title: First empirical evaluation of the link between attachment, social cognition and borderline features in adolescents.
abstract: OBJECTIVE
  Several developmental models of borderline personality disorder (BPD) emphasize the role of disrupted interpersonal relationships or insecure attachment. As yet, attachment quality and the mechanisms by which insecure attachment relates to borderline features in adolescents have not been investigated. In this study, we used a multiple mediational approach to examine the cross-sectional interplay between attachment, social cognition (in particular hypermentalizing), emotion dysregulation, and borderline features in adolescence, controlling for internalizing and externalizing symptoms.
  
  
  METHODS
  The sample included 259 consecutive admissions to an adolescent inpatient unit (Mage=15.42, SD=1.43; 63.1% female). The Child Attachment Interview (CAI) was used to obtain a dimensional index of overall coherence of the attachment narrative. An experimental task was used to assess hypermentalizing, alongside self-report measures of emotion dyregulation and BPD.
  
  
  RESULTS
  Our findings suggested that, in a multiple mediation model, hypermentalizing and emotion dysregulation together mediated the relation between attachment coherence and borderline features, but that this effect was driven by hypermentalizing; that is, emotion dysregulation failed to mediate the link between attachment coherence and borderline features while hypermentalizing demonstrated mediational effects.
  
  
  CONCLUSIONS
  The study provides the first empirical evidence of well-established theoretical approaches to the development of BPD.
authors: University of Houston, Houston, TX, USA; The Menninger Clinic, Houston, TX, USA. Electronic address: Csharp2@uh.edu.
authors: Carla
authors: C
authors: Sharp
authors: Sam Houston State University, Huntsville, TX, USA.
authors: Amanda
authors: A
authors: Venta
authors: University of Houston, Houston, TX, USA; The Menninger Clinic, Houston, TX, USA.
authors: Salome
authors: S
authors: Vanwoerden
authors: The Menninger Clinic, Houston, TX, USA.
authors: Andrew
authors: A
authors: Schramm
authors: University of Houston, Houston, TX, USA; The Menninger Clinic, Houston, TX, USA.
authors: Carolyn
authors: C
authors: Ha
authors: The Menninger Clinic, Houston, TX, USA.
authors: Elizabeth
authors: E
authors: Newlin
authors: University of Houston, Houston, TX, USA.
authors: Radhika
authors: R
authors: Reddy
authors: University College London, London, England, UK.
authors: Peter
authors: P
authors: Fonagy
mesh_terms: D000293:Adolescent; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology*; D002648:Child; D003071:Cognition; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology; D007389:Internal-External Control; D007398:Interpersonal Relations; D008297:Male; D009769:Object Attachment; D012919:Social Behavior; D056345:Theory of Mind