An attachment theoretical framework for personality disorders.

Abstract

Personality disorders are highly prevalent, associated with considerable morbidity, and difficult to treat. Intrapersonal and interpersonal difficulties are central to the pathology observed in personality disorders. Attachment theory provides a broad yet parsimonious explanatory framework for understanding the development, maintenance, and treatment of personality pathology. Attachment theory conceptualizes human behaviour in ways consistent with multiple scientific traditions, including evolutionary, developmental, and neuropsychological domains. The relevant literature has focused predominately on borderline personality disorder, although a few studies have examined attachment associations with other personality disorders, such as narcissistic and avoidant personality disorders. The authors first outline attachment theory and discuss assessment of attachment patterns from both developmental and social psychological viewpoints. Next, the authors present empirical support for attachment theory and its associations with personality, including studies of developmental, physiological, neurobiological, and genetic correlates of personality pathology. They then look at psychotherapy research relevant to (a) underlying components of current psychotherapies, (b) the relation between attachment and both therapy process and treatment outcome, and (c) changes in attachment styles as a result of personality disorder treatment. Finally, the authors call for future research to delve deeper into specific relationships between attachment constructs and personality pathology, as well as to address personality disorders more broadly.

Pseudosecure vs. individuated-secure client attachment to therapist: Implications for therapy process and outcome

“…Based on these findings, clinical observations, and studies of clients with borderline personality features (Levy, Johnson, Clouthier, Scala, & Temes, 2015), we believe there is an important distinction between two types of clients who-based only on selfreports, both indicate they are securely attached to their therapist. If they do genuinely perceive a secure psychotherapy attachment, no strong tendencies toward a secondary strategy of hyperactivation or deactivation should emerge.…”

Your responses guide me: Decreased attachment anxiety through an online relationship-building paradigm

“…They show love and forgiveness, feel connected, commit to altruistic and ethical behavior, and have a generally positive view of others (Lopez & Brennan, 2000;Mikulincer & Shaver, 2003, 2007aMikulincer, Shaver, Gillath, & Nitzberg, 2005). Secure attachment promotes stronger feelings of safeness, resiliency, optimism, hopefulness, positivity, curiosity, positive self-esteem, and the absence of personality disorders (Levy, Johnson, Clouthier, Scala, & Temes, 2015;Lopez & Brennan, 2000;. All in all, attachment security appears to undergird successful interpersonal and romantic relationship interactions, and fostering attachment security has the potential to improve individuals' relationships with others.…”

To formulate or not to formulate? A case study

“…Laura described that her mother did not love her and also had chaotic relationships with other family members including her father and siblings. Both ASPD and BPD have been described in terms of attachment theory; it is thought that maladaptive schemas and styles of attachment developed in childhood relating to attachment could explain the traits seen in many personality disorders (Levy et al, 2015). However, these theories also threaten the validity of personality disorder diagnosis as, according to Levy et al (2015) BPD can be explained by an anxious attachment style whilst ASPD arises from an avoidant attachment style both of which develop in different ways.…”

“…Both ASPD and BPD have been described in terms of attachment theory; it is thought that maladaptive schemas and styles of attachment developed in childhood relating to attachment could explain the traits seen in many personality disorders (Levy et al, 2015). However, these theories also threaten the validity of personality disorder diagnosis as, according to Levy et al (2015) BPD can be explained by an anxious attachment style whilst ASPD arises from an avoidant attachment style both of which develop in different ways. Furthermore, Laura presented as violent at times and this may be explained by her observing and imitating violence she saw in her childhood; she has thus learnt to incorporate this into how she lives her life (Bandura, 1969;Newrith et al, 2006).…”