Miriam Frankel



Effect of Maternal Borderline Personality Disorder on Autonomy and Relatedness in the Mother-Adolescent Relationship

Miriam R. Frankel, Kristen McCullum, Rebecca D. Trupe, Rachel Jones, and Jenny Macfie

University of Tennessee-Knoxville

Presented at the biannual meeting of the Society for Research in Child Development April 2009, Denver CO.

Introduction

• Developmental psychopathology allows us to identify normative developmental processes, while also informing and pointing to interventions (Cicchetti, 1984). This study explores the developmental task of adolescence: developing autonomy and maintaining relatedness (Allen & Hauser, 1996; Allen, Hauser, Eickholt, Bell, & et al., 1994). Children of mothers with borderline personality disorder (BPD) may be at high risk for difficulties in this domain (Macfie, 2009).

• Adolescence is the time for young adults to take on issues of identity formation and autonomy, while also developing significant, rich interpersonal relationships outside the family (Allen, McElhaney et al., 2003; Boykin-McElhaney & Allen, 2001). This prepares these young adults for the challenges of choosing a career, romantic partner, peers, and engaging in citizenship (Schulenberg, Bryant, & O'Malley, 2004).

• “Autonomy during adolescence is typically defined as self-governance, self-regulation, and independence,” p200 (Turner, Irwin, Tschann, & Millstein, 1993). Relatedness may manifest in engagement with others, curiosity about the needs and opinions of others, and the expression of validating and supportive comments (Allen, Hauser, Bell, McElhaney, & Tate, 2003). The parents’ task for the promotion of autonomy is to support the adolescent’s independence, and simultaneously uphold relatedness by promoting family cohesion and providing acceptance (Turner et al., 1993).

• Autonomy and relatedness, either together or individually, are associated with or predictive of adolescent: popularity, quality of romantic relationships (Rankin-Esquer, Burnett, Baucom, & Epstein, 1997), abstinence from drug use, academic success (Allen, Kuperminc, Philliber, & Herre, 1994), feelings of vigor and alertness (Reis, Sheldon, Gable, Roscoe, & Ryan, 2000), ego development and self esteem (Allen, Hauser, Bell, & O'Connor, 1994), and depressive and anxiety disorders (Allen, Hauser, O'Connor, Bell, & Eickholt, 1996).

• Symptoms of BPD include self-harm, relationship difficulties, binging and purging, recklessly spending, suicidal behavior, and engagement in other risk taking behaviors (Sansone, Michele, Dakroub, & Butler, 2006; Westen, Ludolph, Misle, Ruffins, & Block, 1990; Yen, Shea, Sanislow, & Grilo, 2004).

• One way to understand the symptoms BPD is in part, as a failure to develop autonomy and relatedness. (Bradley & Westen, 2005; Critchfield, Levy, Clarkin, & Kernberg, 2008). Twin fears of abandonment and domination can act in painful opposition within the mind of the borderline person, and interfere with forming mature and autonomous romantic, platonic, and familial ties (Melges & Swartz, 1989).

• Previous studies of mothers with BPD indicate that their children are more likely to be classified as disorganized in their attachment to mother (Hobson, Patrick, Crandell, Garcia-Perez, & Lee, 2005), anxiety, depression, low self esteem, aggression (Barnow, Spitzer, Grabe, Kessler, & Freyberger, 2006), attention and conduct problems (Weiss et al., 1996), and more frequently encounter family instability, parental drug use, and maternal suicide attempts (Feldman et al., 1995).

• This research examines the differences mothers’ and adolescents’ autonomy and relatedness in maternal BPD, and a normative comparison group.

Hypotheses

Hypothesis 1

• Mothers with BPD, in contrast with normative comparisons, will score lower on measures of healthy autonomy and relatedness, while scoring higher on inhibiting the autonomy of their adolescents, as well as displaying increased negative interpersonal behaviors towards their adolescents.

Hypothesis 2

• Adolescents of women with BPD, in contrast with normative comparisons, will score lower on measures of healthy autonomy and relatedness, while scoring higher on inhibiting the autonomy of their mothers, as well as displaying increased negative interpersonal behaviors towards their mothers.

Hypothesis 3

• Specifically, mothers who have BPD and their adolescents will have higher scores on hostility, use of personal attack as a negotiating style, and recanting statements, relative to the normative comparisons.

Methods

Participants

• A low SES sample of N = 47 adolescents, and their mothers, N = 25 adolescents whose mothers have BPD, and N = 22 whose mothers do not have BPD.

• Adolescents 14-17 years old. See table 1.

Table 1, Demographic descriptive statistics, and group differences

|Variable |Whole Sample |BPD |Comparison | |

| |N= 47 | | | |

| |M (SD) |n = 25 |n = 22 | |

| | |M (SD) |M (SD) |t (df = 45) |

|Family Yearly Income |23,924 |21,928 |26,191 |0.96 |

| |(15,197) |(12,458) |(17,843) | |

|Adolescent Age |15.58 (1.22) |15.12 (1.04) |16.09 (1.22) |2.91* |

| | | | |X2 |

|Adolescent Gender (female) |56% |60% |52% |0.42 |

|Adolescent Minority Ethnicity Background |17% |8% |27% |0.08 |

|Latino |04% |8% |5% |0.93 |

|Marital Status (partnered) |64% |68% |57% |0.65 |

*p < .05

Recruitment

• Mothers with BPD were recruited via clinician referrals and fliers posted in the community.

• Comparison group recruited in Boys and Girls Clubs, high schools, and fliers posted in the community.

• Participants were recruited from a five county region including both rural and urban areas.

Measures

Structured Clinical Interview for DSM Disorders, Axis II (First, Spitzer, Benjamin, Gibbon, & Williams, 1997)

• Used to assess for BPD status in mothers (yes/no).

Relationship Problem Inventory (Knox, 1971)

• List of problems that adolescents and their mothers argue about at home, e.g. friends, grades, communication, dating, use of the phone; both mother and adolescent elaborate and star the most salient issues

• Each parent-adolescent pair discussed 3 topics, for 5 minutes each, in an attempt to resolve their conflict

Autonomy and Relatedness Coding System, Manual, Version 2.14 (Allen., Hauser, Bell, Boykin McElhaney, & Tate, 2003).

• Mother-adolescent problem discussions were coded from transcripts of filmed interactions and were assessed for ten subscales (listed in Table 2). Scores ranged between 0 and 4, and were then summed into larger categories of autonomy and relatedness.

• Coders were trained to reliability with Dr. Allen’s lab. Coders then established reliability on 30% of the current sample. Intra-class correlations were used to assess reliability, with scores ranging from .73 (recanting) to .91 (confidence). Coders were blind to the participants’ group status.

Table 2, Means and standard deviations for autonomy and relatedness coding system in sample

| |Mother |Adolescent |

| |M (SD) |M (SD) |

|Promotes Autonomy |15.01 (3.60) |11.44 (4.51) |

| Reasoning |6.93 (1.88) |4.88 (1.97) |

| Confidence |8.17 (2.08) |6.56 (2.77) |

|Inhibits Autonomy |4.66 (2.86) |3.72 (2.35) |

| Recanting |0.42 (0.79) |1.01 (1.21) |

| Blurring |2.42 (1.51) |2.05 (1.58) |

| Pressures |1.82 (1.67) |0.66 (0.75) |

|Promotes Relatedness |15.39 (2.28) |10.86 (3.50) |

| Queries |5.47 (1.44) |2.67 (1.58) |

| Validates |3.08 (1.63) |2.69 (1.30) |

| Engaged |6.83 (1.09) |5.42 (1.45) |

|Inhibits Relatedness |3.42 (1.95) |5.36 (2.50) |

| Distracting |2.46 (1.28) |4.23 (1.69) |

| Hostile |0.96 (1.14) |1.14 (1.34) |

|Promotes Autonomy and Relatedness |30.49 (4.37) |22.30 (6.76) |

|Inhibits Autonomy and Relatedness |8.07 (4.38) |9.08 (4.07) |

Table 3, Parent and adolescent group differences in autonomy and relatedness

|Variable |Whole Sample |BPD |Comparison | |

| |N= 47 |n = 25 |n = 22 | |

| |M(SD) |M(SD) |M(SD) |t (df = 46) |

|Mother (Hypothesis 1) | | | | |

|Promotes Autonomy and Relatedness |30.49 (4.37) |29.92 (4.20) |31.11 (4.55) |0.22 |

|Inhibits Autonomy and Relatedness |8.07 (4.38) |9.30 (4.66) |6.74 (3.70) |2.36* |

|Promotes Autonomy |15.01 (3.60) |14.68 (3.27) |15.57 (3.96) |0.09 |

|Inhibits Autonomy |4.66 (2.86) |5.52 (3.10) |3.72 (2.28) |2.55* |

|Promotes Relatedness |15.39 (2.28) |15.24 (2.21) |15.54 (2.39) |0.55 |

|Inhibits Relatedness |3.42 (1.95) |3.78 (2.04) |3.02 (1.81) |1.56 |

|Adolescent (Hypothesis 2) | | | | |

|Promotes Autonomy and Relatedness |22.30 (6.76) |22.66 (5.93) |21.91 (7.68) |0.89 |

|Inhibits Autonomy and Relatedness |9.08 (4.07) |9.38 (4.15) |8.76 (4.04) |1.08 |

|Promotes Autonomy |11.44 (4.51) |11.64 (3.67) |11.22 (5.37) |0.78 |

|Inhibits Autonomy |3.72 (2.35) |3.96 (2.34) |3.46 (2.37) |1.33 |

|Promotes Relatedness |10.86 (3.50) |11.02 (3.61) |10.70 (3.44) |0.76 |

|Inhibits Relatedness |5.36 (2.50) |5.42 (2.59) |5.30 (2.44) |0.56 |

|Hypothesis 3 | | | | |

|Maternal Hostile |0.96 (1.14) |1.32 (1.29) |0.57 (0.80) |2.41* |

|Adolescent Hostile |1.14 (1.34) |1.34 (1.60) |0.91 (0.96) |1.26 |

|Maternal Blurring |2.42 (1.51) |2.90 (1.68) |1.89 (1.13) |2.59* |

|Adolescent Blurring |2.05 (1.58) |2.08 (1.53) |2.02 (1.67) |0.61 |

|Maternal Recanting |0.42 (0.79) |0.46 (0.88) |0.37 (0.69) |0.81 |

| Adolescent Recanting |1.01 (1.21) |1.26 (1.31) |0.74 (1.06) |1.78† |

†p < .10, *p < .05

Table 4, Inter-correlations among autonomy and relatedness variable in the sample N = 48

|1. |2. |3. |4. |5. |6. |7. |8. |9. |10. |11. | |1. Maternal promote autonomy |__ | | | | | | | | | | | |2. Adol. promote autonomy |.25† |__ | | | | | | | | | | |3. Maternal promote relatedness |.05† |-.04† |__ | | | | | | | | | |4. Adol. promote relatedness |.57* |.41** |.40** |__ | | | | | | | | |5. Maternal promote A&R

|.85** |.19 |.57** |.50** |__ | | | | | | | |6. Adol. promote A&R

|.35* |.88** |.18 |.79** |.39** |__ | | | | | | |7. Maternal inhibit

Autonomy |.37* |.50** |-.08 |.14 |.26† |.41** |__ | | | | | |8. Adol. inhibit autonomy |.32** |.61** |.11 |.47** |.32* |.65** |.47** |__ | | | | |9. Maternal inhibit

Relatedness |.24† |.47** |-.28 |.12 |.06 |.38** |.65** |.41** |__ | | | |10. Adol. inhibit relatedness |-.07 |.38** |-.10 |-.15 |-.11 |.18 |.31* |.41** |.33* |__ | | |11. Maternal inhibit A&R

|.35* |.54* |-.17 |.14 |.20 |.43** |.94** |.49** |.87** |.35* |__ | |12. Adol. inhibit A&R

|.14 |.58** |.002 |.18 |.12 |.49** |.46** |.83** |.43** |.85** |.50** | |†p < .10, *p < .05, **p ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download