Mothers with borderline personality and their young children: Adult Attachment Interviews, mother-child interactions, and children's narrative representations.

Borderline personality disorder (BPD) involves disruptions in attachment, self, and self-regulation, domains conceptually similar to developmental tasks of early childhood. Because offspring of mothers with BPD are at elevated risk of developing BPD themselves (White, Gunderson, Zanarini, & Hudson, 2003), studying them may inform precursors to BPD. We sampled 31 children age 4-7 whose mothers have BPD and 31 normative comparisons. We examined relationships between mothers' Adult Attachment Interview (AAI) representations (George, Kaplan, & Main, 1984), mothers' observed parenting, and children's narrative representations. Replicating previous studies, mothers with BPD were more likely to be classified as preoccupied and unresolved on the AAI. In a larger sample, which included the current one, we also replicated two underlying AAI dimensions found in normative samples (Roisman, Fraley, & Belsky, 2007; Whipple, Bernier, & Mageau, 2011). Controlling for current mood, anxiety, and other personality disorders, mothers with BPD were significantly higher than were comparisons on the preoccupied/unresolved, but not the dismissive, dimension. Children's narrative representations relevant to disruptions in attachment (fear of abandonment and role reversal), self (incongruent child and self/fantasy confusion), and self-regulation (destruction of objects) were significantly correlated with the preoccupied/unresolved, but not the dismissive, dimension. Furthermore, mothers' parenting significantly mediated the relationship between the preoccupied/unresolved dimension and their children's narrative representations of fear of abandonment.

Rorschach measures of aggression: a laboratory-based validity study.

This study sought to complement the archival research designs that have established the empirical foundations of Rorschach aggression scores, including Exner's ( 2003 ) Aggressive Movement (AG) score and Meloy and Gacono's ( 1992 ) Aggressive Content (AgC), Aggressive Past (AgPast), and Aggressive Potential (AgPot) variables. Utilizing a highly controlled laboratory-based aggression paradigm and self-report measures of violence history in a sample of 35 undergraduate males with an average age of 19.38 (SD = 2.11), this study found that only AgC was positively associated with in vivo aggression (r = .40, p = .02). None of the Rorschach measures of aggression were significantly associated with self-reported violence history, although there were several trends approaching significance. Theoretical and methodological implications are discussed.

Pragmatic psychodynamic psychotherapy for a patient with depression and breast cancer: functional MRI evaluation of treatment effects.

Time-limited psychodynamic psychotherapy is garnering empirical support as an intervention for clinical depression. However, research is needed to examine the efficacy of psychodynamic approaches among patients presenting with diverse psychiatric and medical problems. This case study examined the efficacy of eight sessions of pragmatic psychodynamic psychotherapy (PPP) in treating a woman with major depression and breast cancer. Pre- to posttreatment assessment indicated significant reductions in depression and weekly assessment indicated increased environmental reward was associated with reduced depression. Secondary aims involved piloting a functional magnetic resonance imaging (fMRI) task as a neurobiological indicator of depression attenuation as a function of PPP. This assessment was conducted to explore alternative means of evaluating treatment responsiveness and addressing the problem of arbitrary metrics in measuring change. Clinical and assessment implications are discussed, with a focus on innovative approaches to evaluate treatment outcome and behavioral and neurobiological mechanisms of change associated with PPP.

Representations of the caregiver-child relationship and of the self, and emotion regulation in the narratives of young children whose mothers have borderline personality disorder.

Borderline personality disorder (BPD) represents a severe distortion in the development of attachment, self, and emotion regulation. Study of children at high risk of developing BPD may inform precursors to BPD. In a low socioeconomic status sample of 30 children aged 4-7 whose mothers have BPD and 30 normative comparisons, representations of the caregiver-child relationship and of the self, and emotion regulation were assessed with a story-stem completion measure. In contrast to comparisons and controlling for major depressive disorder, children whose mothers have BPD told stories with the following: (a) more parent-child role reversal, more fear of abandonment, and more negative mother-child and father-child relationship expectations; (b) more incongruent and shameful representations of the self; and (c) poorer emotion regulation indicated by more confusion of boundaries between fantasy and reality and between self and fantasy, more fantasy proneness, less narrative coherence, and marginally more intrusion of traumatic themes. In the sample as a whole, (a) a maladaptive caregiver-child relationship composite was associated with maternal identity disturbance and self-harm; (b) a maladaptive self-composite was associated with maternal self-harm; and (c) a maladaptive emotion regulation composite was associated with maternal identity disturbance, negative relationships, and self-harm. Results are discussed in terms of putative precursors to BPD and preventive interventions.