Adolescent attachment insecurity and the influence of MBT

The aim of this study in a high-risk adolescent sample with personality disorders receiving intensive mentalisation-based treatment (MBT), was first, to examine deviations in insecure attachment distribution of the normative pattern, and in borderline personality disorder and other personality disorders; second, to explore whether MBT alters attachment representations and whether these alterations are related to changes in psychological distress. A total of 60 adolescents were investigated pre-treatment for both categorical and continuous measures of the Adult Attachment Interview (AAI). Pre- and post-AAI (N = 33) data were compared with psychological distress measured by the Symptom Checklist-90. While the most disturbed category of insecure attachment, the "cannot classify" category, was overrepresented (46.7%) at pre-treatment, no differences were observed by type of personality disorder. At post-treatment, 48.5% of the participants showed positive change in the attachment representation, and their psychological distress lowered significantly (p = .002). The whole sample demonstrated change towards increased secure attachment (z = -2.85, p = .004). Attachment insecurity was found in all adolescent personality disorders which MBT seemed to be able to alter. However, as we included no control group, we cannot conclude that changes are due to the treatment itself.