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J Psychiatr Res. 2011 Jun;45(6):823-8. doi: 10.1016/j.jpsychires.2010.10.015. Epub 2010 Dec 3.

Predictors of self-mutilation in patients with borderline personality disorder: A 10-year follow-up study.

Author information

1
McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States. zanarini@mclean.harvard.edu

Abstract

BACKGROUND:

Self-mutilation is a common and serious problem in patients with borderline personality disorder (BPD). The purpose of this study was to determine the most clinically relevant baseline and time-varying predictors of self-mutilation over 10 years of prospective follow-up among patients with BPD.

METHOD:

Four semistructured interviews assessing axis I disorders, childhood adversity, adult experiences of abuse, and experiences of self-mutilation were administered at baseline to 290 patients meeting DIB-R and DSM-III-R criteria for BPD. Three of these interviews (all except for the childhood adversity interview) and two self-report measures pertaining to dysphoric affects and cognitions were administered at each of five contiguous two-year follow-up periods.

RESULTS:

Eleven variables were found to be significant bivariate predictors of self-mutilation over the five follow-up periods. Six of these predictors remained significant in multivariate analyses: female gender, severity of dysphoric cognitions (mostly overvalued ideas), severity of dissociative symptoms, major depression, history of childhood sexual abuse, and sexual assaults as an adult.

CONCLUSIONS:

Taken together, the results of this study suggest that factors pertaining to traumatic experiences throughout the lifespan are significant risk factors for self-mutilation over time. These results also suggest that major depressive episodes and cognitive symptoms, particularly overvalued ideas and dissociation, significantly heighten the risk of self-injurious behaviors tracked for a decade.

PMID:
21129758
PMCID:
PMC3203731
DOI:
10.1016/j.jpsychires.2010.10.015
[Indexed for MEDLINE]
Free PMC Article

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