Maternal Mood and Comorbid Personality Disorders: Attachment Development from Infancy to Young Adulthood

Abstract

Maternal psychopathology, particularly maternal mood disorders, is an important developmental context for attachment development, as maternal sensitivity and other caregiving behaviors necessary for a secure attachment may be impaired. While maternal depression in relation to offspring attachment has been well examined, less attention has been given to the impact of maternal psychiatric comorbidity, particularly between maternal mood and personality disorders (PD) on attachment development. Leveraging a prospective longitudinal study of well and psychiatrically ill mothers and two of their children (60 children of well mothers, 75 children of mothers with comorbid mood and PDs, and 57 children of mothers with mood disorders), this study seeks to further examine the role of maternal psychiatric illness on attachment development over three time points, early and middle childhood, and young adulthood. In study 1, I characterized the sample using cross-sectional analyses to predict attachment at each time point. Although I predicted that mothers in the mood and comorbid groups would have offspring with greater incidence of insecure attachment across all developmental periods, my hypotheses were not confirmed as maternal psychiatric mood and comorbid group membership did not predict attachment in early, middle, and young adulthood. The study provided preliminary evidence that maternal bipolar disorder predicted lower log odds of secure attachment in early childhood, and that offspring of mothers with higher Cluster B dimensional scores had increasing logs odds of being securely attached in early childhood. For study 2, I predicted that offspring of mothers with mood disorders would be characterized by greater discontinuity over development, moving towards insecurity over time, and ran exploratory analyses to examine attachment discontinuity in offspring of mothers in the comorbid group. Results suggest that for offspring of mothers with maternal personality Cluster C diagnosis, attachment across development may be characterized as discontinuous with increasing log odds of secure attachment from early to middle childhood. Offspring of mother with Cluster A dimensional scores also demonstrated decreasing log odds of being securely attached across development. These results expand upon our existing understanding of maternal psychopathology on offspring attachment development, and offers preliminary evidence on attachment in the context of maternal comorbid psychiatric illnesses with PDs. However, results should be considered in light of limitations of the study, including sample size and general sparse findings, and await further replication and extension. This study offers a preliminary understanding of maternal mental illness, beyond maternal depression, and extends the current literature by examining the role of maternal comorbidity on cross sectional and longitudinal offspring attachment outcomes.