The neglected parental mental health problem? Borderline personality disorder: A preliminary exploration of borderline mothers' attributions of children's behaviour
Norfolk, Claire Louise Knowles
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BACKGROUND: Despite the significant interpersonal difficulties experienced by individuals with borderline personality disorder (“BPD”) and the high family aggregation of BPD, the relationship between borderline parents and their children has been largely neglected. The unstable relationships of borderline individuals are characterised by alternating views of others as alternately ‘malevolent’ and ‘protective’. In experimental studies, the former representation dominates borderline individuals’ view of other adults. However, the preliminary findings of studies of borderline parents indicate that borderline mothers may view the child from an idealised frame of reference. Parental attributions are proposed to play a critical mediating or moderating role in relation to parents’ affect and behaviour. Exploring the nature of borderline parents’ attributions may, therefore, offer valuable insight into the potential pathways underlying the increased psychiatric risk posed to their children.OBJECTIVES: This study aimed to explore the borderline parents’ child-centered attributions in relation to:I.The degree of hostile intent attributed to ambiguous and negative child behaviour.II.The perceived balance of control in negative adult-child interactions.METHOD: Nine mothers with a confirmed diagnosis of BPD and nine mothers with mild to moderate mental health difficulties without a diagnosis of BPD completed a parent report questionnaire, which included measures of parental attributions, maternal depression and children’s emotional and behavioural strengths and difficulties. Screening measures for personality disorder and psychological distress were also included, to exclude participants with potential Cluster B personality disorders or severe mental health difficulties from the control group.RESULTS: Non-parametric Mann-Whitney U-tests indicated that, relative to mothers in the control group, borderline mothers attributed significantly less hostile intent and considered significantly lower levels of punishment in response to ambiguous or negative child behaviour. No significant differences emerged in relation to maternal attributions of the balance of control in negative adult-child interactions. Exploratory analysis clarified the potential role of maternal depression and emotional and behavioural difficulties of participants’ children in mediating or moderating these findings. All significant results were marked by large effect sizes.CONCLUSIONS: The findings in the present study are consistent with the picture that emerges from empirical studies of borderline mothers, where maternal behaviour is characterised as helpless and frightened as opposed to hostile and frightening. The absence of attributions linked to parental abuse or hostile affect potentially call into question the assumptions of hostile and abusive parenting in borderline parents that dominate clinical texts, and may indicate different pathways to abuse in this population. The findings further pointed to the possibility of a permissive parenting styles and an idealised representation of the child in borderline mothers, potentially offering new insights into the possible mechanism underlying the risk to children of borderline parents.