In this study, we will conduct and evaluate the first disorder-specific parenting training program for mothers with Borderline Personality Disorder (“Borderline und Mutter sein”; Buck-Hostkotte, Renneberg & Rosenbach, 2015; Engl.: Rosenbach, Buck-Horstkotte & Renneberg, 2020) in a randomized controlled trial.
The training aims to improve parenting behavior, parental self-efficacy and emotion regulation. It therefore covers, inter alia, topics around children’s basic needs, stress as well as strategies to better cope with individual stressors, dealing with emotions, and dysfunctional assumptions about parenting. We assume that the training program will have positive effects on parenting behavior as well as emotion regulation, and hence decrease the risk of child maltreatment. In order to evaluate the parenting training program, mothers with Borderline Personality Disorder will be randomly assigned to either a group receiving the training in addition to treatment as usual, or a group initially receiving treatment as usual without the parenting training. Treatment success will be assessed post training and at 6-month follow-up via questionnaires. In order to investigate normative changes in parenting and in maternal emotion regulation, mothers with Borderline Personality Disorder who received the treatment as usual will be compared to a healthy control group.
Finally, we aim to describe disorder-specific aspects of dysfunctional parenting behavior as well as Borderline-specific aspects of child maltreatment by comparing mothers with Borderline Personality Disorder to a clinical control group of mothers with Anxiety or Depressive Disorders and healthy mothers.
Based on the results of this research project, we aim to improve standard treatment for mothers with Borderline Personality Disorder and to interrupt the cycle of transmission of abuse and violence from parent to child.
(A) to compare emotion regulation and mental health status in children of mothers with Borderline Personality Disorder, in children of mothers with anxiety disorders or depression and children of mothers with no mental disorder;
(B) to examine the impact of a disorder-specific parenting program (baseline vs. post intervention vs. 6 months follow-up) on children’s emotion regulation and mental health status;
(C) to examine mediators and moderators of change.
(A) children of mothers with Borderline Personality Disorder will show more unfavorable emotion regulation and mental health status than children of mothers with anxiety disorders or depression and children of mothers with no mental disorder; children of mothers with anxiety disorders or depression will show more unfavorable motion regulation and mental health status than children of mothers with no mental disorder at baseline;
(B) children of mothers with Borderline Personality Disorder of the intervention group will show stronger improvement in emotion regulation and mental health status than the treatment as usual group at post/ follow-up assessment;
(C) Post-intervention/ follow-up change will be predicted by improvement of parent-child interaction, family climate (see P3), and by (epi)genetic variables (see P4).
Two principal research questions focusing on family climate and relationship quality in a sample of mothers at high risk for child maltreatment will be addressed:
Objective 1: How is the family climate for children raised by mothers with Borderline Personality Disorder in comparison to children raised by mothers with other mental disorders (clinical comparison group) or mentally healthy mothers (non-clinical comparison group) Objective 2: Is the delivery of an additional parent intervention in a group setting tailored to mothers with Borderline Personality Disorder associated with significant changes in these selected family climate and relationship quality variables?
We will consider different levels of family climate and relationship quality, including emotional (e.g. expressed emotion), cognitive (e.g. attributions, interpretations), psychophysiological (e.g. voice pitch as an indicator for arousal) and behavioral (the actually observable interaction behavior in a given situation).
Four principal research questions will be addressed. We will test in 240 mother-child pairs
i) whether mothers diagnosed with Borderline Personality Disorder and their children show altered DNA methylation patterns at the oxytocin receptor gene (OXTR) locus
ii) whether the effects of an intervention to improve parenting skills are reflected in dynamic alterations of OXTR DNA methylation patterns in mothers and children
iii) whether intervention-associated changes in socio-emotional functioning in children are associated with changes in OXTR DNA methylation patterns
iv) whether differences in OXTR DNA methylation before treatment predict intervention outcome
The aim of this project is to analyze cooperation processes between the different help systems, especially the Youth Welfare System and the Health Care System, dealing with mothers with Borderline Personality Disorder and their children. Our objective is to examine the different (adult) perspectives within the help process in order to understand potential problems and tensions. This includes the practitioners of the help systems as well as the affected mothers. Our research questions focus on three different levels. First, we analyze key processes in the cooperation between the social worker in charge, the mother’s psychiatrist/psychotherapist and the trainer of the parenting program. Second, we identify how mother’s experience the interaction with the professionals as well as the professionals’ view of them. Third, we investigate how the different professionals define their mandate with regard to the child and how they perceive children. With our findings we intend to foster good practice in interdisciplinary and institutional cooperation in child protection, to support the implementation of parenting programs in care processes and to give advice on a political level to provide a conducive framework for cooperation in casework with mothers with Borderline Personality Disorder and their children.