J. (2000). What are the dimensions underlying Cluster B personality disorders? Comprehensive Psychiatry 41, 432–437.Google Scholar
Ludolph, P. S., Westen, D., & Misle, B. (1990). The borderline diagnosis in adolescents, symptoms and developmental history. American Journal of Psychiatry 147, 470–476.Google Scholar
Malinovsky–Rummell, R., & Hansen, D. J. (1993). Long-term consequences of physical abuse. Psychological Bulletin 114, 68–79.Google Scholar
Masse, L. C., & Tremblay, R. E. (1997). Behavior of boys in kindergarten and the onset of substance use during adolescence. Archives of General Psychiatry 54, 62–68.Google Scholar
Mattanana, B. A., Becker, D. F., Levy, K. N., Edell, W. S., & McGlashan, T. H. (1995). Diagnostic stability in adolescents followed up 2 years after hospitalization. American Journal of Psychiatry 152, 889–894.Google Scholar
Meijer, M., Goedhart, A. W., & Treffers, P. D. (1998). The persistence of borderline personality disorder in adolescence. Journal of Personality Disorders 12, 13–22.Google Scholar
Millon, T. (1993). Borderline personality disorder, a psychosocial epidemic. In J. Paris (Ed.), Borderline personality disorder, etiology and treatment (pp. 197–210). Washington, DC: American Psychiatric Association.
Millon, T. (2000). Personality disorders in modern life. New York: Wiley.
Moffitt, T. E. (1993). “Life-course persistent” and “adolescence-limited” antisocial behavior, a developmental taxonomy. Psychological Review 100, 674–701.Google Scholar
Nicolson, R., Lenane, M., Brookner, F., Gochman, P., Kumra, S., Spechler, L., et al. (2001). Children and adolescents with psychotic disorder not otherwise specified: A 2- to 8-year follow-up study. Comprehensive Psychiatry 42, 319–325.Google Scholar
O'Leary, K. M. (2000). Borderline personality disorder. Neuropsychological testing results. Psychiatric Clinics of North America 23, 41–60.Google Scholar
Paris, J. (1994). Borderline personality disorder, a multidimensional approach. Washington, DC: American Psychiatric Association.
Paris, J. (1995). Memories of abuse in BPD, true or false? Harvard Review of Psychiatry 3, 10–17.Google Scholar
Paris, J. (1996). Social factors in the personality disorders. New York: Cambridge University Press.
Paris, J. (1997). Antisocial and borderline personality disorders, two separate diagnoses or two aspects of the same psychopathology? Comprehensive Psychiatry 38, 237–242.Google Scholar
Paris, J. (1998). Anxious traits, anxious attachment, and anxious cluster personality disorders. Harvard Review of Psychiatry 6, 142–148.Google Scholar
Paris, J. (2000a). Myths of childhood. Philadelphia, PA: Brunner/Mazel.
Paris, J. (2000b). Childhood precursors of borderline personality disorder. Psychiatric Clinics of North America 23, 77–88.Google Scholar
Paris, J. (2002). Chronic suicidality in borderline personality disorder. Psychiatric Services 53, 738–742.Google Scholar
Paris, J. (2003). Personality disorders over time. Washington, DC: American Psychiatric Association.
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, 770–774.Google Scholar
Paris, J., Zweig–Frank, H., Ng, F., Schwartz, G., Steiger, H., Nair, X. (2004). Neurobiological correlates of diagnosis and underlying traits in patients with borderline personality disorder compared with normal controls. Psychiatry Research 121, 239–252.Google Scholar
Pepper, C. M., Klein, D. N., Anderson, R. L., Riso, L. P., Ouimette, P. C., & Lizardi, H. (1995). DSM-III-R Axis II comorbidity in dysthymia and major depression. American Journal of Psychiatry 152, 239–247.Google Scholar
Petti, T. A., & Vela, R. M. (1990). Borderline disorders of childhood: An overview. Journal of the American Academy of Child and Adolescent Psychiatry 29, 327–337.Google Scholar
Pfeffer, C. (2000). Suicidal behavior in children: An emphasis on developmental influences. In K. Hawton & K. van Heeringen (Eds.), The International handbook of suicide and attempted suicide (pp. 237–248). New York: Wiley.
Pfohl, B., Coryell, W., Zimmerman, M., & Stangl, D. (1986). DSM-III personality disorders, diagnostic overlap and internal consistency of individual DSM-III criteria. Comprehensive Psychiatry 27, 21–34.Google Scholar
Plomin, R., DeFries, J. C., McClearn, G. E., & Rutter, M. M. (2000). Behavioral genetics: A primer (3rd ed.). New York: W.H. Freeman.
Rey, J. M., Singh, M., Morris–Yates, A., & Andrews, G. (1997). Referred adolescents as young adults. The relationship between psychosocial functioning and personality disorder. Australian and New Zealand Journal of Psychiatry 31, 219–226.Google Scholar
Rind, B., & Tromovitch, P. (1997). A meta-analytic review of findings from national samples on psychological correlates of child sexual abuse. Journal of Sexual Research 34, 237–255.Google Scholar
Robins, L. N. (1966). Deviant children grown up. Baltimore, MD: Williams & Wilkins.
Robins, L. N. (1978). Sturdy childhood predictors of adult outcome. Psychological Medicine 8, 611–622.Google Scholar
Robins, L. N, & Regier, D. A. (Eds.). (1991). Psychiatric disorders in America. New York: Free Press.
Rusch, K. M., Guastello, S. J., & Mason, P. T. (1992). Differentiating symptom clusters of borderline personality disorder. Journal of Clinical Psychology 48, 730–738.Google Scholar
Rutter, M. (1987a). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry 57, 316–331.Google Scholar
Rutter, M. (1987b). Temperament, personality, and personality development. British Journal of Psychiatry 150, 443–448.Google Scholar
Rutter, M. (1989). Pathways from childhood to adult life. Journal of Child Psychology & Psychiatry 30, 23–51.Google Scholar
Samuels, J., Eaton, W. W., Bienvenu, J., Clayton, P., Brown, H., Costa, P. T., et al. (2002). Prevalence and correlates of personality disorders in a community sample. British Journal of Psychiatry 180, 536–542.Google Scholar
Schuckit, M. A., & Smith, T. L. (1996). An 8 year follow-up of 450 sons of alcoholic and control subjects. Archives of General Psychiatry 53, 202–210.Google Scholar
Siever, L. J., Buchsbaum, M. S., New, A. S., & Spiegel–Cohen, J. (1999). d,l-Fenfluramine response in impulsive personality disorder assessed with 18F-fluorodeoxyglcuose positron emission tomography. Neuropychopharmacology 20, 413–423.Google Scholar
Siever, L. J., & Davis, K. L. (1991). A psychobiological perspective on the personality disorders. American Journal of Psychiatry, 148, 1647–1658.Google Scholar
Soloff, P. H., Lynch, K. G., Kelly, T. M., Malone, K. M., & Mann, J. J. (2000). Characteristics of suicide attempts of patients with major depressive episode and borderline personality disorder: A comparative study. American Journal of Psychiatry 157, 601–608.Google Scholar
Stein, D. J., Hollander, E., Cohen, L., & Frenkel, M. (1993). Neuropsychiatric impairment in impulsive personality disorders. Psychiatry Research 48, 257–266.Google Scholar
Swartz, M., Blazer, D., George, L., & Winfield, I. (1990). Estimating the prevalence of borderline personality disorder in the community. Journal of Personality Disorders 4, 257–272.Google Scholar
Torgersen, S., Kringlen, E., & Cramer, V. (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry 58, 590–596.Google Scholar
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, 416–425.Google Scholar
Tremblay, R. E., Pihl, R. O., Vitaro, F., & Dobkin, P. L. (1994). Predicting early onset of male antisocial behavior from preschool behavior. Archives of General Psychiatry 51, 732–739.Google Scholar
Trull, T. J., Widiger, T. A., Lynam, D. R., & Costa, P. T. (2003). Borderline personality disorder from the perspective of general personality functioning. Journal of Abnormal Psychology 112, 193–202.Google Scholar
Weiss, M., Zelkowitz, P., Feldman, R., Vogel, J., Heyman, M., & Paris, J. (1996). Psychopathology in offspring of mothers with borderline personality disorder. Canadian Journal of Psychiatry 41, 285–290.Google Scholar
Weissman, M. M., & Klerman, G. L. (1985). Gender and depression. Trends in Neuroscience 8, 416–420.Google Scholar
Werner, E. E., & Smith, R. S. (1992). Overcoming the odds, high risk children from birth to adulthood. New York: Cornell University Press.
White, C. N., Gunderson, J. G., Zanarini, M. C., Hudson, J. I. (2002). Family studies of borderline personality disorder: A review. Harvard Review of Psychiatry 12, 118–119.Google Scholar
Widom, C. (1999). Childhood victimization and the development of personality disorder, unanswered questions remain. Archives of General Psychiatry 56, 607–608.Google Scholar
Widom, C. S., & Kuhns, J. B. (1996). Childhood victimization and subsequent risk for promiscuity, prostitution, and teenage pregnancy, a prospective study. American Journal of Public Health 86, 1607–1612.Google Scholar
Zanarini, M. C. (1993). Borderline personality as an impulse spectrum disorder. In J. Paris (Ed.), Borderline personality disorder, etiology and treatment (pp. 67–86). Washington, DC: American Psychiatric Association.
Zanarini, M. C. (2000). Childhood experiences associated with the development of borderline personality disorder. Psychiatric Clinics of North America 23, 89–101.Google Scholar
Zanarini, M. C., Frankenburg, F. R., Dubo, E. D., Sickel, A. E., Trikha, A., Levin, A., & Reynolds, V. (1998). Axis I comorbidity of borderline personality disorder. American Journal of Psychiatry 155, 1733–1739.Google Scholar
Zanarini, M. C., 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, 274–283.Google Scholar
Zanarini, M. C., Frankenburg, F. R., Khera, G. S., & Bleichmar, J. (2001). Treatment histories of borderline inpatients. Comprehensive Psychiatry 42, 144–150.Google Scholar
Zanarini, M. C., Gunderson, J. G., & Frankenburg, F. R. (1990). Cognitive features of borderline personality disorder. American Journal of Psychiatry 147, 57–63.Google Scholar
Zelkowitz, P., Guzder, J., Paris, J., Feldman, R., & Roy, C. (2004). Follow-up of children with and without borderline pathology. Presented at the Canadian Academy of Child and Adolescent Psychiatry, September 2004.
Zoccolillo, M., Tremblay, R., & Vitaro, F. (1996). DSM-III-R and DSM-III criteria for conduct disorder in preadolescent girls: Specific but insensitive. Journal of the American Academy of Child and Adolescent Psychiatry 35, 461–470.Google Scholar
Zweig–Frank, H., & Paris, J. (1995). The five factor model of personality in borderline personality disorder. Canadian Journal of Psychiatry 40, 523–526.Google Scholar