Page 85 - Personality disorders and insecure attachment among adolescents

disorder: BPD, Other Personality disorders (OP), and No Personality disorder (NP). Fisher’s exact test
was performed between these three SCID-II groups on the categorical variables of the AAI. The analysis of variance (ANOVA) was carried out to compare the continuous variables of the AAI between the three SCID-II groups. The BPD group was further also compared (t-test) with the two other groups (OP and NP) combined (Non-BPD). Subsequently, a binary logistic regression analysis was performed (BPD versus Non-BPD group) on the continuous scales of the AAI that differed significantly as independent variables on the t-test. The Nagelkerke R-square of the model was used as an effect size measure.
In the second and prospective part of this study, a Wilcoxon signed-rank test was performed to compare the pre-treatment and the post-treatment (forced) AAI classification distributions. Continuous AAI-scales ranging from one to nine of both the state-of-mind scales and the experiences toward parents scales were constructed. A paired t-test was carried out to compare these continuous variables at pre- and post-treatment. For the purpose of forming groups based on the differences between the attachment classifications at the beginning and the end of treatment, the severity of the AAI categories was assessed on a scale ranging from the most insecure category (CC/U = 1) to the most secure category (F = 8) (pre M = 3.81, post M = 5.63) which corresponds to the prototype-based model of attachment (Maunder & Hunter, 2012). This resulted in the following quasi-dimensional AAI scale: CC/U-CC-E/U-E-Ds/U-Ds-F/U-F. Outcome groups were formed based on the differences between the five-way attachment classifications at the beginning and the end of treatment on the dimensional AAI scale, namely the AAI-Improved, the AAI-Unchanged, and the AAI-Deteriorated. The continuous variables and SCL-90 scores of the AAI-outcome groups were compared using paired t-tests. Finally, the AAI Improved group was compared with The AAI-Unchanged and the AAI-Deteriorated groups combined using a t-test.
Results
Observational, cross-sectional part of this study
Attachment distribution and comparison with the norm groups at t-1
The attachment classifications of the adolescents in the sample were compared to norm groups of non-clinical mothers, non-clinical adolescents, and clinical adolescents. The latter group consisted of suicidal adolescents with a range of DSM diagnoses (Allen, Hauser, & Borman-Spurrell, 1996; Bakermans-Kranenburg & van IJzendoorn, 2009) (See Table 2).
79