Temperament in Mothers With Borderline Personality Disorder
and in Their Young Children Aged 4-7
Christina G. Mena, Chris D. Watkins, Jennifer M. Strimpfel, Amineh Abbas, & Jenny
Macfie
Poster presented April 2013 at the biennial meeting of the
Society for Research in Child Development, Seattle, WA
Abstract
In this study we sampled mothers with Borderline Personality Disorder (BPD) and their young
children ages 4-7 (n = 36), as well as normative comparisons (n = 34). We assessed temperament
in both mothers and their children. Mothers reported on their own and on their children’s
temperament. Controlling for maternal major depressive disorder, mothers with BPD reported
more negative affectivity, less effortful control, and less positive affect than did normative
comparison mothers. Children whose mothers had BPD had less effortful control and more
negative affectivity (fear and frustration), but not less smiling and laughter. In addition, mothers'
temperamental traits were all correlated with their children’s corresponding ones except for
mothers’ positive affect with children’s smiling and laughter. Furthermore, each self-reported
maternal borderline feature (identity disturbance, negative relationships, affective instability and
self-harm) was significantly positively correlated with mothers’ negative affectivity and
significantly negatively correlated with mother’s effortful control and positive affect. In addition,
each maternal borderline feature was significantly negatively correlated with children’s effortful
control and significantly positively correlated with children’s negative affectivity on most scales,
but not significantly negatively correlated with children's smiling and laughter. Results are
discussed as increasing our understanding of the intergenerational transmission of BPD through
temperament.
Introduction
Borderline Personality Disorder (BPD) is characterized by unstable affect and marked by
impulsivity, fear of abandonment, and self-destructive behaviors (American Psychiatric
Association, 2000). BPD is thought to develop from an interaction between inherited emotional
vulnerability (temperament) and emotionally invalidating caregiving (Linehan, 1993). Despite
the severity and prevalence of this disorder, few studies on the offspring of mothers with BPD
have been conducted, with a gap in the existing literature specifically investigating the
temperament in offspring of mothers with BPD during early childhood.
There is a large heritable component to BPD (Torgersen et al., 2000) thought to consist of
temperamental variables such as low effortful control and high negative affectivity (Posner,
Rothbart et al., 2003; Siever & Davis, 1991). The study of temperament in offspring of women
with BPD, themselves at high risk of developing the disorder (White et al., 2003), may inform
precursors to the disorder.
Research has shown that individuals with BPD demonstrate higher levels of sadness and anger
after hearing emotion-inducing stories (Gitta, Hellstern, Ower, Pillman, Scheel, et al., 2009), a
stronger increase in fear when watching an emotional movie clip (Arntz, Klokman, & Sieswerda,
2005), and higher levels of anger and hostility (Gardner, Leibenluft, O'Leary, & Cowdry, 1991)
than do healthy controls.
Moreover, a BPD diagnosis was significantly negatively correlated with the temperamental trait
of control (Bornovalova, Gratz, Delany-Brumsey, Paulson, Lejeuz, 2006), and low effortful
control was correlated with problems with interpersonal functioning and
personality organization, suggesting that low levels of effortful control may contribute to
difficulties for individuals with this diagnosis (Hoermann, Clarkin, Hull & Levy, 2005).
Given empirical evidence that children have similar temperaments to their mothers in normative
and clinical samples (Kochanska, Clark, & Goldman, 1997; Muris, Steerneman, Merckelbach &
Meesters, 1996; Bridgett, Gartstein, Putnam, Lance, Iddins, et al., 2011; Coffman, Levitt,
Guacci-Franco, & Silver, 1992), it would follow that the children of mothers with BPD may also
have temperaments similar to their children. Previous studies have already shown that that the
offspring of mothers with BPD have more psychopathology than normative and clinical
comparisons (Feldman, Zelkowitz, Weiss, & Vogel, 1995; Weiss, Zelkowitz, Feldman, Vogel,
Heyman et al., 1996; Barnow, Spitzer, Grabe, Kessler, & Freyberger, 2006).
In addition to a categorical diagnosis of BPD, the current study also assessed a continuous
measure of BPD to determine if self-reported maternal borderline features in the sample as a
whole also correlated with certain temperamental traits both in mothers and their children.
It is important to examine deviations in early development that may lead to disorder later in life
with offspring studies (Seifer & Dickstein, 2000), in order to minimize exposure to further risk
factors and to design preventive interventions. The current study used both categorical and
continuous measures of BPD to assess differences in temperament between mothers with BPD
and their offspring and normative comparisons and to assess the relationship between mothers’
and children’s temperament in the sample as a whole.
Controlling for maternal major depressive disorder (MDD), which is the disorder most often comorbid with BPD (Zanarini et al., 1998), it was hypothesized that:
(1) mothers with BPD would have temperaments with higher levels of negative
affectivity (frustration, fear, sadness, discomfort), and lower levels of effortful control (inhibitory
control, attentional control) and positive affect than would normative comparison mothers
(2) children of mothers with BPD would have higher levels of negative affectivity
(anger/frustration, fear, sadness, discomfort), and lower levels of effortful control (inhibitory
control, attentional focusing) and ‘smiling and laughter’ than would normative comparison
children
(3) mothers’ temperamental traits would correlate with their children’s corresponding
temperamental traits
(4) maternal borderline features would significantly positively correlate with their own
and their children’s negative affectivity and significantly negatively correlate with their own and
their children’s effortful control and positive affect/smiling and laughter.
Method
Participants



N =70 children age 4-7 years (M = 5 years, 4 months, SD = 10.7 months) and
their mothers; n= 36 children whose mothers have BPD and n= 34 children whose
mothers do not.
Groups were matched on SES (low), age, gender, and race but not on mothers’
education. Maternal education significantly correlated with some of the dependent
variables, so it was controlled for in analyses. See Table 1.
Sample was 51% female, 93% Caucasian, 4% bi-racial, and 3% African
American. Across racial background, 9% were Hispanic.
Table 1. Child age and demographic differences between the BPD and normative comparison
groups
Variable
Whole sample
BPD
Comparisons
t
N = 70
n = 36
n = 34
M (SD)
M (SD)
M (SD)
Child Age (years)
5.37 (0.89)
5.35 (0.93)
5.38 (0.87)
0.12
Maternal Age (years)
32.41 (5.04)
32.28 (4.84)
32.56 (5.32)
0.23
Family Yearly Income ($)
31,835
(27,855)
29,372
(19,294)
34,443
(34,841)
0.76
# Adults in Home
1.83 (0.78)
1.86 (0.80)
1.79 (0.77)
-0.36
# Children in Home
2.47 (1.16)
2.61 (1.25)
2.32 (1.07)
-1.03
χ²
Child Gender (female)
51%
53%
50%
0.05
Child Minority Ethnic Background
7%
8%
6%
0.16
Mother Graduated High School or
GED
89%
81%
97%
4.71*
Mother Has Partner
*p ≤ .05
76%
72%
79%
0.49
Measures and Procedures
Demographics: Collected using the Mt. Hope Family Center Questionnaire (MHFC,
1995).
Borderline Personality Disorder Diagnosis: SCID-II Structured Clinical Interview (First,
Gibbon, Spitzer, Williams, & Benjamin, 1997).
Major Depressive Disorder Diagnosis: SCID-I Structured Clinical Interview (First,
Gibbon, Spitzer, & Williams, 2002). Used to determine the presence of maternal MDD as
a control variable.
Maternal Borderline Features: Personality Assessment Inventory (Morey, 1991). Selfreport continuous measure of borderline features of affective instability, identity
disturbance, self-harm/impulsivity, and negative relationships. There is support for
convergent validity between the PAI-BOR scale and structured interviews for BPD
(Kurtz & Morey, 2001; Stein, Pinsker-Aspen, & Hilsenroth, 2007).
Maternal Temperament: Adult Temperament Questionnaire short form (ATQ, Evans &
Rothbart, 2000) . Mothers self-reported temperamental traits. The current study chose to
focus on temperamental scales related to BPD: negative affectivity (fear, frustration,
discomfort, sadness), effortful control (inhibitory control, attentional control), and
positive affect. Cronbach’s alpha, measuring internal consistency for this measure, was
α = .74 for frustration, α = .76 for fear, α = .53 for sadness, α = .67 for discomfort,
and α = .86 for a negative affect composite. Cronbach's alpha was α = .44 for inhibitory
control, α = .79 for attentional control, and α = .54 for positive affect.
Child Temperament: Child Behavior Questionnaire short form (Rothbart, 2000). Parentreport used to assess temperamental traits in 3-8 year olds. The current study examined
the same general constructs and sub-constructs in the CBQ as in the ATQ, though some
of the sub-constructs are labeled slightly different. In the CBQ, the sub-construct
frustration is referred to as anger/frustration, attentional control is referred to as
attentional focusing, and positive affect is referred to as smiling and laughter. In this
study, Cronbach’s alpha, measuring internal consistency for this measure, was α = .84
for anger-frustration, α = .71 for fear, α = .65 for sadness, α = .74 for discomfort, and
α = .87 for a negative affect composite. Cronbach's alpha was α = .77 for inhibitory
control, α= .69 for attentional focusing, and α= .63 for smiling and laughter.
Results
Hypothesis (1): Controlling for maternal MDD and education level, mothers with BPD reported
more negative affectivity in an ANCOVA, F (1, 66) = 51.6, p ≤ .001, less effortful control
(inhibitory control: F (1, 66) = 7.3, p ≤ .01; attentional control: F (1, 66) = 52.6, p ≤ .001), and
less positive affect, F (1, 66) = 10.8, p ≤ .01 than did normative comparison mothers.
Hypothesis (2): In a second ANCOVA, again controlling for maternal MDD and education
level, children whose mothers had BPD were reported to have more negative affectivity on some
scales (fear: F (1, 66) = 6.0, p ≤ .05, frustration: F (1, 66) = 5.8, p ≤ .05, but not sadness: F (1,
66) = 1.4, p > .10, or discomfort: F (1, 66) = .25, p > .10) than were the children of normative
comparison mothers. They also had less effortful control (inhibitory control: F (1, 66) = 5.5, p ≤
.05; attentional focusing: F (1, 66) = 5.8, p ≤ .05), but not less 'smiling and laughter', F (1, 66) =
.16, p > .10 than did the children of normative comparison mothers.
Hypothesis (3): Mothers’ temperamental traits were all significantly correlated with their
children’s corresponding ones except for positive affect/smiling and laughter. See Table 2.
Hypothesis (4): Each maternal borderline feature (identity disturbance, negative relationships,
affective instability and self-harm) was significantly positively correlated with maternal negative
affectivity and significantly negatively correlated with maternal effortful control and positive
affect. Each maternal borderline feature was significantly negatively correlated with children’s
effortful control and significantly positively correlated with children’s negative affectivity (fear,
anger/frustration, and sadness scales). However, only the maternal borderline feature of 'identity
disturbance' was significantly correlated with the children’s discomfort scale. 'Smiling and
Laughter' did not significantly negatively correlate with any maternal borderline feature. See
Table 3.
Discussion
The current study assessed temperament in mothers with BPD and their offspring as compared to
normative comparisons and the relationship between temperament in mothers and children in the
sample as a whole. Mothers with BPD and their children do indeed have different temperaments
than do normative comparisons. Mothers with BPD self-reported higher levels of negative
affectivity, lower levels of effortful control, and lower levels of positive affect than did
normative comparisons. Mothers also reported their children to have higher levels of negative
affectivity on two of the four scales and lower levels of effortful control, but not lower levels of
'smiling and laughter' than normative comparisons. Mothers’ temperamental traits were mostly
associated with their children’s. This is important because children with similar temperaments to
mothers with BPD may be at risk for developing the disorder themselves.
Individuals who go on to develop BPD may carry a temperamental diathesis that makes them
more vulnerable to stress and adverse life events (Paris, 2005). Genetic risk factors as well as
environmental stressors may lead to the development of BPD. For example, children whose
temperamental traits are high in frustration and low in effortful control may be more vulnerable
to the adverse effects of negative parenting. Negative parenting behaviors actually predict
increases in these temperamental characteristics (Kiff, Lengua, & Zalewski, 2011). Children
with difficult temperaments may put a strain on even the healthiest of parents, let alone those
with their own emotional, interpersonal, or socioeconomic difficulties (Graybar & Boutilier,
2002), such as mothers with BPD.
More research needs to be conducted on the intergenerational transmission of BPD and potential
risk factors that may lead to the development of this disorder in the offspring of mothers with
BPD. Longitudinal studies building upon this cross-sectional study would help inform
interventions for BPD symptom risk at an early age.
Table 2. Correlations between mother and child temperament
Child
Temperament
Negative
Affect
Composite
Frustration
Maternal Temperament
Fear
Sadness
Discomfort
Inhibitory
Control
Attentional
Control
Positive
Affect
Anger/Frustration
.34**
.42***
.29*
.12
.19
-.26*
-.60***
-.32**
Fear
.36**
.15
.39***
.19
.34**
-.13
-.33**
-.36**
Sadness
.42***
.30*
.36**
.44***
.20†
-.12
-.37**
-.27*
Discomfort
.32**
.26*
.20
.25*
.25*
.00
-.27*
-.24*
Inhibitory
Control
-.20
-.30*
-.20†
-.03
-.09
.34**
.41***
.41***
Attentional
Focusing
-.21†
-.34**
-.23†
-.05
-.01
.35**
.41***
.50***
-.13
-.02
-.12
.18
.19
.22†
Smiling/Laughter
-.10
-.03
†
p ≤ .10; *p ≤ .05; **p ≤ .01; *** p ≤ .001
Table 3. Correlations between Maternal Borderline Features and mother/child temperament
Maternal
Borderline
Total
Maternal
Affective
Instability
Maternal
Identity
Disturbance
Maternal Self
Harm/Impulsivity
Maternal
Negative
Relationships
Maternal Variables
Negative Affect
Composite
.80***
.77***
.78***
.64***
.68***
Frustration
.65***
.66***
.67***
.47***
.53***
Fear
.72***
.70***
.65***
.55***
.66***
Sadness
.64***
.63***
.65***
.53***
.49***
Discomfort
.41***
.35**
.39***
.38***
.38***
Inhibitory
Control
-.50***
-.40***
-.51***
-.51***
-.41***
Attentional
Control
-.72***
-.70***
-.70***
-.62***
-.57***
Positive Affect
-.54***
-.55***
-.49***
-.48***
-.44***
Child Variables
Anger/Frustration
.46***
.42***
.44***
.34**
.44***
Fear
.40***
.41***
.37**
.41***
.29*
Sadness
.43***
.46***
.40***
.30*
.36**
Discomfort
.23†
.17
.26*
.17
.22†
Inhibitory
Control
-.40***
-.40***
-.32**
-.37**
-.36**
Attentional
Focusing
-.44***
-.44***
-.39***
-.37**
-.38***
Smiling/Laughter
-.04
-.05
-.01
-.10
-.01
†
p ≤ .10; *p ≤ .05; **p ≤ .01; *** p ≤ .001
References
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental DisordersText Revision. Arlington, VA: American Psychiatric Publishing (4th edition).
Arntz, Arnoud, Klokman, Janet, & Sieswerda, Simkje. (2005). An experimental test of the schema
mode model of borderline personality disorder. Journal of Behavior Therapy and
Experimental Psychiatry, 36(3), 226-239.
Barnow, Sven, Spitzer, Carsten, Grabe, Hans J., Kessler, Christoph, & Freyberger, Harald J. (2006).
Individual Characteristics, Familial Experience, and Psychopathology in Children of Mothers
With Borderline Personality Disorder. Journal of the American Academy of Child &
Adolescent Psychiatry, 45(8), 965-972.
Bornovalova, Marina A., Gratz, Kim L., Delany-Brumsey, Ayesha, Paulson, Autumn, & Lejuez, C.
W. (2006). Temperamental and environmental risk factors for borderline personality disorder
among inner-city substance users in residential treatment. Journal of Personality Disorders,
20(3), 218-231.
Bridgett, David J., Gartstein, Maria A., Putnam, Samuel P., Lance, Kate Oddi, Iddins, Erin, Waits,
Robin, . . . Lee, Lindsay. (2011). Emerging effortful control in toddlerhood: The role of
infant orienting/regulation, maternal effortful control, and maternal time spent in caregiving
activities. Infant Behavior & Development, 34(1), 189-199.
Coffman, Sherrilyn, Levitt, Mary J., Guacci-Franco, Nathalie, & Silver, Marcia. (1992).
Temperament and interactive effects: Mothers and infants in a teaching situation. Issues in
Comprehensive Pediatric Nursing, 15(3), 169-182.
Evans, David E., & Rothbart, Mary K. (2000). Adult Temperament Questionnaire Short Form
(Version 1.3). University of Oregon.
Feldman, Ronald B., Zelkowitz, Phyllis, Weiss, Margaret, Vogel, Judy, Heyman, Marsha, & Paris,
Joel. (1995). A comparison of the families of mothers with borderline and nonborderline
personality disorders. Comprehensive Psychiatry, 36(2), 157-163.
First, M. B., Gibbon, M., Spitzer, R. L., & Williams, J. B. (2002). User's Guide for the Structured
Clinical Interview for DSM-IV-TR Axis I Disorders-Research Version (SCID-I for DSM-IVTR, Nov. 2002 Revision).
First, M. B., Gibbon, M., Spitzer, R. L., Williams, J. B., & Benjamin, L. S. (1997). User's Guide for
the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II).
Washington, DC: American Psychiatric Press.
Gardner, David L., Leibenluft, Ellen, O'Leary, Kathleen M., & Cowdry, Rex W. (1991). Self-ratings
of anger and hostility in borderline personality disorder. Journal of Nervous and Mental
Disease, 179(3), 157-161.
Graybar, Steven R., & Boutilier, Lynn R. (2002). Nontraumatic pathways to borderline personality
disorder. Psychotherapy: Theory, Research, Practice, Training, 39(2), 152-162.
Hoermann, Simone, Clarkin, John F., Hull, James W., & Levy, Kenneth N. (2005). The Construct of
Effortful Control: An Approach to Borderline Personality Disorder Heterogeneity.
Psychopathology, 38(2), 82-86.
Jacob, Gitta A., Kathrin, Hellstern, Ower, Nicole, Pillmann, Mona, Scheel, Corinna N., Rüsch,
Nicolas, & Lieb, Klaus. (2009). Emotional reactions to standardized stimuli in women with
borderline personality disorder: Stronger negative affect, but no differences in reactivity.
Journal of Nervous and Mental Disease, 197(11), 808-815.
Kochanska, Grazyna, Clark, Lee Anna, & Goldman, Marguerita Sitrin. (1997). Implications of
mothers' personality for their parenting and their young children's development outcomes.
Journal of Personality, 65(2), 387-420.
Kurtz, John E., & Morey, Leslie C. (2001). Use of structured self-report assessment to diagnose
borderline personality disorder during major depressive episodes. Assessment, 8(3), 291-300.
Linehan, Marsha M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New
York, NY, US: Guilford Press, New York, NY.
MHFC. (1995). Mount Hope Family Center Demographic Questionnaire. Unpublished manuscript.
University of Rochester.
Morey, L. C. (1991). Personality Assessment Inventory. Odessa, FL: Psychological Assessment
Resources.
Muris, Peter, Steerneman, Pim, Merckelbach, Harald, & Meesters, Cor. (1996). The role of parental
fearfulness and modeling in children's fear. Behaviour Research and Therapy, 34(3), 265268.
Paris, Joel. (2005). The development of impulsivity and suicidality in borderline personality disorder.
Development and Psychopathology, 17(4), 1091-1104.
Posner, Michael I., Rothbart, Mary K., Vizueta, Nathalie, Thomas, Kathleen M., Levy, Kenneth N.,
Fossella, John, . . . Kernberg, Otto. (2003). An approach to the psychobiology of personality
disorders. Development and Psychopathology, 15(4), 1093-1106.
Rothbart, Mary K. (2000). Children’s Behavior Questionnaire Short Form Version I. University of
Oregon.
Seifer, Ronald, & Dickstein, Susan. (2000). Parental mental illness and infant development. New
York, NY, US: Guilford Press, New York, NY.
Siever, Larry J., & Davis, Kenneth L. (1991). A psychobiological perspective on the personality
disorders. The American Journal of Psychiatry, 148(12), 1647-1658.
Stein, Michelle B., Pinsker-Aspen, Janet H., & Hilsenroth, Mark J. (2007). Borderline pathology and
the Personality Assessment Inventory (PAI): An evaluation of criterion and concurrent
validity. Journal of Personality Assessment, 88(1), 81-89.
Torgersen, Svenn, Lygren, Sissel, Øien, Per Anders, Skre, Ingunn, Onstad, Sidsel, Edvardsen, Jack, .
. . Kringlen, Einar. (2000). A twin study of personality disorders. Comprehensive Psychiatry,
41(6), 416-425.
Weiss, Margaret, Zelkowitz, Phyllis, Feldman, Ronald B., Vogel, Judy, Heyman, Marsha, & Paris,
Joel. (1996). Psychopathology in offspring of mothers with borderline personality disorder: A
pilot study. The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie, 41(5),
285-290.
White, Candace N., Gunderson, John G., Zanarini, Mary C., & Hudson, James I. (2003). Family
studies of borderline personality disorder: A review. Harvard Review of Psychiatry, 11(1), 819.
Zanarini, Mary C., Frankenburg, Frances R., Dubo, Elyse D., Sickel, Amy E., Trikha, Anjana, Levin,
Alexandra, & Reynolds, Victoria. (1998). Axis I comorbidity of borderline personality
disorder. The American Journal of Psychiatry, 155(12), 1733-1739.