Borderline Personality and Substance Use Disorder: the Role of Attachment Styles and Mindfulness

Abstract

The high comorbidity of borderline personality (BP) in people with substance use disorder (SUD) and its increased risk and complexity indicates the need for further research of the risk factors. Although secure attachment and mindfulness have been proposed as protective factors against BP, studies in the population with SUD are scarce. Consequently, this study aims to explore the role of attachment and mindfulness in the severity of BP in people with SUD. The study was conducted with 192 people attending the hospital for intervention for SUD. BP severity was assessed with the Personality Assessment Inventory, secure attachment was measured with the questionnaire of adult attachment, and mindfulness was assessed with the brief version of the Five Facet Mindfulness Questionnaire. The results of path analysis indicated that the indirect effect of secure attachment on BP severity through mindfulness was significant, with mindfulness fully mediating the relationship between attachment and BP severity in individuals with SUD. Emotion-regulation processes may be particularly valuable for people with SUD and insecure attachment, as their mindfulness levels are lower than in people with secure attachment, which could be related to the severity of BP.