Maternal mental health and child problem behaviours: disentangling the role of depression and borderline personality dysfunction

Abstract

BackgroundIt is not known whether associations between child problem behaviours and maternal depression can be accounted for by comorbid borderline personality disorder (BPD) dysfunction.AimTo examine the contributions of maternal depression and BPD symptoms to child problem behaviours.MethodDepression trajectories over the first-year postpartum were generated using repeated measurement from a general population sample of 997 mothers recruited in pregnancy. In a stratified subsample of 251, maternal depression and BPD symptoms were examined as predictors of child problem behaviours at 2.5 years.ResultsChild problem behaviours were predicted by a high maternal depression trajectory prior to the inclusion of BPD symptoms. This association was no longer significant after the introduction of BPD symptoms.ConclusionsRisks for child problem behaviours currently attributed to maternal depression may arise from more persistent and pervasive difficulties found in borderline personality dysfunction.Declaration of interestNone.Copyright and usage© The Royal College of Psychiatrists 2017, this is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license.

Management of perinatal depression with non-drug interventions

“…Mothers with strong borderline and narcissistic traits or disorders often have difficulty with effective parenting, and studies suggest that their dysregulation of affect and difficulty with empathy and mentalizing may all have negative effects on child development 101. In a recent study, borderline personality disorder was found to be an independent risk factor for negative effects of perinatal depression on child development 102. Women with borderline personality disorder are also at increased risk for an array of adverse obstetric outcomes,103 including gestational diabetes (odds ratio 1.45, 1.13 to 1.85), premature rupture of membranes (1.40, 1.07 to 1.83), chorioamnionitis (1.65, 1.14 to 2.39), venous thromboembolism (2.11, 1.12 to 3.96), cesarean delivery (1.44, 1.26 to 1.64), and preterm birth (1.54, 1.29 to 1.83), emphasizing the importance of identifying and treating borderline personality disorder in pregnant women.…”

The Parenting Experience of Those With Borderline Personality Disorder Traits: Practitioner and Parent Perspectives

“…At times, parenting is challenging for everyone, but parents with BPD report particularly high levels of parenting stress and low levels of competency, self-efficacy and reward in the role (Newman et al, 2007;Elliot et al, 2014;Ramsauer et al, 2016). Furthermore, there is a potential bidirectional relationship between family context and symptoms: Children of parents with BPD are more likely than controls to have disruptive behavior disorders and Attention Deficit Hyperactivity Disorder (ADHD), to have higher rates of BPD symptoms and greater levels of aggression and delinquency than children whose parents did not have a psychiatric disorder (Feldman et al, 1995;Weiss et al, 1996;Barnow et al, 2006;Huntley et al, 2017). Parenting a child with psychological, emotional and/or behavioral difficulties is stressful and has the potential to worsen a vulnerable parent's own mental health (Berg-Nielsen et al, 2002).…”