Childhood trauma and its impact on borderline personality disorder development and symptom severity: A study at Allama Iqbal Teaching Hospital, Dera Ghazi Khan.

Abstract

Objective: To examine the relationship between childhood trauma severity and borderline personality disorder (BPD) symptom severity among adult patients, and to explore the role of dissociation and attachment anxiety in this association. Study Design: Cross-sectional study. Setting: Psychiatric Outpatient Department, Allama Iqbal Teaching Hospital, Dera Ghazi Khan. Period: 11-08-2025 to 10 -02-2026. Methods: A purposive sample of 150 adults (18–45 years) diagnosed with BPD was included. Data were collected using a structured proforma assessing demographic variables, childhood trauma (types and severity), BPD symptom severity (DSM-5 criteria), dissociation, and attachment anxiety. Data were analyzed using SPSS version 26. Descriptive statistics, Pearson correlation, multiple regression, and logistic regression analyses were performed. Results: Most participants reported at least one form of childhood trauma, with emotional neglect and witnessing domestic violence being most common. Trauma severity showed a strong positive correlation with BPD symptom severity (r = 0.58, p < 0.001). Dissociation and attachment anxiety were also significantly correlated with trauma and symptom severity. Regression analysis indicated trauma severity as a significant predictor of BPD symptoms, with partial mediation by dissociation and attachment anxiety. Logistic regression showed trauma severity and sexual abuse significantly predicted self-harm behavior. Conclusion: Childhood trauma significantly contributes to the severity of BPD symptoms. Dissociation and attachment anxiety partially mediate this relationship. Trauma-informed and culturally sensitive interventions are essential for improving clinical outcomes in resource-limited settings.