Attachment and Reflective Functioning in Women With Borderline Personality Disorder

Area of Science:

• Psychiatry
• Clinical Psychology
• Developmental Psychology

Background:

• Insecure attachment and impaired reflective functioning (RF) are implicated in borderline personality disorder (BPD).
• The mentalization-based model proposes insecure attachment indirectly impacts BPD features through disrupted RF.
• Direct testing of this mediation model in adult BPD patients is lacking.

Purpose of the Study:

• To investigate the interplay between attachment styles, RF capacities, and BPD clinical status in adult women.
• To examine whether RF mediates the relationship between insecure attachment and BPD.

Main Methods:

• A cross-sectional study involving 55 female adult BPD patients and 105 female healthy controls.
• Utilized self-report measures to assess attachment, RF, and BPD status.

Main Results:

• BPD patients exhibited predominantly insecure attachment, characterized by negative self-perceptions and low self-worth.
• BPD patients demonstrated significantly decreased RF abilities compared to controls.
• Reflective functioning capacities were found to mediate the association between insecure attachment and BPD clinical status.

Conclusions:

• Insecure attachment and reduced RF are prominent in adult BPD.
• RF impairment plays a crucial mediating role in the link between insecure attachment and BPD.
• Findings support the mentalization-based model's proposed pathway in BPD etiology.