An exploration of links between early parenting experiences and personality disorder type and disordered personality functioning

Five-Factor Personality Dimensions Mediated the Relationship between Parents' Parenting Style Differences and Mental Health among Medical University Students

BACKGROUND

Previous studies have identified the relationships between parental parenting style, personality, and mental health. However, the interactive influences between mother's and father's parenting styles on personality have been examined less often. To fill the gaps, the first aim of this study was to build the relationships between parental parenting style differences (PDs) and five-factor personality dimensions. The second aim was to test the mediating effect of five-factor personality dimensions on the relationships between parental parenting style differences and mental health.

METHODS

This is a cross-sectional study conducted among medical university students, and 2583 valid participants were analyzed. Mental health was measured by the Kessler-10 scale. The Chinese Big Five Personality Inventory brief version (CBF-PI-B) was used to access five-factor personality dimensions. PD was calculated by the short form of Egna Minnen av Barndoms Uppfostran. Linear regressions were conducted to analyze the associations between PD and five-factor personality dimensions. The SPSS macros program (PROCESS v3.3) was performed to test the mediating effect of five-factor personality dimensions on the associations between PD and mental health.

RESULTS

Linear regressions found that worse mental health was positively associated with PD (β = 0.15, p < 0.001), higher neuroticism (β = 0.61, p < 0.001), lower conscientiousness (β = -0.11, p < 0.001), lower agreeableness (β = -0.10, p < 0.01), and lower openness (β = -0.05, p < 0.05). The results also supported that PD was positively associated with lower conscientiousness (β = -0.15, p < 0.01), lower agreeableness (β = -0.09, p < 0.001), lower openness (β = -0.15, p < 0.001), and lower extraversion (β = -0.08, p < 0.001), respectively. The mediating effect of agreeableness or openness was supported for the relationships between PD and mental health.

CONCLUSION

These findings remind us of the importance of consistent parenting styles between mother and father, and they also can be translated into practices to improve mental health among medical university students.

The effect of attachment style on long-term outcomes in psychogenic nonepileptic seizures: Results from a prospective study

INTRODUCTION

Insecure and fearful attachment styles have been reported in psychogenic nonepileptic seizures (PNES). We have investigated associations between long-term clinical outcome in PNES, parenting and attachment styles and demographic, clinical, and neuropsychiatric factors.

MATERIAL AND METHODS

Patients aged at least 16 years and with documented PNES, according to criteria from the International League Against Epilepsy, were prospectively recruited to this study. They were assessed at baseline to determine clinical characteristics, experience of attachment and perceptions of experienced parenting styles, trauma history, dissociation, and health-related quality of life. At a mean of 70.45 (SD 29.0, range 22-130) months after inclusion, participants were contacted by telephone and asked about their current medical status and psychiatric/psychological interventions.

RESULTS

Of 53 patients included in the study, 51 (96 %) provided follow-up data. Most (84.9 %) patients were female, and the mean age of PNES onset was 25.6 years. At follow-up, 20 patients (39 %) were free of PNES. Those patients that had achieved PNES freedom at follow-up had lower levels of attachment anxiety (p = 0.01) and reported to have experienced their fathers as less controlling (p = 0.02) and their mothers as more caring (p = 0.04) at baseline compared with those patients still suffering from PNES. Seizure freedom at follow-up was predicted by male gender, younger age at PNES onset, and less attachment anxiety.

CONCLUSION

In our cohort from a tertiary epilepsy center the long-term prognosis of PNES is poor. Attachment anxiety is a risk factor for persistent PNES. It may be of therapeutic relevance to assess attachment patterns in patients with PNES.

Perceived Adverse Parenting in Childhood and Psychological Distress Among Psychotherapy Patients: The Mediating Role of Pathogenic Beliefs

ABSTRACT

The way people derive inferences from actual adverse experiences plays an important role in the development of psychopathology. This study aims to examine the mediating role of pathogenic beliefs (i.e., emotion-laden, powerful, painful convictions about self and others) on the relation between perceived adverse parenting behaviors in childhood and subsequent adult psychopathology. Participants (mostly Caucasian and heterosexual) were 204 consecutively admitted patients with a range of psychological difficulties, including depression, anxiety, and interpersonal problems, at a low-fee outpatient clinic. Participants completed standard self-report assessments of perceived parental style, depressive and anxiety symptoms, and a clinically derived measure of pathogenic beliefs. We examined the indirect effects of adverse parenting on anxiety and depressive symptom severity through pathogenic beliefs. Pathogenic beliefs reflecting the unreliability of others significantly mediated the relationship between adverse parenting and anxiety symptoms. The other mediation model is consistent with the theory that perceived adverse parenting contributes to the severity of depressive symptoms through beliefs about not being deserving and other people being unreliable. Within the limitations of the cross-sectional, retrospective, and self-report nature of the data, our results seem to suggest that attending to intermediary subjective beliefs might be important in understanding psychopathology development in the context of childhood adversity. Aiming to modify the beliefs in therapy might modify the symptoms. However, this would remain to be demonstrated through formal intervention research.

Association between different types of childhood trauma and parental bonding with antisocial traits in adulthood: A systematic review

BACKGROUND

ASPD describes individuals with a pervasive pattern of disregard for the rights of others that begins in childhood and continues into adulthood. The relationship between parental bonding, trauma, and ASPD is well established, however, it remains unclear what types of trauma or which patterns of bonding are more associated with ASPD.

OBJECTIVES

Review the literature regarding what types of trauma and bonding characteristics were related to antisocial personality traits.

METHOD

Systematic searches of PubMed, Embase, Web of Science, and Scielo for studies about the relationship between antisocial personality traits and the Childhood Trauma Questionnaire (CTQ) and/or the Parental Bonding Instrument (PBI).

RESULTS

357 abstracts were selected, and 18 studies met the inclusion criteria. Regarding CTQ, the most consistent finding was the association between physical abuse and neglect to antisocial traits. Sexual abuse was the variable least related to antisocial traits. Regarding PBI, the most consistent finding was the inverse relationship between maternal and paternal care and antisocial traits. Concerning overprotection, the data is less consistent. Also, there was a considerable heterogenity between studies.

CONCLUSIONS

The literature little explores how these variables interact with each other. Thus, more studies are important to aidpolitical,educational, and public health programs to create preventive initiatives for ASPD.

Interaction between perceived maternal care, anxiety symptoms, and the neurobehavioral response to palatable foods in adolescents

Studies in rodents have shown that early life trauma leads to anxiety, increased stress responses to threatening situations, and modifies food intake in a new environment. However, these associations are still to be tested in humans. This study aimed to verify complex interactions among anxiety diagnosis, maternal care, and baseline cortisol on food intake in a new environment in humans. A community sample of 32 adolescents and young adults was evaluated for: psychiatric diagnosis using standardized interviews, maternal care using the Parental Bonding Inventory (PBI), caloric consumption in a new environment (meal choice at a snack bar), and salivary cortisol. They also performed a brain fMRI task including the visualization of palatable foods vs. neutral items. The study found a three-way interaction between anxiety diagnosis, maternal care, and baseline cortisol levels on the total calories consumed (snacks) in a new environment. This interaction means that for those with high maternal care, there were no significant associations between cortisol levels and food intake in a new environment. However, for those with low maternal care and who have an anxiety disorder (affected), cortisol was associated with higher food intake; whereas for those with low maternal care and who did not have an anxiety disorder (resilient), cortisol was negatively associated with lower food intake. In addition, higher anxiety symptoms were associated with decreased activation in the superior and middle frontal gyrus when visualizing palatable vs. neutral items in those reporting high maternal care. These results in humans mimic experimental research findings and demonstrate that a combination of anxiety diagnosis and maternal care moderate the relationship between the HPA axis functioning, anxiety, and feeding behavior in adolescents and young adults.

A Persian version of the parental bonding instrument: factor structure and psychometric properties

The Parental Bonding Instrument (PBI) is a widely used self-report measure for quantifying key parenting styles as perceived by the child during its first 16 years. While its development study identified two key parental dimensions, subsequent studies have variably confirmed those two or argued for one or more additional parental constructs. We developed a Persian translation of the PBI and administered it to a sample of 340 high school students. The construct validity of the Persian PBI was examined by Exploratory Factor Analysis while Confirmatory Factor Analysis was used to identify the most adequate model. Analyses of the Persian PBI favored a four-factor model for both parental forms. The Persian PBI has a factorial structure consistent with constructs identified in western cultures, as well as high internal consistency and test-retest reliability. Multivariate analyses indicated significant differences between boys and girls across some factors. The PBI appears an acceptable and appropriate measure for quantifying parent-child bonding in Iranian samples.

Dysfunctional parental styles perceived during childhood in outpatients with substance use disorders

People who suffer from substance use disorders (SUDs) frequently report to have undergone childhood adversity that is often associated with father or mother dysfunction, or both. Yet that issue has been barely addressed in opiate dependent patients. Therefore we sought to evaluate parent-specific dysfunctional styles perceived during childhood in a clinical sample from an outpatient addiction treatment program using the Measure Of Parental Styles (MOPS) questionnaire. DSM-IV diagnoses of substance use disorders and history of suicide attempts, family structure and changes of caregiver during childhood were obtained from 159 consecutive outpatients, along with their perception of parental bonding with the MOPS, in which mother and father scores are separate. Mother neglect dimension was significantly correlated with an earlier age at onset of several substances' use, the number of prior hospitalizations and of lifetime suicide attempts. Most of these associations remained significant in multivariate models. This was the first assessment of a representative sample of outpatients with SUDs by the MOPS questionnaire. Given its excellent acceptance and its association with several key correlates of SUDs, it should be used to design specific interventions targeted at attachment and familial management as well as in research models on gene × environment interactions.

Psychometric properties of the Chinese version of the Parental Bonding Instrument

BACKGROUND

The Parental Bonding Instrument (PBI) is a widely used assessment tool for measuring parental characteristics that affect parent-child bonds. The measure was developed for and has been most administered in Western populations. Psychometric analyses have yielded discrepant results as to whether the PBI is best represented by a two-factor model (care and overprotection) or a three-factor model (care, overprotection, and autonomy).

OBJECTIVES

Little is known about how the PBI performs in Chinese samples, and there is limited data from Eastern populations as a whole. The purpose of this study is to: (1) explore the data and identify the underlying structural model that best fits the Chinese culture, and (2) to further compare the factor structure that emerges in a Chinese sample with that which has emerged in other Eastern cultures (i.e., Japanese) and Western countries.

METHODS

The present study investigated the psychometric properties of a Chinese translation of the PBI among a sample (N=1417) of mothers of kindergarten children. Confirmatory factor analysis was used to identify the most adequate model.

RESULTS

Results supported a four-factor model that included an indifference factor (χ(2)/df<3.0; RMSEA<0.06; SRMR<0.08). Both the two-factor and three-factor models performed poorly (χ(2)/df>5.0; RMSEA>0.08; SRMR>1.0; CFI<0.90 for both). In this sample, use of a Chinese translated version of the PBI was successful. Support for the four-factor model is consistent with findings from previous studies of Eastern populations and discrepant from those among Western samples.

CONCLUSIONS

The indifference factor may reflect aspects of parenting specific to Eastern cultures, which tend to value group cohesion over individualization and independence. More research is needed to determine whether these findings are generalizable to all Eastern countries and whether aspects of Chinese culture (e.g., the single-child law) produce unique effects that may impact PBI administration in China.

Genetic covariance structure of the four main features of borderline personality disorder

The patient population of borderline personality disorder (BPD) is heterogeneous; many different combinations of BPD symptoms can lead to a BPD diagnosis. We investigated to what extent the covariance among four main components of BPD is explained by shared genetic and environmental factors. Using an extended twin design, multivariate genetic models were applied to the scales of the PAI-BOR, a self-report questionnaire tapping four main features of BPD (affective instability, identity problems, negative relationships, and self-harm). Data on the four BPD scales were available for 5,533 twins and 1,202 siblings from the Netherlands, Belgium, and Australia. The correlations among the scales ranged from 0.23 to 0.50 and were best explained by a genetic common pathway model. This model specifies that genes and environment influence the covariance between four main features of BPD in qualitatively similar ways, through a single latent factor representing the BPD construct. The heritability of the latent BPD factor was 51% and the remainder of its variance was explained by unique environmental influences. For each BPD scale, except self-harm, around 50% of its variance was explained by the latent BPD factor. The remaining variance for each of the four scales was explained by genetic (4% for affective instability to 20% for self-harm) and environmental (38% for negative relationships to 67% for self-harm) factors that were specific to each scale.

Mediation of early maladaptive schemas between perceptions of parental rearing style and personality disorder symptoms

In schema therapy (ST), early maladaptive schemas (EMS) are proposed to be the defining core of personality disorders. Adverse relational experiences in childhood are assumed to be the main cause for the development of EMS. The present study explored the links between perceived parental rearing behaviours, EMS, and personality disorder symptoms in a clinical sample (N=108). Results from mediation analyses suggest that EMS mediate the relationships between recalled parenting rearing behaviours and personality disorder symptoms. Findings give support to the theoretical model ST is based on.

Parental bonding and self-esteem as predictors of severe depressive symptoms: a 10-year follow-up study of Norwegian physicians

Elevated rates of suicide and depression among physicians have been reported. The associations between perceived parental bonding and depressive symptoms have yet to be studied longitudinally in this occupational group. In a nationwide cohort, we sought to study parental bonding as a predictor for severe depressive symptoms and to determine whether self-esteem mediates this relationship. After graduation (T1), medical students (N = 631) were followed-up after 1 (T2), 4 (T3), and 10 (T4) years. There were no gender differences in mean depressive scores. Female physicians reported higher levels of care from their mothers (p < 0.05) and less overprotection from their fathers (p < 0.05). Low-care from the mother predicted severe depressive symptoms (p = 0.01), an effect shown to be stronger for male than for female physicians. The relationship between perceived parental bonding and depressive symptoms was partially mediated by low self-esteem for both sexes.

Childhood neglect and abuse as predictors of antidepressant response in adult depression

BACKGROUND

Childhood neglect and abuse are recognized as risk factors for depression, but are not often studied as predictors of treatment response in depression.

METHODS

Clinically depressed outpatients (n=195) were asked about childhood experiences before beginning a randomized antidepressant trial with either fluoxetine or nortriptyline. Three treatment outcomes were measured: Adequate trial, six-week response and two months sustained recovery.

RESULTS

Patients reporting low paternal care (paternal neglect), as measured by the Parental Bonding Instrument (PBI), were less likely to complete an adequate six-week trial of medication. Patients who reported high maternal protection (maternal overprotection) on the PBI had poorer treatment response in the short-term at six weeks, and longer term, for two months of sustained recovery. However, abuse, whether sexual, physical, or psychological in nature, did not predict treatment response.

CONCLUSIONS

The experience of having a neglectful father or an overprotective mother was more predictive of response to treatment for depression than abuse, suggesting that the quality of ongoing intra-familial relationships has a greater impact on treatment outcomes for depression than experiences of discrete abuse in childhood.

Personality trait interactions in parents of patients with borderline personality disorder: a controlled study using the Temperament and Character Inventory

Family environment is a pathogenic factor of borderline personality disorder (BPD). However, the personality traits of patients with BPD and their parents have never been assessed using the same instrument and then examined for relationships. In the present study, we explored the temperament and character traits of BPD patients and their parents to investigate possible interactions. In total, 56 patients with BPD and their parents were evaluated with the Temperament and Character Inventory (TCI) and compared with 53 control families. Discriminant and correlation analyses indicated that subjects with BPD displayed higher levels of novelty seeking, harm avoidance, and self-transcendence and lower levels of self-directedness than control subjects. Their fathers displayed higher levels of novelty seeking and lower levels of persistence and self-directedness, and their mothers displayed lower levels of self-directedness compared with levels in control parents. In BPD families, temperament and character traits displayed high levels of discriminatory power. Novelty seeking in offspring with borderline personality disorder was significantly correlated with their mothers' novelty seeking and their fathers' self-transcendence. Self-directedness in borderline offspring was significantly correlated with both their mothers' and fathers' novelty seeking, and their self-transcendence was significantly correlated with their mothers' novelty seeking and harm avoidance. The different correlational pattern for borderline and control families is discussed. Characteristic personality patterns were found in BPD offspring and in both parents. The relationship between personality traits of borderline offspring and those of their parents may be related to both genetic transmission and family dynamics. Ramifications for treatment are discussed.

Adaptação transcultural para o português brasileiro do Parental Bonding Instrument (PBI)

OBJETIVO: O artigo apresenta a adaptação transcultural do Parental Bonding Instrument, um questionário auto-aplicável desenvolvido em 1979 e usado desde então para avaliar a percepção da qualidade do vínculo com os pais até os 16 anos. MÉTODO: Foram realizadas as etapas de equivalência conceitual, equivalência dos itens, equivalência semântica, equivalência operacional, equivalência funcional e aprovação da versão final pelo autor original do instrumento. RESULTADOS: Os critérios de equivalência foram satisfeitos, tendo a versão final sido aprovada pelo autor do instrumento original. CONCLUSÃO: A adaptação do Parental Bonding Instrument disponibiliza para uso um instrumento que já demonstrou ser extremamente útil em pesquisas de risco e resiliência nas últimas décadas, ao avaliar a percepção de características do comportamento dos pais tradicionalmente associadas ao desenvolvimento da personalidade.

The Depressive Personality Disorder Inventory and Its Relationship to Quality of Life, Hopefulness, and Optimism

The construct validity of the Depressive Personality Disorder Inventory (DPDI; Huprich, Margrett, Barthelemy, & Fine, 1996) was examined through its relationship to the constructs of hope, optimism, and quality of life (QOL). Three hundred thirty-two undergraduate students were administered the DPDI and measures of the aforementioned constructs. As predicted, the DPDI negatively correlated with all measures. Individuals classified with a depressive personality disorder had significantly higher scores on measures of hope, optimism, and QOL compared to a control group. Stepwise regression analysis indicated that optimism, QOL, and one component of hope significantly predicted DPDI scores, although more variance was accounted for in women than men. These findings are explained in light of Carver and Scheier's (2000) explanation of optimism and its relationship to hope. In sum, it appears that the construct validity of the DPDI is supported within an undergraduate sample.

Developmental antecedents of borderline personality disorder

Developmental antecedents of borderline personality disorders (BPDs) were examined in 25 DSM-IV-diagnosed subjects with BPD and 107 non-borderline control subjects on the basis of medical records and 28 years follow-up. Abuse, neglect, environmental instability, paternal psychopathology, and lower score on protective factors differentiated significantly between the groups. Environmental instability and lower score on protective factors such as artistic talents, superior school performance, above average intellectual skills, and talents in other areas were found to be independent predictors of BPD diagnosis. The results of this study suggest that both abuse and neglect, unpredictable and unstable early environment, as well as deficit in protective factors may substantially contribute to the development of BPD in persons constitutionally predisposed for the disorder. The results of the study also suggest that future research should address the impact of social and cultural context, as well as the absence of protective factors, on the development of the BPD.

Childhood Attachment Experience and Adulthood Cognitive Vulnerability: Testing State Dependence and Social Desirability Hypotheses

Childhood attachment experiences correlate with personality and cognitive factors associated with vulnerability to depression. The majority of the research in this area, however, relies on self-report measures which may be influenced by mood state and individual differences in social desirability. The present study examines whether mood and social desirability confound the association between attachment experience and cognitive vulnerability in a sample of clinically depressed adults. Regression analyses revealed a strong link between the two domains that is almost entirely independent of mood state and social desirability. The findings suggest that the association between early interpersonal experience and dysfunctional cognitive processes can not be attributed to current depression or willingness to present oneself in an unfavorable light. Limitations and clinical implications of the results and future directions are discussed.

Parental care and personality in melancholic and nonmelancholic depression

The authors hypothesized that low parental care is linked to nonmelancholic depression through depressive personality traits and personality dysfunction. This hypothesis was tested using path analysis with data provided from a sample of patients meeting DSM-IV criteria for major depression and distinguished on the basis of melancholic symptoms. The results supported their hypothesis. Lack of parental care was associated with self-critical traits, and higher levels of these traits were associated with personality dysfunction, which in turn was associated with nonmelancholic, but not melancholic, depression. Dependent traits were uniquely associated with the onset of an anxiety disorder before the first episode of depression. Researchers interested in the link between personality and depression are encouraged to focus their efforts on patients whose depressive episodes do not meet DSM-IV criteria for melancholia, and on the personality dimension of self-criticism rather than dependency.

Personality and anxiety disorders: a review

In this article, we summarize research on how normal personality and personality disorder traits may relate to anxiety disorders as predisposing factors, complications, and results of common underlying etiologies. We outline important questions and how these may be addressed through future research using genetically informative longitudinal and other designs, including: Are high neuroticism/cluster C personality traits causally related to the development of anxiety disorders? To what extent does the state of having an anxiety disorder influence the assessment of personality traits? Do high neuroticism/personality disorder traits and anxiety disorders co-occur because of shared genetic and environmental determinants? And, do personality disorder traits add to the prediction of anxiety disorders when normal personality traits are taken into account?

Depressive personality and its relationship to depressed mood, interpersonal loss, negative parental perceptions, and perfectionism

Eighty veteran psychiatric outpatients were evaluated for depressive personality disorder on the Depressive Personality Disorder Inventory (DPDI). It was predicted that those classified with depressive personality would report higher levels of interpersonal loss, negative perceptions of their parents, and higher levels of perfectionism than psychiatric control subjects. Nine of the 12 measures of these variables were significantly greater in those with depressive personality compared with psychiatric control subjects. When statelike depression was controlled for, seven of the nine variables still significantly differed between the two groups. Hierarchical regression analysis and discriminant function analysis found that these variables predicted 9% of the variance in the DPDI above and beyond statelike depression, and that a combination of these variables correctly classified 91% of the depressive personalities and 88% of the psychiatric control subjects. It is concluded that, as hypothesized, depressive personality disorder is associated with loss, negative parental perceptions, and perfectionism, and that these relationships are not accounted for exclusively by a depressed mood.

Sexual trauma and personality: developmental vulnerability and additive effects

Two types of sexual trauma, sexual abuse in childhood and rape in adulthood, were investigated in terms of possible effects on personality. Four groups of participants were studied: women who had experienced sexual abuse in childhood, women who had experienced rape as adults, women who had experienced both of these sexual traumas, and a control group of women who had experienced no sexual trauma. Personality functioning was assessed using the Dimensional Assessment of Personality Pathology. Groups who had experienced childhood sexual abuse displayed the highest degree of personality disturbance; however, the additive effects of repeated sexual trauma were limited. These findings may reflect the outcome of specific adversity in childhood on the psychobiological constructs underlying personality.