Page 79 - Personality disorders and insecure attachment among adolescents
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Mayseless, & Kivenson-Baron, 2012). Therefore, this study investigated both the underlying continuous AAI scales and the CC category of the AAI with regard to personality disorders.
For the reasons mentioned above, the first and observational, cross-sectional part of this study examined insecure attachment in BPD as opposed to other personality disorders in a clinical adolescent population clinically diagnosed with personality disorders. First, deviations in attachment distribution of the normative adult and adolescent pattern (Bakermans-Kranenburg & van IJzendoorn, 2009) were inspected by comparing the whole sample with norm groups. Second, the sample was divided into three groups, namely, BPD, other personality disorders (OP), and no personality disorder (NP), in which associations with insecure attachment representations including the CC category were analysed. Last, continuous scales for both childhood experiences with parents and current state of mind with respect to these experiences of the AAI were compared between BPD, OP, and NP. This approach was based on the study by (Kim et al., 2014) conducted on BPD and non-BPD (OP and NP combined). Drawing on previous studies, it was expected that, first, insecure attachment, especially the more dismissive attachment, would be over presented at pre-treatment; second, that the sample would differ from the norm groups; and third, that attachment insecurity would differ across different personality disorders. The second and prospective part of this study aimed at examining changes in insecure attachment in the adolescent sample receiving intensive MBT, and the relationship between such changes and alterations in psychological distress. Based on previous studies it was assumed that, first, changes in attachment would be related to changes in psychological distress; and second, that intensive MBT would change an insecure attachment representation towards a more secure one.
Methods
Participants
The 60 participants comprised a subsample of 67 patients voluntary admitted to a partial residential MBT facility of a youth psychiatry institution in the urban area of The Hague in The Netherlands. Referrals to this facility came unsystematically from the outpatient facilities of the same and other institutions and of urban and rural areas of the Netherlands. The total sample consisted of 67 adolescents with a personality disorder with a mean age at the start of treatment of 17.8 years (SD = 1.3 range = 15-22), (females 82.1%) (see Table 1). The average duration of treatment was 348.5 days (SD = 164.4; range = 17–549), with an average of 236.1 days (SD = 156.6) hospitalised. Intelligence, estimated based on level of education, was average to above average. All participants were fluent in the Dutch language and followed the treatment on a voluntary basis. Of 67 admissions from February 2008 until February 2012, 60 pre-AAI and 33 pre- and post-AAI were administrated. Three out of the
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