Prospective Effects of Caregiver-Child Interaction on Changes in Developmental Personality Pathology During Adolescence

This study investigates the caregiver-child relationship as a proximal risk factor in the transactional development of youth personality pathology. Laboratory-based conflictual interactions between 129 girls (aged 11-13) and their caregivers were rated for positive and negative escalation, mutuality, relationship quality and satisfaction. Concurrently and two years later, girls' maladaptive traits were assessed via self- and caregiver-reports based on the DSM-5 Alternative Model for Personality Disorders (AMPD) domains (negative affect, detachment, antagonism, disinhibition, psychoticism). Using a series of path models, we assessed whether dyadic interactions predicted changes in self- and caregiver reported maladaptive traits. In dyads with reduced positive interaction patterns, particularly a lack of mutuality and relationship satisfaction, girls were characterized by elevated levels of negative affect, detachment, disinhibition, and psychoticism. These patterns were notably more consistent for girls’ self-reports. Patterns of negative escalation predicted self- and caregiver reported antagonism, but they were not linked to other maladaptive trait domains. The study illustrates the importance of the caregiver-child relationship in the etiology of developmental personality pathology by establishing a link between observed caregiver-child interactions and prospective changes in key domains of maladaptive traits. It expands the literature on dyadic interaction and developmental personality pathology to the dimensional framework of the AMPD.