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

Abstract

Childhood adversity has been found to be an important aetiological factor in the development of personality disorder (PD) in several studies. However, the role of disorganized attachment with unresolved mental states for traumatic experiences requires further investigation. This study explores the relationship between childhood adversities, unresolved states of mind, PD diagnosis and psychiatric distress. Two hundred forty-five adult participants, 124 from a clinical PD group and 121 non-psychiatric controls were assessed using the Structured Clinical Interview for DSM-IV, the Cassel Baseline Questionnaire, the Symptom Checklist-90-R and the Adult Attachment Interview, in order to ascertain presence of PD, childhood adversity, level of psychiatric distress and unresolved states of mind. Within the overall unresolved (U-overall) attachment category, a distinction was made between unresolved for abuse (U-abuse) and unresolved for loss (U-loss). The results indicated that childhood adversity was significantly associated with unresolved states of mind, as well as with overall PD diagnosis, paranoid PD, borderline PD, avoidant PD and psychiatric distress. Mediation analyses confirmed that U-overall and U-loss were significant mediators between childhood adversity and PD diagnoses, but surprisingly, U-abuse was not a significant mediator. The strength, limitations and clinical implications of the findings are discussed. Copyright © 2017 John Wiley & Sons, Ltd.

A Cross-Cultural Study on Attachment and Adjustment Difficulties in Adolescence: The Mediating Role of Self-Control in Italy, Spain, China, and Poland

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Frustration Tolerance and Personality Traits in Patients With Substance Use Disorders

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Apego y Organizaciones Límite: Ajustes en Psicoterapia

“…Winnicott y Balint ya advirtieron sobre el uso peculiar de las interpretaciones que hacían estos pacientes y de su nula eficacia. Sin embargo, la integración de estados mentales irresueltos es uno de los objetivos principales de la terapia (Cirasola et al, 2017;Crittenden y Newman, 2010), y la interpretación es una herramienta que pone en relación aspectos no relacionados previamente, posee gran potencial integrador. Existe evidencia de que la eficacia de las interpretaciones no se asocia sólo al contenido de las mismas, también deben tener en cuenta los procesos, es decir, el hecho de que una interpretación es un acto que ejerce sus efectos en el contexto de una relación interpersonal (Caspar et al, 2000).…”