Zur Psychogenese der Persönlichkeitsstörungen

Abstract

Personality - and thus, personality disorder - represents a complex entity encompassing the entire spectrum of inner experience and outer behaviour. Therefore, when studying the aetiology of personality disorders, it may be preferable to separate genetically driven temperament, character with a number of non-behavioural components and impairment. Even though genetic effects bring about environmental risks or cause an increased vulnerability to such risks, they cannot explain the recent general increase in behavioural pathology in young people. Apart from macrosocial factors the most important microsocial environmental factors include dysfunctional family, traumatic experiences and other psychosocial stressors. The role of these factors has most often been studied in borderline personality disorder. The majority of borderline personality disorders suffered traumatic events, most of them being repeated sexual and physical abuse in childhood and adolescence; the hypothesis has even been promoted that borderline personality disorder represents a special form of posttraumatic stress disorder. Regarding family factors, parental bonding (mostly assessed with the Parental Bonding Instrument [PBI], reflecting parental attitudes and behaviours) has frequently been studied in borderline and other personality disorders. Our results underline the role of gender: whereas early trauma experiences correlated significantly with the overall (and especially cluster B, including borderline) pathology of personality disorders in women, high correlations were found between the overall pathology of personality disorders and parental bonding dimensions in men, with lack of paternal care and high paternal control accounting for 38% of the entire variance. A paradigm of biological priority and psychological supremacy has been developed and our results showing a much higher link between psychopathology and PBI dimensions in healthy probands than in their mentally ill, same-sex siblings are in agreement with this model. Environmental factors seem to play a less important role in the case of a more pronounced psychopathology.