Maternal borderline personality disorder features and mediational parenting behaviors during conflict discussions

Date

2021-08

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Abstract

Mounting evidence supports that mothers with personality pathology, particularly BPD, face significant challenges in parenting and have offspring at high risk for psychosocial problems. Examining how personality pathology affects real-time parent-child interactions could provide valuable implications to intervene with parents and interrupt intergenerational transmission of risk. The current study examined relations between personality pathology in mothers and parenting behaviors during a conflict discussion with children/adolescents oversampled for emotional instability (N = 56, age 10 – 13, 54% female). Using the Observing Mediational Interactions (OMI) system from the Mediational Intervention for Sensitizing Caregivers (MISC), parenting behaviors were coded for attachment-based emotional components and behaviorally anchored cognitive/mediational components. We also developed negative cognitive components to capture insensitive, hostile, intrusive, or invalidating parenting behaviors. Our primary aim was to examine relations between maternal personality pathology (assessed by measures of BPD symptom severity, pathological personality traits, and emotion dysregulation) and OMI parenting variables. While controlling for maternal depression, hierarchical linear regressions revealed that maternal BPD symptom severity was associated with lower ratings on the emotional components and greater use of negative cognitive components. Our secondary aim was to examine whether parenting sense of competence (PSOC) moderates the relation between maternal BPD symptom severity and parenting. We were surprised to find that BPD was associated with less positive mediation and more negative mediation only in mothers with moderate or high PSOC. In response, we developed a new scale by rescoring the PSOC efficacy subscale items to reflect optimal mentalizing and found that BPD was associated with more negative mediation only in mothers with low or moderate levels of mentalizing. Taken together, findings suggest that attachment-based and negative parenting behaviors present unique challenges for mothers with BPD and should be addressed in treatment. Future research should elaborate and validate our novel negative cognitive components and consider adapting MISC for mothers with personality pathology. Additionally, although our mentalizing measure requires psychometric evaluation, we found preliminary evidence that optimal mentalizing buffers the impact of BPD features on negative parenting practices, further suggesting that interventions that target mentalizing, such as MISC, may be particularly effective for mothers with personality pathology.

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Keywords

borderline personality disorder, parenting, parent-child interaction, conflict discussion

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