Page 65 - Personality disorders and insecure attachment among adolescents

psychodynamic group psychotherapy programme. This treatment commonly starts as residential treatment and transitions into a day treatment halfway through. It is a mentalization based treatment (MBT) programme, manualized and adapted for adolescents (Bateman & Fonagy, 2006, 2012; Hauber, 2010) facilitated by a multidisciplinary team trained in MBT. The programme differs from the MBT programme for adolescents in England (Rossouw & Fonagy, 2012) in the psychodynamic group psychotherapy approach with an optimal group therapy size of 6 members instead of 8. The different therapies main focus is on the adolescents’ subjective experience of himself or herself and others, and on the relationships with the group members and the treatment staff. Next to weekly group psychotherapy, other (non-verbal) group therapies as well as individual- and family psychotherapy are offered. In case medication is needed in addition to the treatment, this is prescribed by a psychiatrist of the treatment according to protocol.
Participants
The participants were a sample of 105 patients with clinically diagnosed personality disorders admitted between 2013 and 2018. Upon arrival, patients and their parents were asked to sign a consent form to indicate that their data could be used anonymously for scientific research. Adolescents mean age at the start of treatment was 17.7 (SD = 1.7 range = 15-22), (females 81.0%). Average duration of treatment during this study was 215.2 days (SD = 100.8, range 21-640). Most of the patients (90.4%) were clinically diagnosed with a personality disorder often with comorbid axis- I disorders (mood disorder 48.5%, anxiety disorder including PTSS 57.3%, eating disorder 8.7%, ADHD 7.6 %, substance dependence 3.9 %, dissociative disorder 1.9% and ASD 4.8%). Of the 94 patients diagnosed with a personality disorder, 49 (52.1%) were diagnosed as Personality disorder NAO, 16 (17%) Borderline, 16 (17%) Avoidant, 2 (2.1) Dependent and 1 (1.1%) Antisocial. Intelligence estimated based on level of education was average to above average. Most patients 94.4% had a native Dutch background and the Dutch language was fluently spoken by all participants.
Measures
The Child-Session Rating Scale or C-SRS (Duncan et al., 2006; Miller & Duncan, 2004) is a four item visual analogue instrument. The version for adolescents differs from the adult version of the SRS because it uses emoticons: a smiley (positive) and a frowny face (negative). The C-SRS has been translated in Dutch by (Hafkenscheid et al., 2006). The Dutch C-SRS has already been used in Dutch research (Boon et al., 2012; De Haan, Boon, Vermeiren, & De Jong, 2014). The reliability (internal
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