Risk factors affecting children of mothers with borderline personality disorder: Comment on Stepp, Whalen, Pilkonis, Hipwell, and Levine (2011).Personal Disord. 2012 Jan; 3(1):92-4; discussion 104-6.PD
Comments on an article Children of mothers with borderline personality disorder: Identifying parenting behaviors as potential targets for intervention by Stepp, Whalen, Pilkonis, Hipwell, and Levine (see record 2011-05873-001). Despite both a limited empirical literature and the muddy problem of borderline personality disorder (BPD) classification, the authors have significantly clarified the risk factors relevant to children of mothers with BPD and have outlined important and reasonable skill-based interventions likely to mitigate these risks. Not only have they sensibly connected the dots among the extant studies (which included very different samples, ages of children, criterion behaviors, etc.), they have identified the few key points of agreement across studies and translated these into a blueprint for early intervention. This commentary (a) further elaborates on some of the parameters of BPD that make risk assessment for children of mothers with BPD complicated, including both diagnostic heterogeneity and myriad other problems that reduce the specificity of BPD as a classification tool for these purposes and (b) identifies direct, indirect, and general mechanisms of transmission of difficulties from a mother (or parent or caregiver) with BPD to her child.