A thematic analysis of the subjective experiences of mothers with borderline personality disorder who completed Mother-Infant Dialectical Behaviour Therapy: a 3-year follow-up.

Background: Perinatal borderline personality disorder (BPD) is a common condition in perinatal mental health settings with few specialised treatment options, and little is known about the enduring effects of available treatment programs. This study explored the follow-up experiences of women with BPD after completing Mother-Infant Dialectical Behaviour Therapy (MI-DBT).

Methods: Semi-structured interviews were conducted with eight women who had completed MI-DBT 3 years prior.

Dissociation in mothers with borderline personality disorder: a possible mechanism for transmission of intergenerational trauma? A scoping review.

Background: Dissociation is a feature of Borderline Personality Disorder (BPD), but rarely a focus for research, particularly in the perinatal literature. BPD partly has its aetiology in childhood and is characterised by emotional changes and difficulty with self-coherence that impacts on the processes of caregiving.

Methods: A scoping review was conducted to synthesise current perspectives on the effect of dissociation in caregivers with BPD, particularly regarding the impact of caregiver dissociation on the interactional quality of relationship within parent-child dyads.

The Management of Perinatal Borderline Personality Disorder.

Borderline personality disorder (BPD) is highly prevalent in clinical perinatal mental health settings, although there are few systematic programmes to identify BPD at this time. Retrospective studies show compromised birth outcomes for women with this condition, and several authors have highlighted a significant range of problem outcomes for offspring identifiable from early infancy through the adult years, including the intergenerational transfer of mental health problems from mother to child. A literature review identifies the varying prevalence rates found in non-clinical and clinical settings and the paucity of published studies on the management of perinatal BPD, in particular focused both on the mother and mother-infant relationships.

Reflective functioning and mother-infant relationships among mothers with Borderline Personality Disorder post-therapy.

The stressful nature of parenting infants exacerbates the characteristics of Borderline Personality Disorder (BPD). Consequently, mothers with BPD tend to be emotionally dysregulated, respond impulsively to their infants, and have poorer mother-infant relationships. Few parenting interventions target the specific skill deficits observed in mothers with BPD.

Interventions for perinatal borderline personality disorder and complex trauma: a systematic review.

Perinatal borderline personality disorder (BPD) and complex post-traumatic stress disorder (cPTSD) are associated with significant impairment to interpersonal functioning, and risk of intergenerational transmission of psychopathology. Evaluation of interventions, however, is scarce. To date, no systematic review has addressed interventions for perinatal BPD, cPTSD, and associated symptomatology.

Holistic community-based group parenting programs for mothers with maternal mental health issues help address a growing public health need for a diversity of vulnerable mothers, children and families: Findings from an action research study.

Background: Maternal mental illness is a major growing global concern which can affect parenting with serious negative implications for offspring. Group-based parenting programs for mothers which both enhance the parent-child relationship and address mental health symptoms in a supportive social setting may optimise better outcomes for mothers and children. The Acorn program in South Australia draws on attachment theory to integrate dance play, reflective diary keeping and therapeutic letters in a holistic program for a diversity of vulnerable mothers and children aged 1-36 months.

Mothers with borderline personality disorders' experiences of mother-infant dialectical behavior therapy.

Background: Borderline personality disorder (BPD) is increasingly diagnosed in perinatal and infant settings, and research suggests that as well as an escalation of BPD symptoms in this period, these symptoms may also be detrimental to infant development. Providing tailored treatments during the postnatal period may help women and prevent an intergenerational cycle of emotional and interpersonal symptoms in infants. Mother-infant dialectical behavior therapy (MI-DBT) has produced promising, yet inconsistent, improvements on quantitative scales of maternal mental health and the mother-infant relationship.

"A service we know was missing": bridging the gap between referral to admission for women with moderate-severe perinatal mental health disorders at an Australian psychiatric mother-baby unit.

Objectives: Service demand at Australian psychiatric mother-baby units is high. This project aimed to test a model of care providing step up/step down support to women with moderate-severe perinatal mental health disorders awaiting hospital admission.

Method: A multi-disciplinary team was convened to provide pre-admission assessment and support to women waiting for admission, as well as post-discharge support as needed.

Seeing it clearly: How to use graphics to guide collaborative consultation in pregnancy.

Objective: This study aims to examine the use of decision aids which may improve shared decision making through an exploration of risk apprehension and modes of collaborative communication.

Conclusions: Decision aids such as graphics have a key role in facilitating shared treatment decision making, perhaps particularly in perinatal mental health care. They are most useful within a trusting, two-way conversation.

Health of the Nation Outcome Scales for Infants field trial: concurrent validity.

Background: A review of Australian mental health services identified a gap in routine outcome measures addressing social, emotional and behavioural domains for pre-schoolers and infants. A Child and Adolescent Mental Health Information Development Expert Advisory Panel working group developed the Health of the Nation Outcome Scales for Infants (HoNOSI), a clinician-reported routine outcome measure for infants 0-47 months. Prior face validity testing showed that the HoNOSI was considered useful in measuring mental health outcomes.

The interrater reliability of a routine outcome measure for infants and pre-schoolers aged under 48 months: Health of the Nation Outcome Scales for Infants.

Background: A review of Australian mental health services identified a gap in routine outcome measures addressing social, emotional and behavioural domains for pre-schoolers and infants. The Child and Adolescent Mental Health Information Development Expert Advisory Panel Working Group developed the Health of the Nation Outcome Scales for Infants (HoNOSI), a clinician-reported routine outcome measure for use with those aged under 4 years. Prior psychometric testing showed that the HoNOSI was considered to show face validity, and that it met the standards for concurrent validity and internal consistency.

Changing intergenerational patterns of emotional dysregulation in families with perinatal borderline personality disorder.

A pilot study with women with borderline personality disorder (BPD) and their infants showed promising results. This clinical research program sought to discover whether ongoing implementation confirmed preliminary results in relation to maternal mental health and, in addition, whether parenting and the mother-infant relationship showed sufficient improvement. Women with BPD and their infants were referred to a 25-week group program of Mother-Infant Dialectical Behavior Therapy (MI-DBT).

Impact of infant crying on mothers with a diagnosis of borderline personality disorder: A qualitative study.

Mothers with borderline personality disorder (BPD) and their infants often have compromised relationships. To further understand the complexities, this study explored (a) the experiences of mothers with BPD in response to infant crying and (b) how these parenting responses impact on mothers' interpersonal functioning with significant others. Six mothers with clinical BPD were recruited from a mother-baby psychiatric unit and interviewed using an interpretative phenomenological analysis (IPA) approach.

Treatment of postpartum psychosis in a mother-baby unit: do both mother and baby benefit?

Objectives: To describe characteristics and treatments of mother-baby dyads affected by postpartum psychosis admitted to a specialist mother-baby inpatient psychiatric unit in Australia.

Methods: A retrospective review of medical records for all mothers with postpartum psychosis and their babies admitted to a mother-baby unit over a 5-year period was conducted.

Results: A total of 25 dyads met the study criteria.

A New Therapeutic Group To Help Women With Borderline Personality Disorder and Their Infants.

Objectives: Few treatments have been described to treat the population of women with borderline personality structure who present in a dysregulated state with their infants. Therefore, a new treatment program was developed for this target group.

Methods: A total of 45 women, who were identified clinically as meeting full or partial diagnostic criteria for borderline personality disorder (BPD) and having an infant younger than 3 years of age, were offered entry with their infant(s) into specialized dialectical behavior therapy groups, adapted to focus on parenting and the mother-infant relationship.

Infants of emotionally dysregulated or borderline personality disordered mothers: Issues and management in primary care.

Background: Knowledge has increased regarding the developmental needs and capabilities of infants, and parental behaviours that support optimum infant development. Despite a better understanding of the emotional dysregulation in borderline personality disorder (BPD) and its effects on infants, general practitioners have had few guidelines for how to recognise and help emotionally dysregulated mother-infant dyads.

Objective: This article focuses on the behaviours and needs of infants whose mothers have BPD, including knowledge and skills for primary care practitioners to help these troubled families.

Helping mothers with the emotional dysregulation of borderline personality disorder and their infants in primary care settings.

Background: Six per cent of patients who present to primary care have borderline personality disorder (BPD). Mothers with full or partial features of BPD, often undiagnosed and perhaps previously functioning adequately enough on the surface, may rapidly be-come emotionally dysregulated by the normal needs of an infant. Family and maternal functioning can rapidly destabilise.

Perinatal and infant mental health in Australia: moving forward towards REAL prevention and early intervention - can we do it?

Objectives: Australia has been at the forefront of appropriate early intervention. Prevention of mental illness in infants by early identification and intervention in the mental health of their mothers has stalled since the cessation of funding through the National Perinatal Depression Initiative (NPDI, 2009-2015). Whilst screening for maternal mental illness has been widely implemented throughout Australia during the last two decades, services are now diminishing and great opportunities to ride the crest of a wave for appropriate mental illness intervention are receding.

Behavioral Interventions for Infant Sleep Problems: A Randomized Controlled Trial.

Objectives: To evaluate the effects of behavioral interventions on the sleep/wakefulness of infants, parent and infant stress, and later child emotional/behavioral problems, and parent-child attachment.

Methods: A total of 43 infants (6-16 months, 63% girls) were randomized to receive either graduated extinction (n = 14), bedtime fading (n = 15), or sleep education control (n = 14). Sleep measures included parent-reported sleep diaries and infant actigraphy.

Clinical characteristics and mental health outcomes for women admitted to an Australian Mother-Baby Unit: a focus on borderline personality disorder and emotional dysregulation?

Objective: To describe the clinical population of women admitted to a Mother-Baby Unit in Adelaide, South Australia and to evaluate changes during admission in both Axes I and II diagnoses of maternal mental health, and in mother-infant relationships.

Method: Both clinical and self-report assessments of maternal mental health were made at admission and discharge, and self-report comparisons of the mother-infant relationship.

Results: Depressive illnesses (46.

Managing Life, Motherhood and Mental Health After Discharge from a Mother-Baby Unit: An Interpretive Phenomenological Analysis.

Women who are admitted to a mother-baby psychiatric unit during the postnatal period often experience ongoing difficulties after discharge and require support in the community. This study explored the experiences of women following discharge from a mother-baby unit and their use of services and supports in the community. Semi-structured interviews were conducted with eight women who had been discharged from a mother-baby unit.