BORDERLINE PERSONALITY, NIGHTMARES, AND ADVERSE LIFE EVENTS IN THE RISK FOR EATING DISORDERS

Several scattered lines of evidence suggest that there is a triad of r elationships between early adverse life events, borderline personality structure, and susceptibility to nightmares; and, further, that these associations might throw light on the aetiology of the eating disorde rs. These possibilities were examined in three studies of non-clinical samples of female subjects who completed scales of borderline persona lity, trauma, nightmare experience, and, in one study, weight preoccup ation. Results showed consistent positive correlations between the per sonality, life events, and nightmare variables, including, among the l atter, measures based on detailed analysis of subjects' reported night mare content. Also evident in the data were positive associations betw een weight preoccupation and several of these measures - including sex ual and neglectful abuse. However, regression analysis demonstrated th at, among the psychological measures, only borderline personality sign ificantly predicted weight preoccupation. Further examination of the n ightmare accounts of a small group of seriously abused subjects, who w ere also extreme on the personality measure, suggested a tentative ''d iscontinuity'' hypothesis, proposing that the transition from vulnerab ility status to eating disordered pathology might require threshold le vels to be crossed on several risk variables. Aetiological considerati ons aside, it was concluded that enquiring into nightmare experience m ight be a useful adjunct to direct questioning about early trauma in i ndividuals vulnerable to psychological dysfunction, including eating d isorders. (C) 1998 Elsevier Science Ltd. All rights reserved.