Personal distress mediates the relationship between childhood trauma and interpersonal vulnerabilities in individuals with borderline personality disorder

Interpersonal problems are considered core features of borderline personality disorder (BPD). However, the mechanisms underlying these problems have not been well understood. In this cross-sectional study, 100 participants, including 50 patients with a diagnosis of BPD (30 men, 20 women, Mage = 21.9, SD = 3.78) and 50 age and gender-matched healthy controls (30 men, 20 women, Mage = 23.5, SD = 4.66) were recruited through convenience sampling method and assessed in terms of childhood trauma, empathy, and interpersonal problems using Childhood Trauma Questionnaire (CTQ-28), interpersonal reactivity index (IRI), and Inventory of Interpersonal Problems (IIP-32). Multivariate analysis of variance (MANOVA), independent t-tests, correlation analysis, and mediation analyses using macro PROCESS were utilized for data analyses. The results revealed more severe interpersonal problems and childhood trauma, both in general severity and in its subtypes, except for sexual trauma in the BPD group. Concerning empathy, the individuals with BPD scored significantly lower in perspective-taking and higher in personal distress. However, there were no between-group differences in empathic concern and fantasy components. Mediation analysis confirmed the role of heightened personal distress in the association between childhood trauma and interpersonal problems in the BPD group. The findings provide further evidence for the notion of double dissociation of affective and cognitive empathy in patients with BPD. They also suggest increased personal distress as one of the mechanisms mediating the association between negative experiences in childhood and interpersonal problems in individuals with BPD.