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 relationships 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 disorders. These possibilities were examined in three studies of non-clinical samples of female subjects who completed scales of borderline personality, trauma, nightmare experience, and, in one study, weight preoccupation. Results showed consistent positive correlations between the personality, life events, and nightmare variables, including, among the latter, measures based on detailed analysis of subjectsʹ reported nightmare content. Also evident in the data were positive associations between weight preoccupation and several of these measures — including sexual and neglectful abuse. However, regression analysis demonstrated that, among the psychological measures, only borderline personality significantly predicted weight preoccupation. Further examination of the nightmare accounts of a small group of seriously abused subjects, who were also extreme on the personality measure, suggested a tentative “discontinuity” hypothesis, proposing that the transition from vulnerability status to eating disordered pathology might require threshold levels to be crossed on several risk variables. Aetiological considerations aside, it was concluded that enquiring into nightmare experience might be a useful adjunct to direct questioning about early trauma in individuals vulnerable to psychological dysfunction, including eating disorders.