Abstract Background: As suicide rates are alarmingly high worldwide, finding predictors for suicide is imperative. People with borderline personality disorder (BPD) have a heightened risk of...Show moreAbstract Background: As suicide rates are alarmingly high worldwide, finding predictors for suicide is imperative. People with borderline personality disorder (BPD) have a heightened risk of attempting and dying by suicide. BPD is diagnosed using nine distinct criteria, which have all been previously linked to suicidal ideation, suicidal behavior, and suicide attempts (SA) in people with BPD. However, the results of previous studies vary greatly, and no single diagnostic criterium seemed to have a uniquely strong correlation with SA. The aim of this study was to shed more light on the associations of these criteria and SA by including a large group of people with BPD or other psychiatric illnesses, and healthy participants. Method: Diagnostic criteria and previous SA were assessed in a semi-structured interview by trained clinicians. Data was analyzed with multiple regression analyses in the three groups separately. Results: In BPD participants, the criteria of abandonment avoidance and affective instability were significantly linked to SA, while suicidal and self-harm behaviors only showed a marginally significant predictive effect. In the clinical group, all diagnostic criteria had non-significant effects on the number of SA. The analysis for the healthy group was inconclusive due to restricted range of SA. Conclusion: These findings suggest that abandonment avoidance and affective instability may be the most pronounced risk factors for people with BPD; they are more strongly linked to SA than even suicidal behavior and the remaining diagnostic criteria. In people with other psychiatric illnesses, other risk factors may be more important for SA. This may have implications for suicide prevention in clinical practice, though further research is needed.Show less
Introduction: Childhood maltreatment (CM) is a highly prevalent issue in our society that includes physical, emotional and sexual abuse, as well as physical and emotional neglect. CM can lead to...Show moreIntroduction: Childhood maltreatment (CM) is a highly prevalent issue in our society that includes physical, emotional and sexual abuse, as well as physical and emotional neglect. CM can lead to various negative consequences, such as dissociation. Known subtypes are amnestic dissociation, absorption and depersonalization/derealization. There is ample empirical evidence supporting sexual and physical abuse leading to dissociation, but rarely do studies focus on all facets of the variables. This study aims to investigate the relationship between the different types of CM and dissociation taking post-traumatic stress disorder (PTSD) as a mediator into account. Methods: Using an online self-report survey, CM, dissociation and PTSD were assessed cross-sectionally among a sample recruited on online platforms for domestic violence via Leiden University (N=432). Obtained data were analyzed by performing a multivariate analysis of covariance (MANCOVA) and mediation analysis (PROCESS macro). Results: The results support the notion to use all subscales of both variables, as sexual abuse and physical neglect were significantly associated with amnestic dissociation, while sexual abuse, physical neglect and emotional abuse were significant predictors of derealization/depersonalization; physical neglect had a significant relationship with absorption. PTSD was a significant mediator but it did not fully explain the link between CM and dissociation. Discussion: Future studies should focus on using clinical samples and longitudinal designs to gain deeper knowledge into therapeutic implications. Integrating the findings of our paper is an important step to better understand the types of CM, dissociation and the importance of PTSD.Show less
