Preoccupied Attachment and Emotional Dysregulation: Specific Aspects of Borderline Personality Disorder or General Dimensions of Personality Pathology?

Abstract

Emotional dysregulation and impaired attachment are seen by many clinical researchers as central aspects of borderline personality disorder (BPD). Alternatively, these constructs may represent general impairments in personality that are nonspecific to BPD. Using multitrait-multimethod models, we examined the strength of associations among preoccupied attachment, difficulties with emotion regulation, BPD features, and features of two other personality disorders (i.e., antisocial and avoidant) in a combined psychiatric outpatient and community sample of adults. Results suggested that preoccupied attachment and difficulties with emotion regulation shared strong positive associations with each other and with each of the selected personality disorders. However, preoccupied attachment and emotional dysregulation were more strongly related to BPD features than to features of other personality disorders. Our findings suggest that although impairments in relational and emotional domains may underlie personality pathology in general, preoccupied attachment and emotional dysregulation also have specificity for understanding core difficulties in those with BPD.

Attachment styles and sexual dysfunctions: a case–control study of female and male sexuality

“…8 It is known that insecure attachment and emotional dysregulation are very common in dysfunctional behaviours, 9 psychopathological conditions, 10,11 psychosomatic disease 12,13 and sexual problems. [14][15][16] Insecure attachment is also implicated in major depressive episodes with suicidal 17 or postpartum depression, 18 eating disorders, 19,20 dependence on drugs, 21 personality disorders 22 and in the persistence of posttraumatic syndromes. 23 Generally, insecure attachment is a risk factor for pathological conditions, whereas secure attachment is predictive of good health.…”

Personality Pathology and Interpersonal Problem Stability

“…The recruitment procedures for the current study sample have been described in detail elsewhere (Scott et al, 2013). Briefly, the recruitment criteria were designed to sample the full range of BPD severity (i.e., 0–9 criteria).…”

Personality Disorders, Attachment and Psychodynamic Psychotherapy

“…A meta-analysis of attachment studies using the AAI found insecure-preoccupied and unresolved attachment states of mind to be typical of BPD [19]. In a study evaluating preoccupied attachment and difficulties with emotion regulation in a mixed inpatient sample of BPD, antisocial and avoidant personality disorders, preoccupied attachment was seen to be strongly positively associated with each of the personality disorders, albeit more strongly related to BPD than to the other personality disorder populations [20]. …”

“…Nor was insecure attachment limited to a BPD population. In addition to the relationship between several personality disorders and preoccupied attachment [20], research using self-report measures linked avoidant and dependent personality disorders with preoccupied attachment, while schizoid, narcissistic, antisocial and paranoid personality disorders have been linked to dismissing attachment [21,22]; insecure attachment patterns have also been been linked with cluster B ‘dramatic' personality disorders [23]. Insecure/dismissing AAI classifications have been linked to adults with conduct or externalizing disorders [19]; Meyer and Pilkonis [24] implicated dismissing attachment, characterized by an inflated internal working model of the self as superior but insufficiently acknowledged and a negative evaluation of the other, in the development of narcissistic personality disorder.…”

“…If impairments in relational and emotional functioning are conceptualized as underlying all personality pathology [20,36], it becomes more efficacious to examine aspects of attachment that more directly reflect emotional and relational functioning, particularly those factors which impact interpersonal assessment and determine approach or avoidance and which can be more specifically linked to neurobiological function, rather than attachment classification itself. …”