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Peer-reviewedCC BYResearch on child and adolescent psychopathology

Low Caregiver-Child Positive Escalation in Childhood Predicts Late Adolescent BPD.

  • Charlie Huntington1
  • Kirsten Gilbert2
  • Alecia C Vogel2
  • Rebecca Tillman2
  • Brittany Haus2
  • Deanna M Barch2,3,4
  • Joan L Luby2
  • Diana J Whalen2
4 affiliations
  1. 1Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA. [email protected].
  2. 2Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.
  3. 3Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA.
  4. 4Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA.
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Abstract

Borderline personality disorder (BPD) and major depressive disorder (MDD) are highly comorbid, yet little is known about developmental family processes that distinguish between individuals who will go on to develop MDD versus BPD. Using longitudinal, observational data from the Preschool Depression Study, we tested whether caregiver behaviors and caregiver-child interaction patterns during a conflict discussion task predicted later BPD vs. MDD symptoms. Caregiver-child dyads (N = 161) completed five-minute conflict discussions at up to three timepoints across late childhood and early adolescence; these discussions were observationally coded for caregiver and dyadic behaviors. Outcomes were self-reported BPD symptoms and clinical interview-based MDD symptoms assessed in late adolescence. After controlling for caregiver BPD and MDD and correcting for the false discovery rate, hierarchical linear regression models showed that lower dyadic positive escalation between caregiver and child predicted elevated BPD symptoms in late adolescence. Associations with MDD symptoms were not significant. These findings suggest that maintaining or building positive affect during challenging caregiver-child interactions may be a protective interpersonal process that is more specific to risk for BPD than risk for MDD. Implications for our understanding of the development of BPD versus MDD in childhood and adolescence are discussed.

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Cite

BibTeXRIS
BibTeX
@article{huntington2026caregiverchild,
  title = {{Low Caregiver-Child Positive Escalation in Childhood Predicts Late Adolescent BPD.}},
  author = {Charlie Huntington and Kirsten Gilbert and Alecia C Vogel and Rebecca Tillman and Brittany Haus and Deanna M Barch and Joan L Luby and Diana J Whalen},
  journal = {Research on child and adolescent psychopathology},
  year = {2026},
  month = oct,
  doi = {10.1007/s10802-026-01513-3},
  url = {https://europepmc.org/article/MED/42873387},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Low Caregiver-Child Positive Escalation in Childhood Predicts Late Adolescent BPD.
AU  - Charlie Huntington
AU  - Kirsten Gilbert
AU  - Alecia C Vogel
AU  - Rebecca Tillman
AU  - Brittany Haus
AU  - Deanna M Barch
AU  - Joan L Luby
AU  - Diana J Whalen
PY  - 2026
DA  - 2026/10/14
JO  - Research on child and adolescent psychopathology
DO  - 10.1007/s10802-026-01513-3
UR  - https://europepmc.org/article/MED/42873387
AB  - Borderline personality disorder (BPD) and major depressive disorder (MDD) are highly comorbid, yet little is known about developmental family processes that distinguish between individuals who will go on to develop MDD versus BPD. Using longitudinal, observational data from the Preschool Depression Study, we tested whether caregiver behaviors and caregiver-child interaction patterns during a conflict discussion task predicted later BPD vs. MDD symptoms. Caregiver-child dyads (N = 161) completed five-minute conflict discussions at up to three timepoints across late childhood and early adolescence; these discussions were observationally coded for caregiver and dyadic behaviors. Outcomes were self-reported BPD symptoms and clinical interview-based MDD symptoms assessed in late adolescence. After controlling for caregiver BPD and MDD and correcting for the false discovery rate, hierarchical linear regression models showed that lower dyadic positive escalation between caregiver and child predicted elevated BPD symptoms in late adolescence. Associations with MDD symptoms were not significant. These findings suggest that maintaining or building positive affect during challenging caregiver-child interactions may be a protective interpersonal process that is more specific to risk for BPD than risk for MDD. Implications for our understanding of the development of BPD versus MDD in childhood and adolescence are discussed.
SN  - 2730-7166
SN  - 2730-7174
ER  -