During my internship at the Institute of Mental Health and Neurosciences (IMHANS) in Srinagar, I noticed a significant issue; Personality disorders (PDs) are alarmingly common in Kashmir. I encountered a poignant case that underscored the severe impact of familial relationships on mental health. One patient, a 17-year-old girl, had dropped out of school and was so overwhelmed by suicidal thoughts that she required hospitalisation. Diagnosed with Borderline Personality Disorder (BPD), she revealed that her feelings of neglect stemmed primarily from her parents, particularly her mother, who consistently favoured her elder sister. This longstanding perception of being overlooked contributed significantly to her mental health struggles.
Her story is not unique, many patients, particularly young women, shared similar experiences. They spoke of conflicted family dynamics, childhood neglect, and the detrimental effects of constant comparisons to siblings. Such factors often played a crucial role in the development of their psychiatric conditions, leading to increased emotional distress and a range of mental health issues. This troubling pattern highlights the urgent need to understand how parenting styles and family relationships contribute to the prevalence of any psychiatricdisorders. This observation piqued my interest in understanding why personality disorders seem prevalent in the region and what factors contribute to their emergence.
Through research, I discovered that the role of parenting is crucial in either contributing to or preventing personality disorders. A healthy and supportive parenting style can act as a safeguard, preventing the development of these disorders in children. Personality disorders are complex mental health conditions that affect how individuals perceive, think, and interact with the world. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), personality disorders are grouped into three major clusters, which include 10 personality disorders.
- Cluster A: Individuals with Cluster A personality disorders often struggle to connect with others and may exhibit behaviour that is seen as odd, eccentric, or paranoid.
- Cluster B: Those diagnosed with Cluster B disorders may face difficulties in regulating their emotions, leading to impulsive, dramatic, or erratic behaviour that can cause relationship problems.
- Cluster C: Individuals with Cluster C personality disorders tend to be anxious and fearful. They may be perceived as withdrawn.
These disorders are not fleeting mood swings or temporary emotional states. Rather, they are enduring patterns of behaviour that typically emerge in late adolescence or early adulthood. Worldwide pooled prevalence of personality disorder as found by meta-analysis of studies conducted from 21 countries is 7.8%.
The most common personality disorder encountered in mental health settings is Borderline Personality Disorder (BPD). BPD, a prominent personality disorder within Cluster B, is particularly noteworthy due to its high prevalence in clinical settings. Although BPD is believed to occur equally in men and women in the general population, up to 75% of clinical diagnoses are made in women, (National Institute of Health). BPD is characterized by persistent problems with emotional (e.g., emotional lability), behavioural (e.g., deliberate self-harm and suicidal behaviour), cognitive (e.g., dissociation), and interpersonal (e.g., chaotic relationships) functioning (APA, 1994).Individuals with BPD often exhibit intense mood swings, impulsive behaviours, and difficulties managing their emotions.
While the exact causes of BPD are still unclear, experts agree that it results from a combination of genetic, environmental, and social factors. Family dynamics, particularly parenting styles, play a critical role in the development and exacerbation of BPD.The connection between parenting and the development of personality disorders is particularly relevant in the context of Kashmir. Children raised in unstable or maladaptive environments are more likely to develop personality disorders later in life. Research shows that parenting styles characterized by neglect, abuse, or inconsistency are linked to the emergence of disorders like BPD.Family studies have revealed that children of parents with BPD are significantly more likely to develop the disorder themselves.Family members of individuals with BPD have higher rates of psychiatric disorders compared to the general population (White et al., 2003).
In other words, children may inherit certain traits, such as emotional reactivity and impulsivity that predispose them to any form of psychiatric disorders.However, environmental factors, such as poor parenting, often interact with these genetic vulnerabilities, increasing the likelihood that these traits will manifest as clinical symptoms. One of the key contributors to personality disorders is maladaptive parenting. This includes behaviours like emotional neglect, verbal abuse, and inconsistent discipline, all of which disrupt the development of healthy emotional regulation in children. For example, up to 84% of people diagnosed with BPD have reported experiences of neglect or emotional abuse before the age of 18, (Zanarini et al., 2000).
Maladaptive parenting not only affects a child’s emotional development but can also lead to psychological deficits in areas like emotional regulation and social understanding. Children raised in such environments often struggle with managing their emotions, forming stable relationships, and understanding social cues. These early deficits put them at a higher risk of developing personality disorders, including BPD, during adolescence or adulthood.In Kashmir, effective parenting is essential for child development, especially amid socio-economic challenges and conflict. Parents with mental health issues, such as personality disorders, may display maladaptive behaviours that adversely affect their children. For instance, mothers with Borderline Personality Disorder (BPD) often experience increased stress, leading to emotional insensitivity and intrusive behaviour, which can heighten risks of emotional dysregulation and insecure attachments in their children.Positive parenting practices are crucial in mitigating these risks.
By fostering emotional stability and consistency, parents can significantly lower the likelihood of their children developing personality disorders. Targeted mental health interventions focused on enhancing parenting skills emphasizing emotional regulation, empathy, and psychological support can break the cycle of intergenerational transmission of these disorders.
Recognizing Alarm Signs
To identify alarming signs that a child may be developing a personality disorder, look for:
- Extreme Mood Swings: Sudden, intense changes in emotions that seem disproportionate.
- Social Withdrawal: Avoiding social situations or difficulty forming friendships.
- Impulsive Behaviour: Engaging in risky activities without considering the consequences.
- Feelings of Insecurity: Ongoing feelings of worthlessness or fear of rejection.
- Conflict with Authority: Frequent issues with parents or teachers, often marked by hostility.
By recognizing these signs early and seeking appropriate help, parents can play a vital role in nurturing their child’s emotional health. With the right support and strategies, families can foster resilience and promote well-being for future generations. Remember, “Every small step you take in nurturing a child’s well-being creates a ripple effect of positive change.”
(The author is pursuing Masters in Psychology and can be reached at: [email protected])
