Study protocol for a multi-center RCT testing a group-based parenting intervention tailored to mothers with borderline personality disorder against a waiting control group (ProChild*-SP1)

Abstract

Background/aims Borderline personality disorder (BPD) is a severe mental disorder characterized by an unstable sense of self, intense and rapidly changing affect, as well as impulsive and self-destructive behaviors. Interpersonal relationships of individuals with BPD are characterized by marked instability, a lack of dependability, and quick changes between love and hate. For children of individuals with BPD, this can lead to permanent stress and attachment insecurity and an increased risk of adverse physical and mental health development. To reduce dysfunctional parenting and improve positive parenting, and in turn, to promote healthy child development, a group intervention for mothers with BPD was developed. This study aims to evaluate this first disorder-specific parenting intervention for BPD in a randomized controlled trial. Method In a parallel-group, two-arm, randomized controlled trial, an initial N = 178 mothers diagnosed with BPD and their children aged 6 months to 6 years are assigned to either the parenting intervention or a waiting control group. If taking place, participants of both groups continue their regular treatment for BPD diagnosis (e.g., individual therapy, medication). The primary outcomes are changes in parenting from baseline (day 0) to post intervention (week 12) and follow-up (6 months after group intervention; month 9). The waiting control group can attend the group intervention at the end of all assessments. Participants allocated to the intervention group are expected to show improvement in their parenting and a reduction in child abuse potential. Maternal emotion regulation and mental distress are analyzed as secondary outcomes. Discussion Mothers with BPD may need tailored help when reporting difficulties raising their children. The first disorder-specific parenting intervention has been developed to close this gap. ProChild is part of a large government-supported consortium, which aims to investigate different aspects of abuse and maltreatment in childhood and adolescence. Trial registration ClinicalTrials.gov NCT04169048. Registered on Nov 19, 2019.

Microsocial analysis of dyadic interactions with toddlers and mothers with borderline personality disorder

“…To date, few treatment programs exist specifically for parents with BPD; they offer modified dialectical behavior therapy, home visits, and group trainings (Florange and Herpertz, 2019 ; May et al, 2023 ). Such a program has been piloted by Renneberg & Rosenbach ( 2016 ) and is currently tested in a multicenter study (Rosenbach et al 2022 ). An understanding of micro-level patterns could well complement these programs and require further empirical support.…”

Emotion Regulation, Parenting, and Psychopathology: A Systematic Review

“…Evidence-based treatment for BPD (dialectic behavioral therapy; Linehan, 1993) emphasizes the role of emotion regulation in the etiology of BPD and focus on the improvement of emotion regulation in therapy. In the context of parenting in individuals with BPD, interventions with a central focus on supporting parental emotion regulation have been developed in the last years (Rosenbach et al, 2020). For depressive disorders, in addition to the reduction of depressive symptoms, interventions should also consider promoting emotion regulation and the use of strategies.…”

„Ich möchte es anders machen!“ – Persönlichkeitsstörungen und Elternschaft

“…Für manche Eltern kann ein Elterntraining im Gruppensetting ein weiteres sinnvolles Angebot darstellen, um gegenseitigen Austausch zu ermöglichen und Entlastung durch und in der Gruppe zu erfahren. Für Mütter mit einer BPS liegt ein Manual vor [11], das aktuell in einer groß angelegten randomisiert-kontrollierten Multicenterstudie ("Pro-Child") evaluiert wird [12]. Die Ergebnisse der Pilotuntersuchung sind vielversprechend [1].…”