| dc.description.abstract | Dysfunction in interpersonal relationships is central to Borderline Personality
Disorder (BPD) and provides the context in which self-harming behaviour, impulsivity and
affective liability manifest (Lazarus et al., 2014). A growing evidence base exists for
Mentalisation Based Treatment (MBT) in regard to symptom burden and extent of personality
disturbance in BPD (Choi-Kain, Albert, & Gunderson, 2016). Less is known about patients’
experience of MBT, potential moderators or the utility of group only MBT.
Method: First, a meta-analysis examining the relationship between attachment organisation
and BPD diagnosis was conducted. Second, a mixed method design was employed to assess
change in interpersonal problems and symptomatic distress following a group only MBT
intervention. Potential moderators were examined and patient narratives were elicited and
qualitatively analysed.
Results: Across 20 studies including 1,948 participants, we found significant, medium to large
effect sizes linking BPD to insecure attachment organisation. The largest effect sizes were
found for a negative relationship between BPD diagnosis and attachment security, and a
positive relationship between BPD and unresolved, anxious and avoidant attachment. The
results of the empirical study revealed a significant reduction in interpersonal problems and
psychological distress over the course of the intervention. Pre-treatment level of interpersonal
problems did not function as a moderator. Patients found the group to be a challenging but
rewarding experience.
Conclusion: There is a strong relationship between BPD and insecure and disorganised
attachment. Less intensive, group only MBT interventions may be effective in reducing levels
of interpersonal problems and psychological distress in adults with a diagnosis of BPD. | en |
