Maternal assessments of family climate in mother-child dyads: investigating the role of maternal borderline personality disorder in mental representations.

BACKGROUND

Family climate substantially influences children’s socio-emotional development. We examined mothers’ mental representations of their children and their relationships in three groups of mothers with young children (0–6 years): mothers (1) with a borderline personality disorder (BPD) (2), with a depressive or anxiety disorder but no BPD (AD/D), or (3) without a current mental disorder (CON). We expected both clinical groups to show more negative mental representations – more expressed emotion reflecting a critical attitude toward the child in general, more hostile attributions to child misbehavior in particular, and a less balanced view of the child (i.e., lower narrative coherence) – than CON mothers. We also expected mothers with BPD to have more impaired mental representations than mothers with AD/D.

METHODS

Data were collected as part of an intervention study (at the pre-intervention assessment). To assess parental attributions, 172 mothers with BPD, 69 mothers with AD/D, and 96 CON mothers provided responses to vignettes and participated in a five-minute speech sample coded for expressed emotion and narrative coherence.

RESULTS

BPD was associated with more criticism (OR = 3.17 and OR = 3.93) in comparison with CON mothers and mothers with AD/D, and with lower narrative coherence (OR = 5.45) compared with CON mothers but not compared with mothers with AD/D (OR = 1.41). Only narrative coherence remained significantly associated with group membership after education was controlled for. Mothers with BPD also showed more hostile attributions than CON mothers, with the AD/D group in between.

CONCLUSION

Without controlling for maternal education, critical attitudes toward the child in general were specifically associated with BPD, hostile attributions were less clearly associated, and narrative coherence was transdiagnostically associated with mental disorders in general. Once education was controlled for, disorder-specific associations were no longer observed, while transdiagnostic associations were maintained. Early interventions may specifically aim to decrease levels of criticism, help mothers increase non-hostile attributions of child misbehavior, and support mothers in building more coherent mental representations of their children. TRIAL REGISTRATION: This study was pre-registered at the German Registry of Clinical Studies (DRKS-ID: DRKS00020460).