title: Categorical and dimensional approaches in the evaluation of the relationship between attachment and personality disorders: an empirical study.
abstract: Although several studies have highlighted the relationship between attachment states of mind and personality disorders, their findings have not been consistent, possibly due to the application of the traditional taxonomic classification model of attachment. A more recently developed dimensional classification of attachment representations, including more specific aspects of trauma-related representations, may have advantages. In this study, we compare specific associations and predictive power of the categorical attachment and dimensional models applied to 230 Adult Attachment Interview transcripts obtained from personality disordered and nonpsychiatric subjects. We also investigate the role that current levels of psychiatric distress may have in the prediction of PD. The results showed that both models predict the presence of PD, with the dimensional approach doing better in discriminating overall diagnosis of PD. However, both models are less helpful in discriminating specific PD diagnostic subtypes. Current psychiatric distress was found to be the most consistent predictor of PD capturing a large share of the variance and obscuring the role played by attachment variables. The results suggest that attachment parameters correlate with the presence of PD alone and have no specific associations with particular PD subtypes when current psychiatric distress is taken into account.
authors.affiliation: a Research Department of Clinical, Educational and Health Psychology, University College London , London , UK.|b Research Department, Cassel Hospital , Richmond , UK.
authors.forename: Marco
authors.initials: M
authors.lastname: Chiesa
authors.affiliation: c Child Attachment and Psychological Therapies Research Unit, The Anna Freud Centre & University College London.
authors.forename: Antonella
authors.initials: A
authors.lastname: Cirasola
authors.affiliation: d Department of Dynamic and Clinical Psychology , "Sapienza" University of Rome , Rome , Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Williams
authors.affiliation: d Department of Dynamic and Clinical Psychology , "Sapienza" University of Rome , Rome , Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Nassisi
authors.affiliation: a Research Department of Clinical, Educational and Health Psychology, University College London , London , UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Fonagy
mesh_terms: D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D010287:Parent-Child Relations; D010554:Personality Disorders / Q000145:classification / Q000209:etiology / Q000523:psychology*; D012044:Regression Analysis; D057566:Self Report; D013995:Time; D055815:Young Adult
keywords: Categorical model of attachment; dimensional model of attachment; personality disorder; predictive analyses; psychiatric distress