Recent research indicates a high incidence of childhood sexual abuse and incest among female patients with a diagnosis of borderline personality disorder (BPD). The author investigated the detection and long-term aftereffects of this abuse using a constellation of Rorschach scores that were predicted to occur more frequently in borderline patients with extended sexual victimization before age 14. Sixty-two subjects were divided into two groups (33 with and 29 without such a history) and compared on the following features: color-dominated percepts, primary-process content, confabulation, activity versus passivity, and two new scores related to dissociative symptoms. Some subjects were also administered the Dissociative Experiences Scale and the DSM-III Structured Clinical Interview for posttraumatic stress disorder. The sexually abused group had significantly higher scores both on the Rorschach features and on the clinical measures. The author contends that the identified Rorschach constellation reflects symptoms associated with these trauma-related syndromes, which are more central to the profile of BPD, both on psychological tests and clinically, than is generally recognized.
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