Reflective functioning, attachment and personality: an empirical investigation

Reflective functioning is the individual’s ability to understand and interpret their own and others behavior in terms of mental states, such as desires, motivations, emotions and needs (Fonagy, Target, 2002). Several clinical contributions suggest that deficits of reflective functioning characterize many mental diseases, including depression (Täubner, Kessler, Buchheim, Kächele, Staun, 2011), anxiety (Rudden, Milrod, Aronson, Target, 2008), eating disorders (Skarderud, 2007), personality pathology, in particular borderline disorder (Fonagy, Bateman, 2008). However, a few empirical studies sought to explore the associations between reflective functioning and specific personality disorders. The aim of this study is to investigate the relationship between reflective functioning, attachment style, and personality disorders/styles. We recruited a sample of 80 participants interviewed using the Adult Attachment Interview (George, Kaplan, Main, 1985) to detect the state of mind with respect to attachment. We used also the Scale of Reflective Functioning (Fonagy, Steele, Steele, Target, 1998) applied to the transcript of the AAI’s to evaluate the capacity of reflective functioning, and the Shedler Westen Assessment Procedure-200 (Westen, Shedler, 1999a, 1999 b, 2007) to assess personality disorders/styles and level of psychological functioning. Results showed that reflective functioning was lower in the participants who had an insecure attachment style. Additionally, low level of reflective functioning were related to the borderline and schizoid personality disorders, while higher levels of reflective functioning were related to the style of high-functioning and depressive: high-functioning. We will discuss the clinical implications of these findings

Memories of attachment hamper EEG cortical connectivity in dissociative patients.

In this study, we evaluated cortical connectivity modifications by electroencephalography (EEG) lagged coherence analysis, in subjects with dissociative disorders and in controls, after retrieval of attachment memories. We asked thirteen patients with dissociative disorders and thirteen age- and sex-matched healthy controls to retrieve personal attachment-related autobiographical memories through adult attachment interviews (AAI). EEG was recorded in the closed eyes resting state before and after the AAI. EEG lagged coherence before and after AAI was compared in all subjects. In the control group, memories of attachment promoted a widespread increase in EEG connectivity, in particular in the high-frequency EEG bands. Compared to controls, dissociative patients did not show an increase in EEG connectivity after the AAI. Conclusions: These results shed light on the neurophysiology of the disintegrative effect of retrieval of traumatic attachment memories in dissociative patients