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Personal relatedness and attachment in infants of mothers with borderline personality disorder

Published online by Cambridge University Press:  12 May 2005

R. PETER HOBSON ,
MATTHEW PATRICK ,
LISA CRANDELL ,
ROSA GARCÍA–PÉREZ  and
ANTHONY LEE
R. PETER HOBSON
Affiliation:
Tavistock Clinic, University College, London
MATTHEW PATRICK
Affiliation:
Tavistock Clinic, University College, London
LISA CRANDELL
Affiliation:
Tavistock Clinic, University College, London
ROSA GARCÍA–PÉREZ
Affiliation:
Tavistock Clinic, University College, London
ANTHONY LEE
Affiliation:
Tavistock Clinic, University College, London
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Abstract

The principal aim of this study was to assess personal relatedness and attachment patterns in 12-month-old infants of mothers with borderline personality disorder (BPD). We also evaluated maternal intrusive insensitivity toward the infants in semistructured play. We videotaped 10 mother–infant dyads with borderline mothers and 22 dyads where the mothers were free from psychopathology, in three different settings: a modification of Winnicott's Set Situation in which infants faced an initially unresponsive (“still-face”) stranger, who subsequently tried to engage the infant in a game of give and take; the Strange Situation of Ainsworth and Wittig; and a situation in which mothers were requested to teach their infants to play with miniature figures and a toy train. In relation to a set of a priori predictions, the results revealed significant group differences as follows: (a) compared with control infants, toward the stranger the infants of mothers with BPD showed lower levels of “availability for positive engagement,” lower ratings of “behavior organization and mood state,” and a lower proportion of interpersonally directed looks that were positive; (b) in the Strange Situation, a higher proportion (8 out of 10) of infants of borderline mothers were categorized as Disorganized; and (c) in play, mothers with BPD were rated as more “intrusively insensitive” toward their infants. The results are discussed in relation to hypotheses concerning the interpersonal relations of women with BPD, and possible implications for their infants' development.This research was generously supported by grants from the Winnicott Trust, the Hayward Foundation, and the Baily Thomas Charitable Fund, as well as by a Wellcome Fellowship to Matthew Patrick and an NIH Fellowship to Lisa Crandell. We also received support from the UK National Health R&D Budget. We are indebted to the mothers and infants who agreed to take part, Lynne Murray for inspiration and guidance, Lucy Chiemielski and Leezah Hertzmann for their help with ratings of videotapes, Betty Carlson and Alan Sroufe for their invaluable and very generous input, and Jessica Meyer for her helpful comments and suggestions.

Type
Research Article
Information
Development and Psychopathology , Volume 17 , Issue 2 , June 2005 , pp. 329 - 347
Copyright
© 2005 Cambridge University Press

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References

REFERENCES

Ainsworth, M. D., Blehar, M., Waters, E., & Wall, S. (1978). Patterns of attachment. Hillsdale, NJ: Erlbaum.
Ainsworth, M. D., & Wittig, B. (1969). Attachment and exploratory behavior of one-year-olds in a strange situation. In B. M. Foss (Ed.), Determinants of infant behavior IV (pp. 111–136). London: Methuen.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders—Revised (3rd ed.). Washington, DC: Author.
Baron, M. J. O. (1993). Fear, attachment and affiliation: The interaction of functional systems in 8- and 12-month-old infants. Early Development and Parenting 2, 121–130.CrossRefGoogle Scholar
Barone, L. (2003). Developmental protective and risk factors in borderline personality disorder: A study using the Adult Attachment Interview. Attachment & Human Development 5, 64–77.CrossRefGoogle Scholar
Bezirganian, S., Cohen, P., & Brook, J. S. (1993). The impact of mother–child interaction on the development of borderline personality disorder. American Journal of Psychiatry 150, 1836–1842.Google Scholar
Bion, W. R. (1962). A theory of thinking. International Journal of Psychoanalysis 43, 306–310.Google Scholar
Bokhorst, C. L., Bakermans–Kranenburg, M. J., Fearon, R. M., van IJzendoorn, M. H., Fonagy, P., & Schuengel, C. (2003). The importance of shared environment in mother–infant attachment security: A behavioral genetic study. Child Development 74, 1769–1782.CrossRefGoogle Scholar
Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. New York: Basic Books.
Bradshaw, D. A., Goldsmith, H. A., & Campos, J. J. (1987). Attachment, temperament, and social referencing: Interrelationships among three domains of infant affective behavior. Infant Behavior and Development 10, 223–231.CrossRefGoogle Scholar
Brazelton, T. B., Koslowski, B., & Main, M. (1974). The origins of reciprocity: The early mother–infant interaction. In M. Lewis & L. A. Rosenblum (Eds.), The effect of infancy on its caregiver (pp. 49–77). New York: Wiley.
Bretherton, I., & Ainsworth, M. D. S. (1974). Responses of one-year-olds to a stranger in a strange situation. In M. Lewis & L. A. Rosenblum (Eds.), Origins of fear (pp. 131–164). New York: Wiley.
Bretherton, I., & Munholland, K. A. (1999). Internal working models in attachment relationships: A construct revisited. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research and clinical applications (pp. 89–111). New York: Guilford Press.
Buss, A. H., & Plomin, R. (1984). Temperament: Early developing personality traits. Hillsdale, NJ: Erlbaum.
Carlson, E. A. (1998). A prospective longitudinal study of attachment disorganization/disorientation. Child Development 69, 1107–1128.CrossRefGoogle Scholar
Carlson, V., Cicchetti, D., Barnett, D., & Braunwald, K. (1989). Disorganized/disoriented attachment relationships in maltreated infants. Developmental Psychology 25, 525–531.CrossRefGoogle Scholar
Cohn, J. F., Campbell, S. B., Matias, R., & Hopkins, J. (1990). Face-to-face interactions of postpartum depressed and nondepressed mother–infant pairs at 2 months. Developmental Psychology 26, 15–23.CrossRefGoogle Scholar
Cohn, J. F., Matias, R., Tronick, E. Z., Connell, D., & Lyons–Ruth, K. (1986). Face-to-face interactions of depressed mothers and their infants. In E. Tronick & T. Field (Eds.), New directions for child development: Vol. 34. Maternal depression and infant disturbance (pp. 31–44). San Francisco, CA: Jossey–Bass.
Cohn, J. F., & Tronick, E. (1989). Specificity of infants' response to mothers' affective behavior. American Academy of Child and Adolescent Psychiatry 28, 242–248.CrossRefGoogle Scholar
Crandell, L. E., Patrick, M. P. H., & Hobson, R. P. (2003). “Still-face” interactions between mothers with borderline personality disorder and their 2-month-old infants. British Journal of Psychiatry 183, 239–247.CrossRefGoogle Scholar
Crockenberg, S. (1981). Infant irritability, mother responsiveness, and social support influences on the security of infant–mother attachment. Child Development 52, 857–865.CrossRefGoogle Scholar
DeMulder, E. K., & Radke–Yarrow, M. (1991). Attachment with affectively ill and well mothers: Concurrent behavioral correlates. Development and Psychopathology 3, 227–242.CrossRefGoogle Scholar
De Wolff, M., & van IJzendoorn, H. (1997). Sensitivity and attachment: A meta-analysis on parental antecedents of infant attachment. Child Development 68, 571–591.CrossRefGoogle Scholar
Field, T. M., Healy, B., Goldstein, S., & Guthertz, M. (1990). Behavior-state matching and synchrony in mother–infant interactions in non-depressed versus depressed dyads. Developmental Psychology 26, 7–14.CrossRefGoogle Scholar
Field, T. M., Healy, B., Goldstein, S., Perry, S., Bendell, D., Schanberg, S., Zimmerman, E. A., & Kuhn, C. (1988). Infants of depressed mothers show “depressed” behavior even with non-depressed adults. Child Development 59, 1569–1579.CrossRefGoogle Scholar
Field, T. M., Sandberg, D., Garcia, R., Vega–Lahr, N., Goldstein, S., & Guy, L. (1985). Pregnancy problems, postpartum depression and early mother–infant interactions. Developmental Psychology 21, 1152–1156.CrossRefGoogle Scholar
Fonagy, P., Leigh, T., Steele, M., Steele, H., Kennedy, R., Mattoon, G., Target, M., & Gerber, A. (1996). The relation of attachment status, psychiatric classification, and response to psychotherapy. Journal of Consulting and Clinical Psychology 64, 22–31.CrossRefGoogle Scholar
Fox, N. A., Kimmerly, N. L., & Schafer, W. D. (1991). Attachment to mother/attachment to father. Child Development 62, 210–225.CrossRefGoogle Scholar
Garcia–Coll, C. T., Kagan, J., & Reznick, J. S. (1984). Behavioral inhibition in young children. Child Development 55, 1006–1019.Google Scholar
George, C., Kaplan, N., & Main, M. (1985). The Adult Attachment Interview for Adults (2nd ed.). Unpublished manuscript, University of California at Berkeley.
Goldsmith, H. H., & Campos, J. J. (1990). The structure of temperamental fear and pleasure in infants: A psychometric perspective. Child Development 61, 1944–1964.CrossRefGoogle Scholar
Greenberg, J. R., & Mitchell, S. A. (1983). Object relations in psychoanalytic theory. Cambridge, MA: Harvard University Press.
Gunderson, J. G. (2001). Borderline personality disorder: A clinical guide. Washington, DC: American Psychiatric Publishing.
Guntrip, H. (1977). Personality structure and human interaction. London: Hogarth.
Gustafson, G. E., Green, J., & West, M. J. (1979). The infant's changing role in mother–infant games: The growth of social skills. Infant Behavior and Development 2, 301–308.CrossRefGoogle Scholar
Hay, D. F., & Murray, P. (1982). Giving and requesting: Social facilitation of infants' offers to adults. Infant Behavior and Development 5, 301–310.CrossRefGoogle Scholar
Herman, J., Perry, C., & Van der Kolk, B. (1989). Childhood trauma in borderline personality disorder. American Journal of Psychiatry 146, 490–495.Google Scholar
Hipwell, A. E., Goossens, F. A., Melhuish, E. C., & Kumar, R. (2000). Severe maternal psychopathology and infant–mother attachment. Development and Psychopathology 12, 157–175.CrossRefGoogle Scholar
Hobson, R. P. (1997). Psychoanalysis and infancy. In G. Bremner, G. Butterworth, & A. Slater (Eds.), Infant development: Recent advances (pp. 275–290). Hove: Psychology Press.
Hobson, R. P. (2002). The cradle of thought. London: Macmillan.
Hobson, R. P., Patrick, M. P. H., Crandell, L. E., Garcia–Perez, R. M., & Lee, A. (2004). Maternal sensitivity and infant triadic communication. Journal of Child Psychology and Psychiatry 45, 470–480.CrossRefGoogle Scholar
Hobson, R. P., Patrick, M. P. H., & Valentine, J. D. (1998). Objectivity in psychoanalytic judgements. British Journal of Psychiatry 173, 172–177.CrossRefGoogle Scholar
Jackson, J. (1996). An experimental investigation of Winnicott's set situation: A study of South African white, black and institutionalized infants aged 7 to 9 months old. Journal of Child Psychotherapy 22, 343–361.CrossRefGoogle Scholar
Kernberg, O. F. (1976). Object relations theory and clinical psychoanalysis. Northvale, NJ: Aronson.
Lakatos, K., Nemoda, Z., Toth, I., Ronai, Z., Ney, K., Sasvari–Szekely, M., & Gervai, J. (2002). Further evidence for the role of the dopamine D4 receptor (DRD4) gene in attachment disorganization: Interaction of the exon III 48-bp repeat and the −521 C/T promoter polymorphisms. Molecular Psychiatry 7, 27–31.CrossRefGoogle Scholar
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics 33, 159–174.CrossRefGoogle Scholar
Lyons–Ruth, K., Bronfman, E., & Atwood, G. (1999). A relational diathesis model of hostile–helpless states of mind. Expressions in mother–infant interaction. In J. Solomon & C. George (Eds.), Attachment disorganization (pp. 33–70). New York: Guilford Press.
Lyons–Ruth, K., Bronfman, E., & Parsons, E. (1999). Maternal frightened, frightening, or atypical behavior and disorganized infant attachment patterns. Monographs of the Society for Research in Child Development 64(3, Serial No. 258), 67–96.CrossRefGoogle Scholar
Lyons–Ruth, K., Connell, D. B., Zoll, D., & Stahl, J. (1987). Infants at social risk: Relations among infant maltreatment, maternal behavior, and infant attachment behavior. Developmental Psychology 23, 223–232.CrossRefGoogle Scholar
Lyons–Ruth, K., & Jacobvitz, D. (1999). Attachment disorganization: Unresolved loss, relational violence, and lapses in behavioral and attentional strategies. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 520–554). New York: Guilford Press.
Lyons–Ruth, K., Repacholi, B., McLeod, S., & Silva, E. (1991). Disorganized attachment behavior in infancy: Short-term stability, maternal and infant correlates, and risk-related subtypes. Development and Psychopathology 3, 377–396.CrossRefGoogle Scholar
Main, M., & Hesse, E. (1990). Parents' unresolved traumatic experiences are related to infant disorganized attachment status: Is frightened and/or frightening parental behavior the linking mechanism? In M. T. Greenberg, D. Cicchetti, & E. M. Cummings (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 161–182). Chicago: University of Chicago Press.
Main, M., & Solomon, J. (1986). Discovery of a new, insecure–disorganized/disoriented attachment pattern. In T. B. Brazelton & M. W. Yogman (Eds.), Affective development in infancy (pp. 95–124). Norwood, NJ: Ablex.
Main, M., & Solomon, J. (1990). Procedures for identifying infants as disorganized/disoriented during the Ainsworth strange situation. In M. T. Greenberg, D. Cicchetti, & E. M. Cummings (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 121–160). Chicago: University of Chicago Press.
Main, M., & Weston, D. R. (1981). The quality of the toddler's relationship to mother and to father: Related to conflict behavior and the readiness to establish new relationships. Child Development 52, 932–940.CrossRefGoogle Scholar
Manassis, K., Bradley, S., Goldberg, S., Hood, J., & Swinson, R. P. (1994). Attachment in mothers with anxiety disorder and their children. Journal of the American Academy of Child and Adolescent Psychiatry 33, 1106–1113.CrossRefGoogle Scholar
Melnick, S. M., Patrick, M. P. H., Lyons–Ruth, K., & Hobson, R. P. (2003). Disorganized (hostile/helpless) attachments in mothers with psychopathology. Poster presented at the Biennial Meeting of the Society for Research in Child Development, Tampa, FL.
Murray, L., & Cooper, P. J. (1997). Postpartum depression and child development. New York: Guilford Press.
Murray, L., Fiori–Cowley, A., Hooper, R., & Cooper, P. (1996). The impact of postnatal depression and associated adversity on early mother–infant interactions and later outcome. Child Development 67, 2512–2526.CrossRefGoogle Scholar
O'Connor, M. J., Sigman, M., & Brill, N. (1987). Disorganization of attachment in relation to maternal alcohol consumption. Journal of Consulting and Clinical Psychology 55, 831–836.CrossRefGoogle Scholar
O'Connor, T. G., & Croft, C. M. (2001). A twin study of attachment in preschool children. Child Development 72, 1501–1511.CrossRefGoogle Scholar
Ogata, S., Silk, K., Goodrich, S., Lohr, N., Westen, D., & Hill, E. (1990). Childhood sexual and physical abuse in borderline patients. American Journal of Psychiatry 147, 1008–1013.Google Scholar
Patrick, M., Hobson, R. P., Castle, D., Howard, R., & Maughan, B. (1994). Personality disorder and the mental representation of early social experience. Development and Psychopathology 6, 375–388.CrossRefGoogle Scholar
Posner, M. I., Rothbart, M. K., Vizueta, N., Thomas, K. M., Levy, K. N., Fossella, J., Silbersweig, D., Stern, E., Clarkin, J., & Kernberg, O. (2003). An approach to the psychobiology of personality disorders. Development and Psychopathology 15, 1093–1106.CrossRefGoogle Scholar
Reinecke, M. A., & Fogel, A. (1994). The development of referential offering in the first year. Early Development and Parenting 3, 181–186.CrossRefGoogle Scholar
Rothbart, M. K., & Derryberry, D. (1981). Development of individual differences in temperament. In M. E. Lamb & A. L. Brown (Eds.), Advances in developmental psychology (Vol. 1, pp. 37–86). Hillsdale, NJ: Erlbaum.
Rodning, C., Beckwith, L., & Howard, J. (1991). Quality of attachment and home environments in children prenatally exposed to PCP and cocaine. Development and Psychopathology 3, 351–366.CrossRefGoogle Scholar
Sandler, J. (Ed.). (1988). Projection, identification, projective identification. London: Karnac.
Schneider Rosen, K., & Rothbaum, F. (1993). Quality of parental caregiving and security of attachment. Developmental Psychology 29, 358–367.CrossRefGoogle Scholar
Schuengel, C., Bakermans–Kranenburg, M. J., & van IJzendoorn, M. H. (1999). Frightening maternal behavior linking unresolved loss and disorganized infant attachment. Journal of Consulting and Clinical Psychology 67, 54–63.CrossRefGoogle Scholar
Shapiro, B., Fagen, J., Prigot, J., Carroll, M., & Shalan, J. (1998). Infants' emotional and regulatory behaviors in response to violations of expectancies. Infant Behavior and Development 21, 299–313.CrossRefGoogle 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
Spangler, G., & Grossmann, K. (1999). Individual and physiological correlates of attachment disorganization in the infancy. In J. Solomon & C. George (Eds.), Attachment Disorganization (pp. 95–124). New York: Guilford Press.
Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. B. (1990). Structured clinical interview for DSM-III-R-Personality disorders (SCID-II Version 1.0); and non-patient edition (SCID-NP, Version 1.0). Washington, DC: American Psychiatric Association.
Sroufe, L. A. (1977). Wariness of strangers and the study of infant development. Child Development 48, 731–746.CrossRefGoogle Scholar
Sroufe, L. A. (1985). Attachment classification from the perspective of infant–caregiver relationships and infant temperament. Child Development 56, 1–14.Google Scholar
Stein, A., Woolley, H., Cooper, S. D., & Fairburn, C. G. (1994). An observational study of mothers with eating disorders and their infants. Journal of Child Psychology and Psychiatry 35, 733–48.CrossRefGoogle Scholar
Stein, A., Woolley, H., & McPherson, K. (1999). Conflict between mothers with eating disorders and their infants during mealtimes. British Journal of Psychiatry 175, 455–461.CrossRefGoogle Scholar
Stevenson, M. B., & Lamb, M. E. (1979). Effects of infant sociability and the caretaking environment on infant cognitive performance. Child Development 50, 340–349.Google Scholar
Stern, D. N. (1985). The interpersonal world of the infant. New York: Basic Books.
Susman–Stillman, A., Kalkoske, M., Egeland, B., & Waldman, I. (1996). Infant temperament and maternal sensitivity as predictors of attachment security. Infant Behavior and Development 19, 33–47.CrossRefGoogle Scholar
Teti, D. M., Gelfand, D. M., Messinger, D. S., & Isabella, R. (1995). Maternal depression and the quality of early attachment: An examination of infants, preschoolers, and their mothers. Developmental Psychology 34, 361–376.CrossRefGoogle Scholar
Thompson, R. A., & Lamb, M. E. (1982). Stranger sociability and its relationships to temperament and social experience during the second year. Infant Behavior and Development 5, 277–287.CrossRefGoogle Scholar
Thompson, R. A., and Lamb, M. E. (1983). Security of attachment and stranger sociability in infancy. Child Development 19, 184–191.CrossRefGoogle Scholar
Trevarthen, C., & Hubley, P. (1978). Secondary intersubjectivity: Confidence, confiding and acts of meaning in the first year. In A. Lock (Ed.), Action, gesture and symbol: The emergence of language (pp. 183–229). London: Academic Press.
Tronick, E. Z., & Cohn, J. F. (1989). Infant–mother face-to-face interaction: Age and gender differences in co-ordination and the occurrence of miscoordination. Child Development 60, 85–92.CrossRefGoogle Scholar
van IJzendoorn, M. H. (1995). Adult attachment representations, parental responsiveness, and infant attachment: A meta-analysis on the predictive validity of the Adult Attachment Interview. Psychological Bulletin 117, 387–403.CrossRefGoogle Scholar
van IJzendoorn, M. H., Schuengel, C., & Bakermans–Kranenburg, M. J. (1999). Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Development and Psychopathology 11, 225–249.CrossRefGoogle Scholar
Vaughn, B. E., Stevenson–Hinde, J., Waters, E., Kotsaftis, A., Lefever, G. B., Shouldice, A., Trudel, M., & Belsky, J. (1992). Attachment security and temperament in infancy and early childhood: Some conceptual clarifications. Developmental Psychology 28, 463–473.CrossRefGoogle Scholar
Weaver, T. L., & Clum, G. A. (1993). Early family environments and traumatic experiences associated with borderline personality disorder. Journal of Consulting and Clinical Psychology 61, 1068–1075.CrossRefGoogle Scholar
Weber, R. A., Levitt, M. J., & Clark, M. C. (1986). Individual variation in attachment security and strange situation behavior: The role of maternal and infant temperament. Child Development 57, 56–65.CrossRefGoogle Scholar
Winnicott, D. W. (1941). The observation of infants in a set situation. International Journal of Psychoanalysis 22, 229–249.Google Scholar