Prospective associations between maternal borderline personality disorder symptoms, observed parenting and adolescent BPD features

Abstract Background Limited evidence, entirely cross sectional and largely in infancy, links maternal borderline personality disorder (BPD) symptoms to lower quality of parenting. We conducted the first prospective study of maternal BPD symptoms and parenting, and tested the hypothesis that observed parenting mediates the association between maternal BPD symptoms and early adolescent BPD features. Methods Participants were members of a stratified subsample (N = 268) of the Wirral Child Health and Development Study (WCHADS), a prospective UK population-based cohort. Maternal DSM BPD symptoms were assessed by interview primarily during pregnancy, and maternal depressive symptoms by self-report up to age 3.5 years. Quality of parenting was rated from recorded mother-child conflict discussions at age 9.5 years, and child self-report of their own BPD features at age 12 years. Analyses were conducted using regression and structural equation models. Results Maternal BPD symptoms predicted lower supportive presence (β = -0.22, p = 0.003) and greater hostility (β = 0.18, p = 0.008), independently of maternal depressive symptoms. There was an association between maternal BPD symptoms and adolescent BPD features (r = 0.18, p = 0.004), which was markedly attenuated after adjustment for maternal depressive symptoms (β = 0.09, p = 0.253), and there was no evidence of mediation by quality of parenting. Conclusions Based on our findings, maternal BPD symptoms rather than depression, are associated with an enduring reduction in supportive presence and increase in hostility. While these dimensions of parenting are important for a range of mental health outcomes in children, they did not contribute to vulnerability to adolescent BPD features.