Page 106 - Personality disorders and insecure attachment among adolescents

treatment. For this purpose the following three groups were compared: a group that performed NSSI in the year preceding treatment, a group that did not perform NSSI in the year preceding treatment and during treatment, and a group that did not perform NSSI in the year preceding treatment but started NSSI during treatment. Based on previous studies, it was assumed, first, that NSSI will be highly common in this inpatient sample; second, that NSSI will be associated with several personality disorders, symptoms and negative copings skills; and third, that NSSI will be contagious, highly frequent, and cutting the most common method and emotion regulation the most common function of NSSI. To enhance the understanding of NSSI in clinical practice, this study examines NSSI forms with and without body tissue damage.
Method
Participants
The 140 participants were voluntary admissions to a partial residential psychotherapeutic
institution for adolescents in the urban area of the Hague in the Netherlands. This facility offers a five days a week intensive mentalization based treatment (MBT) (Bateman & Fonagy, 2006; Hauber, 2010) with partial hospitalisation to adolescents with personality disorders between the ages of 16 and 23 years, although by exception a 15-year old adolescent was accepted. During this intensive MBT programme with average duration of one year with a maximum of 18 month., personality disorders, insecure attachment and symptoms may diminish (Hauber, Boon, & Vermeiren, 2017; Hauber, Boon, & Vermeiren, 2018). At the start of the treatment, patients were asked to report NSSI behaviour with the aim of investigating and reducing this behaviour during treatment. The 140 patients in the sample (see Table 1) ranged in age from 15 to 22 years (M = 17.91, SD = 1.66), and female patients (M = 17.84, SD = 1.58) were (not significantly) younger than male patients (M = 18.24, SD = 1.96). At pre- treatment, the borderline (35.7%), avoidant (42.9%), and depressive personality disorder (41.4%) according to the SCID-II were most common and in more than half of the cases in combination with one or more other personality disorders. Most participants also had other clinically diagnosed comorbid non-psychotic disorders. All patients followed the treatment on a voluntary basis. Table 1 presents an overview of study population according to gender, DSM-IV clinical assessed Axis I disorders and Axis II personality disorders assessed using the SCID-II.
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