Barnett, Sian; (2003) Attachment and coping in Borderline Personality Disorder. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Borderline Personality Disorder (BPD) is often characterised by maladaptive coping in stressful situations. Several studies have demonstrated a correlation between attachment style and an individual's ability to cope with stressful situations. The present study attempted to examine whether there was a relationship between attachment and coping in individuals with BPD. A group of female participants diagnosed with BPD (n=22) were compared to a group of female participants with Axis I disorders (n=17), on a continuous measure of attachment (the Attachment Q-sort) and two coping questionnaires. Scores on the Coping Inventory for Stressful Situations (CISS), a reliable and valid measure of coping designed to identify Task, Emotion and Avoidance Focused coping, were compared to scores on the Barnett Borderline Coping Questionnaire (BBCQ). A questionnaire designed by the researcher to identify the specific coping strategies of individuals diagnosed with BPD. The BBCQ was piloted on undergraduate medical students. The pilot study revealed three scales with high internal reliability, one scale that represented adaptive or helpful coping strategies and two scales which represented dysfunctional coping strategies. The BPD group scored significantly higher than the psychiatric comparison group on the dysfunctional coping scales of the BBCQ. Analyses of covariance showed that this finding was not due to differences between the two groups' scores on the CISS scales, or to general psychopathology. It was therefore concluded that the BBCQ appeared to measure something qualitatively different from the standard measure of coping (the CISS). There were no significant differences between the two groups' attachment scores on the Attachment Q-sort. However, in line with other studies, the BPD group scored higher than the psychiatric comparison group for preoccupied and disorganised attachment. This trend in the data approached significance. It is argued that the failure to find a difference between the two groups is likely to be attributable to the small sample size and not the lack of sensitivity of the Attachment Q-sort. The two groups were then combined and examined as one group with mental health problems. Regression analyses showed that severity of BPD and preoccupied attachment scores, not general psychopathology, accounted for the differences in coping scores. This finding indicated that: 1) The BBCQ measures coping in BPD (although this finding requires further research to establish that the BBCQ is measuring coping in BPD and not BPD itself). 2) Consistent with other research into attachment and coping there was some relationship between attachment and coping in this sample. It is suggested that further research should examine the relationship between attachment and coping in a larger population of individuals with BPD. It is also suggested that, with further development, the BBCQ could become a useful tool in the evaluation of treatment approaches, which focus on facilitating the development of more helpful coping strategies with individuals with BPD.

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