May 20, 2006

Parenting and Personality Disorders

A fascinating article that no one will ever actually read: Parenting Behaviors Associated With Risk For Offspring Personality Disorder During Adulthood.


The authors made a (startling) discovery: there are types of parenting behaviors which predispose your kid to growing up personality disordered.


This was a longitudinal study of 592 families, first assessed when the kids were about 5, and then again when they were in their 30s.   (More info at their website


The results are pretty much what you'd expect: 






The more of these behaviors the parents exhibited, the more the risk of PD increased.   What is interesting is which PD was increased given the number of parental behaviors:


First, overall number of bad parental behaviors:

(antisocial=criminal; avoidant=shy; narcissistic=self-absorbed) 

Prevalence of PD vs. # parenting behaviors 


You'll notice that antisocial PD is essentially zero at baseline, and is dramatically sensitive to bad parenting.  Contrast this with avoidant PD, which, while also sensitive to the parenting, starts out higher at baseline.  In other words, you may be born shy, but not antisocial. 


Looking at specific types of bad parenting:







What you'll see in the top figure is that being an aversive parent is a great way of making someone borderline or passive-aggressive, not to mention paranoid.  But it doesn't make them antisocial.  Hmm.


Meanwhile, having low affection or low nurturing scores increased the risk for antisocial, as well as everything else (but especially avoidant, paranoid, depressive, borderline).  


Some covariate caveats: even when parental psychaitric disorders and  offspring behavioral problems at age 6 were controlled, bad parenting was still associatd with increased risk of their kids' PD. 


Furthermore, the usual association of parental psychiatric disorder leading to child PD could be explained, in fact, 95% due to the bad parenting.  Another way of saying this is that 95% of the effect that a parental psychiatric disorder has on causing their kids' personality disorder can be obviated by better parenting.  In a similar vein, 35% of the effect of childhood behavioral problems leading to later PD can be similarly reduced by better parenting.  In other words, even if you or your kids have a "biological" psychiatric disorder, better parenting skills can darmiatically affect the outcome.


It is not an insignificant fact that only one of the 5 authors was an MD (oddly, he is also a PhD but does not list this in the authorship line.).  The nature vs. nurture debate in psychiatry is all but dead.


The longer we delude ourselves that biology controls behavior, and not the other way around, the longer we'll have to live with the same behaviors.