Parenting stress and competence in borderline personality disorder is associated with mental health, trauma history, attachment and reflective capacity

Kayla R Steele,Michelle L Townsend,Brin F S Grenyer

doi:10.1186/s40479-020-00124-8

Abstract

BackgroundIndividuals with borderline personality disorder (BPD) may experience additional challenges in their parenting role, including increased stress and lower self-efficacy and satisfaction. These difficulties have been shown to impact their children, and may be implicated in the potential intergenerational transmission of personality vulnerabilities.MethodsParental stress and competence variables were examined in a cross-sectional study of 284 parents (94.72% female, M = 37.37, SD = 8.04 years), of which 69 (24.30%) met caseness for BPD criteria. We completed a multivariate analysis of variance to test how parents with ‘high BPD features’ (meeting caseness for BPD) compared to those with ‘low BPD features’ on a range of parenting and mental health variables. Multivariate linear regression modelling was then utilised to explore whether these parenting variables were associated with personality and psychological wellbeing, recalled trauma history, orientation to attachment relationships and reflective capacity.ResultsIndividuals high in BPD features experienced more stress and lower competence in their parenting role than those low in BPD features. These parents also reported more personality vulnerabilities, poorer psychological wellbeing, recalled more traumatic experiences in their childhood, were more likely to endorse insecure attachment styles and had poorer reflective capacity. In the regression model, parenting stress and competence was associated with personality traits, general psychological wellbeing, recalled trauma history, attachment style and reflective capacity variables. Parental reflective capacity had the strongest association with parenting stress, satisfaction, efficacy, the perception of having a difficult child and a difficult parent-child relationship, and psychological wellbeing had the greatest association with parenting distress.ConclusionsParents who were able to imaginatively enter the subjective world of the child and hold the child’s mind in mind with less certainty, reported reduced parenting stress and greater parenting satisfaction and efficacy. Helping to improve personality and mental health functioning, increasing parental reflective capacity and strengthening parent-child attachment relationships, may reduce parenting stress and increase parenting competence in individuals with BPD.

Highlights

Individuals with borderline personality disorder (BPD) may experience additional challenges in their parenting role, including increased stress and lower self-efficacy and satisfaction
Comparing high and low BPD features on parenting and concomitant variables We divided the sample into a ‘high BPD features’ and ‘low BPD features’ group, with the ‘high BPD features’ group defined as endorsing seven or more BPD features on the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) [40] and meeting caseness for BPD
Groups were compared on a number of parenting stress and competence, personality, psychological wellbeing, trauma history, attachment and reflectivity capacity variables

Summary

Introduction

Individuals with borderline personality disorder (BPD) may experience additional challenges in their parenting role, including increased stress and lower self-efficacy and satisfaction. Personality disorder is a complex and severe mental health issue that is characterised by pervasive and enduring difficulties in intra-personal (e.g. identity, self-worth, accuracy of self-view, self-direction), and inter-personal functioning (e.g., ability to develop and maintain close and mutually satisfying relationships, ability to understand others’ perspectives and to manage conflict in relationships) [1]. These difficulties deviate markedly from the expectations of the individual’s culture and are associated with significant distress or impairment in personal, family, social, educational, occupational or other important spheres [1, 2]. Women were more likely to be referred to a personality disorder service or be offered specialist long-term psychological therapy [9, 10]

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