Insecure attachment and maladaptive emotion regulation mediating the relationship between childhood trauma and borderline personality features

Abstract

Background: Previous studies suggested that childhood trauma is an important etiologic factor for the development of borderline personality disorder (BPD). Moreover, insecure attachment and maladaptive emotion regulation (ER) might be related to childhood trauma and BPD. This study was aimed to explore the relationships among childhood trauma, insecure attachment, maladaptive ER, and BPD features. Methods: A cohort of 637 patients with psychological disorders completed a series of psychometric instruments such as the Personality Diagnostic Questionnaire-4+ (PDQ-4+), the 23-Item Borderline Symptom List, the Childhood Trauma Questionnaire, the Attachment Style Questionnaire, and the Cognitive Emotion Regulation Questionnaire. The path analyses were conducted to investigate the experience-driven model that whether insecure attachment and maladaptive ER could mediate the relationship between childhood trauma and BPD features. The random forest regression was performed to select variables that contribute significantly to BPD features, which variables would be incorporated into the datadriven model to further confirm the experience-driven model. Results: Both the experience-driven model and the data-driven model verified that there were three significant mediation pathways (childhood trauma → insecure attachment/maladaptive ER → BPD features, childhood trauma → insecure attachment → maladaptive ER → BPD features; all p < .05), and the most weighted mediation pathway by which childhood trauma influencing the BPD features was through insecure attachment and then through maladaptive ER (weighted 53.16%). Conclusion: The influence of childhood trauma on BPD features was mainly mediated by the combination of insecure attachment and maladaptive emotion regulation.

Link between History of Childhood Maltreatment and Emotion Dysregulation in Adults Suffering from Attention Deficit/Hyperactivity Disorder or Borderline Personality Disorder

“…Childhood abuse is suggested to lead to insecure attachment patterns, such as anxious or avoidant attachments, which may further contribute to psychopathology development in a wide range of disorders [52][53][54][55][56]. This is particularly well established for BPD: previous work supports the presence of insecure attachment in BPD patients and suggests that core symptoms of the disorder may arise in relation to this aspect [57][58][59][60][61][62][63][64]. Similarly, although research is still scarce, there are some preliminary data suggesting a link between ADHD and insecure attachment [65,66].…”

Attachment anxiety as mediator of the relationship between childhood trauma and personality dysfunction in borderline personality disorder

“…Interestingly, a growing number of studies have recently started to explore the association between childhood maltreatment and different psychopathological outcomes with the perspective of considering attachment as a mediator of the relationship (Chatziioannidis et al, 2019; Kong et al, 2018; Pearce et al, 2017; Tibi et al, 2020; Van Assche et al, 2020). With respect to the interrelation between childhood maltreatment, attachment and personality dysfunction, the few studies existing in the field have been conducted with the general population (Crow & Levy, 2019; Fossati et al, 2016), a clinical sample with mood disorders (Baryshnikov et al, 2017) and heterogeneous clinical samples (Cohen et al, 2017; Peng et al, 2020). In all cases, insecure attachment seemed to mediate the relationship between childhood trauma and personality dysfunctional traits and, in most cases, borderline personality traits.…”

Paradoxes in Borderline Emotional Dysregulation in Adolescence: Influence of Parenting, Stressful Life Events, and Attachment

“…In our multivariate models, the effect of cumulative SLEs on affective symptoms appeared independent of attachment, suggesting a direct effect of adverse life experiences on affective regulation, for example, a direct effect on the axis of stress that causes affective symptoms. In this sense, evidence has emerged in the literature that there are direct psychopathological pathways between childhood abuse and borderline symptoms, not related to attachment, and involving or not emotional dysregulation ( 57 ). Fonagy and Luyten have suggested that the impact of SLEs on emotional dysregulation is a consequence of increased arousal and a lowered threshold for attachment and for deactivation of controlled mentalization ( 13 ).…”