Borderline Personality Disorder (BPD) is a severe and chronic disorder that involves self-destructive behavior, inappropriate displays of anger and high levels of help seeking. Because of this combination, In addition to the burden of individual distress, BPD imposes a severe burden on the health care system. In order to reduce this double burden of mental illness, successful preventive interventions are needed. Although BPD is not diagnosed until early adulthood there is theoretical and empirical support for its roots lying in part in the caregiving environment in early childhood. From a developmental psychopathology perspective, study of early child development in children at high risk of developing BPD, including children whose mothers have BPD, may inform the development of preventive interventions. These interventions would address developmental deviation and bring development back onto adaptive pathways. In this way, the likelihood that BPD will develop would decrease and the burden of mental illness be reduced. Such preventive interventions could then be extended to other children at high risk of developing BPD such as maltreated children. Prior to longitudinal study, a cross-sectional study of preschool-aged children whose mothers have BPD is proposed. N = 32 offspring of BPD mothers will be compared with both clinical and normative comparison groups.
The aims of the study are to examine (1) whether BPD offspring are exposed to specific risk factors in the caregiving environment associated with BPD (maltreatment, separation/loss, problematic maternal caregiving); (2) whether BPD offspring's representations of this caregiving environment in their stories reflect developmental deviation suggestive of precursors to BPD (positive and negative self and other, fear of abandonment, and intrusion of traumatic material); and (3) an adult observer's assessment of current psychopathology. The current study will inform a longitudinal study of development of BPD offspring between 12 months and 5 years designed to examine processes and timing whereby risk factors result in deviations identified in the current study in order to design developmentally sensitive preventive interventions. The relevance of this proposed research to public health lies in its being the first step in informing the design of preventive interventions for BPD. Intervention would target developmental deviation in at risk children bringing development onto an adaptive pathway and thus reducing the risk of future BPD. ? ? ?
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Macfie, Jenny (2009) Development in Children and Adolescents Whose Mothers Have Borderline Personality Disorder. Child Dev Perspect 3:66 |
Macfie, Jenny; Swan, Scott A (2009) Representations of the caregiver-child relationship and of the self, and emotion regulation in the narratives of young children whose mothers have borderline personality disorder. Dev Psychopathol 21:993-1011 |