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Hostile–Helpless states of mind mediate relations between childhood abuse severity and personality disorder features

Objective The present study assessed whether the often reported relation between childhood abuse and the extent of borderline personality disorder (BPD) and antisocial personality disorder (ASPD) features would be mediated by Hostile–Helpless (HH) and/or Unresolved (U) states of mind on the Adult Attachment Interview (AAI). Method One hundred and three young adults from low- to moderate-income families were assessed for HH and U states of mind on the AAI, psychopathology on the SCID I and II, and childhood abuse experiences on three validated measures of abuse. Results As expected, childhood abuse was related to extent of both BPD and ASPD features and to HH states of mind. In addition, BPD and ASPD features were significantly related to HH states of mind on the AAI, and those states of mind mediated the relations between severity of childhood abuse and later BPD and ASPD features. Contrary to predictions, scores for lack of resolution of loss or trauma on the AAI were not found to mediate the relations between childhood abuse and either BPD or ASPD. Conclusions Findings indicate that pervasively contradictory and unintegrated states of mind regarding attachment experiences play an important role in linking past abuse to current personality pathology.