Rejection Sensitivity and Negative Relationships in Adolescent Offspring of Mothers with
Borderline Personality Disorder
Jennifer M. Strimpfel, Chris D. Watkins, Christina G. Mena, Amineh Abbas, & Jenny Macfie
Presented at the Society for Research in Child Development Biennial Meeting
April 2013, Seattle, WA
Abstract
This study assessed rejection sensitivity and borderline features (affective instability,
identity problems, negative relationships, and self-harm) in adolescents at risk for developing
Borderline Personality Disorder (BPD). A low SES sample of adolescent offspring of women with
BPD age 14-18, n = 27, was compared with a normative comparison group, n = 28. We found
no significant difference in levels of rejection sensitivity between the offspring of women with
BPD and the normative comparisons. However, in the sample as a whole, there was a
significant positive correlation between the adolescent participants’ level of rejection sensitivity
and their own self-reported borderline feature of negative relationships. Moreover, female
adolescent participants reported higher levels of rejection sensitivity than did the male
participants. These results lend support to the “self-fulfilling prophecy” model explaining
negative relationship seen in individuals high in rejection sensitivity (Downey & Feldman, 1996).
Introduction
Borderline Personality Disorder (BPD) is a chronic and severe disorder that is associated
with high suicide risk and high utilization of mental health resources. Symptoms of BPD reflect
difficulties with self-regulation (impulsivity, affective instability, difficulty controlling anger,
suicidal gestures), with a stable sense of self (unstable self-image, feelings of emptiness,
dissociative symptoms) and with relationships (fear of abandonment, intense and unstable
relationships) that first manifest in late adolescence to early adulthood (American Psychiatric
Association, 2000). From a developmental psychopathology perspective, the study of offspring
of mothers with BPD, who are at risk from both genetic and environmental factors, may inform
pathways to this disorder (Lenzenweger & Cicchetti, 2005).
Rejection Sensitivity is defined as “anxious expectations of rejection in situations that
afford the possibility of rejection by significant others”(Downey & Feldman, 1996). A high level
of rejection sensitivity is conceptually similar to “frantic efforts to avoid real or imagined
abandonment”, a symptom of BPD (American Psychiatric Association, 2000). Recent research
has shown that individuals with BPD have higher levels of rejection sensitivity than do
normative comparisons (Berenson, Downey, Rafaeli, Coifman, & Paquin, 2011; Selby, Ward, &
Joiner, 2010), and that higher levels of rejection sensitivity are related to borderline features in
non-clinical samples of young adults (Ayduk et al., 2008; Tragesser, Lippman, Trull, & Barrett,
2008). Although there has been previous research linking high levels of rejection sensitivity in
adolescence to externalizing behaviors, aggression, and poor school outcomes, (Downey,
Lebolt, Rincón, & Freitas, 1998), as well as depression and anxiety (Harper, Dickson, & Welsh,
2006; Marston, Hare, & Allen, 2010; McCarty, Vander Stoep, & McCauley, 2007; McDonald,
Bowker, Rubin, Laursen, & Duchene, 2010), there has been no study of rejection sensitivity in
the adolescent offspring of mothers with BPD. This is an important omission, because high
levels of rejection sensitivity may place these adolescents at a higher risk for developing
symptoms of BPD themselves.
In individuals with BPD, difficulties in relationships, reflected in a fear of abandonment,
may be related to rejection sensitivity. Increased levels of rejection sensitivity in individuals
with BPD may explain their difficulties with relationships through the “self-fulfilling prophecy”
model of rejection sensitivity first proposed by Downey, et al., (1996). An individual with high
rejection sensitivity may perceive rejection in ambiguous situations and then over-react with
hostility and aggression towards the person that they perceived to be rejecting them (Downey,
Irwin, Ramsay, & Ayduk, 2004). The individual’s hostile reaction to perceived rejection then may
cause interpersonal difficulties and actual rejection from a significant other, sustaining or
increasing their level of rejection sensitivity: in effect, a “self-fulfilling prophecy” (Downey,
Freitas, Michaelis, & Khouri, 1998).
Several studies have supported the “self-fulfilling prophecy” model of rejection
sensitivity in adults (Ayduk, Downey, Testa, Yen, & Shoda, 1999; Downey & Feldman, 1996;
Downey, Freitas, et al., 1998). Recent research has also supported the link between high levels
of rejection sensitivity and difficulties in romantic relationships in adolescents (Galliher &
Bentley, 2010; Purdie & Downey, 2000; Smith, Welsh, & Fite, 2010; Volz & Kerig, 2010). Among
early adolescent girls, high levels of rejection sensitivity predicted higher insecurity about their
partner’s commitment to the relationship (Purdie & Downey, 2000). In adolescents who were
in romantic relationships, higher levels of rejection sensitivity was related to higher levels of
aggression in the relationship and lower levels of relationship satisfaction (Galliher & Bentley,
2010). Another study of adolescents found that the relationship between high levels of
rejection sensitivity and perpetrating dating violence was fully mediated by insecurity about the
relationship (Volz & Kerig, 2010). In addition to a positive relationship between overall
borderline features and rejection sensitivity, in the present study, we expected rejection
sensitivity to be positively correlated with the borderline feature of negative relationships in
the adolescent participants, because of the self-fulfilling prophecy model.
In addition to BPD group differences and the relationship between rejection sensitivity
and the borderline feature of negative relationships, we were also interested in gender
differences. Although in community samples, BPD is found equally in both men and women,
women diagnosed with BPD are lower functioning than are men diagnosed with BPD, and are
more likely to seek treatment (Grant et al., 2008). Previous research on gender differences in
rejection sensitivity has been mixed. A previous study has shown no gender differences in
levels of rejection sensitivity in preadolescents (Downey, Lebolt, et al., 1998). In college
students, several studies have shown no gender differences in levels of rejection sensitivity
(Ayduk, Gyurak, & Luerssen, 2009; Downey & Feldman, 1996; Mellin, 2008), while one large
study of 500 college students showed that females had higher levels of rejection sensitivity
(Erozkan, 2009). Of studies of rejection sensitivity in mid- to late-adolescence, one previous
study has shown higher levels of rejection sensitivity in 16-17 year old boys, with gender
differences disappearing by age 18 (Marston et al., 2010). Another study of rejection sensitivity
in mid-adolescence showed that females had higher levels of rejection sensitivity (Volz & Kerig,
2010). In the present study population encompassing the period of mid-adolescence, we
anticipated that there would be a gender difference in rejection sensitivity, with females
reporting higher levels of rejection sensitivity than males.
In testing hypotheses, we controlled for Major Depressive Disorder (MDD), because it is
the most frequently found disorder to be co-morbid with BPD (Zanarini et al., 1998) and
because of the negative effects that maternal MDD can have on their children’s development
(Downey & Coyne, 1990). We hypothesized that 1) adolescents whose mothers have BPD have
higher levels of rejection sensitivity than normative comparisons, when controlling for maternal
Major Depressive Disorder (MDD) diagnosis; 2) adolescents’ rejection sensitivity is positively
correlated with their own overall borderline features score and subscale scores of affective
instability, identity problems, negative relationships, and self-harm; 3) female adolescents
report higher levels of rejection sensitivity than male adolescents.
Method
Participants:
The sample consisted of adolescents age 14-18, n = 27 whose mothers have BPD and n
= 28 normative comparisons. The only significant difference in the demographics data was that
the mothers in the BPD group were less likely to have a high school diploma or GED than were
the mothers in the comparison group. See Table 1. Attainment of a high school diploma or GED
was not significantly correlated with the dependent variables, however, so it was not controlled
for in analyses.
Measures:
Demographics. Demographic information for this study was collected through an
interview with the mothers (Mt. Hope Family Center, 1995).
BPD Diagnosis. Mother participants were interviewed using the SCID-II Structured
Clinical Interview (First, Gibbon, Spitzer, Williams, & Benjamin, 1997).
MDD Diagnosis. Mother participants were interviewed using the SCID-I Structured
Clinical Interview (First, Gibbon, Spitzer, & Williams, 2002).
Borderline Features. Adolescent participants completed the Borderline Features Scale of
the PAI (PAI-BOR). The PAI-BOR has four subscales that measure four factors common in BPD:
affective instability, identity problems, negative relationships, and self-harm (Morey, 1991).
Rejection Sensitivity. Adolescent participants completed a modified version of the
Rejection Sensitivity Questionnaire (RSQ-R), a self-report measure of rejection sensitivity
(Downey & Feldman, 1996).
Results
Hypothesis 1. The results did not support hypothesis 1, as there was no significant difference
between the mean RSQ-R scores in the BPD group (M = 10.02, SD = 3.72) and the comparison
group (M = 9.74, SD = 2.72), F(1,52) = 0.30, p > .10, when controlling for maternal MDD
diagnosis.
Hypothesis 2. As hypothesized, the adolescents’ level of rejection sensitivity was significantly
correlated (p < .01) with their own negative relationships, and marginally correlated (p < .10)
with their own identity problems and overall borderline features. However, contrary to
prediction, adolescents’ level of rejection sensitivity was not significantly correlated with their
own affective instability and self-harm. See Table 3.
Hypothesis 3. Rejection sensitivity was significantly higher in girls (M = 10.80, SD = 3.73) than in
boys (M = 8.99, SD = 2.38), t(53) = 2.15, p = < .05
Discussion
Group differences in RS reported by the adolescents in this study were not significant.
Although not investigated in the present study, relationships with caregivers other than the
mother could have shaped these adolescents’ internal working models of viewing others as
rejecting or not. Also, the participants in both the BPD group and the comparison group of the
present study all had low family SES. Low SES is related to increased risk of family violence,
possibly due to risk variables associated with low SES such as parental stress (Bradley &
Corwyn, 2002). Exposure to family violence has been found to be related to higher levels of RS
(Feldman & Downey, 1994). Exposure to family violence may in part explain the similar levels of
RS found in both groups in the current study. Future research could involve families across the
socioeconomic spectrum to determine if early exposure to violence in low SES families might
confound group differences in rejection sensitivity between adolescents who have a parent
with BPD versus normative comparisons.
In the present study, rejection sensitivity was higher in the adolescent girls than in the
adolescent boys. There is a need for more research on gender differences in rejection
sensitivity in middle to late adolescence. Further research should explore the possible
implications of higher levels of rejection sensitivity in women on the observed gender
differences in the severity of BPD in adults, such that women diagnosed with BPD report higher
levels of disability due to the disorder than men diagnosed with BPD (Grant et al., 2008).
The present finding that the adolescents’ self-reported rejection sensitivity was
positively correlated with their negative relationships supports the “self-fulfilling prophecy”
model first proposed by Downey, et al., (1996). The present finding that levels of rejection
sensitivity were correlated with negative relationships in adolescents in the sample as a whole
may have important clinical implications. Interventions could focus on cognitive approaches to
challenge the tendency to over-perceive rejection in adolescents high in rejection sensitivity in
order to break the “self-fulfilling prophecy” prior to the development of more severe
relationship difficulties.
To learn more about the Child and Adolescent Development Lab, please visit :
http://web.utk.edu/~macfie/
Table 1
Demographic Information
_________________________________________________________________
Variable
BPD Group
n = 27
M (SD)
Comparison Group
n = 28
M (SD)
t(53)_
Family Income ($)
22,988 (12,769)
28,668 (16,081)
1.447
Adolescent Age
(years)
15.26 (1.13)
15.69 (1.26)
1.345
Number of Adults
In the Home
1.70 (0.67)
1.93 (0.77)
1.158
Number of Children
In the Home
2.22 (1.37)
2.54 (1.67)
0.775
Χ²
Minority Ethnic
Status of Adolescent
4%
11%
1.002
Female Adolescents
48%
50%
0.019
Mother has GED/
H.S. Diploma
70%
100%
9.708**
Mother has Partner
71%
67%
0.146__
** = p < .01
Table 2
Bivariate Correlations Between Adolescents’ level of Rejection Sensitivity and Adolescents’
Borderline Features
______________________________________________________________________________
Variable
n
M
SD
Total BPD Affective
Features
Instability
Identity
Problems
Negative
Relationships
Self
Harm
Rejection
55 9.88 3.22 .25†
.20
.22†
.47**
-.05
Sensitivity
______________________________________________________________________________
† = p < .10
** = p < .01
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