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Family interaction and the development of borderline personality disorder: A transactional model

Published online by Cambridge University Press:  12 December 2005

ALAN E. FRUZZETTI ,
CHAD SHENK  and
PERRY D. HOFFMAN
ALAN E. FRUZZETTI
Affiliation:
University of Nevada, Reno
CHAD SHENK
Affiliation:
University of Nevada, Reno
PERRY D. HOFFMAN
Affiliation:
Mt. Sinai College of Medicine, New York
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Abstract

Although no prospective epidemiological studies have evaluated the relationship between family interactions and the development of borderline personality disorder (BPD), there is considerable evidence for the central role of family interactions in the development of BPD. This paper describes the role of family interactions or processes, especially those that might be regarded as invalidating or conflictual, negative or critical, and the absence of more validating, positive, supportive, empathic interactions, in the development of BPD. Perhaps more importantly, the proposed model considers how these parental and family behaviors transact with the child's own behaviors and emotional vulnerabilities, resulting in a developmental model of BPD that is neither blaming of the family member with BPD nor of her or his parents and caregivers, and has important and specific implications for both prevention and intervention.

Type
Research Article
Information
Development and Psychopathology , Volume 17 , Issue 4 , December 2005 , pp. 1007 - 1030
Copyright
© 2005 Cambridge University Press

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References

REFERENCES

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Atre–Vaidya, N., & Hussain, S. M. (1999). Borderline personality disorder and bipolar mood disorder: Two distinct disorders or a continuum? Journal of Nervous and Mental Disease 187, 313–315.Google Scholar
Battle, C. L., Shea, M. T., Johnson, D. M., Yen, S., Zlotnick, C., Zanarini, M. C., et al. (2004). Childhood maltreatment associated with adult personality disorders: Findings from the collaborative longitudinal personality disorders study. Journal of Personality Disorders 18, 193–211.Google Scholar
Baumrind, D. (1967). Child care practices anteceding three patterns of preschool behavior. Genetic Psychology Monograph 75, 43–88.Google Scholar
Baumrind, D. (1991). Effective parenting during the early adolescent transition. In P. A. Cowan & E. M. Hetherington (Eds.), Family transitions (pp. 111–163). Hillsdale, NJ: Erlbaum.
Biglan, A., Lewin, L., & Hops, H. (1990). A contextual approach to the problem of aversive practices in families. In G. R. Patterson (Ed.), Depression and aggression in family interaction (pp. 103–129). Hillsdale, NJ: Erlbaum.
Binder, R. L., McNiel, D. E., & Goldstone, R. L. (1996). Is adaptive coping possible for adult survivors of childhood sexual abuse? Psychiatric Services 47, 186–188.Google Scholar
Brodsky, B. S., Malone, K. M., Ellis, S. P., Dulit, R. A., & Mann, J. J. (1997). Characteristics of borderline personality disorder associated with suicidal behavior. American Journal of Psychiatry 154, 1715–1719.Google Scholar
Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.
Calkins, S. D., Dedmon, S. E., Gill, K. L., Lomax, L. E., & Johnson, L. M. (2002). Frustration in infancy: Implications for emotion regulation, physiological processes, and temperament. Infancy 3, 175–197.Google Scholar
Calkins, S. D., Smith, C. L., Gill, K. L., & Johnson, M. C. (1998). Maternal interactive style across contexts: Relations to emotional, behavioral, and physiological regulation during toddlerhood. Social Development 7, 350–369.Google Scholar
Carter, J. D., Joyce, P. R., Mulder, R. T., & Luty, S. E. (2001). The contribution of temperament, childhood neglect, and abuse to the development of personality dysfunction: A comparison of three models. Journal of Personality Disorders 15, 123–135.Google Scholar
Cicchetti, D., & Rogosch, F. A. (2001). The impact of child maltreatment and psychopathology on neuroendocrine functioning. Development and Psychopathology 13, 783–804.Google Scholar
Cicchetti, D., & Rogosch, F. A. (2002). A developmental psychopathology perspective on adolescence. Journal of Consulting and Clinical Psychology 70, 6–20.Google Scholar
Cioffi, D., & Holloway, J. (1993). Delayed costs of suppressed pain. Journal of Personality & Social Psychology 64, 274–282.Google Scholar
Critchfield, K. L., Sanford, J. I., Levy, K. N., & Clarkin, J. F. (2004). The relationship between impulsivity, aggression, and impulsive–aggression in borderline personality disorder: An empirical analysis of self-report measures. Journal of Personality Disorders 18, 555–570.Google Scholar
Dahl, A. A. (1993). The personality disorders: A critical review of family, twin, and adoption studies. Journal of Personality Disorders, 7(Suppl. 1), 86–99.Google Scholar
Depue, R. A., & Lenzenweger, M. F. (2001). A neurobehavioral dimensional model. In W. J. Livesley (Ed.), Handbook of personality disorders: Theory, research, and treatment (pp. 136–176). New York: Guilford Press.
deVegvar, M.-L., Siever, L. J., & Trestman, R. L. (1994). Impulsivity and serotonin in borderline personality disorder. Progress in Psychiatry 45, 23–40.Google Scholar
Diamond, L. M., & Aspinwall, L. G. (2003). Emotion regulation across the life span: An integrative perspective emphasizing self-regulation, positive affect, and dyadic processes. Motivation and Emotion 27, 125–156.Google Scholar
Everson, M. D., Hunter, W. M., Runyon, D. K., Edelsohn, G. A., & Coulter, M. L. (1991). Maternal support following disclosure of incest. In S. Chess & M. E. Hertzig (Eds.), Annual progress in child psychiatry and child development, 1990 (pp. 292–306). Philadelphia, PA: Brunner/Mazel.
Everson, M. D., Hunter, W. M., Runyon, D. K., Edelsohn, G. A., & Coulter, M. L. (1989). Maternal support following disclosure of incest. American Journal of Orthopsychiatry 59, 197–207.Google Scholar
Fabrega, H., Ulrich, R., Pilkonis, P., & Mezzich, J. E. (1992). Pure personality disorders in an intake psychiatric setting. Journal of Personality Disorders 6, 153–161.Google Scholar
Figueroa, E., & Silk, K. R. (1997). Biological implications of childhood sexual abuse in borderline personality disorder. Journal of Personality Disorders 11, 71–92.Google Scholar
Follette, W. C., & Houts, A. C. (1996). Models of scientific progress and the role of theory in taxonomy development: A case study of the DSM. Journal of Consulting and Clinical Psychology 64, 1120–1132.Google Scholar
Frick, P. J. (2004). Special selection: Temperament and childhood psychopathology integrating research on temperament and childhood psychopathology: Its pitfalls and promise. Journal of Clinical Child and Adolescent Psychology 33, 2–7.Google Scholar
Fruzzetti, A. E. (1995). The Closeness–Distance Family Interaction Coding System: A functional approach to coding couple and family interactions. Unpublished manuscript, University of Nevada, Reno.
Fruzzetti, A. E. (1996). Causes and consequences: Individual distress in the context of couple interactions. Journal of Consulting and Clinical Psychology 64, 1192–1201.Google Scholar
Fruzzetti, A. E. (2002). Dialectical behavior therapy for borderline personality and related disorders. In T. Patterson (Ed.), Comprehensive handbook of psychotherapy: Vol. 2. Cognitive–behavioral approaches (pp. 215–240). New York: Wiley.
Fruzzetti, A. E. (2005). Beyond support and criticism: The role of validating and invalidating responses in couple and family interaction. Unpublished manuscript.
Fruzzetti, A. E., & Fruzzetti, A. R. (2003). Borderline personality disorder. In D. Snyder & M. A. Whisman (Eds.), Treating difficult couples: Helping clients with coexisting mental and relationship disorders (pp. 235–260). New York: Guilford Press.
Fruzzetti, A. E., & Iverson, K. M. (2004). Mindfulness, acceptance, validation and “individual” psychopathology in couples. In S. C. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive–behavioral tradition (pp. 168–191). New York: Guilford Press.
Fruzzetti, A. E., & Iverson, K. M. (in press). Intervening with couples and families to treat emotion dysregulation and psychopathology. In D. K. Snyder, J. Simpson, & J. Hughes (Eds.), Emotion regulation in families. Washington, DC: American Psychological Association.
Fruzzetti, A. E., Shenk, C., Lowry, K., & Mosco, E. (2005). Defining and measuring validating and invalidating behaviors: Reliability and validity of the Validating and Invalidating Behaviors Coding Scale. Unpublished manuscript, University of Nevada, Reno.
Fruzzetti, A. E., Shenk, C., Mosco, E., & Lowry, K. (2003). Emotion regulation. In W. T. O'Donohue, J. E. Fisher, & S. C. Hayes (Eds.), Cognitive behavior therapy: Applying empirically supported techniques in your practice (pp. 152–159). New York: Wiley.
Fruzzetti, A. R., & Fruzzetti, A. E. (2005). Child-contingent parenting: Effects on children's emotion regulation and self-development. Unpublished manuscript.
Garnet, K. E., Levy, K. N., Mattanah, J. J. F., Edell, W. S., & McGlashan, T. H. (1994). Borderline personality disorder in adolescents: Ubiquitous or specific? American Journal of Psychiatry 151, 1380–1382.Google Scholar
Giesler, R. B., Josephs, R. A., & Swann, W. B. (1996). Self-verification in clinical depression: The desire for negative evaluation. Journal of Abnormal Psychology 105, 358–368.Google Scholar
Golden, R. N., & Gilmore, J. H. (1990). Serotonin and mood disorders. Psychiatric Annals 20, 580–586.Google Scholar
Gottman, J. M., & Katz, L. F. (2002). Children's emotional reactions to stressful parent–child interactions: The link between emotion regulation and vagal tone. Marriage and Family Review 34, 265–283.Google Scholar
Greenberg, L. S., & Safran, J. D. (1989). Emotion in psychotherapy. American Psychologist 44, 19–29.Google Scholar
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology 2, 271–299.Google Scholar
Guzder, J., Paris, J., Zelkowitz, P., & Feldman, R. (1999). Psychological risk factors for borderline pathology in school-age children. Journal of the American Academy of Child and Adolescent Psychiatry 38, 206–212.Google Scholar
Hooley, J. M., & Hoffman, P. D. (1999). Expressed emotion and clinical outcome in borderline personality disorder. American Journal of Psychiatry 156, 1557–1562.Google Scholar
Hops, H., Biglan, A., & Sherman, L. (1987). Home observations of family interactions of depressed women. Journal of Consulting & Clinical Psychology 55, 341–346.Google Scholar
Horesh, N., Sever, J., & Apter, A. (2003). A comparison of life events between suicidal adolescents with major depression and borderline personality disorder. Comprehensive Psychiatry 44, 277–283.Google Scholar
Horwitz, A. V., Widom, C., McLaughlin, J., & White, H. R. (2001). The impact of childhood abuse and neglect on adult mental health: A prospective study. Journal of Health and Social Behavior 42, 184–201.Google Scholar
Johnson, J. G., Cohen, P., Brown, J., Smailes, E., & Bernstein, D. P. (1999). Childhood maltreatment increases risk for personality disorders during early adulthood. Archives of General Psychiatry 56, 600–606.Google Scholar
Johnson, J. G., Cohen, P., Gould, M. S., Kasen, S., Brown, J., & Brook, J. S. (2002). Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. Archives of General Psychiatry 59, 741–749.Google Scholar
Katz, L. F., & Gottman, J. M. (1995). Vagal tone protects children from marital conflict. Development and Psychopathology 7, 83–92.Google Scholar
Keenan, K. (2000). Emotion dysregulation as a risk factor for child psychopathology. Clinical Psychology: Science and Practice 7, 418–434.Google Scholar
Kendall–Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin 113, 164–180.Google Scholar
Koerner, K., Kohlenberg, R. J., & Parker, C. R. (1996). Diagnosis of personality disorder: A radical behavioral alternative. Journal of Consulting and Clinical Psychology 64, 1169–1176.Google Scholar
Kohlenberg, R. J., & Tsai, M. (1991). Functional analytic psychotherapy: Creating intense and curative therapeutic relationships. New York: Plenum Press.
Krakowski, M. (2003). Violence and serotonin: influence of impulse control, affect regulation, and social functioning. Journal of Neuropsychiatry and Clinical Neurosciences 15, 294–305.Google Scholar
Lahey, B. (2004). Commentary: Role of temperament in developmental models of psychopathology. Journal of Clinical Child and Adolescent Psychology 33, 88–93.Google Scholar
Lamborn, S. D., Mounts, N. S., Steinberg, L., & Dornbusch, S. M. (1991). Patterns of competence and adjustment among adolescents from authoritative, authoritarian, indulgent, and neglectful families. Child Development 62, 1049–1065.Google Scholar
Lenzenweger, M. F., Loranger, A. W., Korfine, L., & Neff, C. (1997). Detecting personality disorders in a nonclinical population: Application of a 2-stage for case identification. Archives of General Psychiatry 54, 345–351.Google Scholar
Levy, K. N., Becker, D., Grilo, C. M., Mattanah, J. J. F., Garnet, K. E., Quinlan, D. M., et al. (1999). Concurrent and predictive validity of the personality disorder diagnosis in adolescent inpatients. The American Journal of Psychiatry 156, 1522–1528.Google Scholar
Linehan, M. M. (1993). Cognitive–behavioral treatment of borderline personality disorder. New York: Guilford Press.
Links, P. S., Heslegrave, R., & van Reekum, R. (1999). Impulsivity: Core aspect of borderline personality disorder. Journal of Personality Disorders 13, 1–9.Google Scholar
Links, P. S., & Munroe Blum, H. (1990). Family environment and borderline personality disorder: Development of etiologic models. In P. S. Links (Ed.), Family environment and borderline personality disorder. Progress in psychiatry series (pp. 3–24). Washington, DC: American Psychiatric Association.
Livesley, W. J., Jang, K. L., & Vernon, P. A. (1998). Phenotypic and genetic structure of traits delineating personality disorder. Archives of General Psychiatry 55, 941–948.Google Scholar
Livesley, W. J., Schroeder, M. L., Jackson, D. N., & Jang, K. L. (1994). Categorical distinctions in the study of personality disorder: Implications for classification. Journal of Abnormal Psychology 103, 6–17.Google Scholar
Lynch, M., & Cicchetti, D. (1998). An ecological-transactional analysis of children and contexts: The longitudinal interplay among child maltreatment, community violence, and children's symptomatology. Development and Psychopathology 10, 235–257.Google Scholar
Meehl, P. E. (1977). Specific etiology and other forms of strong inference: Some quantitative meanings. The Journal of Medicine and Philosophy 2, 33–53.Google Scholar
Miller, A. L., Wyman, S. E., & Huppert, J. D. (2000). Analysis of behavioral skills utilized by adolescents receiving dialectical behavior therapy. Cognitive and Behavioral Practice 7, 183–187.Google Scholar
Morey, L. C. (1988). Personality disorders under DSM-III and DSM-III-R: An examination of convergence, coverage, and internal consistency. American Journal of Psychiatry 145, 573–577.Google Scholar
Norden, K. A., Klein, D. N., Donaldson, S. K., Pepper, C. M., & Klein, L. M. (1995). Reports of the early home environment in DSM-III-R personality disorders. Journal of Personality Disorders 9, 213–223.Google Scholar
Ogata, S. N., Silk, K. R., & Goodrich, S. (1990). The childhood experience of the borderline patient. In P. S. Links (Ed.), Family environment and borderline personality disorder (pp. 85–103). Washington, DC: American Psychiatric Association.
Ogata, S. N., Silk, K. R., Goodrich, S., Lohr, N. E., Westen, D., & Hill, E. (1990). Childhood sexual and physical abuse in adult patients with borderline personality disorder. American Journal of Psychiatry 147, 1008–1013.Google Scholar
Oldham, J. M., Skodol, A. E., Kellman, H. D., Hyler, S. E., Rosnick, L., & Davies, M. (1992). Diagnosis of DSM-III-R personality disorders by two structured interviews: Patterns of comorbidity. American Journal of Psychiatry 149, 213–220.Google Scholar
Paris, J., Zweig–Frank, H., Ng Ying Kin, N. M. K., Schwartz, G., Steiger, H., & Nair, N. P. V. (2004). Neurobiological correlates of diagnosis and underlying traits in patients with borderline personality disorder compared with normal controls. Psychiatry Research 121, 239–252.Google Scholar
Patterson, G. R. (2002). The early development of coercive family process. In J. B. Reid & G. R. Patterson (Eds.), Antisocial behavior in children and adolescents: A developmental analysis and model for intervention (pp. 25–44). Washington, DC: American Psychological Association.
Porges, S. W., Doussard–Roosevelt, J. A., & Maita, A. K. (1994). Vagal tone and the physiological regulation of emotion. Monographs of the Society for Research in Child Development, 59, 167–186, 250–283.Google Scholar
Ramsay, D. S., & Lewis, M. (1994). Developmental change in infant cortisol and behavioral response to inoculation. Child Development 65, 1491–1502.Google Scholar
Rinne, T., Westenberg, H. G. M., den Boer, J. A., & van den Brink, W. (2000). Serotonergic blunting to meta-chlorophenylpiperazine (m-CPP) highly correlates with sustained childhood abuse in impulsive and autoaggressive female borderline patients. Biological Psychiatry 47, 548–556.Google Scholar
Robins, C. J., & Chapman, A. L. (2004). Dialectical behavior therapy: Current status, recent developments, and future directions. Journal of Personality Disorders 18, 73–89.Google Scholar
Scarr, S., & McCartney, K. (1983). How people make their own environments: A theory of genotype–environment effects. Child Development 54, 424–435.Google Scholar
Schneider, R. A., & Shipman, K. L. (2005). Maternal emotion socialization and risk for child depression. Unpublished manuscript.
Seifer, R. (2000). Temperament and goodness of fit: Implications for developmental psychopathology. In A. J. Sameroff, M. Lewis, & et al. (Eds.), Handbook of developmental psychopathology (2nd ed., pp. 257–276). Dordrecht: Kluwer Academic.
Shenk, C., & Fruzzetti, A. E. (2005). The impact of parental validating and invalidating responses on adolescent emotion regulation: A comparison of clinic and non-clinic samples. Unpublished manuscript.
Shields, A., & Cicchetti, D. (1998). Reactive aggression among maltreated children: The contributions of attention and emotion dysregulation. Journal of Clinical Child Psychology 27, 381–395.Google Scholar
Silk, K. R., Lee, S., Hill, E. M., & Lohr, N. E. (1995). Borderline symptoms and severity of sexual abuse. American Journal of Psychiatry 152, 1059–1064.Google Scholar
Skodol, A. E., Siever, L. J., Livesley, W. J., Gunderson, J. G., Pfohl, B., & Widiger, T. A. (2002). The borderline diagnosis II: Biology, genetics, and clinical course. Biological Psychiatry 51, 951–963.Google Scholar
Soloff, P. H. (2005). Pharmacotherapy in borderline personality disorder. In J. G. Gunderson (Ed.), Understanding and treating borderline personality disorder: A guide for professionals and families (pp. 65–82). Washington, DC: American Psychiatric Association.
Soloff, P. H., Meltzer, C. C., Becker, C., Greer, P. J., Kelly, T. M., & Constantine, D. (2003). Impulsivity and prefrontal hypometabolism in borderline personality disorder. Psychiatry Research: Neuroimaging 123, 153–163.Google Scholar
Stein, D., Apter, A., Gidon, R., Har–Even, D., & Avidan, G. (1998). Association between multiple suicide attempts and negative affects in adolescents. Journal of the American Academy of Child & Adolescent Psychiatry 37, 488–494.Google Scholar
Stein, D. J., Hollander, E., DeCaria, C. M., Simeon, D., Cohen, L., & Aronowitz, B. (1996). m-Chlorophenylpiperazine challenge in borderline personality disorder: Relationship of neuroendocrine response, behavioral response and clinical measures. Biological Psychiatry 40, 508–513.Google Scholar
Steinberg, L., & Avenevoli, S. (2000). The role of context in the development of psychopathology: A conceptual framework and some speculative propositions. Child Development 71, 66–74.Google Scholar
Steinberg, L., Lamborn, S. D., Darling, N., Mounts, N. S., & Dornbusch, S. M. (1994). Over-time changes in adjustment and competence among adolescents from authoritative, authoritarian, indulgent, and neglectful families. Child Development 65, 754–770.Google Scholar
Swann, W. B. (1997). The trouble with change. Psychological Science 8, 177–180.Google Scholar
Swann, W. B., & Schroeder, D. G. (1995). The search for beauty and truth: A framework for understanding reactions to evaluations. Personality & Social Psychology Bulletin 21, 1307–1318.Google Scholar
Thompson, R. A. (1994). Emotion regulation: A theme in search of definition. Monographs of the Society for Research in Child Development 59, 24–52.Google Scholar
Torgersen, S., Lygren, S., Oien, P. A., Skre, I., Onstad, S., Edvardsen, J., et al. (2000). A twin study of personality disorders. Comprehensive Psychiatry 41, 416–425.Google Scholar
Trull, T. J. (2001). Structural relations between borderline personality disorder features and putative etiological correlates. Journal of Abnormal Psychology 110, 471–481.Google Scholar
Wagner, A. W., & Linehan, M. M. (1997). Biosocial perspective on the relationship of childhood sexual abuse, suicidal behavior, and borderline personality disorder. Progress in Psychiatry 49, 203–223.Google Scholar
Wegner, D. M., & Gold, D. B. (1995). Fanning old flames: Emotional and cognitive effects of suppressing thoughts of a past relationship. Journal of Personality & Social Psychology 68, 782–792.Google Scholar
White, C. N., Gunderson, J. G., & Zanarini, M. C. (2003). Family studies of borderline personality disorder: A review. Harvard Review of Psychiatry 11, 8–19.Google Scholar
Widiger, T. A., & Sanderson, C. J. (1995). Towards a dimensional model of personality disorders in DSM-IV and DSM-V. In T. A. Widiger (Ed.), The DSM-IV personality disorders (pp. 433–458). New York: Guilford Press.
Yen, S., Shea, M. T., Sanislow, C. A., Grilo, C. M., Skodol, A. E., Gunderson, J. G., et al. (2004). Borderline personality disorder criteria associated with prospectively observed suicidal behavior. American Journal of Psychiatry 161, 1296–1298.Google Scholar
Zanarini, M. C. (Ed.). (1997). Role of sexual abuse in the etiology of borderline personality disorder (Vol. 49). Washington, DC: American Psychiatric Association.
Zanarini, M. C., Gunderson, J. G., & Marino, M. F. (1989). Childhood experiences of borderline patients. Comprehensive Psychiatry 30, 18–25.Google Scholar
Zanarini, M. C., Williams, A. A., Lewis, R. E., Reich, R. B., Vera, S. C., Marino, M. F., et al. (1997). Reported pathological childhood experiences associated with the development of borderline personality disorder. American Journal of Psychiatry 154, 1101–1106.Google Scholar
Zweig–Frank, H., & Paris, J. (1991). Parents' emotional neglect and overprotection according to the recollections of patients with borderline personality disorder. American Journal of Psychiatry 148, 648–651.Google Scholar