Maternal personality disorder symptoms in primary health care: associations with mother\u2013toddler interactions at one-year follow-up

Magnhild Singstad Høivik,Turid Suzanne Berg-Nielsen,Stian Lydersen,Ingunn Ranøyen

doi:10.1186/s12888-018-1789-5

Abstract

BackgroundResearch is scarce on how mothers’ symptoms of personality disorders are linked to the mother-toddler relationship. In this study we have explored the extent to which these symptoms are associated with mutual mother-toddler interactions assessed 1 year after the initial assessment.MethodsMothers and their 0–24-month-old children (n = 112) were recruited by nurses at well-baby clinics due to either self-reported or observed mother–toddler interaction problems. At inclusion (T1), mothers filled out the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q), which measures symptoms of ten personality disorders. A year later (T2), mother-toddler interactions were video-recorded and coded using a standardised observation measure, the Emotional Availability Scales.ResultsOnly maternal schizotypal personality disorder symptoms predicted both the mothers’ and the toddlers’ interactional styles. Mothers with schizotypal personality symptoms appeared less sensitive, less structuring and more intrusive in their interactions with their toddlers, while mothers’ borderline personality disorder symptoms were associated with increased hostility. Furthermore, toddlers who had mothers with schizotypal personality symptoms were less responsive towards their mothers.ConclusionMeasured dimensionally by self-report, maternal schizotypal personality symptoms were observed to predict the interaction styles of both mothers and their toddlers in the dyad, while borderline personality disorder symptoms predicted mothers’ interactional behaviour only.Trial registrationCurrent Controlled Trials ISRCTN99793905, retrospectively registered. Registered on (04/08/2014).

Highlights

Research is scarce on how mothers’ symptoms of personality disorders are linked to the mothertoddler relationship
The parents with the highest depression and personality disorder symptoms tended to participate in follow-ups less frequently (Table 2)
Adjusting for all the mentioned confounders/moderator in treatment group versus control group resulted in higher p-values, relative to the low frequencies of schizotypal Personality disorder (PD) symptoms and multiple adjustments

Summary

Introduction

Research is scarce on how mothers’ symptoms of personality disorders are linked to the mothertoddler relationship. How mothers’ personality disorders (PDs) affect the mother–child relationship has attracted far less attention in research than might be expected, given that chronic parental mental illness is, in general, thought to be an important predictor of maladaptive parenting [1,2,3,4]. Central elements of personality organisation are affected, such as the ability to flexibly regulate impulses and affect and effectively cope with stressful events [6]. Because of their apparent problems with emotional regulation and self-control, Høivik et al BMC Psychiatry (2018) 18:198 mothers with PDs might be challenged when faced with a child’s negative affect or difficult temperament [7]. Some families may be faced with ‘a double risk’ of mother–toddler relationship problems because PDs are hereditary conditions, potentially causing the offspring to have challenging temperamental traits and/or negative emotionality [11]

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Results

Conclusion