Categorical and dimensional approaches in the evaluation of the relationship between attachment and personality disorders: an empirical study

Abstract

Although several studies have highlighted the relationship between attachment states of mind and personality disorders, their findings have not been consistent, possibly due to the application of the traditional taxonomic classification model of attachment. A more recently developed dimensional classification of attachment representations, including more specific aspects of trauma-related representations, may have advantages. In this study, we compare specific associations and predictive power of the categorical attachment and dimensional models applied to 230 Adult Attachment Interview transcripts obtained from personality disordered and nonpsychiatric subjects. We also investigate the role that current levels of psychiatric distress may have in the prediction of PD. The results showed that both models predict the presence of PD, with the dimensional approach doing better in discriminating overall diagnosis of PD. However, both models are less helpful in discriminating specific PD diagnostic subtypes. Current psychiatric distress was found to be the most consistent predictor of PD capturing a large share of the variance and obscuring the role played by attachment variables. The results suggest that attachment parameters correlate with the presence of PD alone and have no specific associations with particular PD subtypes when current psychiatric distress is taken into account.

The centrality of affective instability and identity in Borderline Personality Disorder: Evidence from network analysis

“…Moreover this is coherent with the idea that interpersonal disturbances are central in BPD (e.g. [ 49 ]) and with attachment [ 45 , 50 ] and mentalization research [ 46 ].…”

Mapping the road from childhood adversity to personality disorder: The role of unresolved states of mind

“…Although most studies have reported on the AAI unresolved state of mind as a categorical variable, in recent years, it has been increasingly used as on a continuous scale of severity, as it increases statistical power (Hesse, ; Hughes et al, ; Thomson & Jaque, ). This is in line with more recent research, which has investigated the usefulness of scoring the AAI on continuous scales to arrive at a dimensional understanding of attachment representations (Chiesa, Cirasola, Williams, Nassisi, & Fonagy, ; Roisman, Fraley, & Belsky, ).…”

Anger as a Basic Emotion and Its Role in Personality Building and Pathological Growth: The Neuroscientific, Developmental and Clinical Perspectives

“…In order to maintain at least a form of positive relatedness with the meaningful others and a sense of personal worthiness and autonomy, the BPD patients are supposed to split the angry and raging aspects of their personality from their self-representation and from the experience of their relationship with outer world ( Kernberg, 1975 ). BPD patients are reported to experience such an unbearable amount of anger given their proneness to perceive personal threats in the outside world, mainly in close relationships, owing to both temperamental factors ( New et al, 2008 ; Gunderson, 2010 ) and early traumatic experience in the attachment matrix ( Chiesa et al, 2016 ). As a result, anger reactions are easily elicited as a basic defensive (flight-fight) response to the feeling of being attacked.…”