Child versus adolescent borderline personality disorder traits: Frequency, psychosocial correlates, and observed mother–child interactions.

Fleck, Leonie; Fuchs, Anna; Moehler, Eva; Williams, Katharina; Koenig, Julian; Resch, Franz; Kaess, Michael

doi:10.1037/per0000574

Cited by 6 publications

(9 citation statements)

References 56 publications

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“…For adolescents with BPD traits, in our sample mainly characterized by impulsivity, self-harm/suicidality and uncontrollable anger [ 48 ], adaptive co-regulatory processes in behavior and physiology during social interaction could function as important stabilizers supporting adolescent self-regulatory systems. In our community sample, mothers and adolescents showed a constant decrease in cortisol on average.…”

Section: Discussionmentioning

confidence: 99%

Adolescent borderline personality traits and dyadic behavior shape mother-adolescent cortisol synchrony

Fleck

Fuchs

Lerch

et al. 2023

bord personal disord emot dysregul

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Background Associations between parent and child cortisol levels (“cortisol synchrony”) are often reported and positive synchrony may mark dyadic regulation on a physiological level. Although dyadic behavior during interaction and adolescent borderline personality disorder (BPD) traits are linked with individual and dyadic regulatory capacities, little is known about how both factors influence parent-adolescent cortisol synchrony. We hypothesized that cortisol synchrony would differ depending on behavioral synchrony, i.e., smooth reciprocal dyadic interaction patterns, adolescent BPD traits, and their interactions. Methods Multilevel state-trait modeling was implemented to investigate associations between concurrent mother-adolescent state cortisol and mother-adolescent average cortisol levels in a community sample of 76 mother-adolescent dyads. Three saliva samples were collected across interaction paradigms. Behavioral synchrony was observed, and adolescent BPD traits were evaluated using clinical interviews. Results First, behavioral synchrony and absence of BPD traits were linked with positive associations between adolescent and maternal state cortisol (positive synchrony), BPD traits with negative associations (negative synchrony). When interaction effects were examined, results were more nuanced. In low-risk dyads (higher behavioral synchrony, no BPD traits) asynchrony was found. When risk (BPD traits) and resource (higher behavioral synchrony) were combined, synchrony was positive. Lastly, in high-risk dyads (lower behavioral synchrony, adolescent BPD traits), negative synchrony was observed. Average adolescent and maternal cortisol levels were consistently positively associated in dyads with higher risk. Conclusions Positive dyadic interaction patterns are associated with positive state cortisol synchrony in mother-adolescent dyads and could buffer the effect of BPD traits, possibly supporting the process of physiological regulation.

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Section: Discussionmentioning

confidence: 99%

Adolescent borderline personality traits and dyadic behavior shape mother-adolescent cortisol synchrony

Fleck

Fuchs

Lerch

et al. 2023

bord personal disord emot dysregul

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“…Whilst overall collaboration as a marker for dyadic behavior during conflict discussions did not predict adolescent BPD traits in a high-risk community sample [60], it contributed to a more secure attachment profile in the clinical sample of young adults [54]. Fleck et al [34] observed interactions in two community samples. At age 9, they found less maternal structuring and more child withdrawal during a conflict discussion task to be associated with BPD traits, but no relations during a fun day planning task.…”

Section: Caregiver-child Interactions and Bpdmentioning

confidence: 98%

“…This seems to be especially relevant in stressful contexts (e.g. [34], when problems with emotion regulation would become noticeable. There is also first evidence that positive parental and dyadic behavior might mitigate the development of the disorder [39,92].…”

Section: Caregiver-child Interactions and Bpdmentioning

confidence: 99%

“…To the best of our knowledge, only four studies have studied the influence of current BPD traits on parent, child and dyadic behavior during the same interaction [34,54,60,92]; the only study including a case-control design focused on young adults rather than adolescents [54]. Only one study compared observed mother-child interactions in a positive versus a stressful context [34], although context seems to have an impact on relations between mother-child interactions and child behavioral problems [27].…”

Section: Caregiver-child Interactions and Bpdmentioning

confidence: 99%

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Mother–child interactions in adolescents with borderline personality disorder traits and the impact of early life maltreatment

Williams

Fleck

Fuchs

et al. 2023

Child Adolesc Psychiatry Ment Health

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Background Early detection and intervention of borderline personality disorder (BPD) in adolescence has become a public health priority. Theoretical models emphasize the role of social interactions and transgenerational mechanisms in the development of the disorder suggesting a closer look at caregiver-child relationships. Methods The current study investigated mother-adolescent interactions and their association with adolescent BPD traits by using a case–control design. Thirty-eight adolescent patients with ≥ 3 BPD traits and their mothers (BPD-G) were investigated in contrast to 35 healthy control dyads (HC-G). Maternal, adolescent and dyadic behavior was coded using the Coding Interactive Behavior Manual (CIB) during two interactions: a fun day planning and a stress paradigm. Additional effects of maternal and/or adolescent early life maltreatment (ELM) on behavior were also explored. Results BPD-G displayed a significantly lower quality of maternal, adolescent and dyadic behavior than the HC-G during both interactions. Maternal and adolescent behavior was predicted by BPD traits alone, whilst dyadic behavior was also influenced by general adolescent psychopathology. Exploratory analyses of CIB subscales showed that whilst HC-G increased their reciprocal behavior during stress compared to the fun day planning, BPD-G dyads decreased it. Maternal ELM did not differ between groups or have any effect on behavior. Adolescent ELM was correlated with behavioral outcome variables, but did not explain behavioral outcomes above and beyond the effect of clinical status. Discussion/Conclusion Our data suggest a stronger focus on parent–child interactions in BPD-specific therapies to enhance long-term treatment outcomes in adolescent BPD patients. Further research employing study designs that allow the analyses of bidirectional transactions (e.g. longitudinal design, behavioral microcoding) is needed.

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“…Another significant underlying psychopathology is personality disorder, especially borderline personality disorder (BPD) and other cluster B entities. Although the diagnosis of BPD in children and adolescents is controversial, more and more clinicians are using this term to explain recurring DSH among adolescents, especially girls [32].…”

Section: Ideation-to-action and Imminent Risk Frameworkmentioning

confidence: 99%

Recent research advances in identification and prevention of youth suicide risk

Barzilay

Apter

2022

Current Opinion in Psychiatry

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Purpose of the reviewThe rate of youth suicidal behaviors has gradually increased over the last 15 years and continues to grow during the COVID-19 pandemic. This trend burdens mental health services and demands significant developments in risk detection and delivery of interventions to reduce the risk. In this article we outline significant advances and recent findings in youth suicide research that may facilitate strategies for identifying and preventing suicide risk among youth at risk in general and in specific risk groups.Recent findingsThe rise in suicide and suicidal behaviors is most likely to affect young people of racial, ethnic, sexual, and gender identity minorities and those living in poverty or experiencing maltreatment. The suicide rate in children is rising and demands special attention. Proximal risk factors for suicidal behavior compared with suicidal ideation have been suggested to identify near-term suicidal risk. Effective and scalable prevention strategies were identified, and the role of new technologies in suicide prevention among youth is to be determined.SummaryTo reach broader suicide prevention in youth and reduce the pressure on mental healthcare, public health approaches and improved service access for minority youth and those living in underserved areas of the world are needed.

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Child versus adolescent borderline personality disorder traits: Frequency, psychosocial correlates, and observed mother–child interactions.

Cited by 6 publications

References 56 publications

Adolescent borderline personality traits and dyadic behavior shape mother-adolescent cortisol synchrony

Adolescent borderline personality traits and dyadic behavior shape mother-adolescent cortisol synchrony

Mother–child interactions in adolescents with borderline personality disorder traits and the impact of early life maltreatment

Recent research advances in identification and prevention of youth suicide risk

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