|Year : 2016 | Volume
| Issue : 4 | Page : 238-243
The quality of mother-child relationship and borderline personality: The role of mediator object relations
Mohsen Tamaddonfard1, Nader Monirpoor2
1 Department of Psychology, Isfahan(Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
2 Department of Clinical Psychology, Islamic Azad University, Qom, IR Iran
|Date of Web Publication||2-Sep-2016|
Dr. Nader Monirpoor
Department of Clinical Psychology, Qom branch, Islamic Azad University, Pardisan Town, Qom
Source of Support: None, Conflict of Interest: None
Aim: Borderline personality characterized by the instability of interpersonal relationships, self-concept and mood swings is one the most common disorders in clinical settings. Scholars theorizing on object relations, as pioneers of borderline personality, consider borderline personality as a result of childhood trauma, and associated with initial objects. The present paper aims to explain the structural model of borderline personality based upon the quality of mother-child relationships through the mediator role of object relations. Methods: A total of 402 students (184 males and 218 females) at Islamic Azad University of Qom and University of Qom in the first semester of 2013–2014 were selected by stratified random sampling. They completed Borderline Personality Inventory, Bell Object Relations Inventory, and Parent-Child Relationship Scale–Mother. The data were analyzed using SPSS, LISREL, Cronbach's alpha coefficients, exploratory factor analysis, confirmatory factor analysis, and structural equation modeling. Results: The quality of the mother-child relationship directly explains 1.44% and through mediating object relations 14.31%, and a total of 15.75% of the variance of borderline personality. Conclusion: Based on these results, the quality of object relations plays a crucial role in mediating mother-child relationship and borderline personality.
Keywords: Borderline personality, object relations, the quality of mother-child relationship
|How to cite this article:|
Tamaddonfard M, Monirpoor N. The quality of mother-child relationship and borderline personality: The role of mediator object relations. Int J Educ Psychol Res 2016;2:238-43
|How to cite this URL:|
Tamaddonfard M, Monirpoor N. The quality of mother-child relationship and borderline personality: The role of mediator object relations. Int J Educ Psychol Res [serial online] 2016 [cited 2020 Jun 1];2:238-43. Available from: http://www.ijeprjournal.org/text.asp?2016/2/4/238/189665
| Introduction|| |
Kernberg used the term “Borderline Personality Organization” (BPO) for a range of patients characterized by the lack of an integrated sense of identity, ego weakness, absence of superego integration, relying on primitive defense mechanisms such as splitting and projective identification, and inclination toward primary process thinking. The term “borderline” was first coined by Stern (1938). It is not applied for patients with psychotic and neurotic personality organization, but for those who are being on the border between the two, characterized by cycles of the symptoms, ego defensive operation cycle, damage in internal object relations, and dynamic genetic features of personality.
Psychodynamic theorists such as Kernberg (1975), Masterson and Rinsley (1975), Adler and Buie (1979) as pioneers of borderline personality, presented a pathology model based upon parent-child relationship, and believed that abnormal relationship with parents and anxious attachment style, especially with the mother, are well-known factors in the development of borderline personality. Based on psychodynamic theories, the development of borderline personality constructs is the result of living in unorganized environments, dysfunctional families, and damage experience in early childhood. Shortages, early separations, troubled family relationships, intense conflicts between parents, physical and sexual abuse are environmental factors involved in borderline psychopathology. Emphasizing early parent-child relationship, Freud suggests that the absence or weakness of caregivers in the first few months of life can have negative effects on the growth of ego, leading to weakness of impulse control, and vulnerability to personality and psychosis disorders. Furthermore, Winnicott views maternal care as an essential element in facilitating the development of children by introducing the notion of “good and enough mothering.” Studies on the relationship between children development and maternal personality traits suggest that responsive, friendly, and supportive mothers have emotionally stable children who grow steadily; on the contrary, children who were deprived of adequate maternal support become aggressive, social phobic and without positive feelings. Thus, in the literature of analytical psychology, early life is extremely important in psychopathology, given that borderline personality disorder is diagnosed as being caused by damages early in life. Immature traumatic parents who were trained with pain, neglect, and physical sexual abuse, make children susceptible to this type of personality.,, Studies showed that most people with borderline personality experienced separation from both parents during childhood. They were also beaten by their fathers, and father's violence against the mother has been reported. Other research indicates a significant relationship between lack of paternal care as well as children's anger toward their father and the borderline personality.
Kernberg introduced similar structural units or internalized object relations at all levels of personality organization and argued that the initial healthy object relations lead to healthy coherent, strong, integrated, and stable ego in interpersonal relationships; otherwise, insufficient child-mother relationships with self-representations contradictory, will cause psychological damage. Kernberg believes that the stability of objects or the establishment of total object relation is faulty in borderline patients due to their incapacity to tolerate ambivalent operation toward the objects  what prevents people from achieving normal coherence during childhood is emotions such as frustration or aggression, and due to this initial intense aggression, borderline personality fails integrate loved and hated of self and object images, and part object relations that is passionate and unstable relations are developed.,, According to Kernberg's model of borderline personality (1976) aggressive impulses resulted from parental damages consistently threaten to destroy positive images of self and others and break up a person's mind (splitting) so that good mental images are separated from bad image, leading to rupture in personal interpretation and identity-related problems in borderline personalities. Masterson argues that the main problem of borderline patients can be found out in the maternal pathology, mothers' libidinal separation from children and the failure in the process of separation-individuation. Therefore, Masterson believes that in borderline patients' families, mother's desire to maintain a close relationship with her children conflicts with the gradual growth of children's autonomy. He believes that basically in such families, the mother has a borderline personality. Research findings indicate that borderline patients encountered difficulties in obtaining early stable attachments  and their attachments are negative. A study suggests that the memories of borderline personality patients penetrated deep into a bad representation of relations and disappointing harmful objects. Other studies showed that such patients have weak, faulty representations, the lowest differentiation of objects, lack of maintenance of boundaries between themself and others, highly irrational justifications, lack of emotions in relationships, and overwhelming need for pleasure.,,, Timmerman and Emmelkamp indicate that there is a significant negative correlation between borderline personality and secure attachment style to parents and positive one between borderline personality and disorganized and frightening attachment style.
Psychodynamic theories to explain and assess borderline personality are mostly conceptual and studies to inquiries the etiology of borderline personality is in short supply. Most studies in Iran have investigated it through correlational and predictive methods using limited variables and few studies were conducted through structural equation modeling. The advantage of the methodology of structural equation modeling in the present study is to determine the role of a mediating variable between the quality of mother-child relationship and borderline personality. In this study, borderline personality variable (including subscales of identity confusion, primitive defense mechanisms, impaired reality testing, and fear of intimacy), object relations variable (including subscales alienation, insecure attachment, egocentricity, and social incompetence), and the variable of the quality of mother-child relationship (including subscales of positive affection, role confusion, identification, and communication or conversation) are factored for a measurement model and the factored elements were used as the indicators of the latent variables.
Borderline personality, covering a wide range of clinical and psychological disorders, is increasingly prevalent. It results in negative consequences such as high-risk and self-defeating behavior, drug abuse, unstable relationships, sexual experimentation outside of marriage, and divorce. Given the prevalence of borderline personality disorder, and the importance of the role of mothers in preventing it, this study aims to determine the mediator role of object relation between the quality of the mother-child relationship and borderline personality in the framework of a structural model.
| Methods|| |
The present paper is descriptive correlational study. The population included all students of Islamic Azad University of Qom and University of Qom in the academic year 2013–2014, out of which, 402 students were selected through stratified random sampling. Data were analyzed with SPSS (IBM) version 18 and LISREL (SSI Inc.) version 8.70, using exploratory factor analysis, confirmatory factor analysis, and structural equation modeling. A typical LISREL model is composed of two measurement models and structural equation model. In this section, the measuring model of instruments used in the research is examined and in the next section (results), structural equation modeling is discussed.
To illustrate the fitness of model, indices such as standardized root mean residual (SRMR), goodness-of-fit index (GFI), adjusted goodness-of-fit index (AGFI), and the ratio of Chi-square to the degree of freedom (Chi/df) were used as the most common indices of absolute fitness. Values higher than 0.90 for GFI and AGFI, 3 or <3 for the ratio of Chi-square to degrees of freedom, and values close to zero for SRMR are proposed as acceptable goodness-of-fit models. Comparative fitness index (CFI) is a relative index, the acceptable value of this index to fit the model being suggested at least 0.90., Root mean square error of approximation (RMSEA) is the deviation test of degree of freedom that is <0.05 for fit models. Higher values of up to 0.08 indicate acceptable approximation error in the community. Hu and Bentler (1999) have proposed 0.06 or less as the cut-off point for the fitness of the model.
The questionnaires used in this study include:
Borderline personality inventory
Borderline Personality Inventory is developed by Leichsenring (1999) to determine borderline personality traits in clinical and nonclinical samples in a yes-no self-report format. This 51-item instrument is based on Kernberg's concept of BPO and Diagnostic and Statistical Manual-IV diagnostic criteria. It includes factors for assessing identity confusion, primitive defense mechanisms, impaired reality testing and fear of intimacy. Some reports on the internal consistency, of this instrument, indicate its coefficient alpha and 1-week test-retest reliability as 0.68–0.91 and 0.73–0.89, respectively. This instrument has been standardized in Iran by Mohammadzadeh and Rezaei, and its concurrent validity coefficient was determined as 0.71–0.80 and its test-retest reliability, split half, and internal consistency coefficients were 0.80, 0.83, and 0.85, respectively.
After conducting the present study, the reliability of the questionnaire was assessed, Cronbach's alpha coefficient being 0.83. To measure the constructs validity, exploratory factor analysis with principal components method and varimax rotation was used. Nineteen items were excluded from the analysis due to poor factor loading. Finally, 11 factors were determined with eigen value higher than 1. Due to the multitude of items, factors were used as indicators of borderline personality variables (borderline personality uni-factor structure). The confirmatory factor analysis confirms the fitness of the factors obtained by exploratory factor analysis. Chi-square of 103.70 with 44 degrees of freedom was significant at 0.000. In addition, SRMR = 0.039, AGFI = 0.92, GFI = 0.95, CFI = 0.98, RMSEA = 0.062, and Chi/df = 2.35 indicated good validity of the questionnaire.
Bell object relations inventory
Bell Object Relations Inventory (BORI) is a 45-item questionnaire which is part of the 90-item object relations and reality testing questionnaire developed by Bell, Billington and Becker (1986). It was a self-report instrument to measure object relations. BORI consists of four factors: Alienation, insecure attachment, egocentricity, and social incompetence. Internal consistency by Cronbach's alpha coefficient and Spearman–Brown split-half for four factors of object relations have been reported between 0.78 and 0.90. Rezagholizadeh translated this instrument into Persian in Iran and had its face and content validity confirmed by several specialists. He also calculated its test-retest reliability for different factors between 0.60 and 0.80.
In the present paper, the alpha coefficient of 0.72 was determined for BORI. Ten factors came up with eigenvalue higher than 1 using exploratory factor analysis with principle components and varimax rotation. Fifteen items were excluded from the analysis due to poor factor loading. Due to the multitude of items, factors were used as indicators of object relation variables (object relation uni-factor structure). Confirmatory factor analysis indicates a goodness-of-fit of the questionnaire. Chi-square of 94.23 with 33 degrees of freedom was significant at 0.000. SRMR = 0.053, AGFI = 0.91, GFI = 0.95, CFI = 0.95, RMSEA = 0.074, and Chi/df = 2.85 indicated good validity of the questionnaire.
Parent-child relationship scale–mother form
It is a 24-item scale to measure child-mother relationship designed by Fine et al. Positive affection, confusion role, identification, and communication or conversation are all included in this questionnaire. Parent-child relationship scale–mother with Cronbach's alpha coefficients 0.61–0.94 and total alpha of 0.96 enjoys excellent internal consistency.
In this study, the alpha coefficient of the questionnaire was 0.73. Four factors came up with a eigenvalue higher than 1 using exploratory factor analysis with principle components and varimax rotation. Four items were excluded from the analysis due to poor factor loading. Due to the multitude of items, factors were used as indicators of variables of the quality of mother-child relationship. Confirmatory factor analysis indicates a goodness-of-fit of the questionnaire. Chi-square of 3.05 with a degree of freedom of 2 was not significant at 0.217. SRMR = 0.013, AGFI = 0.98, GFI = 1, CFI = 1, RMSEA = 0.038, and Chi/df = 1.52 indicated good validity of the questionnaire.
| Results|| |
The current model [Figure 1] was consistent with the conceptual model [Figure 2] to represent borderline personality. Hence, the quality of mother-child relationship directly explained 1.44% and with object relations mediating role 14.31% and a total of 15.75% borderline personality variance. The results of the fitness model have been reported in [Table 1]. The results of fit indices GFI, AGFI, and RMSEA (in the upper part of [Table 1]) were not satisfactory; by releasing the error covariance of some components, fit indices became satisfactory.
|Figure 1: The structural model of the quality of mother-child relationship and borderline personality directly and with the mediator role of object relations|
Click here to view
|Figure 2: The conceptual model of the quality of mother-child relationship and borderline personality directly and with mediating object relations|
Click here to view
|Table 1: The indices of fit of the quality of mother-child relationship model directly with borderline personality and with object relations mediation|
Click here to view
| Conclusions|| |
This paper aims to explain the correlation between the quality of mother-child relationship and borderline personality through an intermediary role of object relations. The structural model [Figure 2] reported in the previous section supports the hypothetical model [Figure 1]. The results revealed that the quality of mother-child relationship directly explains borderline personality and so through an intermediary role of object relations.
The results also indicated that the quality of mother-child relationship directly explains 1.44% of the variance of borderline personality. Based upon psychodynamic theories, borderline personality constructs are a result of living in the unorganized environments, dysfunctional families, and a lot of trauma experience in early childhood. Early childhood deprivation and separation, troubled family relationships, intense conflicts of parents, immature parents and traumatic life, physical and sexual abuses are environmental factors involved in borderline psychopathology.,,,,, Research reveals that most borderline patients experienced separation from both parents during childhood; they were also beaten by their fathers, and father's violence against the mother is reported in their families. The findings of this study are consistent with Frank and Paris indicating that such patients experienced a lack of parental care and high levels of parental dominance. Furthermore, the results of this study are similar to Monirpoor et al. that the lack of paternal care and feeling of anger toward the father explained 9.7% of borderline personality variance, as well as Angela et al. predicting borderline personality features by lack of parental bond or maternal care, and insecure, anxious, and ambivalent attachment styles. Such patients' fathers are characterized with poor parenting, lack or shortage of affection and care, mood instability and impulsivity.
Other findings of the present paper revealed that object relations with an intermediary role between mother-child relationship and borderline personality accounts for 14.31% of borderline personality. No studies have previously been conducted into the intermediary role of object relations, and several studies support a direct correlation between object relations and borderline personality. Based upon object relations theory, a predictable relationship exists between troubled family relationship and psychological trauma, which is an impaired representation of the self and object and the process of interjection in patients with severe psychological trauma. The results of the present study was consistent with Bagherian et al., predicting children behavioral problems through permissive parenting style and avoidant attachment style, and Timmerman and Emmelkamp reporting that there is a negative correlation between borderline personality and secure attachment style to parents and a positive correlation between borderline personality and disorganized and frightening styles.
According to Klein's approach, infants have alternating experiences of the contentment and frustration resulted from introjected good and bad breast in the first months of life and at the same time as paranoid-schizoid position; and in the 5th and 6th months with an experience of depressive position, the more developed ego provides the infant integrated and realistic images of external objects. Accordingly, borderline patients have passed the self-differentiation stage of love object, but they have not yet reached internal coherence that requires internal stability objects, hence unable to integrate positive and negative images and conflicting feelings without regression to childhood. The findings of this study was also consistent with Lieb, et al. suggesting no attachment with primary stability in borderline patients and Armelius and Granberg suggesting that such patients have negative attachments., The findings of other studies indicate poor representations of the objects, the lowest level of differentiation from others, and lack of maintaining boundaries between self and others in borderline patients.,,,,
Literature and research on the pathology of borderline personality point out traumatic frustration and severe failures in early childhood. The clinical experience of the authors working with such borderline patients showed that they suffer from serious injuries such as neglect of their needs, instability and aggression, lack or inadequacy of caregivers, and primary objects. Through defective representations of their parents despite the fear of loneliness, borderline patients projected constantly the fear of losing the love object to their spouse, friendship, love affairs, and authority through transference emotions. Thus, they feel the familiar but unconscious childhood trauma with themes of rejection, loneliness, and abandonment through identification of these objects with fear, and they experience multiple and harmful relationships by this psychological mechanism. Accordingly, the quality of parenting, especially the mother, is considered important in the first months of life. Based on the findings of this study, it is recommended that psychologists run parenting workshop for the public, and also psychotherapists treat borderline patients in clinical centers with a dynamic structural based approach to limited re-parenting and by creating a holding and supportive environment. In a bigger picture, it is recommended that policy makers of psychotherapy services take on symptom-based approaches (such as cognitive and behavioral therapy) to analytic and dynamic psychotherapy. Realizing the above objectives can be effective in preventing the prevalence of this personality organization.
This was a cross-sectional and static study. The main limitation of such studies is the change of target population over time which cross-sectional studies fail to handle. Cross-sectional studies investigate the prevalence of phenomena in a given point of time hence they miss the changes that happen over a period. Therefore, it is suggested that longitudinal and dynamic studies be replaced. Limiting the target population to the student community may affect the generalizability of this paper's findings, so it is recommended that future research be carried out on the clinical population of borderline patients.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Sadock BJ, Sadock VA. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 10th
ed. New York: Lippincott Williams and Wilkins; 2007.
Kernberg OF. Borderline Conditions and Pathological Narcissism. Northvale, NJ: Jason Aronson; 1985.
Helgeland MI, Torgersen S. Developmental antecedents of borderline personality disorder. Compr Psychiatry 2004;45:138-47.
Halgin RP, Whitbourne SK. Abnormal Psychology: Clinical Perspectives on Psychological Disorders. 4th
ed., Vol. 2. New York: McGraw-Hill; 2003.
Mahmoudalilou M, Sharifi M. Boederline Personality Disorders Theory and Management. Tehran: Arjmand Publication; 2013.
Choi S, Goo K. Holding environment: The effects of group art therapy on mother – Child attachment. Arts Psychother 2012;39:19-24.
Bandelow B, Krause J, Wedekind D, Broocks A, Hajak G, Rüther E. Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with borderline personality disorder and healthy controls. Psychiatry Res 2005;134:169-79.
Zanarini MC. Childhood experiences associated with the development of borderline personality disorder. Psychiatr Clin North Am 2000;23:89-101.
Paris J, Chenard-Poirier MP, Biskin R. Antisocial and borderline personality disorders revisited. Compr Psychiatry 2013;54:321-5.
Monirpoor N, Gholamizarch M, Tamaddonfard M. The role of father and early maladaptive schemas in predicting borderline personality disorder. Contemp Psychol 2011;5th
Kernberg OF. Object-Realations Theory and Clinical Psychoanalysis. New York: Aronson; 1976.
St Clair M. Object Relations and Self Psychology: An Introduction. 4th
ed. Belmont: Brooks/Cole Cengage Learning; 2000.
Lieb K, Zanarini MC, Schmahl C, Linehan MM, Bohus M. Borderline personality disorder. Lancet 2004;364:453-61.
Armelius K, Granberg A. Self-image and perception of mother and father in psychotic and borderline patients. Psychother Res 2000;10:147-58.
Nigg JT, Lohr NE, Western D, Gold LJ, Silk KR. Malevolent object representations in borderline personality disorder and major depression. J Abnorm Psychol 1992;101:61-7.
Huprichc SK, Porcerelli JH, Binienda J, Karana D, Kamoo R. Parental representations, object relations and their relationship to depressive personality disorder and dysthymia. Pers Individ Dif 2007;43:2171-81.
Westen D, Lohr N, Silk KR, Gold L, Kerber K. Object relations and social cognition in borderlines, major depressive, and normals: A thematic apperception test analysis. Psychol Assess J Consult Clin Psychol 1990;2:355-64.
Westen D, Ludolph P, Lerner H, Ruffins S, Wiss FC. Object relations in borderline adolescents. J Am Acad Child Adolesc Psychiatry 1990;29:338-48.
Blatt SJ, Wiseman H, Gibson E, Gatt C. Object representations and change in clinical functioning. Psychotherapy 1991;28:273-83.
Timmerman IG, Emmelkamp PM. The relationship between attachment styles and Cluster B personality disorders in prisoners and forensic inpatients. Int J Law Psychiatry 2006;29:48-56.
Ghazi-Tabatabaie M. The process of formulation, implementation and interpretation of the output of a lisrel model: A concrete example. Coll Humanit Soc Sci Univ Tabriz 1995;1:85-125.
Hu L T, Bentler P
M. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal 1999;6:1-55.
Schumacker RE, Lomax RG. A Beginner's Guide to Structural Equation Modeling. 2nd
ed. New York: Taylor and Francis; 2004.
Leichsenring F. Development and first results of the borderline personality inventory: A self-report instrument for assessing borderline personality organization. J Pers Assess 1999;73:45-63.
Mohammadzadeh A, Rezaei A. Validation of the borderline personality inventory in Iran, J Behav Sci 2011;5:269-77.
Bell M, Billington R, Becker B. A scale for the assessment of object relations: Reliability, validity, and factorial invariance. J Clin Psychol 1986;42:733-41.
Rezagholizadeh T. The Relationship of Father Absence Whit Object Relations and Narcissistic Personality Disorder. M.A Thesis. Shahid Beheshti University, Department of Psychology; 2010.
Fine M, Moreland R, Schwebel A. Longitudinal effects of divorce on parent – Child relationship. J Dev Psychol 1983;19:703-13.
Sanaiy B, Alaghband S, Falahaty S, Homan A. Family and Marriage Scales. Tehran: Be'sat; 2008.
Krawitz R, Watson C. Borderline Personality Disorder. A Practical Guide to Treatment. New York: Oxford University Press; 2003.
Zweig-Frank H, Paris J. Parents' emotional neglect and overprotection according to the recollections of patients with borderline personality disorder. Am J Psychiatry 1991;148:648-51.
Nickell AD, Waudby CJ, Trull TJ. Attachment, parental bonding and borderline personality disorder features in young adults. J Pers Disord 2002;16:148-59.
Fassino S, Amianto F, Gastaldi F, Abbate-Daga G, Brambilla F, Leombruni P. Personality trait interactions in parents of patients with borderline personality disorder: A controlled study using the Temperament and Character Inventory. Psychiatry Res 2009;165:128-36.
Bagherian S, Baezzat F, Hasanzadeh R. The relationship between parenting styles, styles of attachment and behavior problems in preschool children. Contemp Psychol 2013;7th
Feist J, Feist G. Theories of Personality. 5th
ed. New York: McGraw-Hill; 2002.
Abedin A, Shoghinia E. Diagnosis and treatment of borderline personality disorder from the perspective of psychodynamic. Tehran: Ghatreh Publication; 2011.
[Figure 1], [Figure 2]