Structural model of borderline personality disorder based on early life trauma, schema mentality and perception of maternal parenting with the mediating role of emotion regulation difficulty

Document Type : Research Paper


1 PhD Student in General Psychology, Islamic Azad University, Central Tehran Branch, Tehran, Iran.

2 Assistant Professor, Department of General Psychology, Islamic Azad University, Central Tehran Branch, Tehran, Iran.

3 Associate Professor, Department of Clinical Educational Psychology, Islamic Azad University, Central Tehran Branch, Tehran, Iran.

4 Assistant Professor, Department of Clinical Psychology, Islamic Azad University, West Tehran Branch, Tehran, Iran.


Background and Aim: Borderline personality disorder is a severe and debilitating disorder that is estimated in one to two percent of the general population. The aim of this study was to structurally model borderline personality disorder based on early life trauma, schema mentality and perception of maternal parenting with the role of mood mediator.
Methods: The statistical population of the study consisted of people with borderline personality disorder referred to medical centers (clinics and psychiatric hospitals) in Tehran in the years 1997-98 that 250 people were selected as a sample by purposive sampling. Data collection tools included Borderline Personality Scale (BPI) Questionnaire (1999), Mood Personality Questionnaire (TCI), Cloninger et al (1993), Child Abuse Experience Questionnaire (CASRS), Mohammadkhani et al (2003) and Mentality Questionnaire. Schematic (SMQ) and Perceived Parenting Methods Questionnaire (POPS) by Grolling et al (1997). Data analysis was performed by structural equation modeling (SEM) and using SPSS24 software.
Findings: The findings showed that mood plays a mediating role in the relationship between early life trauma and borderline personality. Mood mediates the relationship between schema mentality and borderline personality and mood mediates the relationship between maternal parenting and borderline personality (P <0. 05)
Conclusion: The present study confirmed the role of mood, early life traumas, schema mentality and perceived parenting practices in explaining borderline personality disorder, which provide the theoretical basis for preventive programs to clinical professionals. Gives.


  1. Kaplan C, Tarlow N, Stewart JG, Aguirre B, Galen G, Auerbach RP. Borderline personality
    disorder in youth: The prospective impact of child abuse on non-suicidal self-injury and
    suicidality. Comprehensive psychiatry. 2016 Nov 1;71:86-94.
    2. Apfelbaum S, Regalado P, Herman L, Teitelbaum J, Gagliesi P. La comorbilidad del
    trastorno bipolar con trastornos de la personalidad tipo B como indicador de severidad
    clínica y desregulación afectiva. Actas Españolas de Psiquiatria. 2013 Sep 1;41 (5).
    3. Schienle A, Leutgeb V, Wabnegger A. Symptom severity and disgust-related traits in
    borderline personality disorder: the role of amygdala subdivisions. Psychiatry Research:
    Neuroimaging. 2015 Jun 30;232 (3):203-7.
    4. Ball JS, Links PS. Borderline personality disorder and childhood trauma: evidence for a
    causal relationship. Current psychiatry reports. 2009 Feb 1;11 (1):63-8.
    5. Giugliano JR. Object relations treatment of a woman with borderline personality disorder
    from a Mahlerian perspective: A case illustration. Clinical Case Studies. 2012 Dec;11
    6. Paris J, Zweig-Frank H. The 27-year follow-up of patients with borderline personality
    disorder. Comprehensive psychiatry. 2001 Nov.
    7. Trull TJ. Structural relations between borderline personality disorder features and putative
    etiological correlates. Journal of Abnormal Psychology. 2001 Aug;110 (3):471.
    8. Infurna MR, Brunner R, Holz B, Parzer P, Giannone F, Reichl C, Fischer G, Resch F, Kaess
    M. The specific role of childhood abuse, parental bonding, and family functioning in female
    adolescents with borderline personality disorder. Journal of personality disorders. 2016
    Apr;30 (2):177-92.
    9. Bandelow B, Gutermann J, Peter H, Wedekind D. Early traumatic life events, parental
    attitudes, family history, and birth risk factors in patients with depressive disorder and
    healthy controls. International journal of psychiatry in clinical practice. 2013 Feb 1;17
    10.Hiraoka R, Crouch JL, Reo G, Wagner MF, Milner JS, Skowronski JJ. Borderline
    personality features and emotion regulation deficits are associated with child physical abuse
    potential. Child abuse & neglect. 2016 Feb 1;52:177-84.
    11.Kuo JR, Khoury JE, Metcalfe R, Fitzpatrick S, Goodwill A. An examination of the
    relationship between childhood emotional abuse and borderline personality disorder features:
    The role of difficulties with emotion regulation. Child abuse & neglect. 2015 Jan 1;39:147-
    12.Lobbestael J, Arntz A, Sieswerda S. Schema modes and childhood abuse in borderline and
    antisocial personality disorders. Journal of behavior therapy and experimental psychiatry.
    2005 Sep 1;36 (3):240-53.
    13.Young JE, Klosko JS, Weishaar ME. Schema therapy: A practitioner's guide. guilford press;
    2006 Nov 1.
  2. 14.Young, J. E. , Klosko, J. S. , & Weishaar, M. E (2003). Schema therapy: a practitioner's
    guide. NY: Guilford Press.
    15.Vanwoerden S, Kalpakci A, Sharp C. The relations between inadequate parent-child
    boundaries and borderline personality disorder in adolescence. Psychiatry research. 2017
    Nov 1;257:462-71.
    16.Shshsmst Fatima, Sabeti Alireza , Rezvani, Samaneh. Investigating the relationship between
    parenting styles and early maladaptive schemas. Educational Psychology Studies,2011, 11
    (2), 239-254.. [Pesrsian]
    17.Grolnick WS, Ryan RM, Deci EL. Inner resources for school achievement: Motivational
    mediators of children's perceptions of their parents. Journal of educational psychology. 1991
    Dec;83 (4):508.
    18.Giannotta F, Rydell AM. The role of the mother-child relationship in the route from child
    ADHD to adolescent symptoms of depressed mood. Journal of adolescence. 2017 Dec
    19.Masoudian S. The relationship between personality traits and parenting styles of parents with
    the child's mood. Faculty of Psychology, Department of General Psychology, Thesis for
    Master's Degree in Psychology. Islamic Azad University, Shahroud Science and Research
    Unit. 2016. [Pesrsian]
    20.Baryshnikov, I. , Joffe, G. , Koivisto, M. , Melartin, T. , Aaltonen, K. , Suominen, K. ,
    Rosenström, T. , Näätänen, P. , Karpov, B. , Heikkinen, M. and Isometsä, E. , 2017.
    Relationships between self-reported childhood traumatic experiences, attachment style,
    neuroticism and features of borderline personality disorders in patients with mood disorders.
    Journal of affective disorders, 210, pp. 82-89.
    21.Rezaeian H ,. Manirpour N , Ahmadi M ,Heratian A (1396). The Role of Natural
    Characteristics and Parenting Styles in Predicting Areas of Self-Governance and Impaired
    Functionality, Orientation, and Early Adaptive Schemas. Cultural and Educational Quarterly
    of Women and Family , 2015, 40: 147-127. [Pesrsian]
    22.Paul Schlette. `Sven Brandstrom` Martin Eisemann` Soren Sigvardsson`. Per-Olof Nyiander`
    Rolf Adolfsson & Carlo Perris. Perceived parental rearing behaviours and temperament and
    character in healthy adults. Person Individ. Diff 1997,24-5,661-668.
    23.Akiskal HS, Akiskal K, Allilaire JF, Azorin JM, Bourgeois ML, Sechter D, Fraud JP,
    Chatenêt-Duchêne L, Lancrenon S, Perugi G, Hantouche EG. Validating affective
    temperaments in their subaffective and socially positive attributes: psychometric, clinical and
    familial data from a French national study. Journal of affective disorders. 2005 Mar 1;85 (1-
    24.Thimm JC. Personality and early maladaptive schemas: A five-factor model perspective.
    Journal of behavior therapy and experimental psychiatry. 2010 Dec 1;41 (4):373-80.
    25.Goldberg JF, Gerstein RK, Wenze SJ, Welker TM, Beck AT. Dysfunctional attitudes and
    cognitive schemas in bipolar manic and unipolar depressed outpatients: Implications for
    cognitively based psychotherapeutics. The Journal of Nervous and Mental Disease. 2008
    Mar 1;196 (3):207-10.
    26.Hawke LD, Provencher MD, Arntz A. Early Maladaptive Schemas in the risk for bipolar
    spectrum disorders. Journal of Affective Disorders. 2011 Oct 1;133 (3):428-36.
    27.Cline MS, Blume J, Cawley S, Clark TA, Hu JS, Lu G, Salomonis N, Wang H, Williams A.
    ANOSVA: a statistical method for detecting splice variation from expression data.
    Bioinformatics. 2005 Jun 1;21 (suppl_1):i107-15.
    28.Homan H. Understanding the scientific method in behavioral sciences, Samt Publications,
    29.Leichsenring F. Development and first results of the Borderline Personality Inventory: A
    self-report instrument for assessing borderline personality organization. Journal of
    Personality Assessment. 1999 Aug 1;73 (1):45-63.
    30.Mohamad zadeh A, Rezaei. Validation of the Borderline Personality Questionnaire in Iranian
    Society, Behavioral Sciences, 2011, 5 (3): 267-278. [Pesrsian]
  3. 31.Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and
    character. Archives of general psychiatry. 1993 Dec 1;50 (12):975-90.
    32.Kaviani H, Poor Naseh M. Validation Of Temperament And Character Inventory (TCI) In
    Iranian Sample: Normative Data. Tehran Univ Med J. 2005; 63 (2) :89-98. [Pesrsian]
    33.Mohammadkhani P, Mahmoudi A , Ahmadi H , Jamshidi R. Prepared and validated Finding
    a child abuse questionnaire. Master Thesis, 2003. [Pesrsian]
    34.Young, J. E, & Brown, G, 1994, Young schema questionnaire: A schema-focused approach,
    Cognitive Therapy for Personality Disorders, Sarasota, LF, professional resource press, p.
    35.Beck AT, Freeman A. Associates. Cognitive therapy of personality disorders. 1990, 81.
    36.Lobbestael J, Arntz A, Sieswerda S. Schema modes and childhood abuse in borderline and
    antisocial personality disorders. Journal of behavior therapy and experimental psychiatry.
    2005 Sep 1;36 (3):240-53.
    37.Karshki H, Kharazi S A,N , Ejei J, Ghazi Tabatabai, S M. Relationship between family
    environmental perceptions, motivational beliefs and self-regulated learning, Journal of
    Scientific-Research Psychology. 2009. 50 (2): 190-205. [Pesrsian]
    38.Kharazi A , Karshki H. Investigating the relationship between parental perception
    components and self-regulated learning strategies. New Journal of Cognitive Sciences. 2009.
    11 (1): pp. 55-49. [Pesrsian]
    39.Goodman J, Fertuck E, Chesin M, Lichenstein S, Stanley B. The moderating role of rejection
    sensitivity in the relationship between emotional maltreatment and borderline symptoms.
    Personality and Individual Differences. 2014 Dec 1;71:146-50.
    40.van Dijke A, Ford JD, van Son M, Frank L, van der Hart O. Association of childhoodtrauma-by-primary caregiver and affect dysregulation with borderline personality disorder
    symptoms in adulthood. Psychological Trauma: Theory, Research, Practice, and Policy.
    2013 May;5 (3):217.
    41.Igarashi H, Hasui C, Uji M, Shono M, Nagata T, Kitamura T. Effects of child abuse history
    on borderline personality traits, negative life events, and depression: A study among a
    university student population in Japan. Psychiatry research. 2010 Dec 30;180 (2-3):120-5.
    42.Linehan MM, Bohus M, Lynch TR. Dialectical behavior therapy for pervasive emotion
    dysregulation. Handbook of emotion regulation. 2007;1:581-605.
    43.Sleuwaegen E, Claes L, Luyckx K, Berens A, Vogels C, Sabbe B. Subtypes in borderline
    patients based on reactive and regulative temperament. Personality and Individual
    Differences. 2017 Apr 1;108:14-9.
    44.MÄ…cik D. Early maladaptive schemas, parental attitudes and temperament, and the evolution
    of borderline and avoidant personality features–the search for interdependencies. Psychiatria
    i Psychologia Kliniczna. 2018;18 (1).
    45.Tschan T, Peter-Ruf C, Schmid M, In-Albon T. Temperament and character traits in female
    adolescents with nonsuicidal self-injury disorder with and without comorbid borderline
    personality disorder. Child and adolescent psychiatry and mental health. 2017 Dec;11 (1):1-
    46.Toda H, Inoue T, Tanichi M, Saito T, Nakagawa S, Masuya J, Tanabe H, Yoshino A,
    Kusumi I. Affective temperaments play an important role in the relationship between child
    abuse and the diagnosis of bipolar disorder. Psychiatry research. 2018 Apr 1;262:13-9.
    47.Wolff KT, Baglivio MT, Klein HJ, Piquero AR, DeLisi M, Howell JC. Adverse childhood
    experiences (ACEs) and gang involvement among juvenile offenders: assessing the
    mediation effects of substance use and temperament deficits. Youth violence and juvenile
    justice. 2020 Jan;18 (1):24-53.
    48.Sexton E. Adverse Childhood Experiences (ACEs) and Temperament in Children Aged 14 to
    49.Pancar Yuksel E, Durmus D, Sarisoy G. Perceived stress, life events, fatigue and
    temperament in patients with psoriasis. Journal of International Medical Research. 2019
    Sep;47 (9):4284-91. 
  4. 50.Clark LA, Watson D, Mineka S. Temperament, personality, and the mood and anxiety
    disorders. Journal of abnormal psychology. 1994 Feb;103 (1):103.
    51.Hanaei N , Mahmoud Alilou M , Bakhshipour Rudsari A , Akbari E. Schematic mentalities,
    child abuse experiences, and attachment styles in borderline personality disorder. Clinical
    Psychology and Personality, 2015; 13 (1): 101-120.
    52.Nabizadeh Chianeh Q , Poursharifi H , Farnam A , Ghaderi H , Ansari Z , Behjat, Shir
    Alizadeh, Narmin. Comparison of emotional moods and early maladaptive schemas in
    people with borderline personality disorder, bipolar disorder and normal people. Clinical
    Psychology, 2014; 6 (2): 13-28.
    53.Mohammad Amini Jazi, M. Investigating the relationship between maladaptive schemas and
    activation-behavioral inhibition systems with borderline and avoidance personality traits.
    Master Thesis in Clinical Psychology. Mohaghegh Ardabili University, Faculty of Literature
    and Humanities, 2011.
    54.Flink N, Honkalampi K, Lehto SM, Leppänen V, Viinamäki H, Lindeman S. Comparison of
    early maladaptive schemas between borderline personality disorder and chronic depression.
    Clinical psychology & psychotherapy. 2018 Jul;25 (4):532-9.
    55.Cohen LJ, Tanis T, Ardalan F, Yaseen Z, Galynker I. Maladaptive interpersonal schemas as
    sensitive and specific markers of borderline personality disorder among psychiatric
    inpatients. Psychiatry research. 2016 Aug 30;242:395-403.
    56.Koppers D, Van H, Peen J, Dekker JJ. Psychological symptoms, early maladaptive schemas
    and schema modes: predictors of the outcome of group schema therapy in patients with
    personality disorders. Psychotherapy Research. 2020 Dec 2:1-2.