Am J Psychiatry 1993; 150:1836-1842
Copyright © 1993 by American Psychiatric Association
The impact of mother-child interaction on the development of borderline personality disorder
S Bezirganian, P Cohen and JS Brook
Columbia University Department of Psychiatry, NY.
OBJECTIVE: Two major psychodynamic theories of the etiology of borderline
personality disorder posit two aspects of mother-child interaction as
uniquely pathogenic: maternal over-involvement with the child and
mismanagement and inappropriateness of maternal guidance and support of the
child. This study is an attempt to examine these putative risk factors
empirically, using epidemiologic methods. METHOD: Mother-child interaction,
father-child interaction, maternal personality, and adolescent diagnoses of
personality disorders were measured on two occasions, 2.5 years apart, in a
random sample of 776 adolescents. RESULTS: Maternal inconsistency in
upbringing of the child predicted a persistence or an emergence of
borderline personality disorder, but not of any other axis II disorder.
However, this effect occurred only in the presence of high maternal
overinvolvement. Neither maternal overinvolvement nor maternal
inconsistency alone predicted emergence of borderline personality disorder.
Pathological features of maternal personality did not account for the
combined effect of maternal overinvolvement and inconsistency on borderline
personality disorder. CONCLUSIONS: The two child-rearing risk factors
hypothesized to be important by two psychodynamic models of borderline
personality disorder were found to be pathogenic only when they coexisted.
Their effect could not be accounted for by the biological or environmental
vulnerability represented by maternal borderline personality traits.
