Borderline personality disorder mediates the effect of childhood abuse on substance dependence

To better understand the sequelae of childhood emotional, physical and sexual abuse, the authors provided the first test of a risk model in which borderline personality disorder (BPD) is differentiated from post-traumatic stress disorder (PTSD) in the mediation of the influence of childhood abuse on substance dependence. Among 311 adults in a substance abuse rehabilitation center, childhood abuse was associated with alcohol and cocaine dependence in adulthood and that relationship was significantly mediated by BPD but not PTSD. The additive influence of sexual abuse above physical and emotional abuse on alcohol and cocaine dependence was also mediated by BPD, and this relationship was significantly stronger than for experiencing non-sexual forms of abuse alone. Individuals with histories that include sexual abuse appear to be at increased risk for BPD and alcohol and cocaine dependence, even in a substance abuse population. Substance use dependence, including binge drinking is related to sexual trauma exposure in women.