Personality disorder diagnosis in substance - dependent women in Iran : Relationship to childhood maltreatment

Objective: Few studies have examined the relationship between childhood maltreatment and personality disorder in later years of the children's life especially in Eastern Mediterranean countries . This study was conducted to explore the relationship between adverse childhood experiences and personality disorder during their later years of life in an Iranian sample. A cross sectional study was conducted in Kerman , a city in South East of Iran in 2005 . Method: Cases were 148 substances dependent women who were admitted in Shahid Beheshti hospital and women who were in Kerman's prison for detoxification. With emphasis on confidentiality and obtaining oral consent, we asked the subjects to fill out a questionnaire which included demographic variables and 27 questions concerning all types of abuse , neglect and household dysfunction . Using multivariate Logistic regression, the association between baseline characteristics, childhood maltreatment and household dysfunction variables and personality disorder were analyzed . Results: The mean age of the cases was 33.13 ± 10.94, and borderline personality disorder (24.3%) was the most frequent type of personality disorder in this sample. Physical abuse (45.4%) , emotional abuse (36.2%) and emotional neglect (92.1%) were the most frequent type of maltreatment. While dependency was considered as an independent variable, with logistic regression analysis, sexual abuse was the only type of childhood maltreatment which showed statistically significant association with personality disorder . Conclusion: There was a statistically significant association between increased prevalence of severe personality disturbances among those experiencing multiple types of abuse and neglect . Such studies are important for a more complete understanding of these problems and for practical efforts to alleviate them . Keywords: Addiction, Adult survivors of child abuse, Personality disorders, Women Iran J Psychiatry 2009; 4:52-55 Research conducted over the past decade indicates that a wide range of psychological and interpersonal problems are more prevalent among those who have been abused including but not limited to sexual abuse than among individuals with no such experiences (1-3). A good deal of scholarly attention has been paid to the possibility that maltreatment during the first 18 years of life increases the likelihood of symptoms of dissociation ,increased hostility ,higher impulsivity Levels , borderline personality disorder and drug use during adolescence . The deficits in cognitive, social, emotional , behavioral functioning and negative peer relationships are associated with maltreatment (4-7). An increased prevalence of severe personality disturbances was observed among those experiencing multiple types of abuse including emotional , physical , sexual and neglect (3, 4, 7) . Women are at high risk for being exposed to childhood maltreatment (3, 8-10). Furthermore, we conducted this study to further clarify the relationship between personality disturbances and childhood maltreatment in substance dependent women in Iran as improved understanding of the potential outcomes could lead to better targeted efforts for secondary prevention. Materials and Method A cross - sectional study was conducted in Kerman, a city in South East of Iran in 2005 . At first, the cases were 152 substance dependent women admitted in Shahid Beheshti hospital and those in Kerman 's prison ; 4 subjects dropped out of the study for they have no completely compliance. The diagnosis of substance dependency and personality disorder was made by means of semi structural clinical interview for DSM - IV axis I and II disorder (11) by a psychiatrist or assistant of psychiatry . The subjects were asked to fill out a questionnaire which included demographic variables and 27 questions concerning child maltreatment including abuse(physical , emotional , or sexual )and questionnaire and neglect as child and teenager questions measuring household dysfunction including household substance abuse, parental separation or divorce. …