Background: Mentalization-based treatment (MBT) and dialectical behavioral therapy (DBT) are two treatments with a strong theoretical basis for borderline personality disorder (BPD). Objectives: We investigated the structures that influence the process of symptom recovery from the perspective of mentalization-based treatment. Methods: This is a single-blind randomized controlled clinical trial conducted on 60 patients diagnosed with BPD. Data were collected from March 2017 to June 2017 by a psychiatrist in a semi-structured clinical interview. The participants were categorized into intervention and control groups. Before, immediately and two months after the group therapy based on MBT and DBT, the participants were assessed with Revised Adult Attachment Scale (RAAS), Reflective Function Questionnaire for Adult (RFQA), Eye Test-Test Revised Version, Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II). Results: Both of the treatments were effective in improving avoidant (P = 0.0001) and ambivalent (P = 0.0001) attachment styles, mentalization (P = 0.0001), and social cognition (P = 0.0001). These changes persisted from post-test to follow-up in mentalization (P = 0.003) and social cognition (P = 0.02). Conclusions: Although both methods are effective in improving the symptoms of the disorder, MBT is more effective in improving the basic structures of the BPD. This may lead to greater stability in the treatment.

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