Attachment and Borderline Personality Disorder

• Published in: The Psychiatric clinics of North America Vol. 41; no. 4; pp. 651 - 668
• Main Authors: Buchheim, Anna, PhD, Diamond, Diana, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2018
• Subjects: Adult; Attachment representation; Borderline Personality Disorder - psychology; Borderline Personality Disorder - therapy; Female; Humans; Male; Object Attachment; Oxytocin; Psychiatric/Mental Health; Psychotherapy - methods; Randomized Controlled Trials as Topic; Reflective functioning; Transference focused psychotherapy; Unresolved trauma; Unresolved trauma; Transference focused psychotherapy; Attachment representation; Reflective functioning; Oxytocin
• ISSN: 0193-953X; 1558-3147
• DOI: 10.1016/j.psc.2018.07.010

Borderline personality disorder is associated with predominant insecure and unresolved attachment representations, linked history of trauma, impaired cognitive functioning and oxytocin levels, and higher limbic activations. Two randomized clinical trials on transference-focused psychotherapy assessed change of attachment representation and reflective functioning. The first showed that transference-focused psychotherapy was superior, demonstrating significant improvements toward attachment security and higher reflective functioning. The second randomized clinical trial study on transference-focused psychotherapy compared with therapy as usual replicated these results and additionally showed a significant shift from unresolved to organized attachment in the transference-focused psychotherapy group only, suggesting its effectiveness in traumatized patients.