The role of family in the development of borderline personality disorder is examined with an emphasis on dimensions of family functioning. A synthesis of theoretical concepts implicating such factors, derived mostly from psychoanalysis, is proposed with an emphasis on separation-individuation, early frustrations, regression to recognition memory, oscillations in attachment and social influences. Empirical studies are reviewed. Affective neglect and parental overprotection are often cited, although dysfunctional behaviour control may have a regulatory effect on these factors and a crucial impact on psychic reality of the patient recalling his childhood.
References
1.
TarnopolskyA., BerelowitzM.Borderline personality: a review of recent research.Br J Psychiatry1987; 151: 724–734.
2.
SegalB.M.A borderline style of functioning: the role of family, society and heredity: an overview.Child Psychiatry Hum Dev1988; 18: 219–238.
3.
StoneM.H.The borderline syndrome: evolution of the term. Genetics aspects and prognosis.Am J Psychother1977; 31: 345–365.
4.
CowdryR.W., PickarD., DaviesR.Symptoms and EEG findings in the borderline syndrome.Int J Psychiatry Med1985; 15: 201–211.
5.
MastersonJ.F., RinsleyD.The borderline syndrome: the role of the mother in the genesis and psychic structure of the borderline personality.Int J Psychoanal1975; 56: 163–177.
6.
WalshF.The family of the borderline patient. In: GrikerR.R.Sr, WerbleB. eds. The borderline patient.New York NY: Jason Aronson Inc., 1977.
7.
OgataS.N., SickK.R., GoodrichS.Childhood sexual and physical abuse in adult patients with borderline personality disorder.Am J Psychiatry1990; 147: 1008–1013.
8.
StoneM.H., KahnE., FlyeB.Psychiatrically ill relatives of borderline patients: a family study.Psychiatr Q1981; 53: 71–84.
9.
MahlerM.A study of the separation-individuation process and its possible application to borderline phenomena in the psychoanalytic situation.Psychoanal Study Child1971; 26: 403–424.
10.
ShapiroE.R., ShapiroR.L., ZinnerJ.The borderline ego and the working alliance: indications for family and individual treatment in adolescence.Int J Psychoanal1977; 58: 77–87.
11.
KernbergO.Borderline conditions and pathological narcissism.New York NY: Jason Aronson Inc.,1975.
12.
KernbergO.Early ego integration and objet relations.Ann NY Acad Sci1972; 193: 233–247.
13.
WongN.Classical psychoanalysis. In: KaplanH.I., SadockB.J. eds. Comprehensive textbook of psychiatry, volume I.Baltimore MD: Williams and Wilkins, 1989: 382.
14.
WinnicottD.W.The use of an object.Int J Psychoanal1969; 50: 711–716.
15.
KernbergO.Factors in the psychoanalytic treatment of narcissistic personalities.J Am Psychoanal Assoc1970; 18: 51–85.
16.
FraibergS.Libidinal object constancy and mental representation.Psychoanal Study Child1969: 24.
17.
GreenspanS.I., CurryJ.F.Piaget's approach to intellectual functionning. In: KaplanH.I., SadockB.J. eds. Comprehensive textbook of psychiatry, volume I. Baltimore MD: Williams and Wilkins, 1989: 258.
18.
BellS.M.The development of the concept of object related to infant-mother attachment.Child Dev1970; 41: 292–311.
19.
AdlerG., BuieD.Aloneness and borderline psychopathology: the possible relevance of child development issues.Int J Psychoanal1979; 60: 83–96.
20.
MelgesF.T., SwartzM.S.Oscillations of attachment in borderline personality disorder.Am J Psychiatry1989; 146: 1115–1120.
21.
BerkovitzD.The disturbed adolescent and his family: problems in individuation.J Adolesc1979; 2: 27–39.
22.
ShapiroE., ZinnerJ., ShapiroF.The influence of family experience on borderline personality development.Int Rev Psychoanal1975; 2: 399–411.
23.
RinsleyD.B.The adolescent, the family and the culture of narcissism: a psychosocial commentary.Adolesc Psychiatry1986; 7–28.
24.
McMurrayJ.Mothering and the borderline patient.Psychiatric Annals1976; 6: 91–100.
25.
FrankH., ParisJ.Recollections of family experience in borderline patients.Arch Gen Psychiatry1981; 38: 1031–1034.
26.
FrankH., HoffmanN.Borderline empathy: an empirical investigation.Compr Psychiatry1986; 27: 387–395.
27.
GundersonJ., KerrJ., EnglundD.The families of borderlines: a comparative study.Arch Gen Psychiatry1980; 37: 27–33.
28.
ZanariniM.C., GundersonJ.G., MarinoM.F.Childhood experiences of borderline patients.Compr Psychiatry1989; 30: 18–25.
29.
SoloffPh, MillwardJ.W.Developmental histories of borderline patients.Compr Psychiatry1983; 24: 574–588.
30.
BradleyS.J.The relationship of early maternal separation to borderline personality in children and adolescents: a pilot study.Am J Psychiatry1979; 136: 424–426.
31.
GrinkerR.R.Sr, WerbleB., DryeR.C.The borderline syndrome: a behavioral study of ego-functions.New York NY: Basic Books,1968.
32.
GoldbergR.L., MannL.S., WiseT.N.Parental qualities as perceived by borderline personality disorders.Hillside J Clin Psychiatr1985; 7: 134–140.
SingerM.The borderline delinquent: the interlocking of intrapsychic and interactional determinants.Int Rev Psychoanal1975; 2: 429–440.
35.
MaziadeM., CapéraàP., LaplanteB.Value of difficult temperament among 7-year olds in the general population for predicting psychiatric diagnosis at age 12.Am J Psychiatry1985; 142: 943–946.
36.
BryerJ.B., NelsonB.A., MillerJ.B.Childhood sexual and physical abuse as factors in adult psychiatric illness.Am J Psychiatry1987; 144: 1426–1430.
37.
HermanJ.L., PerryJ.C., Van Der KolkB.A.Childhood trauma in borderline personality disorder.Am J Psychiatry1989; 146: 490–495.
38.
AkiskalH.S.Subaffective disorders: dysthymic, cyclothymic and bipolar II disorders in the “borderline” realm.Psychiatr Clin North Am1981; 4: 25–46.
39.
AndrulonisP.A., VogelN.G.Comparison of borderline personality subcategories to schizophrenic and affective disorders.Br J Psychiatry1984; 144: 358–363.
40.
LorangerA.W., OldhamJ.M., TulisE.H.Familial transmission of DSM-III borderline personality disorder.Arch Gen Psychiatry1982; 39: 795–799.
41.
SoloffP.H., MillwardJ.W.Psychiatric disorders in the families of borderline patients.Arch Gen Psychiatry1983; 40: 37–44.
42.
PopeH.G., JonasJ.M., HudsonJ.I.The validity of DSM-in borderline personality disorder.Arch Gen Psychiatry1983; 40: 23–30.
43.
LinksP.S., SteinerM., HuxleyG.The occurence of borderline personality disorder in the families of borderline patients.J Pers Dis1988; 2: 14–20.
44.
KrullM.Freud and his father.London: W.W. Norton and Co. Ltd.,1986: 54–58.
45.
EpsteinN.B., BishopD.S., LevinS.The McMaster model of family functioning.J Marriage Fam Counselling1978; October: 19–31.
46.
VaillantG.E.Adaptation to life.Boston MA: Little Brown,1977.
47.
KornerA.F.Individual differences at birth: implications for early experience and later development.Am J Orthopsychiatry1971; 41: 608–619.
48.
ThomasA., ChessS.Genesis and evolution of behavioral disorders.Am J Psychiatry1984; 141: 1–9.
49.
RutterM.Resilience in the face of adversity: protective factors and resistance to psychiatric disorder.Br J Psychiatry1985; 147: 598–611.
50.
CrockenbergS.B.Infant irritability, mother responsiveness, and social support influences on the security of infant-mother attachment.Child Dev1981; 52: 857–865.
51.
PuccettiR., DykesR.W.Sensory cortex and the mind-brain problem.Behav Brain Sci1978; 3: 337–375.
52.
EisenbergL.Mindlessness and brainlessness in psychiatry.Br J Psychiatry1986; 148: 497–508.
