Romantic attachment style and borderline personality pathology: A meta-analysis

• Published in: Clinical psychology review 2020-02, Vol.75, p.101781-101781, Article 101781
• Main Authors: Smith, Madison, South, Susan
• Format: Article
• Language: English
• Subjects: Borderline personality disorder; Disorganized; Insecure attachment; Romantic attachment
• ISSN: 0272-7358; 1873-7811
• DOI: 10.1016/j.cpr.2019.101781

Borderline Personality Disorder (BPD) implies profound impairment in interpersonal relationships, particularly romantic relationships (Daley, Burge, & Hammen, 2000). Insecure attachment bears striking resemblance to BPD traits in both empirical and theoretical work (Levy, Johnson, Clouthier, Scala, & Temes, 2015) and may be particularly suited for understanding the BPD-related deficits in romantic functioning. Despite several qualitative reviews concluding that secure attachment is disrupted in those with BPD traits, no consensus has emerged regarding the form of this disruption (Levy et al., 2015), with most reviews focusing on whether BPD is best captured as high levels of attachment anxiety or attachment avoidance. The purpose of the current review is to provide a quantitative synthesis of the strength and direction of the associations between attachment insecurity and BPD traits. Searches on PsycINFO and Pubmed resulted in 27 effect sizes that measured BPD and adult romantic attachment on the two primary dimensions of anxiety and avoidance (Fraley, Waller, & Brennan, 2000). Results demonstrated that attachment anxiety correlates most strongly with BPD traits (r = 0.48); however, attachment avoidance also evinced a significant effect (r = 0.30). Findings from regression analyses indicate that attachment anxiety and avoidance interact, suggesting a particularly strong relationship between attachment disorganization and BPD traits. •Attachment anxiety has a large meta-analytic correlation with Borderline PD.•Attachment avoidance is also significantly related to BPD traits.•Several moderators explain large portions of heterogeneity.•Attachment disorganization may best reflect BPD dysfunction.