Sadie, C.; (2005) Childhood experiences of men with borderline personality disorder. Doctoral thesis , University of London.

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Abstract

Borderline personality disorder is a severe, psychologically and socially debilitating condition that tends to develop in people who have experienced multiple forms of adversity in their early lives. For a variety of reasons, most research into the aetiology of the disorder has focused on women. This research seeks to explore potential aetiological factors among men. There is evidence that known risk factors for BPD differ in incidence between men and women, and that responses to and interpretations of such experiences may also differ by gender. It is possible, then, that BPD may develop along different pathways for men and women, or may act on different vulnerabilities. These differences may be clinically significant, and could influence the way in which therapeutic interventions are conceptualised and delivered. The first section, a review paper, describes and critiques the existing research into risk factors for BPD, including aspects of childhood maltreatment and neurobiological markers of the disorder. It examines the literature on gender and BPD, exploring explanations for the apparent rarity of men in research and clinical settings. The review then evaluates the existing research specifically regarding men with BPD, and makes a case for a more inclusive programme of research, incorporating a consideration of gender-specific risk factors. The second section, an empirical paper, presents an analysis of the responses of 30 men, 19 meeting criteria for BPD and 11 forming a psychiatric control group, to questions exploring their childhood experiences of abuse, neglect and adversity, and their current symptomatology. Characteristics of the BPD group were described, and hypotheses regarding the nature and severity of experiences of maltreatment between the BPD and non-BPD group were tested. Then, the findings of this study were compared with those of two recent similar studies. Finally, the paper discusses the theoretical and clinical implications of the results, appraises their validity, and makes suggestions for further investigation. Third, a critical appraisal reflects on several salient issues in some depth. It examines criteria for BPD in the light of gender differences and patterns of responding in this study, and explores the validity of the diagnosis for men. Methodological debates regarding the use of retrospective data collection are detailed and the decisions made in the current study discussed. Finally, some observations are made regarding the research process, noting challenges endemic in research in this area, and specific points of learning.

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