UK study results suggest that children who are bullied by their peers in primary school have an increased risk for developing borderline personality disorder (BPD) during childhood.
And this appears to remain true irrespective of the type of bullying experienced by the child, say Dieter Wolke, from the University of Warwick in Coventry, and co-authors.
They add: "In particular, children who were exposed to combined (overt and relational) or chronic victimization (at 8 and 10 years) were at highly increased risk of developing BPD symptoms, indicating a dose-response relationship."
The results also indicate that the relationship between bullying and BPD development is unaffected by other behavior-modifying variables, such as parental hostility and sexual abuse.
As reported in the Journal of Child Psychology and Psychiatry, 6050 UK-based mothers and their children were recruited for the study.
All children, their mothers, and their teachers were asked to complete questionnaires reporting the type and frequency of peer-related victimization experienced by each child over the previous 6 months. These questionnaires were completed when each child was aged 8 years and again when aged 10 years.
Mothers were also asked to complete a questionnaire designed to identify the exposure of each child to "upsetting events" unrelated to peer-based victimization.
Such events included hostile parenting practices between the ages of 2.0 and 7.0 years and sexual abuse between the ages of 1.5 and 9.0 years.
All children were subsequently interviewed by a trained psychologist, at a mean age of 11.8 years, to assess the presence of BPD.
Wolke and colleagues report that child-, mother-, and teacher-reported bullying, occurring when the child was aged 8 or 10 years, raised the risk for BPD development risk 2.82-, 2.43-, and 1.95-fold, respectively, compared with no bullying.
When child-reported bullying was chronic (present at both 8 and 10 years), the risk for BPD development rose further to become more than fivefold higher than in the absence of bullying.
Children exposed to combined methods of bullying (physical and psychologic) had a 7.10-fold higher risk for developing BPD symptoms, compared with nonbullied children.
"BPD is characterized by unstable and intense relationships, affective dysregulation, and a broad incapacity to trust appropriately the actions and motives of others," explain Wolke et al.
They conclude: "Clinicians should routinely consider peer problems as a factor in adolescents presenting with BPD symptoms."
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