Temperament, but not childhood trauma, distinguishes borderline personality disorder from bipolar disorder and ADHD

Abstract

Background

The aim of this study was to investigate if temperament and experience of childhood trauma differed between young psychiatric patients with borderline personality disorder (BPD), bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD).

Methods

Diagnoses were based on the Structured Clinical Interview for DSM Axis I and Axis II. Temperament was assessed by the Temperament and Character Inventory (TCI) and childhood trauma by the Early Trauma Inventory-Self Report-Short Form (ETI-SR-SF). Temperament and childhood trauma were compared between the BPD group (n = 19) and the non-BPD group (BD/ADHD) (n = 95). Interactions between trauma and temperament were evaluated using a logistic regression model with a BPD diagnosis as outcome variable.

Results

Participants in the BPD group showed higher novelty seeking (NS) and harm avoidance (HA). Traumatic experiences in childhood were common but the BPD group differed very little from the others in this regard. The interaction between temperament and trauma had low explanatory power for a BPD diagnosis in this sample.

Conclusion

Temperament might be useful to distinguish BPD when symptoms of impulsivity and affective instability are evaluated in psychiatric patients. The results from the interaction analysis support the multifactorial background to BPD.

Keywords:

• Borderline personality disorder
• bipolar disorder
• attention-deficit/hyperactivity disorder (ADHD)
• childhood trauma
• temperament

Acknowledgements

The authors would like to acknowledge Niklas Hörberg for his valuable contribution to data collection.

Author contributions

IK and MR conceptualized the research and its methodology, were involved in data collection and were major contributors to writing the original draft, reviewing and editing. HH curated the data, ran statistical analyses, and contributed to writing the original draft and reviewing the final version. LE contributed to conceptualizing the research, supervising and reviewing. All authors read, revised and approved the final manuscript.

Ethical approval

The study was approved by the Uppsala University Ethics Committee, Dnr 2008/171.

Consent form

Not applicable.

Disclosure statement

The authors declare that they have no competing interests.

Data availability statement

The data that support the findings of this study are available on reasonable request from the corresponding author [IK]. The data are not publicly available due to them containing information that could compromise research participant consent.

No funding sources.

Additional information

Notes on contributors

Ioannis Kouros

Ioannis Kouros, MD, PhD student in psychiatry at Uppsala University, Department of Medical sciences and Senior Consultant at the Department of Adult Psychiatry, Akademiska University Hospital, Uppsala, Sweden.

Håkan Holmberg

Håkan Holmberg, statistician, at the time of the study working with the national health registers at at the National Board of Health and Welfare in Sweden.

Lisa Ekselius

Lisa Ekselius, MD, PhD, Senior professor in psychiatry at Uppsala University, Department for Women’s and Children’s Health, Uppsala University, Uppsala, Sweden.

Mia Ramklint

Mia Ramklint, MD, PhD, Professor in child and adolescent psychiatry at Uppsala University, Department of Medical sciences, and Senior Consultant at the Department of Child and adolescent psychiatry, Akademiska University Hospital, both inUppsala, Sweden.