Body Image Disturbance as a Moderator Between Childhood Sexual Abuse and Self-Injury in Borderline Personality Disorder in Turkey

Abstract

Objective

Body image disturbance may moderate childhood sexual abuse and self-injury in borderline personality disorder (BPD).

Methods

The study involved 60 female patients diagnosed with BPD and 60 healthy participants. The diagnosis of BPD (and identification of healthy participants) was conducted through standardized psychiatric interviews. Participants were assessed with the Multidimensional Body Self Relations Questionnaire (MBSRQ), Inventory of Statements About Self-injury (ISAS), and Childhood Trauma Questionnaire-Short Form (CTQ-SF).

Results

The findings indicated significantly higher negative scores on both the CTQ-SF and MBSRQ among patients diagnosed with BPD. Appearance orientation moderated the relationship between sexual abuse experiences and self-harm behaviors in a non-linear way. Specifically, low appearance orientation amplified the effect of sexual abuse on self-injury risk, whereas high appearance orientation acted as a protective factor, buffering the impact of sexual abuse on self-harm.

Conclusions

The relationship between childhood sexual abuse and self-injury in BPD patients is non-linear, and appearance orientation conditionally moderates this link. Low appearance orientation amplifies the impact of sexual abuse whereas high appearance orientation attenuates it. Therefore, appearance orientation is a clinically meaningful individual-difference indicator in trauma-informed self injury risk assessment and case formulation in BPD.