Without exception, sadomasochistic subjects (n =48), unlike controls (n =35), are found to have developed insecure internal models of personal attachment, as a result of childhoods which were all problematic in one way or another. Their capacity for metacognition and their coherence of mind are found to be, on average, less than that of controls.

The Adult Attachment Interview

Attachment Disorganization: Unresolved Loss, Relational Violence, and Lapses in Behavioral and Attentional Strategies

The Developing Mind: Toward a Neurobiology of Interpersonal Experience

Attachment, the Reflective Self, and Borderline States: The Predictive Specificity of the Adult Attachment Interview and Pathological Emotional Development

Background
Transient dissociation is a core feature of borderline personality disorder (BPD). Dissociation is characterized by detachment from reality, which can be mild (e.g. daydreaming) to severe (e.g. depersonalization, amnesia). High levels of dissociation are linked to more severe psychopathology and likely to impede therapy effectiveness. Objective
Assessing the efficacy of psychological interventions in reducing dissociation in BPD and the impact of dissociation on therapy outcome.
Results
Psychological interventions were not found to be superior to treatment as usual. A small number of studies showed that higher dissociation at baseline predicted greater improvement. The use of narrative building techniques also showed related to reduce dissociation.
Conclusion
The evidence-base for treating dissociation is fairly limited. Standard interventions for BPD show promising results, but further research is required.
Methods
An electronic search of Psychinfo, Medline and Embase along with a hand search of relevant papers identified 20 studies.

/pdf/dissociative-symptoms-and-the-quality-of-structural-3gdb8hix1i.pdf

Dissociative symptoms and the quality of structural integration in borderline personality disorder

This thesis focuses on the association between attachment style and mentalizing ability and the extent to which the two are predictive of psychopathology. It is a joint thesis with Dissociative symptoms and the quality of structural integration in BPD (Sole, 2014). Part 1, the literature review, examines the evidence for an association between attachment style and mentalizing ability. Twelve studies represent a small but compelling body of research evidencing a robust link between parents’ ability to mentalize and infant attachment style. However, the evidence varies greatly due to differences in how variables, particularly those relating to mentalizing, have been operationalised, e.g. through direct observation of infant-caregiver behaviour or by recording caregivers' representations of their mentalizing abilities. Moreover, mentalizing alone does not fully account for the intergenerational transmission of attachment. Part 2, the empirical paper, describes a study investigating the role of reflective functioning in mediating the association between attachment style and psychopathology, and examining the scale reliability and criterion validity of a new measure of structural integration, the Operationalized Psychodynamic Diagnosis Structure Questionnaire (OPD-SQ). A group of participants with a diagnosis of personality disorder (N = 80) were compared to a group of healthy controls (N = 85) on attachment style, reflective functioning, structural integration and psychopathology. Group comparisons showed unexpected findings for reflective functioning and attachment style. Reflective functioning was shown to mediate attachment-related differences in psychopathology in the total and non-clinical samples only. Part 3, the critical appraisal, reflects on the process and impact on the researcher of conducting the research. It comprises a discussion of my motivation for conducting research in this area, my reflection on the current state of research into the relationship between attachment and mentalizing, methodological issues relating to the operationalisation of the mentalizing construct, and ethical considerations relating to the interviewing of participants.

https://discovery.ucl.ac.uk/1449075/2/DG%20Thesis%20Volume%20I.pdf

The role of reflective functioning in mediating the relationship between attachment style and psychopathology

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The role of reflective functioning in mediating the relationship between attachment style and psychopathology