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The role of prenatal stress as a pathway to personality disorder: longitudinal birth cohort study

  • Ross Brannigan (a1), Antti Tanskanen (a2), Matti O. Huttunen (a3), Mary Cannon (a4), Finbarr P. Leacy (a5) and Mary C. Clarke (a6)...

Abstract

Background

Many studies have reported associations between prenatal stress and the development of psychotic, anxiety and depressive disorders; however, to date no studies have investigated potential associations with personality disorders.

Aims

This study investigated potential associations between exposure to prenatal stress and personality disorder in offspring.

Method

In a subsample (N = 3626) of a large Finnish birth cohort, we used logistic regression models to examine associations between self-reported maternal stress during pregnancy, collected monthly during antenatal clinic appointments, and personality disorder in offspring. Familial and outcome information were obtained by linking data from the Finnish Hospital Discharge Register and the Finnish Population Register.

Results

Compared with those unexposed, children exposed to any maternal stress during gestation had three times the odds of developing a personality disorder (odds ratio 3.28, 95% CI 1.75–6.15, P < 0.0001). Those exposed to moderate stress had three times the odds (odds ratio 3.13, 95% CI 1.42–6.88, P = 0.005) and those exposed to severe stress had seven times the odds (odds ratio 7.02, 95% CI 2.08–23.66, P = 0.002) of developing a personality disorder. These associations remained after adjusting for parental psychiatric history, comorbid psychiatric diagnoses, prenatal smoking and antenatal depression.

Conclusions

Exposure to stress during gestation increases the odds of personality disorder in offspring, independent of other psychiatric disorders. These results suggest the assessment of maternal stress and well-being during pregnancy may be useful in identifying those at greatest risk of developing personality disorder, and highlight the importance of prenatal care for good maternal mental health during pregnancy.

Declaration of interest

None.

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Copyright

Corresponding author

Correspondence: Ross Brannigan, Psychology Department, Royal College of Surgeons in Ireland, Room 2, Floor –1, Beaux Lane House, Lower Mercer Street, Dublin 2, Ireland. Email: rossbrannigan@rcsi.com

References

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1Rice, F, Jones, I, Thapar, A. The impact of gestational stress and prenatal growth on emotional problems in offspring: a review. Acta Psychiatr Scand 2007; 115: 171–83.
2Glover, V. Annual research review: prenatal stress and the origins of psychopathology: an evolutionary perspective. J Child Psychol Psychiatry 2011; 52: 356–67.
3Chanen, AM, Jovev, M, McCutcheon, LK, Jackson, HJ, McGorry, PD. Borderline personality disorder in young people and the prospects for prevention and early intervention. Curr Psychiatry Revi 2008; 4: 4857.
4Chanen, AM, McCutcheon, L. Prevention and early intervention for borderline personality disorder: current status and recent evidence. Br J Psychiatry 2013; 202: s249.
5Pompili, M, Girardi, P, Ruberto, A, Tatarelli, R. Suicide in borderline personality disorder: a meta-analysis. Nord J Psychiatry 2005; 59: 319–24.
6Chanen, AM, Jackson, HJ, McCutcheon, LK, Jovev, M, Dudgeon, P, Yuen, HP, et al. Early intervention for adolescents with borderline personality disorder using cognitive analytic therapy: randomised controlled trial. Br J Psychiatry 2008; 193: 477–84.
7Bandelow, B, Krause, J, Wedekind, D, Broocks, A, Hajak, G, Rüther, E. Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with borderline personality disorder and healthy controls. Psychiatry Res 2005; 134: 169–79.
8Plana-Ripoll, O, Pedersen, CB, Holtz, Y, Benros, ME, Dalsgaard, S, De Jonge, P, et al. Exploring comorbidity within mental disorders among a Danish national population. JAMA Psychiatry 2019; 76: 259–70.
9Brannigan, R, Cannon, M, Tanskanen, A, Huttunen, MO, Leacy, FP, Clarke, MC. The association between subjective maternal stress during pregnancy and offspring clinically diagnosed psychiatric disorders. Acta Psychiatr Scand 2019; 139: 304–10.
10Brown, AS, van Os, J, Driessens, C, Hoek, HW, Susser, ES. Further evidence of relation between prenatal famine and major affective disorder. Am J Psychiatry 2000; 157: 190–5.
11O'Connor, TG, Heron, J, Golding, J, Glover, V, Team, ASS. Maternal antenatal anxiety and behavioural/emotional problems in children: a test of a programming hypothesis. J Child Psychol Psychiatry 2003; 44: 1025–36.
12Khashan, AS, Abel, KM, McNamee, R, Pedersen, MG, Webb, RT, Baker, PN, et al. Higher risk of offspring schizophrenia following antenatal maternal exposure to severe adverse life events. Arch Gen Psychiatry 2008; 65: 146–52.
13Wakschlag, LS, Pickett, KE, Cook, E Jr, Benowitz, NL, Leventhal, BL. Maternal smoking during pregnancy and severe antisocial behavior in offspring: a review. Am J Public Health 2002; 92: 966–74.
14Kouvonen, A, Kivimäki, M, Virtanen, M, Pentti, J, Vahtera, J. Work stress, smoking status, and smoking intensity: an observational study of 46 190 employees. J Epidemiol Community Health 2005; 59: 63–9.
15StataCorp. Stata Statistical Software: Release 14. StataCorp LP, 2015.
16Driessen, M, Herrmann, J, Stahl, K, Zwaan, M, Meier, S, Hill, A, et al. Magnetic resonance imaging volumes of the hippocampus and the amygdala in women with borderline personality disorder and early traumatization. Arch Gen Psychiatry 2000; 57: 1115–22.
17Lyoo, IK, Han, MH, Cho, DY. A brain MRI study in subjects with borderline personality disorder. J Affect Disord 1998; 50: 235–43.
18Buss, C, Davis, EP, Muftuler, LT, Head, K, Sandman, CA. High pregnancy anxiety during mid-gestation is associated with decreased gray matter density in 6–9-year-old children. Psychoneuroendocrinology 2010; 35: 141–53.
19Wingenfeld, K, Driessen, M, Adam, B, Hill, A. Overnight urinary cortisol release in women with borderline personality disorder depends on comorbid PTSD and depressive psychopathology. Eur Psychiatry 2007; 22: 309–12.
20Simeon, D, Knutelska, M, Smith, L, Baker, BR, Hollander, E. A preliminary study of cortisol and norepinephrine reactivity to psychosocial stress in borderline personality disorder with high and low dissociation. Psychiatry Res 2007; 149: 177–84.
21Entringer, S, Kumsta, R, Hellhammer, DH, Wadhwa, PD, Wüst, S. Prenatal exposure to maternal psychosocial stress and HPA axis regulation in young adults. Horm Behav 2009; 55: 292–8.
22Hannigan, LJ, Eilertsen, EM, Gjerde, LC, Reichborn-Kjennerud, T, Eley, TC, Rijsdijk, FV, et al. Maternal prenatal depressive symptoms and risk for early-life psychopathology in offspring: genetic analyses in the Norwegian Mother and Child Birth Cohort Study. Lancet Psychiatry 2018; 5: 808–15.
23Bergman, K, Sarkar, P, Glover, V, O'Connor, TG. Maternal prenatal cortisol and infant cognitive development: moderation by infant-mother attachment. Biol Psychiatry 2010; 67: 1026–32.
24Plant, DT, Jones, FW, Pariante, CM, Pawlby, S. Association between maternal childhood trauma and offspring childhood psychopathology: mediation analysis from the ALSPAC cohort. Br J Psychiatry 2017; 211: 144–50.
25Plant, DT, Pariante, CM, Sharp, D, Pawlby, S. Maternal depression during pregnancy and offspring depression in adulthood: role of child maltreatment. Br J Psychiatry 2015; 207: 213–20.
26Bowlby, J. The making and breaking of affectional bonds: I. Aetiology and psychopathology in the light of attachment theory. Br J Psychiatry 1977; 130: 201–10.
27Levy, KN. The implications of attachment theory and research for understanding borderline personality disorder. Dev Psychopathol 2005; 17: 959–86.
28Isohanni, M, Mäkikyrö, T, Moring, J, Räsanen, P, Hakko, H, Partanen, U, et al. A comparison of clinical and research DSM-III-R diagnoses of schizophrenia in a Finnish national birth cohort. Soc Psychiatry Psychiatr Epidemiol 1997; 32: 303–8.
29Widiger, TA, Rogers, JH. Prevalence and comorbidity of personality disorders. Psychiatr Ann 1989; 19: 132–6.
30Glover, V. Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol 2014; 28: 2535.
31Vieten, C, Astin, J. Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study. Arch Women Ment Health 2008; 11: 6774.

Keywords

The role of prenatal stress as a pathway to personality disorder: longitudinal birth cohort study

  • Ross Brannigan (a1), Antti Tanskanen (a2), Matti O. Huttunen (a3), Mary Cannon (a4), Finbarr P. Leacy (a5) and Mary C. Clarke (a6)...

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The role of prenatal stress as a pathway to personality disorder: longitudinal birth cohort study

  • Ross Brannigan (a1), Antti Tanskanen (a2), Matti O. Huttunen (a3), Mary Cannon (a4), Finbarr P. Leacy (a5) and Mary C. Clarke (a6)...
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