Borderline personality disorder is a serious mental illness characterized by extreme emotions, chaotic interpersonal relationships, suicidal behaviors, and a poor sense of self. Offspring of mothers with Borderline Personality Disorder (BPD) are at an elevated risk for developing mental illness across the lifespan. Difficulty managing emotions are a hallmark feature of BPD, and yet the ability to do so is necessary for responding effectively to children’s emotions. This process is called maternal emotion socialization, which has a major impact on how children develop their own emotion regulation (ER) skills. ER develops rapidly during preschool and deficits in preschool ER are recognized as underlying future mental disorders. Our grant is testing a model that examines the extent to which maternal ER and emotion socialization impact child ER.
About half of mothers with BPD in our study will receive 1 year of Dialectical Behavior Therapy (DBT) Skills training, a robust and effective method for improving ER. A total of 270 dyads (initial child age: 36-48 months) will be collected in Eugene, Oregon and Pittsburgh Pennsylvania, with 90 pairs in each of three groups: children who have mothers with BPD who receive DBT Skills, children who have mothers with BPD who receive Family Services as Usual, and children who have non-disordered mothers, matched on income. Each site has about 50 more families to recruit! Enrollment for our study will end in April 2021, allowing the final year for mothers enrolled to complete treatment and all families to complete the 1-year battery of mother-child assessments.
During the mother-child assessments, we use a battery to measure child ER, assessing emotion understanding, strategy use, attention regulation and inhibitory control, and parasympathetic regulation. In mothers, we use a similar approach to assess emotion acceptance, strategy use, recognition, and parasympathetic regulation. In addition, we assess children for related developmental processes such as executive functioning and theory of mind. Finally, during each laboratory assessment, we observe mother’s ability to effectively respond to children in the context of child negative emotions as well assess for other parenting behaviors.
Our broad goal is to identify a modifiable pathway by which offspring of mothers with BPD are at risk and determine the extent to which child ER can be restored by treating their mothers with DBT. In fact, we are the first RCT to test DBT Skills for the purpose of understanding how it impacts offspring.