The contribution of attachment insecurities and impaired mentalization to the severity of pathological personality traits in a clinical sample

It is well-known that attachment insecurities and impaired mentalization are associated with personality disorders. In the current study, we examined these associations within the context of the Alternative DSM-5 Model of Personality Disorders (AMPD) in a clinical sample. A total of 148 adult clients seeking mental health treatment at a community clinic in Israel completed self-report measures assessing attachment orientations (anxiety, avoidance), mentalization ability, and pathological personality traits. Higher attachment anxiety and lower mentalization were associated with more severe pathological traits. Attachment avoidance was associated only with detachment and psychoticism. In addition, whereas clients with high attachment avoidance and low mentalization scored highest in disinhibition, clients with high attachment anxiety and low mentalization scored highest in psychoticism. The findings highlight the relevance of attachment insecurities and mentalization in explaining the severity of pathological traits within the context of AMPD. The theoretical and clinical implications of the findings are discussed.