Personal relatedness and attachment in infants of mothers with borderline personality disorder

The principal aim of this study was to assess personal relatedness and attachment patterns in 12-month-old infants of mothers with borderline personality disorder (BPD). We also evaluated maternal intrusive insensitivity toward the infants in semistructured play. We videotaped 10 mother–infant dyads with borderline mothers and 22 dyads where the mothers were free from psychopathology, in three different settings: a modification of Winnicott's Set Situation in which infants faced an initially unresponsive (“still-face”) stranger, who subsequently tried to engage the infant in a game of give and take; the Strange Situation of Ainsworth and Wittig; and a situation in which mothers were requested to teach their infants to play with miniature figures and a toy train. In relation to a set of a priori predictions, the results revealed significant group differences as follows: (a) compared with control infants, toward the stranger the infants of mothers with BPD showed lower levels of “availability for positive engagement,” lower ratings of “behavior organization and mood state,” and a lower proportion of interpersonally directed looks that were positive; (b) in the Strange Situation, a higher proportion (8 out of 10) of infants of borderline mothers were categorized as Disorganized; and (c) in play, mothers with BPD were rated as more “intrusively insensitive” toward their infants. The results are discussed in relation to hypotheses concerning the interpersonal relations of women with BPD, and possible implications for their infants' development. This research was generously supported by grants from the Winnicott Trust, the Hayward Foundation, and the Baily Thomas Charitable Fund, as well as by a Wellcome Fellowship to Matthew Patrick and an NIH Fellowship to Lisa Crandell. We also received support from the UK National Health R&D Budget. We are indebted to the mothers and infants who agreed to take part, Lynne Murray for inspiration and guidance, Lucy Chiemielski and Leezah Hertzmann for their help with ratings of videotapes, Betty Carlson and Alan Sroufe for their invaluable and very generous input, and Jessica Meyer for her helpful comments and suggestions.