Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-13T07:13:22.018Z Has data issue: false hasContentIssue false

15 - Personality disorder in parents: developmental perspectives and intervention

from Part III - Specific disorders: the impact on parent–child relationships

Published online by Cambridge University Press:  09 August 2009

Michael Göpfert
Affiliation:
Webb House Democratic Therapeutic Community, Crewe
Jeni Webster
Affiliation:
5 Boroughs Partnership, Warrington
Mary V. Seeman
Affiliation:
University of Toronto
Get access

Summary

Introduction

Both personality disorder and parental inability to meet children's needs have their origins, at least in part, in the quality of early experiences. Where individuals engaged in the constellation of disruptive behaviours and interpersonal role and relationship difficulties associated with personality disorder also have child-care responsibilities, the implications for the well-being and safety of children will be considerable. For individuals with severe relationship difficulties who are, or become, parents, that key life transition will have profound implications for themselves as individuals, as partners and as parents. Personality disorder itself presents considerable diagnostic, risk management and therapeutic challenges for (mental) health, social care and criminal justice systems because of the diverse and competing needs of parents and children which challenge the existing separateness of the various adult and children's services.

This chapter will use two theoretical frameworks, attachment theory and role relationships, to examine the concept of personality disorder, and how/why personality disorder interferes with ‘good enough’ parenting. These frameworks will also be used to describe implications for assessment and therapeutic interventions. This includes use of alternative care provision for children within the public sector.

Background issues and definitions

Personality disorder (PD) is defined by DSM–IV (American Psychiatric Association, 1994) as: ‘Behaviours or traits that are characteristic of the person's recent and long-term functioning. The behaviours and traits must be sufficient to cause impairment of functioning or subjective distress.’

Type
Chapter
Information
Parental Psychiatric Disorder
Distressed Parents and their Families
, pp. 217 - 238
Publisher: Cambridge University Press
Print publication year: 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adshead, G. (2001). Murmurs of discontent: treatment and treatability of personality disorder. Advances in Psychiatric Treatment, 7, 407–15Google Scholar
Adshead, G. & Bluglass, K. (2001). Attachment representations and Factitious illness by Proxy: relevance for assessment of parenting capacity in child maltreatment. Child Abuse Review, 10, 398–410Google Scholar
Ahnert, L., Meischner, T. & Schmidt, A. (2000). Maternal sensitivity and attachment in East German and Russian family networks. In The Organization of Attachment Relationships: Maturation, Culture, and Context, ed. P. M. Crittenden & A. H. Clausen, pp. 61–74. Cambridge: Cambridge University Press
Appleby, L. & Lewis, G. (1988). Personality disorder: the patients psychiatrists dislike. British Journal of Psychiatry, 153, 44–9Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th revision (DSM–IV). Washington, DC: APA
Austin, W. G. (2001). Partner violence and risk assessment in child custody evaluations. Family Court Review, 39, 483–96Google Scholar
Belsky, J. (1993). Etiology of child maltreatment: a developmental-ecological analysis. Psychological Bulletin, 114, 413–34Google Scholar
Benjamin, L. S. (1993). The Interpersonal Diagnosis and Treatment of Personality Disorders. New York: Guilford Press
Bernstein, D. P., Cohen, P., Skodol, A., Bezirganian, S. & Brook, J. (1996). Childhood antecedents of adolescent personality disorder. American Journal of Psychiatry, 153, 907–13Google Scholar
Bools, C., Neale, B. & Meadow, R. (1994). Munchausen's Syndrome by Proxy: a study of psychopathology. Child Abuse and Neglect, 18, 773–88Google Scholar
Bowlby, J. (1969). Attachment and Loss, Vol. 1. Attachment. London: Hogarth Press
Bugental, D. B. & Lewis, J. C. (1998). Interpersonal power repair in response to threats to control from dependent others. In Personal Control in Action: Cognitive and Motivational Mechanisms, ed. M. Kofta & G. Weary, pp. 341–62. New York: Plenum Press
Byng-Hall, J. (1995). Rewriting Family Scripts. New York: Guilford Press
Campling, P. (1997). Maintaining the therapeutic alliance with personality-disordered patients. Journal of Forensic Psychiatry, 793, 535–50Google Scholar
Casey, P. & Tyrer, P. (1990). Personality disorder and psychiatric illness in general practice. British Journal of Psychiatry, 156, 261–5Google Scholar
Chase, N. D. (ed.) (1999). Burdened Children: Theory, Research and Treatment of Parentification. Thousand Oaks: Sage
Craik, K. (1943). The Nature of Explanation. Cambridge: Cambridge University Press
Crittenden, P., Partridge, M. & Claussen, A. (1991). Family patterns of relationship in normative and dysfunctional families. Development and Psychopathology, 3, 491–512Google Scholar
Davison, S. (2002). Principles of managing patients with personality disorder. Advances in Psychiatric Treatment, 8, 1–9Google Scholar
DeLozier, P. (1982). Attachment theory and child abuse. In The Place of Attachment in Human Behaviour, ed. C. M. Parkes & J. Stevenson-Hinde, pp. 95–117. London: Tavistock
Department of Health (2000). Framework for the Assessment of Children in Need and their Families. London: The Stationery office
Dinwiddie, S. & Bucholz, K. (1993). Psychiatric diagnoses of self-reported child abusers. Child Abuse and Neglect, 17, 465–76Google Scholar
Earley, L. & Cushway, D. (2002). The parentified child. Clinical Child Psychology and Psychiatry, 7, 163–78Google Scholar
Falkov, A. (1997). Adult psychiatry – a missing link in child protection. Child Abuse Review, 6, 41–5Google Scholar
Famularo, R., Kinscherff, R. & Fenton, T. (1992). Psychiatric diagnoses of abusive mothers: a preliminary report. Journal of Nervous and Mental Disease, 180, 658–61Google Scholar
Flynn, A., Matthews, H. & Hollins, S. (2002). Validity of the diagnosis of personality disorder in adults with learning disability and severe behaviour problems. British Journal of Psychiatry, 180, 543–6Google Scholar
Fonagy, P., Leigh, T., Steele, M. et al. (1996). The relationship of attachment status, psychiatric classification and response to psychotherapy. Journal of Consulting and Clinical Psychology, 64, 23–31Google Scholar
Fonagy, P., Target, M., Steele, M. et al. (1997). Morality, disruptive behaviour, borderline personality disorder, crime and their relationship to attachment. In Attachment and Psychopathology, ed. L. Atkinson & K. Zucker, pp. 233–74. New York: Guilford Press
George, C. & Solomon, J. (1996). Representational models of relationships: links between care giving and attachment. Infant Mental Health Journal, 17, 198–216Google Scholar
George, C., Kaplan, N. & Main, M. (1994). Adult Attachment Interview protocol, 4th edn. Unpublished. Berkeley, CA: University of California at Berkeley, Dept. of Psychology
Gergen, K. J., Hoffman, L. & Anderson, H. (1996). Is diagnosis a disaster? A constructionist trialogue. In Handbook of Relational Diagnosis and Dysfunctional Family Patterns, ed. F. W. Kaslow, pp. 102–118. New York: John Wiley & Sons
Glaser, D. (2001). Attachment and child protection. Child Abuse Review, 10, 371–5Google Scholar
Göpfert, M. (1991). Families with a Schizophrenic Parent. A Preliminary Enquiry. Unpublished dissertation. Toronto: University of Toronto
Hadden, Y. & Haigh, R. (2001/2002). Personality disorder – how much more stigmatising could a label be? Dialogue, Issues No. 9 (2001) and 10 (2002). Published as part of the Virtual Institute of Severe Personality Disorder by the Henderson Hospital (South-West London and St. George's Mental Health Trust). Also on http://www.doh.gov.uk/hspsch/visped
Horowitz, M. J., Eells, T., Singer, J. & Salovey, P. (1995). Role-relationship models for case formulation. Archives of General Psychiatry, 52, 625–32Google Scholar
Howe, D., Brandon, M., Hinings, D. & Schofield, G. (1999). Attachment Theory, Child Maltreatment and Family Support. London: Macmillan
Johnson, J., Cohen, P. & Brown, J. et al. (1999). Childhood maltreatment increases the risk for personality disorders in early adulthood. Archives of General Psychiatry, 56, 600–6Google Scholar
Jones, D. (1987). The untreatable family. Child Abuse and Neglect, 11, 409–20Google Scholar
Kelly, G. A. (1955). The Psychology of Personal Constructs. New York: Norton
Kelly, J. B. & Johnston, J. R. (2001). The alienated child: a reformulation of the parental alienation syndrome. Family Court Review, 39, 249–66Google Scholar
Kendell, R. E. (2002). The distinction between personality disorder and mental illness. British Journal of Psychiatry, 180, 110–15Google Scholar
Kraemer, G. (1992). A psychobiological theory of attachment. Behavioural and Brain Sciences, 15, 493–511Google Scholar
Lansky, M. R. (1992). Fathers who Fail: Shame and Psychopathology in the Family System. Hillsdale, NJ: The Analytic Press
Lee, M. S. & Olesen, N. W. (2001). Assessing for alienation in child custody and access evaluations. Family Court Review, 39, 282–98Google Scholar
Lees, J., Manning, N. & Rawlings, B. (1999). Therapeutic Community Effectiveness. NHS Centre Reviews and Dissemination Report, No. 17. York: University of York
Levey, T. & Orlans, M. (1998). Attachment Trauma and Healing: Understanding and Treating Attachment Disorder in Children and Families. Washington, DC: Child Welfare League of America
Livesley, W. J., Jang, K. L., Jackson, D. N. & Vernon, P. A. (1993). Genetic and environmental contributions to dimensions of personality disorder. American Journal of Psychiatry, 150, 1826–31Google Scholar
Lovrin, M. (1999). Parental murder and suicide: post-traumatic stress disorder in children. Journal of Child and Adolescent Psychiatric Nursing, 12, 110–17Google Scholar
Mitchell, M. (1990). Attachment antecedents and sociocultural factors in Hispanic mothers' physical abuse of their children. In Research Explorations in Adult Attachment, ed. K. Pottharst, pp. 129–97. New York: Peter Lang
Modestin, J., Oberson, B. & Erni, T. (1998). Possible antecedents of DSM–III–R personality disorders. Acta Psychiatrica Scandinavica, 97, 260–6Google Scholar
Norton, K. & Dolan, B. (1996). Personality disorder and parenting. In Parental Psychiatric Disorder: Distressed Parents and Their Families, ed. M. Göpfert, J. Webster & M. V. Seeman, pp. 219–232. Cambridge: Cambridge University Press
Pryce, C. R. (1995). Determinants of motherhood in human and non-human primates. In Motherhood in Human and Non-human Primates, ed. C. R. Pryce, R. Martin & D. Skuse, pp. 1–15. Basel: Karger
Raczek, S. (1992). Childhood abuse and personality disorders. Journal of Personality Disorders, 6, 109–16Google Scholar
Radke-Yarrow, M. (1998). Children of Depressed Mothers. Cambridge: Cambridge University Press
Reiss, D., Pedersen, N. L., Cederblad, M. et al. (2001). Genetic probes of three theories of maternal adjustment: I. Recent evidence and a model. Family Process, 40, 247–59Google Scholar
Roth, A. & Fonagy, P. (1996). What Works for Whom? A Critical Review of Psychotherapy Research. New York: Guilford Press
Royal College of Psychiatrists (2002a). Domestic Violence. Council Report CR 102. London: Royal College of Psychiatrists
Royal College of Psychiatrists (2002b). Patients as Parents. Council Report CR 105. London: Royal College of Psychiatrists
Ryle, A. (1998). Cognitive-analytic Therapy and Borderline Personality Disorder. Chichester: John Wiley & Sons
Ryle, A. & Kerr, I. (2002). Introducing Cognitive-analytic Therapy: Principles and Practice. Chichester: John Wiley & Sons
Sabo, A. N. (1997). The etiological significance of associations between childhood trauma and borderline personality disorders: conceptual and clinical implications. Journal of Personality Disorders, 11, 50–70Google Scholar
Sack, A., Sperling, M. M., Fagen, G. & Foelsch, P. (1996). Attachment styles, histories and behavioural contrasts for a borderline and normal sample. Journal of Personality Disorders, 10, 88–101Google Scholar
Samuels, J., Eaton, W. W., Bienvenu, O. J. III, Brown, C. H., Costa, P. T. Jr & Nestadt, G. (2002). Prevalence and correlates of personality disorder in a community sample. British Journal of Psychiatry, 180, 536–42Google Scholar
Schore, A. (2001). Minds in the making: attachment, the self-organising brain, and developmentally oriented psychoanalytic psychotherapy. British Journal of Psychotherapy, 17, 299–328Google Scholar
Schreier, H. A. & Libow, J. A. (1993). Hurting for Love: Munchausen by Proxy Syndrome. New York: Guilford Press
Stanley, N. & Penhale, B. (1999). The mental health problems of mothers experiencing the child protection system. Child Abuse Review, 8, 34–45Google Scholar
Taylor, J.Spencer, N. & Baldwin, N. (2000). Social, economic and political context of parenting. Archives of Disease in Childhood, 82, 113–17Google Scholar
Ijzendoorn, M. (1995). Adult attachment representations, predictive responsiveness and infant attachment: a meta-analysis of the predictive validity of the Adult Attachment Interview. Psychological Bulletin, 117, 387–403Google Scholar
Ijzendoorn, M., Feldbruggen, J., Derks, F. C. H., et al. (1997). Attachment representations of personality disordered criminal offenders. American Journal of Orthopsychiatry, 67, 449–59Google Scholar
Ward, A. (1995). The impact of parental suicide on children and staff in residential care: a case study in the function of containment. Journal of Social Work Practice, 9, 23–32Google Scholar
Westen, D. (1997). Divergences between clinical and research methods for assessing personality disorders: Implications for research and the evolution of Axis II. American Journal of Psychiatry, 154, 895–903Google Scholar
Westen, D. & Harnden-Fischer, J., (2001). Personality profiles in eating disorders: rethinking the distinction between axis I and axis II. American Journal of Psychiatry, 158, 547–62Google Scholar
Williams, J. R. (2001). Should judges close the gate on PAS and PA?Family Court Review, 39, 267–81Google Scholar
Zanarini, M. C., Frankenburg, F. R., Reich, D. B. et al. (2000). Biparental failure in the childhood experiences of borderline patients. Journal of Personality Disorder, 14, 264–73Google Scholar
Zirogiannis, L. (2001). Evidentiary issues with parental alienation syndrome. Family Court Review, 39, 334℄43.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×