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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.


Corresponding author

Address correspondence and reprint requests to: R. Peter Hobson, Tavistock Clinic, 120 Belsize Lane, London NW35BA, UK; E-mail:


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Ainsworth, M. D., Blehar, M., Waters, E., & Wall, S. (1978). Patterns of attachment. Hillsdale, NJ: Erlbaum.
Ainsworth, M. D., & Wittig, B. (1969). Attachment and exploratory behavior of one-year-olds in a strange situation. In B. M. Foss (Ed.), Determinants of infant behavior IV (pp. 111136). London: Methuen.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders—Revised (3rd ed.). Washington, DC: Author.
Baron, M. J. O. (1993). Fear, attachment and affiliation: The interaction of functional systems in 8- and 12-month-old infants. Early Development and Parenting 2, 121130.
Barone, L. (2003). Developmental protective and risk factors in borderline personality disorder: A study using the Adult Attachment Interview. Attachment & Human Development 5, 6477.
Bezirganian, S., Cohen, P., & Brook, J. S. (1993). The impact of mother–child interaction on the development of borderline personality disorder. American Journal of Psychiatry 150, 18361842.
Bion, W. R. (1962). A theory of thinking. International Journal of Psychoanalysis 43, 306310.
Bokhorst, C. L., Bakermans–Kranenburg, M. J., Fearon, R. M., van IJzendoorn, M. H., Fonagy, P., & Schuengel, C. (2003). The importance of shared environment in mother–infant attachment security: A behavioral genetic study. Child Development 74, 17691782.
Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. New York: Basic Books.
Bradshaw, D. A., Goldsmith, H. A., & Campos, J. J. (1987). Attachment, temperament, and social referencing: Interrelationships among three domains of infant affective behavior. Infant Behavior and Development 10, 223231.
Brazelton, T. B., Koslowski, B., & Main, M. (1974). The origins of reciprocity: The early mother–infant interaction. In M. Lewis & L. A. Rosenblum (Eds.), The effect of infancy on its caregiver (pp. 4977). New York: Wiley.
Bretherton, I., & Ainsworth, M. D. S. (1974). Responses of one-year-olds to a stranger in a strange situation. In M. Lewis & L. A. Rosenblum (Eds.), Origins of fear (pp. 131164). New York: Wiley.
Bretherton, I., & Munholland, K. A. (1999). Internal working models in attachment relationships: A construct revisited. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research and clinical applications (pp. 89111). New York: Guilford Press.
Buss, A. H., & Plomin, R. (1984). Temperament: Early developing personality traits. Hillsdale, NJ: Erlbaum.
Carlson, E. A. (1998). A prospective longitudinal study of attachment disorganization/disorientation. Child Development 69, 11071128.
Carlson, V., Cicchetti, D., Barnett, D., & Braunwald, K. (1989). Disorganized/disoriented attachment relationships in maltreated infants. Developmental Psychology 25, 525531.
Cohn, J. F., Campbell, S. B., Matias, R., & Hopkins, J. (1990). Face-to-face interactions of postpartum depressed and nondepressed mother–infant pairs at 2 months. Developmental Psychology 26, 1523.
Cohn, J. F., Matias, R., Tronick, E. Z., Connell, D., & Lyons–Ruth, K. (1986). Face-to-face interactions of depressed mothers and their infants. In E. Tronick & T. Field (Eds.), New directions for child development: Vol. 34. Maternal depression and infant disturbance (pp. 3144). San Francisco, CA: Jossey–Bass.
Cohn, J. F., & Tronick, E. (1989). Specificity of infants' response to mothers' affective behavior. American Academy of Child and Adolescent Psychiatry 28, 242248.
Crandell, L. E., Patrick, M. P. H., & Hobson, R. P. (2003). “Still-face” interactions between mothers with borderline personality disorder and their 2-month-old infants. British Journal of Psychiatry 183, 239247.
Crockenberg, S. (1981). Infant irritability, mother responsiveness, and social support influences on the security of infant–mother attachment. Child Development 52, 857865.
DeMulder, E. K., & Radke–Yarrow, M. (1991). Attachment with affectively ill and well mothers: Concurrent behavioral correlates. Development and Psychopathology 3, 227242.
De Wolff, M., & van IJzendoorn, H. (1997). Sensitivity and attachment: A meta-analysis on parental antecedents of infant attachment. Child Development 68, 571591.
Field, T. M., Healy, B., Goldstein, S., & Guthertz, M. (1990). Behavior-state matching and synchrony in mother–infant interactions in non-depressed versus depressed dyads. Developmental Psychology 26, 714.
Field, T. M., Healy, B., Goldstein, S., Perry, S., Bendell, D., Schanberg, S., Zimmerman, E. A., & Kuhn, C. (1988). Infants of depressed mothers show “depressed” behavior even with non-depressed adults. Child Development 59, 15691579.
Field, T. M., Sandberg, D., Garcia, R., Vega–Lahr, N., Goldstein, S., & Guy, L. (1985). Pregnancy problems, postpartum depression and early mother–infant interactions. Developmental Psychology 21, 11521156.
Fonagy, P., Leigh, T., Steele, M., Steele, H., Kennedy, R., Mattoon, G., Target, M., & Gerber, A. (1996). The relation of attachment status, psychiatric classification, and response to psychotherapy. Journal of Consulting and Clinical Psychology 64, 2231.
Fox, N. A., Kimmerly, N. L., & Schafer, W. D. (1991). Attachment to mother/attachment to father. Child Development 62, 210225.
Garcia–Coll, C. T., Kagan, J., & Reznick, J. S. (1984). Behavioral inhibition in young children. Child Development 55, 10061019.
George, C., Kaplan, N., & Main, M. (1985). The Adult Attachment Interview for Adults (2nd ed.). Unpublished manuscript, University of California at Berkeley.
Goldsmith, H. H., & Campos, J. J. (1990). The structure of temperamental fear and pleasure in infants: A psychometric perspective. Child Development 61, 19441964.
Greenberg, J. R., & Mitchell, S. A. (1983). Object relations in psychoanalytic theory. Cambridge, MA: Harvard University Press.
Gunderson, J. G. (2001). Borderline personality disorder: A clinical guide. Washington, DC: American Psychiatric Publishing.
Guntrip, H. (1977). Personality structure and human interaction. London: Hogarth.
Gustafson, G. E., Green, J., & West, M. J. (1979). The infant's changing role in mother–infant games: The growth of social skills. Infant Behavior and Development 2, 301308.
Hay, D. F., & Murray, P. (1982). Giving and requesting: Social facilitation of infants' offers to adults. Infant Behavior and Development 5, 301310.
Herman, J., Perry, C., & Van der Kolk, B. (1989). Childhood trauma in borderline personality disorder. American Journal of Psychiatry 146, 490495.
Hipwell, A. E., Goossens, F. A., Melhuish, E. C., & Kumar, R. (2000). Severe maternal psychopathology and infant–mother attachment. Development and Psychopathology 12, 157175.
Hobson, R. P. (1997). Psychoanalysis and infancy. In G. Bremner, G. Butterworth, & A. Slater (Eds.), Infant development: Recent advances (pp. 275290). Hove: Psychology Press.
Hobson, R. P. (2002). The cradle of thought. London: Macmillan.
Hobson, R. P., Patrick, M. P. H., Crandell, L. E., Garcia–Perez, R. M., & Lee, A. (2004). Maternal sensitivity and infant triadic communication. Journal of Child Psychology and Psychiatry 45, 470480.
Hobson, R. P., Patrick, M. P. H., & Valentine, J. D. (1998). Objectivity in psychoanalytic judgements. British Journal of Psychiatry 173, 172177.
Jackson, J. (1996). An experimental investigation of Winnicott's set situation: A study of South African white, black and institutionalized infants aged 7 to 9 months old. Journal of Child Psychotherapy 22, 343361.
Kernberg, O. F. (1976). Object relations theory and clinical psychoanalysis. Northvale, NJ: Aronson.
Lakatos, K., Nemoda, Z., Toth, I., Ronai, Z., Ney, K., Sasvari–Szekely, M., & Gervai, J. (2002). Further evidence for the role of the dopamine D4 receptor (DRD4) gene in attachment disorganization: Interaction of the exon III 48-bp repeat and the −521 C/T promoter polymorphisms. Molecular Psychiatry 7, 2731.
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics 33, 159174.
Lyons–Ruth, K., Bronfman, E., & Atwood, G. (1999). A relational diathesis model of hostile–helpless states of mind. Expressions in mother–infant interaction. In J. Solomon & C. George (Eds.), Attachment disorganization (pp. 3370). New York: Guilford Press.
Lyons–Ruth, K., Bronfman, E., & Parsons, E. (1999). Maternal frightened, frightening, or atypical behavior and disorganized infant attachment patterns. Monographs of the Society for Research in Child Development 64(3, Serial No. 258), 6796.
Lyons–Ruth, K., Connell, D. B., Zoll, D., & Stahl, J. (1987). Infants at social risk: Relations among infant maltreatment, maternal behavior, and infant attachment behavior. Developmental Psychology 23, 223232.
Lyons–Ruth, K., & Jacobvitz, D. (1999). Attachment disorganization: Unresolved loss, relational violence, and lapses in behavioral and attentional strategies. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 520554). New York: Guilford Press.
Lyons–Ruth, K., Repacholi, B., McLeod, S., & Silva, E. (1991). Disorganized attachment behavior in infancy: Short-term stability, maternal and infant correlates, and risk-related subtypes. Development and Psychopathology 3, 377396.
Main, M., & Hesse, E. (1990). Parents' unresolved traumatic experiences are related to infant disorganized attachment status: Is frightened and/or frightening parental behavior the linking mechanism? In M. T. Greenberg, D. Cicchetti, & E. M. Cummings (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 161182). Chicago: University of Chicago Press.
Main, M., & Solomon, J. (1986). Discovery of a new, insecure–disorganized/disoriented attachment pattern. In T. B. Brazelton & M. W. Yogman (Eds.), Affective development in infancy (pp. 95124). Norwood, NJ: Ablex.
Main, M., & Solomon, J. (1990). Procedures for identifying infants as disorganized/disoriented during the Ainsworth strange situation. In M. T. Greenberg, D. Cicchetti, & E. M. Cummings (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 121160). Chicago: University of Chicago Press.
Main, M., & Weston, D. R. (1981). The quality of the toddler's relationship to mother and to father: Related to conflict behavior and the readiness to establish new relationships. Child Development 52, 932940.
Manassis, K., Bradley, S., Goldberg, S., Hood, J., & Swinson, R. P. (1994). Attachment in mothers with anxiety disorder and their children. Journal of the American Academy of Child and Adolescent Psychiatry 33, 11061113.
Melnick, S. M., Patrick, M. P. H., Lyons–Ruth, K., & Hobson, R. P. (2003). Disorganized (hostile/helpless) attachments in mothers with psychopathology. Poster presented at the Biennial Meeting of the Society for Research in Child Development, Tampa, FL.
Murray, L., & Cooper, P. J. (1997). Postpartum depression and child development. New York: Guilford Press.
Murray, L., Fiori–Cowley, A., Hooper, R., & Cooper, P. (1996). The impact of postnatal depression and associated adversity on early mother–infant interactions and later outcome. Child Development 67, 25122526.
O'Connor, M. J., Sigman, M., & Brill, N. (1987). Disorganization of attachment in relation to maternal alcohol consumption. Journal of Consulting and Clinical Psychology 55, 831836.
O'Connor, T. G., & Croft, C. M. (2001). A twin study of attachment in preschool children. Child Development 72, 15011511.
Ogata, S., Silk, K., Goodrich, S., Lohr, N., Westen, D., & Hill, E. (1990). Childhood sexual and physical abuse in borderline patients. American Journal of Psychiatry 147, 10081013.
Patrick, M., Hobson, R. P., Castle, D., Howard, R., & Maughan, B. (1994). Personality disorder and the mental representation of early social experience. Development and Psychopathology 6, 375388.
Posner, M. I., Rothbart, M. K., Vizueta, N., Thomas, K. M., Levy, K. N., Fossella, J., Silbersweig, D., Stern, E., Clarkin, J., & Kernberg, O. (2003). An approach to the psychobiology of personality disorders. Development and Psychopathology 15, 10931106.
Reinecke, M. A., & Fogel, A. (1994). The development of referential offering in the first year. Early Development and Parenting 3, 181186.
Rothbart, M. K., & Derryberry, D. (1981). Development of individual differences in temperament. In M. E. Lamb & A. L. Brown (Eds.), Advances in developmental psychology (Vol. 1, pp. 3786). Hillsdale, NJ: Erlbaum.
Rodning, C., Beckwith, L., & Howard, J. (1991). Quality of attachment and home environments in children prenatally exposed to PCP and cocaine. Development and Psychopathology 3, 351366.
Sandler, J. (Ed.). (1988). Projection, identification, projective identification. London: Karnac.
Schneider Rosen, K., & Rothbaum, F. (1993). Quality of parental caregiving and security of attachment. Developmental Psychology 29, 358367.
Schuengel, C., Bakermans–Kranenburg, M. J., & van IJzendoorn, M. H. (1999). Frightening maternal behavior linking unresolved loss and disorganized infant attachment. Journal of Consulting and Clinical Psychology 67, 5463.
Shapiro, B., Fagen, J., Prigot, J., Carroll, M., & Shalan, J. (1998). Infants' emotional and regulatory behaviors in response to violations of expectancies. Infant Behavior and Development 21, 299313.
Skodol, A. E., Siever, L. J., Livesley, W. J., Gunderson, J. G., Pfohl, B., & Widiger, T. A. (2002). The borderline diagnosis: II. Biology, genetics, and clinical course. Biological Psychiatry 51, 951963.
Spangler, G., & Grossmann, K. (1999). Individual and physiological correlates of attachment disorganization in the infancy. In J. Solomon & C. George (Eds.), Attachment Disorganization (pp. 95124). New York: Guilford Press.
Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. B. (1990). Structured clinical interview for DSM-III-R-Personality disorders (SCID-II Version 1.0); and non-patient edition (SCID-NP, Version 1.0). Washington, DC: American Psychiatric Association.
Sroufe, L. A. (1977). Wariness of strangers and the study of infant development. Child Development 48, 731746.
Sroufe, L. A. (1985). Attachment classification from the perspective of infant–caregiver relationships and infant temperament. Child Development 56, 114.
Stein, A., Woolley, H., Cooper, S. D., & Fairburn, C. G. (1994). An observational study of mothers with eating disorders and their infants. Journal of Child Psychology and Psychiatry 35, 73348.
Stein, A., Woolley, H., & McPherson, K. (1999). Conflict between mothers with eating disorders and their infants during mealtimes. British Journal of Psychiatry 175, 455461.
Stevenson, M. B., & Lamb, M. E. (1979). Effects of infant sociability and the caretaking environment on infant cognitive performance. Child Development 50, 340349.
Stern, D. N. (1985). The interpersonal world of the infant. New York: Basic Books.
Susman–Stillman, A., Kalkoske, M., Egeland, B., & Waldman, I. (1996). Infant temperament and maternal sensitivity as predictors of attachment security. Infant Behavior and Development 19, 3347.
Teti, D. M., Gelfand, D. M., Messinger, D. S., & Isabella, R. (1995). Maternal depression and the quality of early attachment: An examination of infants, preschoolers, and their mothers. Developmental Psychology 34, 361376.
Thompson, R. A., & Lamb, M. E. (1982). Stranger sociability and its relationships to temperament and social experience during the second year. Infant Behavior and Development 5, 277287.
Thompson, R. A., and Lamb, M. E. (1983). Security of attachment and stranger sociability in infancy. Child Development 19, 184191.
Trevarthen, C., & Hubley, P. (1978). Secondary intersubjectivity: Confidence, confiding and acts of meaning in the first year. In A. Lock (Ed.), Action, gesture and symbol: The emergence of language (pp. 183229). London: Academic Press.
Tronick, E. Z., & Cohn, J. F. (1989). Infant–mother face-to-face interaction: Age and gender differences in co-ordination and the occurrence of miscoordination. Child Development 60, 8592.
van IJzendoorn, M. H. (1995). Adult attachment representations, parental responsiveness, and infant attachment: A meta-analysis on the predictive validity of the Adult Attachment Interview. Psychological Bulletin 117, 387403.
van IJzendoorn, M. H., Schuengel, C., & Bakermans–Kranenburg, M. J. (1999). Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Development and Psychopathology 11, 225249.
Vaughn, B. E., Stevenson–Hinde, J., Waters, E., Kotsaftis, A., Lefever, G. B., Shouldice, A., Trudel, M., & Belsky, J. (1992). Attachment security and temperament in infancy and early childhood: Some conceptual clarifications. Developmental Psychology 28, 463473.
Weaver, T. L., & Clum, G. A. (1993). Early family environments and traumatic experiences associated with borderline personality disorder. Journal of Consulting and Clinical Psychology 61, 10681075.
Weber, R. A., Levitt, M. J., & Clark, M. C. (1986). Individual variation in attachment security and strange situation behavior: The role of maternal and infant temperament. Child Development 57, 5665.
Winnicott, D. W. (1941). The observation of infants in a set situation. International Journal of Psychoanalysis 22, 229249.


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