Herta Guttman’s research while affiliated with McGill University Health Centre and other places

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Publications (18)


Using a Sibling Design to Compare Childhood Adversities in Female Patients With BPD and Their Sisters
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October 2012

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120 Reads

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22 Citations

Child Maltreatment

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Herta Guttman

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José A Correa

Abuse and neglect are well-established risk correlates of borderline personality disorder (BPD). The goal of this study was to examine whether BPD probands can be differentiated from their sisters with respect to a range of developmental adversity and maltreatment indicators, including retrospective self-reports of past experiences of childhood abuse and neglect, dysfunctional parent-child relationships and peer victimization and dysfunctional peer relationships. A total of 53 patients with BPD were compared to 53 sisters who were currently free of psychopathology on measures assessing childhood adversities. Both probands and sisters reported similar prevalence of intrafamilial abuse, although BPD patients reported more severe physical and emotional abuse. BPD patients reported higher prevalence of physical abuse by peers. These findings generally support the principle of multifinality, in which similar histories of adversities can be associated with a variety of outcomes, ranging from psychopathology to resilience.


Figure 1. Comparison of BPD probands and relatives with nonpsychiatric controls on the Conners' Continuous Performance Test (Conners, 2000). Note: Scores are plotted in the direction of negative scores representing worse performance (not applicable to Response Bias scale). RT reaction time; SE standard error; ISI interstimulus interval. 
Table 2 Continuous Performance Test Indices and Borderline Personality Disorder Symptom Scales for Empirically Derived Clusters of Patients' Siblings 
Response Inhibition Deficits in Unaffected First-Degree Relatives of Patients With Borderline Personality Disorder
  • Article
  • Full-text available

May 2012

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360 Reads

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35 Citations

Neuropsychology

Impulsiveness is a heritable feature of borderline personality disorder (BPD) which aggregates in families affected with the illness. Whereas BPD patients show deficits on neuropsychological tests of response inhibition, it is unknown whether these deficits are also present in their first-degree biological relatives who are at an increased genetic risk for this illness. The purpose of the current study was to identify and characterize a subgroup of BPD patients with pronounced response inhibition deficits, and secondarily, to estimate the relative recurrence risk of these deficits among affected families. Thirty-nine pairs of female BPD probands and their unaffected first-degree biological sisters were recruited from hospital outpatient clinics. Participants completed the Conners' Continuous Performance Test (CPT) and the Barratt Impulsiveness Scale-11. BPD relatives made a similar number of commission errors on the CPT compared to healthy controls with no personal or family history of psychiatric illness; however, cluster analysis revealed a subgroup of BPD relatives who displayed clinically elevated commission errors and atypically fast RTs to target stimuli, indicating a genuine response inhibition deficit. The estimated relative recurrence risk for response inhibition deficits for all sibling pairs on the CPT was moderate at λ = 4.55. These findings suggest that response inhibition deficits are pronounced in some BPD relatives, may be heritable between siblings, are nonredundant with diagnostic status, and show promise as candidate neuropsychological endophenotypes for BPD.

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Psychopathology, Childhood Trauma, and Personality Traits in Patients with Borderline Personality Disorder and Their Sisters

August 2011

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410 Reads

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84 Citations

Journal of Personality Disorders

The aim of this study was to document and compare adverse childhood experiences, and personality profiles in women with borderline personality disorder (BPD) and their sisters, and to determine how these factors impact current psychopathology. Fifty-six patients with BPD and their sisters were compared on measures assessing psychopathology, personality traits, and childhood adversities. Most sisters showed little evidence of psychopathology. Both groups reported dysfunctional parent-child relationships and a high prevalence of childhood trauma. Subjects with BPD reported experiencing more emotional abuse and intrafamilial sexual abuse, but more similarities than differences between probands and sisters were found. In multilevel analyses, personality traits of affective instability and impulsivity predicted DIB-R scores and SCL-90-R scores, above and beyond trauma. There were few relationships between childhood adversities and other measures of psychopathology. Sensitivity to adverse experiences, as reflected in the development of psychopathology, appears to be influenced by personality trait profiles.


Platelet [H-3] paroxetine binding in female patients with borderline personality disorder and their sisters

March 2011

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25 Reads

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1 Citation

Psychiatry Research

Paroxetine binding could be a vulnerability marker for traits associated with borderline personality disorder (BPD). To study this relationship, we examined [³H] paroxetine binding in female patients with BPD and their sisters. The sample consisted of 54 sibling pairs in which a proband met criteria for BPD. All subjects were given the Diagnostic Interview for Borderlines, revised (DIB-R), the Diagnostic Assessment for Personality Pathology: Brief Questionnaire (DAPP-BQ), the Barratt Impulsivity Scale (BIS), the Affective Lability Scale (ALS), the Hamilton Rating Scale for Anxiety (HAM-A), the Hamilton Rating Scale for Depression (HAM-D), and the Symptom Checklist-90, revised (SCL-90-R). All subjects had platelets assayed for [³H] paroxetine binding. There were no significant differences between probands and sisters, but both groups scored significantly lower than a previously studied control group on B(max). There were no differences on Kd. Neither B(max) nor K(d) was related to most trait or symptomatic measures. Paroxetine binding could reflect endophenotypes common to BPD probands and their first-degree relatives.


Recollections of parental bonding among women with borderline personality as compared with women with anorexia nervosa and a control group

December 2007

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65 Reads

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18 Citations

In this study, we investigated the behaviour of parents of women with borderline personality disorder (BPD) and anorexia nervosa (AN) with the three-factor Parental Bonding Instrument (PBI). Thirty-five women with BPD, 34 with AN, and 33 without any psychiatric illness (NC) scored each parent's level of care, denial of behavioural control and denial of psychological autonomy. All participants reported receiving more maternal than paternal care. However, women with BPD reported very low levels of biparental care and significantly more paternal denial of behavioural freedom. Those with AN experienced more maternal denial of behavioural freedom. In terms of maternal bonding, lack of maternal care was the only factor to predict BPD; in contrast, for paternal bonding, a combination of father's lack of care and denial of behavioural freedom predicted BPD.


L’épigenèse des relations familiales. Un modèle pour comprendre le développement d’une femme souffrant d’un trouble limite de la personnalité

October 2004

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150 Reads

Perspectives Psy

Cet article présentera la souffrance psychique dans le cadre dʼune perspective épigénétique du développement de lʼindividu dans sa famille, développée par Lyman Wynne. Des observations tirées dʼun cas clinique dʼune femme présentant un trouble limite de la personnalité, des implications pour le traitement ainsi que des résultats de recherches sur cette question viendront appuyer la présentation théorique. Mots clés : perspective épigénique, trouble limite de la personnalité, relations familiales, attachement, souffrance psychique. Abstract In this article, psychic suffering is discussed in the context of Lyman Wynneʼs epigenetic perspective on the individualʼs development within the family. This theoretical framework is exemplified by observations from a clinical case of a woman suffering from borderline personality disorder. Implications for treatment and relevant research findings are also addressed.


Alexithymia, empathy, and psychological symptoms in a family context

November 2002

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170 Reads

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263 Citations

Comprehensive Psychiatry

Levels of alexithymia were measured with the Toronto Alexithymia Scale (TAS-20) in families of women with borderline personality disorder (BPD), restricting anorexia nervosa (AN) and a nonclinical (NC) group. Measures were correlated with sociodemographic information, empathy (as measured by the Interpersonal Reactivity Index [IRI]), emotional distress (using the Symptom Checklist-90-R [SCL-90-R]), and experiences of abuse. We have found that male gender, age, and low socioeconomic status are correlated with factor 3 of the TAS-20; that women with BPD and AN are more alexithymic than control subjects; that women with AN are more alexithymic than their parents; and that alexithymia is inversely related to the capacity for empathy. Family members of women with BPD have the highest levels of alexithymia and in these families there seems to be a complementary association between alexithymia in one parent and low levels of empathy in the other. There may be an association between the general emotional distress, history of abuse, and high levels of alexithymia that occur in women with BPD.


Family Members' Retrospective Perceptions of Intrafamilial Relationships

September 2002

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58 Reads

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25 Citations

Contemporary Family Therapy

Parents and daughters in 21 families of women with borderline personality disorder (BPD), 23 women with restricting anorexia nervosa (AN), and 25 women without clinical histories (NC) responded to the Parental Bonding Instrument (PBI) and the Beavers Self-Report Family Inventory (SFI). On the PBI, BPD daughters' perceptions differed from both their parents' whereas AN daughters' perceptions differed from their mothers'. On the SFI, both groups reported less family health than their parents. On both instruments, nonclinical daughters' perceptions were congruent with the parents'. These findings have implications for researchers and therapists for integrating and utilizing the varying perceptions of family members.


The Epigenesis of the Family System as a Context for Individual Development

February 2002

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164 Reads

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19 Citations

Family Process

In this article, the concept introduced by Lyman Wynne, that the individual develops epigenetically within the family system, is discussed and validated with data from a study of the characteristics and relationships of 27 women with borderline personality disorder and their parents. Each stage of the epigenetic process is impaired in one way or another, adversely affecting subsequent stages. Early impairment of attachment-care-giving processes is at least partly attributable to a lack of empathic parenting; effective communication is married by family members' inability to experience or express feelings (alexithymia); this, in turn, makes it difficult to engage in joint family problem solving. Mutuality between family members does not occur in such a context, and there is an absence of intimacy between family members. These are often abusive family systems, with multiple abuse and intrafamilial sexual abuse more specifically directed at the daughter with BPD. The symptoms of the daughter can be understood systemically, as representing both predispositional characteristics and reactions to the family system. It is suggested that the epigenetic paradigm could be used to characterize the specific failure of developmental processes in many different disorders.


Abusive Relationships in Families of Women with Borderline Personality Disorder, Anorexia Nervosa and a Control Group

September 2001

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247 Reads

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38 Citations

The Journal of nervous and mental disease

In a group of intact families, we examined the rates and parameters of verbal, physical, and sexual abuse in 35 women with borderline personality disorder (BPD), 34 women with anorexia nervosa (AN), and 33 women without a clinical history (NC); their experience of multiple abuse and its correlation with their SCL-90-R scores; and their reports of abuse of their siblings. Corroboration of abuse was obtained from some parents in each group. Women with BPD suffered more intrafamilial verbal and physical abuse. Whereas AN and NC women experienced relatively rare single events of extrafamilial sexual abuse at an older age, those with BPD suffered repeated intrafamilial sexual abuse at a younger age and also suffered more multiple abuse. All multiply abused women had more psychopathology. Siblings were reported abused in the same proportions as subjects; many parents of BPDs corroborated their daughters' reports of all three forms of abuse.


Citations (13)


... The men who participated in this study commonly perceived that their mental health struggles arose from early experiences of childhood adversity and trauma. While this is consistent with literature on environmental risk factors for BPD (Goodman et al. 2013;Laporte and Guttman 1996), it is important to note that trauma is neither necessary nor sufficient for the development of BPD (Kleindienst et al. 2021), an observation supported by the present study authors' clinical experience. It was evident that while participants felt their mental health issues derived from early childhood trauma, their accounts suggested that the manifestation of BPD was potentiated through emotional invalidation. ...

Reference:

Exploring the Pathways to Diagnosis for Men With Borderline Personality Disorder: A Qualitative Study
Traumatic Childhood Experiences as Risk Factors for Borderline and other Personality Disorders
  • Citing Article
  • September 1996

Journal of Personality Disorders

... Specifically, a range of literature examining parent-child bonding and the quality of parent-child relationships has shown that offspring diagnosed with BPD tend to report lower levels of parental care and higher levels of parental overprotection than their peers (Boucher et al., 2017;Huang et al., 2014;Infurna et al., 2016). Some studies have linked poor parental bonding and dysfunctional attachment patterns with BPD in offspring (Laporte & Guttman, 2007;Zanarini, 2000). Violations of parent-child boundaries may act as a relational disturbance of relevance for BPD. ...

Recollections of parental bonding among women with borderline personality as compared with women with anorexia nervosa and a control group
  • Citing Article
  • December 2007

... Keywords Eco-informed therapy Á MFT training and practice Á Bateson Anthropologist Gregory Bateson is regarded as one of the founders of the field of family therapy. He is credited with linking concepts from General System Theory (von Bertalanffy 1968) and cybernetics (Weiner 1954) and applying these to the study of human interactions and family systems (Broderick and Schrader 1991;Guttman 1986;Simon et al. 1985). Doing so paved the way for the birth of the field of family therapy and what MFTs now refer to as systems theory. ...

Epistemology systems theory and the theory of family therapy
  • Citing Article
  • January 1986

American Journal of Family Therapy

... Antila et al. assessed psychiatric inpatients and reported a four-fold increased risk of PD development only in female subjects exposed to bullying during childhood and adolescence, indicating a gender-specific association [66]. Laporte et al. reported that victims of physical abuse by peers displayed a significant predisposition toward BPD development [70]. In a recent study in outpatient settings, Bozatello et al. identified emotional abuse, bully victimization, the presence of alcohol or drug abusers in the household, and physical neglect as important predictors for the early onset of BPD [71]. ...

Using a Sibling Design to Compare Childhood Adversities in Female Patients With BPD and Their Sisters
  • Citing Article
  • October 2012

Child Maltreatment

... One previous finding in the affective empathy literature is that individuals with BPD might experience a "paradoxical" deficit in cognitive empathy, but preserved, or even enhanced AE (Guttman and Laporte, 2000;Harari et al., 2010;see Dinsdale and Crespi, 2013 for review). The "borderline paradox" is based on the observation from psychoanalysis that individuals with BPD may experience an enhanced sensitivity to the mental states of others, despite difficulty in correctly interpreting these states (Krohn, 1974). ...

Empathy in Families of Women with Borderline Personality Disorder, Anorexia Nervosa, and a Control Group*
  • Citing Article
  • September 2000

Family Process

... The goal of the seminar is to use the IM-BFT model to provide students with a framework for directing their thinking about assessment and treatment. This investment in training is expected to shape the trainees' current and future clinical practice (Guttman, Feldman, Engelsmann, Spector, & Buonvino, 1999). The seminar itself is organized into an introductory didactic segment and a live supervision section. ...

The relationship between psychiatrists’ couple and family therapy training experience and their subsequent practice profile
  • Citing Article
  • February 1999

Journal of Marital and Family Therapy

... In a study that included patients with BPD and their caregivers, Gunderson and Lyoo [28] found that BPD patients' perceptions of their family environment were more negative than those of their parents. In a similar study, individuals with BPD reported significantly lower levels of parental care, less emotional expression, less family cohesion and more conflicts than did their parents [29]. Yet differing accounts may equally suggest more favorable reporting on the part of the caregivers, more biased interpretations on the part of the patient, or a combination of the two [28]. ...

Family Members' Retrospective Perceptions of Intrafamilial Relationships
  • Citing Article
  • September 2002

Contemporary Family Therapy

... Thus, our results not only found worse performance in the domain of executive functions in general in BPD patients compared to controls, but more specifically, significant differences were found between both groups in the executive subdomains of cognitive flexibility, planning, working memory and response inhibition, with BPD presenting worse performance in all these subdomains compared to controls. These results group those of Piñeiro et al. 4 , Arza et al. 2 , Silbersweigy et al. 10 and Ruocco et al. 6 , who found no concordance in the specific EFs to which such executive deficit was due, because these studies were based on performance in isolated neuropsychological tests, and not on performance in executive indices composed of different tests. ...

Response Inhibition Deficits in Unaffected First-Degree Relatives of Patients With Borderline Personality Disorder

Neuropsychology

... Systematic reviews (Newton-Howes et al., 2006Young, 2020) concur that this co-occurrence yields poorer Although the connection between ACEs and MDD is recognized (e.g., Heim & Nemeroff, 2001;Hovens et al., 2012), few studies have focused on the history of ACE occurrence in individuals with TRD. The ACE frequencies in our study substantially exceed those reported in community, general psychiatric, and specific TRD samples (e.g., Anda et al., 2002;Bellis et al., 2014;Laporte et al., 2011;Lu et al., 2008;Negele et al., 2015; determine whether TRD patients exhibit differing patterns of suicide attempts, health concerns, or functional impairments compared with individuals with untreated or remitted depression. Although our trial's pragmatic design facilitated broader inclusion, promoting a more representative clinical sample, the broader generalizability and relevance of the findings is uncertain due to the relatively small sample size and predominantly White female sample. ...

Psychopathology, Childhood Trauma, and Personality Traits in Patients with Borderline Personality Disorder and Their Sisters
  • Citing Article
  • August 2011

Journal of Personality Disorders

... Particularly, a parenting style based on low care-high control has been shown to predict body image disturbance in female ED outpatients (De Panfilis, Rabbaglio, Rossi, Zita, & Maggini, 2003) and to be the most frequent type amongst ED patients (Jáuregui Lobera, Bolaños Ríos, & Garrido Casals, 2011). High levels of maternal intrusiveness and overprotectiveness (Laporte, Marcoux, & Guttman, 2001;Swanson et al., 2010) and low levels of parental care have been shown to be associated with anorexic symptomatology (Fassino, Amianto, Rocca, & Daga, 2010). Bulimic women reported low levels of parental warmth, affection, empathy (Fassino, Amianto, Rocca, & Daga, 2010) and relatively high levels of paternal overprotection (Calam, Waller, Slade, & Newton, 1990). ...

A comparison of the characteristics of families of women with restricting anorexia nervosa and a control group
  • Citing Article
  • March 2001

L Encéphale