Eu . J. Psychia . Vol. 29, N.° 2, (105-118)
2015
Keywo ds: Bo de line pe sonali y diso de ; Child-
hood auma iza ion; Physical abuse; Sexual abuse;
Emo ional abuse.
The ole o childhood auma iza ion in
he de elopmen o bo de line pe sonali y
diso de in Hunga y
Ka alin Me zaa,*
Gábo Pappb
Ildikó Ku i á né Szabó, PhDa
aUni e si y o Deb ecen, School o Public
Heal h, Depa men o Beha io al
Sciences, Deb ecen
bUni e si y o Deb ecen, Ins i u e
o Psychology, Deb ecen
HUNGARY
ABSTRACT – Backg ound and Objec i es:
The e is a g owing body o e idence sugges -
ing he ole o childhood abuse in he e iology o bo de line pe sonali y diso de (BPD).
S udies ound ha complex auma iza ion ela ed o BPD include emo ional/physical/sex-
ual abuse and neglec . This s udy examines sel - epo ed expe iences o childhood auma-
iza ion in Hunga ian inpa ien s wi h a diagnosis o bo de line pe sonali y diso de and e-
eal which e iological ac o s a e mos s ongly associa ed wi h he de elopmen o BPD.
Me hods:
T auma ic childhood expe iences o 80 bo de line inpa ien s, 73 dep essed
inpa ien s and 51 heal hy con ols we e assessed wi h he T auma ic An eceden s Ques-
ionnai e and he Sexual Abuse Scale o Ea ly T auma In en o y.
Resul s: Ad e se childhood expe iences (neglec , emo ional abuse, physical abuse, sex-
ual abuse, wi nessing auma) we e mo e p e alen among bo de line pa ien s han among
dep essed and heal hy con ols. Bo de line pa ien s epo ed se e e sexual abuse, cha ac-
e ized by inces , pene a ion and epe i i e abuse. Sexually abused bo de line pa ien s ex-
pe ienced mo e physical and emo ional abuse han bo de lines who we e no sexually
abused. The s onges p edic o s o bo de line diagnosis we e sexual abuse, in a amilial
physical abuse and neglec by he ca e ake s.
Conclusions:
O e all, ou esul s sugges ha a epo ed childhood his o y o abuse
and neglec a e bo h common and highly disc imina ing o bo de line pa ien s in Hun-
ga y as well.
Recei ed: 1 Decembe 2014
Re ised: 3 Ma ch 2015
Accep ed: 9
Ap il
2015
106 KATALIN MERZA ET AL.
Backg ound and objec i es
The ole o childhood auma iza ion in
he e iology o bo de line pe sonali y diso -
de (BPD) has been a ocus o esea ch o
mo e han 30 yea s1-4. No h Ame ican and
Wes e n Eu opean s udies ha e p o ided a
la ge body o e idence on he nume ous in-
a amilial pa hological childhood expe i-
ences, such as a his o y o physical, emo-
ional, sexual abuse and neglec ha a e
commonly epo ed by bo de line pa ien s1,4-
6. Mo e speci ically, 40-86% o subjec s wi h
BPD ha e epo ed being sexually abused
du ing hei childhood7-14, o a maximum o
94.7% epo ed by McLean and Gallop in
200315. Fu he mo e, 10-73% ha e epo ed
being physically abused by pa en s o adul
ca e ake s1,9,11,13,16,17 and 17-25% ha e e-
po ed being physically neglec ed11,13. Th ee-
qua e s o bo de line pa ien s ha e epo ed
emo ional abuse and 70% ha e epo ed
childhood emo ional wi hd awal13. In addi-
ion, indings o a la ge numbe o s udies
show ha childhood expe iences o bo h
abuse and neglec a e signi ican ly mo e
common among bo de line pa ien s han
among compa isons wi h a diagnosis o Axis
I o Axis II diso de s2,11-13,18.
O all o he psychosocial ac o s, child-
hood sexual abuse is conside ed o be he
mos speci ic in he e iology o BPD19. Pa a-
me e s o childhood sexual abuse highly dis-
c imina e be ween abused BPD pa ien s and
abused non-BPD pa ien s20,21. Bo de line pa-
ien s compa ed o Axis I and II subjec s ha e
epo ed he mos se e e pa ame e s o sexual
abuse: signi ican ly highe in a- amilia a es
(72%)15, no single inciden s o abuse (50%)11,
mul iple pe pe a o s (35-79%)21,22, ea ly-on-
se abuse (13-60%)8,10,12,17,19, use o o ce
(93%)21 and pene a ion (33-44%)8,11,21. Al-
hough s udies ha e ound ha 40-75% o
bo de line pa ien s a e abused by a ull- ime
adul ca e ake 9,23,24, epo ed childhood sex-
ual abuse in bo de line samples is pe pe a ed
no only by pa en s. Mo eo e , epo ing
memo ies o sexual abuse by siblings, g and-
a he s o o he amily membe s could, in
some cases, be a ‘sc een’ o pa en al inces ,
which some may ind in ole able o ecall8.
Howe e , sexual abuse is nei he neces-
sa y, no su icien o he de elopmen o
BPD13. A me a-analy ic s udy o he pub-
lished li e a u e (con aining 19 No h-Ame -
ican and wo Eu opean s udies) be o e 1999,
conduc ed by Fossa i, Mededdu and Ma -
ei25, has ound ha in Wes e n socie y he e
is only a mode a e associa ion be ween child-
hood sexual abuse and BPD diagnosis. Sex-
ual abuse does no occu in a acuum, i oc-
cu s in he con ex o o he o ms o abuse
and dys unc ional pa en al beha io 26,27 and
con ibu es o he de elopmen o BPD
h ough in e ac ion wi h o he pa hological
childhood expe iences4,5. Fo example, sex-
ually abused BPD pa ien s a e mo e likely o
epo physical neglec , emo ional wi h-
d awal, and inconsis en ea men by ca e-
ake s13. They usually come om dis u bed
amilies which do no o canno p o ec hei
child en and ail o mee hei needs2,8. Thus
BPD pa ien s ha e also epo ed signi ican ly
highe a es o psychia ic diso de s in hei
amilies, especially anxie y diso de s, de-
p ession, sepa a ion om pa en s, un a o -
able pa en al ea ing s yles1, an isocial dis-
o de s and subs ance use diso de 28,29. The
indings o p e ious esea ches sugges ha
s udies should assess a ange o pa hological
childhood expe iences, a he han ocus
solely on he p e alence o sexual abuse13.
Ou side No h-Ame ica and Wes e n Eu-
ope, only a limi ed numbe o s udies ha e ex-
amined he ela ionship be ween childhood
abuse and bo de line psychopa hology. Re-
cen ly, esul s eme ging om s udies con-
duc ed in Japan and China con ibu e o un-
de s anding c oss-cul u al and cul u e-spe-
ci ic aspec s o bo de line e iology30,31,32.
Consis en wi h p io No h Ame ican and
Wes e n Eu opean esea ch, bo h Japanese
and Chinese s udies ha e ound ha expe i-
ences o emo ional, physical, sexual abuse,
emo ional and physical neglec a e mo e
p e alen among BPD pa ien s han among
non-BPD pa ien s30,31,33. In hese s udies, he
epo ed a e o childhood sexual abuse
among bo de line pa ien s was lowe han
epo ed a es in No h Ame ica, a ibu ed by
Huang30 o he lowe a e o epo ed sexual
abuse in he gene al popula ion o China. In
addi ion, in hese s udies only ou pa ien sam-
ples we e used and he indings may no be
gene alizable o mo e se e ely dis u bed in-
pa ien s30. The se e i y o childhood sexual
abuse was also g ea e among BPD pa ien s
in China who had su e ed inces , pene a ion
and epe i i e abuse30. Fu he mo e, Huang
and colleagues30 used mul i a ia e analyses
o examine he a iables which p edic BPD.
The esul s in China e ealed ha a combi-
na ion o sexual abuse, ma e nal neglec , ma-
e nal physical abuse, and pa e nal an ipa hy
we e signi ican p edic o s o BPD, bu none
o hese a iables alone we e p edic i e o
BPD30. In he Japanese s udy, emo ional
abuse, emo ional neglec and pa e nal o e -
p o ec ion we e signi ican p edic o s o
BPD31. The au ho s ha e assumed he esul s
e lec di e ences be ween pa en ing s yles
in Wes e n coun ies and he Fa Eas , he la -
e being mo e collec i is ic and he pa en ing
s yle, mo e au ho i a ian, cha ac e ized by co-
e ci e con ol and low esponsi eness31,32,34.
Impo an ly, pa hological childhood expe i-
ences a e jus a pa o he mo e complex bo -
de line e iology. The mul i ac o ial model o
he de elopmen o BPD sugges s ha he dis-
o de esul s om he in e ac ion and ansac-
ion o biological and en i onmen al ac-
o s35,36. Examining biological ac o s is
ou side he scope o his s udy.
In summa y, childhood expe iences o
abuse a e pa o a c oss-cul u al e iology o
BPD in No h Ame ican and Wes e n Eu o-
pean coun ies as well as he Fa Eas , bu he
ela i e con ibu ion o pa icula o ms o
childhood abuse o he de elopmen o his
diso de seems o a y ac oss cul u es.
A li e a u e sea ch has e ealed ha in
Hunga y and in he Eu opean Pos -So ie
s a es he e ha e been no s udies ha ha e in-
es iga ed he ole o auma ic childhood
expe iences in he de elopmen o BPD. The
pu poses o his s udy a e o assess e o-
spec i ely he sel - epo ed expe iences o
childhood auma iza ion in Hunga ian inpa-
ien s wi h a diagnosis o BPD and o de e -
mine which e iological ac o s a e mos
s ongly associa ed wi h he de elopmen o
BPD. Fu he mo e, we seek o e eal he di -
e ences be ween Hunga ian and No h-Ame -
ican/Wes e n Eu opean bo de line samples in
o de o unde s and he ela i e con ibu ions
o e iological ac o s ha a e cul u e-speci ic
and o he s ha a e c oss-cul u al. Hunga y
and China bo h being coun ies wi h only el-
a i ely ecen Pos -So ie his o ies, pa en s
may no conside co po al punishmen as
abuse and, he e o e, his pa en ing s yle may
be co ela ed wi h highe p e alence o child
physical abuse. We hypo hesized ha in ou
s udy physical abuse as a cul u e-speci ic ac-
o would inc ease he isk o BPD. Fu he -
mo e, we assume ha he majo p edic o s
(neglec , sexual abuse) o BPD in he Wes e n
socie ies would also associa ed wi h he de-
elopmen o BPD in Hunga y.
In his s udy bo de line inpa ien s we e
compa ed wi h dep essed inpa ien s and a
g oup o heal hy indi iduals in he commu-
ni y. The con ol g oups we e ini ially chosen,
because in sexual abuse esea ch, ch onic de-
p ession is o en seen as a long- e m esul o
sexual abuse23,37,38 and because, BPD pa ien s
a e a ely compa ed wi h a heal hy con ol
g oup wi h ega d o childhood auma1.
THE ROLE OF CHILDHOOD TRAUMATIZATION IN THE DEVELOPMENT... 107
Me hods
Pa icipan s and p ocedu e
The p esen s udy was conduc ed o e he
pe iod om Janua y 2013 o June 2013. The
s udy ollowed he e hics decla a ion o
Helsinki and p io o da a collec ion he p ojec
was app o ed by he Hunga ian Scien i ic and
Medical E hics Commi ee (ETT-TUKEB).
171 inpa ien s we e ec ui ed om eigh
Hunga ian psychia ic hospi als. All pa ien s
we e ini ially sc eened o de e mine ha hey
1) we e be ween he ages o 18 and 50 yea s
2) had a leas an a e age le el o in ellec ual
unc ioning and 3) had been gi en a de ini e
o a p obable clinical diagnosis o bo de line
pe sonali y diso de o majo dep essi e dis-
o de by a senio psychia is . Pa icipan s
we e excluded i hey had cu en symp oms
o a his o y o 1) bipola mood diso de 2)
majo psycho ic diso de o 3) cogni i e im-
pai men . A e p o iding pa ien s wi h a
comple e desc ip ion o he s udy, w i en in-
o med consen was ob ained om each o
hem. The Hunga ian e sion o S uc u ed
Clinical In e iew o DSM-IV Axis I and
Axis II diso de s (SCID-I-II)39,40 was hen
adminis e ed o con i m he diagnosis o bo -
de line pe sonali y diso de and majo de-
p essi e diso de (MDD). 18 o 171 pa ici-
pan s we e elimina ed by he diagnos ic
in e iew: 14 because hey we e ound o
ha e diso de s excluded om his s udy, as
abo e, and 4 because hey me less han i e
BPD diagnos ic c i e ia. Pa ien s who me a
leas i e DSM-IV c i e ia o BPD on he
SCID-II we e included in he bo de line co-
ho . Pa ien s who me he diagnosis o ma-
jo dep essi e diso de wi hou pe sonali y
diso de s we e he non-bo de line dep essed
con ols. The in e iews we e conduc ed by
he i s au ho , a well- ained psychologis .
Heal hy con ols we e ec ui ed o he
s udy om employees o local companies in
Deb ecen. Ou o a pool o 62 con ols 51
we e ee o psychia ic diso de s, as assessed
by he SCID.
Measu es
Expe iences o childhood auma iza ion
we e assessed by he T auma ic An eceden s
Ques ionnai e (TAQ) including in he T auma
Cen e Assessmen Package41. The TAQ is a
42-i em sel - epo ques ionnai e o ga he -
ing in o ma ion abou he equency and
se e i y o auma ic and adap i e expe i-
ences and i has been used by many e-
sea che s15,42. The p ocess o he ansla ion
and adap a ion o TAQ o Hunga ian ollowed
a s anda d p ocedu e acco ding o he guide-
lines o sel -assessmen ins umen s. Analy-
sis o he psychome ic p ope ies o he TAQ
is cu en ly unde way, and p elimina y e-
sea ch showed sa is ac o y alidi y and elia-
bili y (wi h C onbach alphas o 0.683-0.923).
In his s udy only 6 subscales o he TAQ
we e used, selec ed o he pu pose o as-
sessing auma ic o ad e se expe iences.
These subscales co e neglec , sepa a ion,
emo ional abuse and physical abuse by a
ca e ake o amily membe , sexual abuse by
an adul and wi nessing o domes ic iolence.
These ad e se expe iences we e assessed a
ou di e en de elopmen al pe iods: ea ly
childhood (0-6 yea s), la ency (7-12 yea s),
adolescence (13-18 yea s), and adul hood
(o e 18 yea s). Responses can be sco ed 1 o
4, wi h 1 co esponding o ‘ne e o no a
all’, 2 o ‘ a ely o a li le bi ’, 3 o ‘occa-
sionally o mode a ely’, 4 o ‘o en o e y
much’. Howe e , in his s udy he ype o
childhood auma iza ion was analyzed as a
dycho omic a iable ( auma ized – non- au-
ma ized), because we aimed o compa e ou
esul s wi h he esul s o p e ious s udies
which also used dycho omic a iables. The
cu -o poin was de e mined 2/3, hus sub-
108 KATALIN MERZA ET AL.
jec s who sco ed 1 (‘ne e o no a all’) o 2
(‘ a ely o li le bi ’) in each i em we e con-
side ed non- auma ized, and subjec s who
sco ed 3 (‘occasionally o mode a ely’) o 4
(‘o en o e y much’) we e conside ed au-
ma ized. The 2/3 cu -o poin was ini ially
chosen o p e en he o e es ima ion o au-
ma ic expe iences in he sample.
P e ious s udies ha e indica ed ha he
pa ame e s o childhood sexual abuse ha e a
speci ic ela ionship wi h he bo de line di-
agnosis and highly disc imina e abused BPD
pa ien s and abused non-BPD pa ien s21. In
iew o his, we aimed o examine he pa a-
me e s o sexual abuse in de ail. In addi ion
o he TAQ, he Sexual Abuse Scale o he
Ea ly T auma In en o y (ETI)43 (wi h C on-
bach alpha o 0.932) was used o assess child-
hood expe iences o sexual abuse mo e ac-
cu a ely. The p ocess o he ansla ion o
ETI Sexual Abuse Subscale o Hunga ian
language ollowed he s anda d p o ocol.
Co ela ion analysis be ween he Sexual
Abuse Scale o ETI and he sexual abuse
subscale o TAQ showed ha he scales mea-
su e he same cons uc ( = 0.88, p< 0.001).
The ETI de ines sexual abuse as unwan ed
sexual con ac pe o med solely o he g a -
i ica ion o he pe pe a o , o he pu pose o
domina ing o deg ading he ic im. This 15-
i em scale ga he s in o ma ion abou e-
quency, age a onse , use o o ce, ela ion-
ship o he pe pe a o and na u e o sexual
abuse a 4 de elopmen al s ages (simila o
he de elopmen al s ages o he TAQ).
All assessmen s we e done by he i s au-
ho .
Be ween-g oup compa ison o age in ol -
ing con inuous da a we e compu ed by means
o one-way analysis o a iance. Chi-squa e
es s we e pe o med o compa e he e-
quency dis ibu ions o ce ain demog aphic
cha ac e is ics, auma ic expe iences and he
na u e o sexual abuse be ween he pa ien
and he con ol g oups. When cell sizes we e
5 o less Fische ’s exac es o p obabili y
was used. Logis ic eg ession was used o
es he esea ch ques ion ega ding he pos-
sible p edic o s o BPD. A p alue less han
0.05 was conside ed s a is ically signi ican .
The s a is ical analyses we e pe o med by
he SPSS s a is ical package e sion 20.0.
Resul s
The inal sample consis ed o 204 pa ici-
pan s, o whom 80 psychia ic inpa ien s we e
in he BPD g oup, 73 psychia ic inpa ien s
we e in he dep essed compa ison g oup and
51 people we e in he heal hy compa ison
g oup. Table 1 p esen s he compa ison o de -
mog aphic da a among he h ee g oups. To
e alua e age di e ences among he g oups
one-way analysis o a iance (ANOVA) was
conduc ed. ANOVA e ealed signi ican di -
e ences among he h ee g oups (F= 49.42,
p< 0.001), he mean ages o he BPD g oup
(30.5 ± 10.87 yea s) and o he heal hy com-
pa ison g oup (33.6 ± 8.71) we e signi ican ly
lowe han o he dep essed compa ison g oup
(44.3 ± 5.91 yea s) acco ding o he esul s o
he Tukey es . Chi-squa e es o he ca e-
go ical da a showed signi ican di e ences
in ma i al s a us (
χ
2= 88.72, p< 0.001) and
employmen (
χ
2= 130.1, p< 0.001) among
he g oups, wi h bo de line pa ien s less likely
o be ma ied and mo e likely o be unem-
ployed han compa ison subjec s. The g oups
we e ound o be simila in sex dis ibu ion,
wi h all g oups con aining signi ican ly mo e
emales han males (
χ
2= 0.43, p= 0.808).
The e we e no s a is ically signi ican di e -
ences among he g oups o educa ion (
χ
2=
9.00, p= 0.061).
THE ROLE OF CHILDHOOD TRAUMATIZATION IN THE DEVELOPMENT... 109

Table 2 compa es bo de line pa ien s and
con ol subjec s on o e all a es o epo ed
childhood auma iza ion, speci ically, ne-
glec by ca e ake s, sepa a ion om ca e ak-
e s, in a amilial emo ional and physical
abuse, in a/ex a amilial sexual abuse and
wi nessing amily iolence. A Chi-squa e es
e ealed signi ican di e ences among he
g oups o neglec (
χ
2= 35.88, p< 0.001),
emo ional abuse (
χ
2= 34.36, p< 0.001),
physical abuse (
χ
2=51.58, p< 0.001), sexual
abuse (
χ
2=45.52, p< 0.001) and wi nessing
auma (
χ
2=45.02, p< 0.001) be o e he age
o 18. The e we e no signi ican di e ences
among he g oups o sepa a ion (
χ
2= 5.19,
p= 0.075). As seen in Table 3, subsequen
compa isons indica ed ha he a es o child-
hood neglec (
χ
2= 24.19, p< 0.001;
χ
2=
31.63, p< 0.001), emo ional (
χ
2=17.47, p<
0.001;
χ
2= 33.77, p< 0.001), physical (
χ
2 =
32.67, p< 0.001;
χ
2 =35.78, p< 0.001), sex-
ual abuse (
χ
2 = 20.42, p< 0.001;
χ
2 = 37.07,
p< 0.001) and wi nessing auma (
χ
2 =12.02,
p< 0.001;
χ
2 = 44.95, p< 0.001) we e sig-
ni ican ly highe in he BPD g oup han in de-
p essed and heal hy con ol g oups.
110 KATALIN MERZA ET AL.
Table 1
Demog aphic cha ac e is ics o he bo de line and dep essed g oups.
Analysis
Demog aphic BPD Dep essed Heal hy
cha ac e is ic (N = 80) (N = 73) (N = 51)
χ
2P
Age (Mean, SD)* 30.5 ± 10.87 44.3 ± 5.91 33.6 ± 8.71 <0.001
Sex
Male 12 (15%) 13 (17.8%) 7 (13.7%) 0.43 (d = 2) 0.808
Female 68 (85%) 60 (82.2%) 44 (86.3%)
Ma i al s a us
Single 50 (62.5%) 6 (8.2%) 19 (37.0%) 88.72 (d = 8) <0.001
Ma ied 3 (3.8%) 42 (57.5%) 12 (24.0%)
Common-law ma iage 10 (12.5%) 6 (8.2%) 16 (31.0%)
Di o ced 14 (17.5%) 14 (19.2%) 2 (4.0%)
Relic 3 (3.8%) 5 (6.9%) 2 (4.0%)
Educa ion
P ima y school o below 19 (23.8%) 13 (17.8%) 5 (9.8%) 9.00 (d = 4) 0.061
Seconda y school 51 (63.8%) 45 (61.6%) 30 (58.8%)
Uni e si y 10 (12.5%) 15 (20.5%) 16 (31.4%)
Employmen
Unemployed 30 (37.5%) 14 (19.2%) 2 (3.9%) 130.1 (d = 12) <0.001
Disabled 13 (16.3%) 39 (53.4%) 0 (0.0%)
Full- ime emloymen 6 (7.5%) 6 (8.2%) 26 (51.0%)
Pa - ime employmen 6 (7.5%) 1 (1.4%) 2 (3.9%)
Tempo a y employmen 4 (5.0%) 0 (0%) 1 (2.0%)
S uden 16 (20.0%) 1 (1.4%) 19 (37.3%)
O he 5 (6.3%) 12 (16.4%) 1 (2.0%)
No e. * F = 49.42.
Table 4 p esen s he p e alence o ad e se
expe iences epo ed by he g oups a he
h ee age pe iods, ea ly childhood (0-6
yea s), la ency (7-12 yea s) and adolescence
(13-18 yea s). A Chi-squa e es indica ed
signi ican di e ences among he g oups o
neglec , emo ional, abuse, physical abuse,
sexual abuse and wi nessing auma a each
de elopmen al pe iod. The e we e no sig-
ni ican di e ences among he g oups o
sepa a ion a ea ly childhood and adoles-
cence. Table 4 shows he subsequen com-
pa isons o he g oups on he epo ed a es
o childhood auma iza ion sepa a ely a
each age pe iod. Chi-squa e es indica ed
signi ican di e ences be ween he bo de -
line and bo h con ol g oups on mos ypes o
auma iza ion a each pe iod. Mo e speci -
ically, a highe pe cen age o BPD pa ien s
han dep essed and heal hy compa isons e-
po ed ha ing expe ienced neglec , emo-
ional abuse, physical abuse, sexual abuse
and wi nessing auma a ea ly childhood, la-
ency and adolescence. A signi ican ly highe
pe cen age o bo de lines han dep essed
con ols also epo ed sepa a ion du ing all
h ee o hese pe iods. Howe e , a ea ly
childhood and adolescence bo de line and
heal hy g oups did no di e on epo ed
a es o sepa a ion om ca e ake s.
THE ROLE OF CHILDHOOD TRAUMATIZATION IN THE DEVELOPMENT... 111
Table 3
Subsequen compa isons o he g oups on epo ed a es o childhood auma iza ion.
BPD s. Dep essed BPD s. Heal hy
Type o auma iza ion
χ
2 (d = 2) P
χ
2 (d = 1) P
Neglec 24.19 <0.001 31.63 <0.001
Sepa a ion 3.94 0.047 0.003 0.956
Emo ional abuse 17.47 <0.001 33.77 <0.001
Physical abuse 32.67 <0.001 35.78 <0.001
Sexual abuse 20.42 <0.001 37.07 <0.001
Wi nessing 12.02 <0.001 44.95 <0.001
Table 2
Repo ed a es o childhood auma iza ion in he bo de line g oup and he con ol g oups be o e he age o 18.
Analysis
Type o BPD Dep essed Heal hy
auma iza ion (N = 80) (N = 73) (N = 51)
χ
2P
Neglec 69 (86.3%) 36 (49.3%) 20 (39.2%) 35.88 <0.001
Sepa a ion 64 (80.0%) 48 (65.8%) 41 (80.4%) 5.19 0.075
Emo ional abuse 70 (87.5%) 42 (57.5%) 20 (39.2%) 34.36 <0.001
Physical abuse 52 (65.0%) 14 (19.2%) 6 (11.8%) 51.58 <0.001
Sexual abuse 45 (56.3%) 15 (20.5%) 2 (3.9%) 45.52 <0.001
Wi nessing 62 (77.5%) 37 (50.7%) 9 (17.6%) 45.02 <0.001
112 KATALIN MERZA ET AL.
Table 4
Compa isons o he g oups on epo ed a es o childhood auma iza ion in he h ee de elopmen al s ages.
Analysis
All G oups BPD s. Heal hy BPD s. Dep essed
Type o auma iza ion BPD Dep essed Heal hy
χ
2
χ
2
χ
2
(N = 80) (N = 73) (N = 51) (d = 2) P(d = 2) P(d = 1) P
Neglec
Ea ly childhood (0-6 yea s) 50 (62.5%) 27 (37.0%) 10 (19.6%) 24.92 <0.001 23.08 <0.001 9.94 0.002
La ency (7-12 yea s) 56 (70.0%) 34 (46.6%) 13 (25.5%) 25.38 <0.001 24.75 <0.001 8.65 0.003
Adolescence (13-18 yea s) 68 (85.0%) 34 (46.6%) 20 (39.2%) 35.43 <0.001 29.61 <0.001 25.36 <0.001
Sepa a ion
Ea ly childhood (0-6 yea s) 32 (40.0%) 18 (24.7%) 19 (37.3%) 4.37 0.112 0.09 0.753 4.08 0.043
La ency (7-12 yea s) 48 (60.0%) 29 (39.7%) 29 (56.9%) 6.94 0.031 0.13 0.722 6.28 0.012
Adolescence (13-18 yea s) 61 (76.3%) 43 (58.9%) 32 (62.7%) 5.64 0.06 2.76 0.097 5.28 0.022
Emo ional abuse
Ea ly childhood (0-6 yea s) 48 (60.0%) 20 (27.4%) 7 (13.7%) 32.98 <0.001 27.38 <0.001 16.43 <0.001
La ency (7-12 yea s) 59 (73.8%) 37 (50.7%) 13 (25.5%) 29.49 <0.001 29.30 <0.001 8.69 0.003
Adolescence (13-18 yea s) 68 (85.0%) 34 (46.6%) 20 (39.2%) 35.43 <0.001 29.61 <0.001 25.36 <0.001
Physical abuse
Ea ly childhood (0-6 yea s) 34 (42.5%) 6 (8.2%) 0 (0.0%) 45.04 <0.001 29.27 <0.001 23.23 <0.001
La ency (7-12 yea s) 40 (50.0%) 10 (13.7%) 2 (3.9%) 43.14 <0.001 30.36 <0.001 22.86 <0.001
Adolescence (13-18 yea s) 47 (58.8%) 10 (13.7%) 6 (11.8%) 47.94 <0.001 28.54 <0.001 33.14 <0.001
Sexual abuse
Ea ly childhood (0-6 yea s) 17 (21.3%) 4 (5.5%) 0 (0.0%) 18.08 <0.001 12.45 <.0001 8.02 0.005
La ency (7-12 yea s) 28 (35.0%) 7 (9.6%) 0 (0.0%) 31.42 <0.001 22.70 <0.001 13.97 <0.001
Adolescence (13-18 yea s) 42 (52.5%) 6 (8.2%) 2 (3.9%) 56.03 <0.001 32.95 <0.001 34.76 <0.001
Wi nessing
Ea ly childhood (0-6 yea s) 45 (56.3%) 16 (21.9%) 3 (5.9%) 41.42 <0.001 34.03 <0.001 18.77 <0.001
La ency (7-12 yea s) 50 (62.5%) 22 (30.1%) 5 (9.8%) 39.61 <0.001 35.51 <0.001 16.05 <0.001
Adolescence (13-18 yea s) 55 (68.8%) 34 (46.6%) 8 (15.7%) 35.21 <0.001 35.13 <0.001 7.71 0.005
Table 5 compa es bo de line and dep essed
pa ien s who epo ed childhood sexual abuse
wi h espec o he pa ame e s o sexual
abuse. In his sample 45 bo de line pa ien s
and 15 dep essed compa isons epo ed ha -
ing expe ienced sexual abuse be o e he age
o 18. Fo pa ien s who had been abused by
mo e han one pe pe a o , da a we e en e ed
o he speci ic pe pe a o whose abuse
would be expec ed o be mo e auma ic, ac-
co ding o he Pa is & Zweig-F ank’s21 hie -
a chy. A signi ican ly highe pe cen age o
bo de line pa ien s han dep essed compa -
isons epo ed childhood sexual abuse pe -
pe a ed by a a he /male ca e ake (
χ
2 =5.93,
p= 0.015). Mo eo e , he equency o mul-
iple pe pe a o s was also highe among
BPD pa ien s (
χ
2 = 9.27, p< 0.001). Mo e
BPD pa ien s epo ed abuse by pe pe a o s
amilia o hem (
χ
2 =0.86, p = 0.353), and by
b o he s (
χ
2 = 0.69, p= 0.41), bu hese di -
e ences we e no signi ican . Fu he mo e,
he a e o childhood sexual abuse by a male
s ange was signi ican ly highe in he de-
p essed con ol g oup (
χ
2 = 4.69, p= 0.03).
The e was a la ge, signi ican di e ence be-
ween he g oups wi h espec o he na u e o
childhood sexual abuse. The p e alence o
THE ROLE OF CHILDHOOD TRAUMATIZATION IN THE DEVELOPMENT... 113
Table 5
Pa ame e s o childhood sexual abuse in he bo de line g oup and in he dep essed con ol g oup.
Analysis
Pa ame e s BPD (N = 45) Dep essed (N = 15)
χ
2 (d = 1) P
Pe pe a o
Fa he /Male ca e ake 22 (48.9%) 2 (13.3%) 5.93 0.015
B o he 2 (4.4%) 0 (0.0%) 0.69 0.41
O he male 18 (40.0%) 4 (26.7%) 0.86 0.353
O he emale 2 (4.4%) 0 (0.0%) 0.69 0.406
Male s ange 13 (28.9%) 9(60.0%) 4.69 0.03
Mul iple 19 (42.2%) 0 (0.0%) 9.27 <0.001
Na u e
Fondling 43 (95.6%) 13 (86.7%) 1.43 0.232
O al sex 23 (51.1%) 3 (20.0%) 4.43 0.035
Pene a ion 34 (75.6%) 3 (20.0%) 14.68 <0.001
Incomple e pene a ion 33 (73.3%) 6 (40.0%) 5.49 0.019
Anal pene a ion 2 (4.4%) 0 (0.0%) 0.69 0.406
F equency
Single inciden 8 (17.8%) 9 (60.0%) 9.87 0.002
Mo e han once a yea 10 (22.2%) 5 (33.3%) 0.124 0.389
Mon hly 18 (40.0%) 1 (6.7%) 5.77 0.016
Weekly 5 (11.1%) 0 (0.00%) 1.82 0.178
Daily 4 (8.9%) 0 (0.00%) 1.43 0.232
Age a onse
Ea ly childhood 0-6 yea s 17 (37.8%) 4 (26.7%) 0.61 0.435
La ency 7-12 yea s 18 (40.0%) 5 (33.3%) 0.212 0.646
Adolescence 13-18 yea s 10 (22.2%) 6 (40.0%) 0.182 0.178