Alexithymia as a Mediator Between Attachment and the Development of Borderline Personality Disorder in Adolescence

Abstract

Insecure attachment and the inability to identify emotions have both been put forward as possible explanations for dysfunction of the emotional system in borderline personality disorder (BPD). This study aimed to test a model according to which the influence of attachment on the development of BPD in adolescence is mediated by alexithymia. Borderline severity was assessed by means of the Structured Interview for DSM-IV Personality Disorders. Attachment and alexithymia were measured respectively with the Relationship Styles Questionnaire and the Toronto Alexithymia Scale. Mediation analyses conducted on 105 participants (54 with BPD and 51 matched controls) suggest that the role of security and negative model of self (i.e., preoccupied and fearful attachment styles) in the development of BPD symptoms are mediated by alexithymia.

Attachment and Reflective Functioning in Women With Borderline Personality Disorder

“…In turn, uncertainty in the value of mental state knowledge increased the probability of belonging to the BPD group. The present results are in line with previous studies that emphasize the mediating role of RF in the specific relationship between attachment disturbances and BPD features expression (Carlson et al, 2009;Deborde et al, 2012;Fossati et al, 2009Fossati et al, , 2011 as well as those reporting on the role of RF in the more general association between childhood adversity and adult functioning (e.g. RF as mediating the relation between childhood maltreatment and personality disorder; Bouchard et al, 2008;Chiesa & Fonagy, 2014 ; for other examples see also McIntosh, 2013 for a review or Stein, Fonagy, Wheat, Kipp, & Gerber, 2004;Taubner & Curth, 2013 for specific examples).…”

“…decreasing) associations with mediating RF processes (Fossati et al, 2011(Fossati et al, , 2014. In another study involving a sample of 54 adolescents with a diagnosis of BPD and 50 matched healthy controls, Deborde et al (2012) show that insecure attachment, and particularly attachment patterns that imply negative internal representation of oneself (i.e. preoccupied and fearful), is related to BPD diagnosis via alexithymia features, namely difficulties in describing and being aware of ones" own feelings, thereby hinting to impairments in RF.…”

A qualitative analysis of emotion and emotion regulation in hoarding disorder

“…For example, in a sample of 1461 outpatients diagnosed with depressive, anxiety, adjustment, somatoform, and eating disorders, the prevalence of alexithymia was relatively high, with a significantly higher prevalence found in the depressive disorders group (Leweke, Leichsenring, Kruse, & Hermes, ). Alexithymia has also been implicated in disorders such as panic disorder, OCD, and PTSD (for a review, see De Berardis et al, ), borderline personality traits and disorder (e.g., Deborde et al, ; Webb & McMurran, ), and disorders characterized by poor impulse control such as gambling (e.g., Parker, Bagby, Taylor, Endler & Schmitz, ; Toneatto, Leece, & Bagby, ) and compulsive buying (e.g., Rose & Segrist, ). Future studies from a nomothetic perspective would be useful to further clarify the specificity of such constructs to HD as opposed to other disorders.…”

Frontal EEG asymmetry in borderline personality disorder is associated with alexithymia

“…Emotion dysregulation is a central feature of borderline personality disorder (BPD) and is often closely related to impairments in emotional awareness [ 1 ]. Conceptualized as alexithymia, this difficulty to recognize and describe one’s own emotions has been found to be a crucial mediator of BPD pathology [ 2 ] and is predictive of psychotherapy outcome [ 3 ]. The neurobiological underpinnings of alexithymia are still poorly understood [ 4 ], so identifying a neurophysiological signature or marker to complement self-report instruments would be useful for research and clinical practice.…”