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Mapping the road from childhood adversity to personality disorder: The role of unresolved states of mind

Cirasola, A; Fonagy, P; Hillman, S; Chiesa, M; (2017) Mapping the road from childhood adversity to personality disorder: The role of unresolved states of mind. Personality and Mental Health , 11 (2) pp. 77-90. 10.1002/pmh.1365. Green open access

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Abstract

Childhood adversity has been found to be an important aetiological factor in the development of personality disorder (PD) in several studies. However, the role of disorganized attachment with unresolved mental states for traumatic experiences requires further investigation. This study explores the relationship between childhood adversities, unresolved states of mind, PD diagnosis and psychiatric distress. Two hundred forty-five adult participants, 124 from a clinical PD group and 121 non-psychiatric controls were assessed using the Structured Clinical Interview for DSM-IV, the Cassel Baseline Questionnaire, the Symptom Checklist-90-R and the Adult Attachment Interview, in order to ascertain presence of PD, childhood adversity, level of psychiatric distress and unresolved states of mind. Within the overall unresolved (U-overall) attachment category, a distinction was made between unresolved for abuse (U-abuse) and unresolved for loss (U-loss). The results indicated that childhood adversity was significantly associated with unresolved states of mind, as well as with overall PD diagnosis, paranoid PD, borderline PD, avoidant PD and psychiatric distress. Mediation analyses confirmed that U-overall and U-loss were significant mediators between childhood adversity and PD diagnoses, but surprisingly, U-abuse was not a significant mediator. The strength, limitations and clinical implications of the findings are discussed.

Type: Article
Title: Mapping the road from childhood adversity to personality disorder: The role of unresolved states of mind
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/pmh.1365
Publisher version: http://dx.doi.org/10.1002/pmh.1365
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Attachment, Childhood adversity, Personality disorder, Psychiatric distress, Unresolved states of mind
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: http://discovery.ucl.ac.uk/id/eprint/1532182
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