Prospective study of family adversity and maladaptive parenting in childhood and borderline personality disorder symptoms in a non-clinical population at 11 years
Prospective study of family adversity and maladaptive parenting in childhood and borderline personality disorder symptoms in a non-clinical population at 11 years
复制标题
儿童期家庭逆境和适应不良养育方式以及 11 岁时非临床人群边缘性人格障碍症状的前瞻性研究
作者：
C. Winsper;M. Zanarini;D. Wolke
背景：回顾性研究一致表明，父母不适应与边缘型人格障碍（BPD）之间存在关联。这需要与前瞻性的纵向设计相印证。我们使用前瞻性样本调查了儿童期次优养育和父母冲突与儿童后期BPD症状之间的关联。方法对1991年4月至1992年12月出生的6050名母亲及其子女进行社区抽样。母亲在怀孕期间的家庭逆境和育儿行为，如打击，大喊大叫，敌意和整个童年的父母冲突进行了评估。在7-8岁时评估智商（IQ）和DSM-IV轴I诊断。训练有素的心理学家采访了11岁（平均年龄11.74岁）的儿童，以确定BPD症状。结果校正混杂因素后，妊娠期家庭不良事件预测BPD可能发生1 ~ 2种不良事件：OR =1.34（95%CI 1.01-1.77），>2种不良事件：OR = 1.99（95%CI 1.34-2.94），明确1 ~ 2种不良事件：OR = 2.48（95%CI 1.01-6.08）。次优养育指数每增加一点，预测BPD可能症状：OR 1.13（95% CI 1.05-1.23）和明确症状：OR 1.28（95% CI 1.03-1.60）。父母冲突预测BPD很可能：OR 1.19（95% CI 1.06-1.34）和明确：OR 1.42（95% CI 1.06-1.91）症状。在路径分析中，次优养育和BPD结果之间的关联部分由DSM-IV诊断和7-8岁时的智商介导。结论：来自不良家庭背景的儿童，经历了次优的养育和父母之间的冲突，认知能力差，DSM-IV诊断，在11岁时BPD症状的风险增加。
Background Retrospective studies have consistently indicated an association between maladaptive parenting and borderline personality disorder (BPD). This requires corroboration with prospective, longitudinal designs. We investigated the association between suboptimal parenting and parent conflict in childhood and BPD symptoms in late childhood using a prospective sample. Method A community sample of 6050 mothers and their children (born between April 1991 and December 1992) were assessed. Mothers' family adversity was assessed during pregnancy and parenting behaviours such as hitting, shouting, hostility and parent conflict across childhood. Intelligence quotient (IQ) and DSM-IV Axis I diagnoses were assessed at 7–8 years. Trained psychologists interviewed children at 11 years (mean age 11.74 years) to ascertain BPD symptoms. Results After adjustment for confounders, family adversity in pregnancy predicted BPD probable 1 to 2 adversities: odds ratio (OR)=1.34 [95% confidence interval (CI) 1.01–1.77]; >2 adversities: OR 1.99 (95% CI 1.34–2.94) and definite 1 to 2 adversities: OR 2.48 (95% CI 1.01–6.08) symptoms. Each point increase in the suboptimal parenting index predicted BPD probable: OR 1.13 (95% CI 1.05–1.23) and definite: OR 1.28 (95% CI 1.03–1.60) symptoms. Parent conflict predicted BPD probable: OR 1.19 (95% CI 1.06–1.34) and definite: OR 1.42 (95% CI 1.06–1.91) symptoms. Within the path analysis, the association between suboptimal parenting and BPD outcome was partially mediated by DSM-IV diagnoses and IQ at 7–8 years. Conclusions Children from adverse family backgrounds, who experience suboptimal parenting and more conflict between parents, have poor cognitive abilities and a DSM-IV diagnosis, are at increased risk of BPD symptoms at 11 years.
影响因子：
22.4
作者：
Crowell, Sheila E.;Beauchaine, Theodore P.;Linehan, Marsha M.
通讯作者：
Linehan, Marsha M.
DOI：
10.1176/ajp.2006.163.5.827
发表时间：
2006-05
期刊：
The American journal of psychiatry
影响因子：
--
作者：
M. Zanarini;F. Frankenburg;J. Hennen;D. B. Reich;K. Silk
通讯作者：
M. Zanarini;F. Frankenburg;J. Hennen;D. B. Reich;K. Silk
DOI：
10.1176/ajp.150.8.1237
发表时间：
1993-08
期刊：
The American journal of psychiatry
影响因子：
--
作者：
D. Bernstein;P. Cohen;C. Vélez;M. Schwab-Stone;L. Siever;Lillian Shinsato
通讯作者：
D. Bernstein;P. Cohen;C. Vélez;M. Schwab-Stone;L. Siever;Lillian Shinsato