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Robin M, Belbèze J, Pham-Scottez A, Shadili G, Peres V, Silva J, Corcos M, Speranza M. Paradoxes in Borderline Emotional Dysregulation in Adolescence: Influence of Parenting, Stressful Life Events, and Attachment. Front Psychiatry 2021; 12:735615. [PMID: 34744826 PMCID: PMC8566741 DOI: 10.3389/fpsyt.2021.735615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Borderline personality disorder (BPD) in adolescents is characterized by emotional dysregulation, insecure attachment, a history of stressful life events (SLEs) as well as dysfunctional parent-child interactions. The respective contribution of each of these factors on BPD affective symptoms is not yet clear. The purpose of this study is to assess the distinct impact of parental adversity and SLEs on BPD affective symptoms and the role of attachment and alexithymia in such emotional processes. Method: This study explored parental dysfunction and SLEs as predictors of affective symptoms of BPD and of attachment insecurity in BPD adolescents (n = 85) and healthy controls (n = 84) aged 13-19 years from the European Research Network on BPD. The links between adversity and BPD symptoms were also investigated by emotional dysregulation assessment, as measured by alexithymia and hopelessness. Results: Dysfunctional parental interactions were linked to affective symptoms, hopelessness, and anxious attachment in healthy controls but not in BPD. Cumulative SLEs were positively correlated with affective symptoms and avoidant attachment in the control group but negatively correlated with both these variables in BPD. Multivariate regression analysis revealed that, in BPD, affective symptoms were independent of dysfunctional parenting but depended on attachment, whereas in controls, a maternal affectionless control style directly predicted affective symptoms. Moreover, increasing numbers of SLEs reduced affective symptoms in BPD, independently of parental interactions or attachment, and were associated with growing use of operative thinking. Discussion: BPD patients showed paradoxical emotional reactions: there was no increase of hopelessness and affective symptoms with an increased parental dysfunction, but a decrease in affective symptoms and hopelessness with cumulative SLE. Two pathways arose, one involving attachment as an emotional dysregulation process for parent-child interactions and a second one for SLE, with a more direct pathway to affective symptoms, independent of attachment but dependent on early interactions, and involving alexithymia. In summary, adversity factors have distinct effects in BPD, and attachment is partly accountable for affective symptoms independently of adversity. Our results suggest that in highly insecure conditions, cumulative adversity may produce paradoxical effects, including a lesser expression of affective symptoms and hopelessness.
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Affiliation(s)
- Marion Robin
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
- Medical School, Paris Descartes University, Medical School, Paris, France
| | - Jean Belbèze
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | | | - Gérard Shadili
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Victoire Peres
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Jérôme Silva
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Maurice Corcos
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
- Medical School, Paris Descartes University, Medical School, Paris, France
| | - Mario Speranza
- Versailles General Hospital, Le Chesnay, France
- Paris-Saclay University, UVSQ, CESP, INSERM, Gif sur Yvette, France
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A systematic review of negative parenting practices predicting borderline personality disorder: Are we measuring biosocial theory's ‘invalidating environment’? Clin Psychol Rev 2018; 65:1-16. [DOI: 10.1016/j.cpr.2018.06.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 01/16/2018] [Accepted: 06/06/2018] [Indexed: 11/19/2022]
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Keng SL, Wong YY. Association among self-compassion, childhood invalidation, and borderline personality disorder symptomatology in a Singaporean sample. Borderline Personal Disord Emot Dysregul 2017; 4:24. [PMID: 29209501 PMCID: PMC5704523 DOI: 10.1186/s40479-017-0075-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/22/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Linehan's biosocial theory posits that parental invalidation during childhood plays a role in the development of borderline personality disorder symptoms later in life. However, little research has examined components of the biosocial model in an Asian context, and variables that may influence the relationship between childhood invalidation and borderline symptoms. Self-compassion is increasingly regarded as an adaptive way to regulate one's emotions and to relate to oneself, and may serve to moderate the association between invalidation and borderline symptoms. The present study investigated the association among childhood invalidation, self-compassion, and borderline personality disorder symptoms in a sample of Singaporean undergraduate students. METHODS Two hundred and ninety undergraduate students from a large Singaporean university were recruited and completed measures assessing childhood invalidation, self-compassion, and borderline personality disorder symptoms. RESULTS Analyses using multiple regression indicated that both childhood invalidation and self-compassion significantly predicted borderline personality disorder symptomatology. Results from moderation analyses indicated that relationship between childhood invalidation and borderline personality disorder symptomatology did not vary as a function of self-compassion. CONCLUSION This study provides evidence in support of aspects of the biosocial model in an Asian context, and demonstrates a strong association between self-compassion and borderline personality disorder symptoms, independent of one's history of parental invalidation during childhood.
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Affiliation(s)
- Shian-Ling Keng
- Division of Social Sciences, Yale-NUS College, Singapore, Singapore
- Elm College Office, 12 College Ave West, #01-201, Singapore, 138610 Singapore
| | - Yun Yi Wong
- Psychological Studies Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
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Boucher MÈ, Pugliese J, Allard-Chapais C, Lecours S, Ahoundova L, Chouinard R, Gaham S. Parent-child relationship associated with the development of borderline personality disorder: A systematic review. Personal Ment Health 2017; 11:229-255. [PMID: 28771978 DOI: 10.1002/pmh.1385] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 05/16/2017] [Accepted: 05/23/2017] [Indexed: 11/12/2022]
Abstract
The parent-child relationship (PCR) is considered as a central factor in most contemporary theories on the aetiology of borderline personality disorder (BPD). This systematic review aimed to answer the three following questions: (1) How is the PCR described by BPD participants and their parents in comparison to other normative and clinical groups? (2) Which aspects of the PCR are specifically associated with a BPD diagnosis in adulthood? (3) How can the facets of the PCR identified in the reviewed studies shed light on the general aetiological models of BPD? Forty studies were retained and divided into three categories: perspective of BPD probands, perspective of their parents and perspective of family. Borderline personality disorder participants consistently reported a much more dysfunctional PCR compared to normal controls. Comparisons with participants presenting DSM-IV Axis-I and Axis-II disorders were a lot less consistent. BPD probands rated more negatively the PCR compared to their parents. Low parental care and high parental overprotection may represent a general risk factor for psychopathology, different from normal controls but common to BPD and other mental disorders. An interesting candidate for a specific PCR risk factor for BPD appears to be parental inconsistency, but further studies are necessary to confirm its specificity. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Marie-Ève Boucher
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
| | - Jessica Pugliese
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
| | - Catherine Allard-Chapais
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
| | - Serge Lecours
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
| | - Lola Ahoundova
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
| | - Rachel Chouinard
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
| | - Sarah Gaham
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montreal, Québec, Canada, H3C 3J7
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Karamanolaki H, Spyropoulou AC, Iliadou A, Vousoura E, Vondikaki S, Pantazis N, Vaslamatzis G. Birth order and memories of traumatic and family experiences in Greek patients with borderline personality disorder versus patients with other personality disorders. Bull Menninger Clin 2016; 80:234-54. [DOI: 10.1521/bumc.2016.80.3.234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Infurna MR, Brunner R, Holz B, Parzer P, Giannone F, Reichl C, Fischer G, Resch F, Kaess M. The Specific Role of Childhood Abuse, Parental Bonding, and Family Functioning in Female Adolescents With Borderline Personality Disorder. J Pers Disord 2016; 30:177-92. [PMID: 25905734 DOI: 10.1521/pedi_2015_29_186] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study examined a broad variety of adverse childhood experiences in a consecutive sample of female adolescent inpatients with borderline personality disorder (BPD; n = 44) compared with a clinical control (CC; n = 47) group with mixed psychiatric diagnoses. BPD was diagnosed using a structured clinical interview; different dimensions of childhood adversity were assessed using the Childhood Experiences of Care and Abuse Questionnaire, the Parental Bonding Instrument, and the Family Assessment Device. A history of childhood adversity was significantly more common in patients with BPD than in the CC group. Using a multivariate model, sexual abuse (OR = 13.8), general family functioning (OR = 8.9), and low maternal care (OR = 7.6) were specific and independent predictors of adolescent BPD. The results increase our knowledge of the specific role of different dimensions of childhood adversity in adolescent BPD. They have important implications for prevention and early intervention as they highlight the need for specific strategies for involving the family.
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Affiliation(s)
- Maria Rita Infurna
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.,Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy.,Institute of Psychology, Faculty of Behavioral and Cultural Studies, University of Heidelberg, Heidelberg, Germany
| | - Romuald Brunner
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Birger Holz
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Peter Parzer
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Francesca Giannone
- Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy
| | - Corinna Reichl
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Gloria Fischer
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Franz Resch
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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