Transmission of traumatic childhood experiences across generations: mother-child interaction in traumatized mothers with borderline personality disorder

童年创伤经历(CT)通常会在几代人之间传递。据估计，25%的受虐待儿童本身可能会成为虐待父母。在这里，CT将被定义为在17岁之前经历过的身体或性虐待。问题是，哪些行为和神经生物学机制是虐待传播的基础。不同的人对CT的反应不同。两种常见的反应是边缘人格障碍(BPD)和抑郁(严重抑郁障碍，MDD)。它们代表对创伤的外在化(BPD)和内在化(MDD)反应风格。这些对创伤反应的差异可能对CT如何在几代人之间传播以及如何预防传播至关重要。虽然一些研究调查了母亲MDD对母子互动的影响，但很少有人关注母亲BPD的影响。在这里，我们关注一个尚未被研究的群体：患有BPD的母亲和她们的小学年龄的孩子。他们将与没有BPD的精神创伤母亲和没有CT的BPD母亲进行比较。我们的主要研究问题是：BPD精神病理学和CT对母子互动的具体影响是什么？这两个因素是如何相互作用的？拟议项目中获得的数据将与正在进行的BMBF项目的数据进行比较，该项目正在应用类似的测试电池。在这个BMBF项目中，我们调查了对CT有抑郁反应的母亲，患有MDD的非创伤母亲和没有CT的健康母亲。我们的第二个研究问题是：CT对母子互动的影响依赖于母亲对创伤的反应吗？为了研究CT的跨代传播，我们将结合情绪可获得性量表、功能磁共振成像(FMRI)和内分泌学对母子互动的行为观察。将特别强调(1)母亲的敌意和(2)儿童在自由游戏互动和压力范例期间与母亲的接触。关于母亲，我们假设：CT和BPD都与更多的敌意有关，而且这两种因素对母亲的影响都是相加的。增加的敌意被催产素和皮质醇缓和，并与杏仁核高反应和母体应激(愤怒)范式中不活跃的前额叶情绪调节网络有关。相比之下，对患有MDD的CT反应的母亲表现出敏感度降低。关于孩子，我们假设：母亲的CT和母亲的BPD都与减少儿童与母亲的参与有关，并且这两种因素对母亲的孩子的影响都是相加的。相比之下，母亲对患有MDD的CT反应的孩子表现出过度参与。这个项目有助于我们理解虐待的跨代循环，并使我们能够确定特定于障碍的干预目标。

Childhood traumatic experiences (CT) are often transmitted across generations. An estimated 25% of abused children are likely to become abusive parents themselves. CT will here be defined as physical or sexual abuse experienced before the age of 17. The question arises which behavioral and neurobiological mechanisms underlie the transmission of abuse. Individuals differ in the way they react to CT. Two common reactions are borderline personality disorder (BPD) and depression (major depressive disorder, MDD). They represent externalizing (BPD) versus internalizing (MDD) styles of reaction to trauma. These variations in reactions to trauma may be critical for how CT are transmitted across generations and how transmission could be prevented.While some studies have investigated effects of maternal MDD on mother-child interaction, little attention has been paid to the effects of maternal BPD. Here we focus on a group that has not yet been studied: mothers who have responded to CT with BPD and their children of primary school age. They will be compared with traumatized mothers without BPD and with BPD mothers without CT. Our primary research question is: What are the specific effects of BPD psychopathology and of CT on mother-child interaction and how do these two factors interact?Data obtained in the proposed project will be compared with data from an ongoing BMBF project which is applying a similar test battery. In this BMBF project, we investigate mothers showing depressive reactions to CT, non-traumatized mothers with MDD and healthy mothers without CT. Our secondary research question is: Do effects of CT on mother-child interaction depend on the maternal reaction to trauma? To study the transgenerational transmission of CT we will combine behavioral observations of mother-child interaction using the emotional availability scale, functional magnetic resonance imaging (fMRI) and endocrinology. Particular emphasis will be placed on (1) maternal hostility and (2) child involvement with the mother during a free-play interaction and during a stress paradigm. Regarding the mother, we hypothesize: Both CT and BPD are associated with increased hostility, and the effects add up in mothers with both factors. Increased hostility is moderated by oxytocin and cortisol and is associated with amygdala hyper-responsiveness and hypo-active prefrontal emotion regulation networks during a maternal stress (anger) paradigm. In contrast, mothers responding to CT with MDD show decreased sensitivity. Regarding the child, we hypothesize: Both maternal CT and maternal BPD are associated with reduced child involvement with the mother, and the effects add up in children of mothers with both factors. In contrast, children of mothers responding to CT with MDD show over-involvement. This project contributes to our understanding of the transgenerational cycle of abuse and allows the identification of disorder-specific targets for intervention.